Psychology RootsQuality of Well-Being Scale
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About Quality of Well-Being Scale
Scale Name
Quality of Well-Being Scale
Author Details
J.W. Bush and R.M. Kaplan
Translation Availability
English
Background/Description
The Quality of Well-Being Scale (QWB), originally the Index of Well-Being, developed by J.W. Bush and R.M. Kaplan in 1973 and revised in 1976 and 1994, is a comprehensive self-administered tool designed to measure health-related quality of life (HRQoL) and estimate quality-adjusted life years (QALYs) for health policy and clinical research. Published in Health Services Research (1973), the QWB integrates three components: symptom/problem complexes (CPX, 27 items), functional status (mobility, physical activity, social activity), and a preference-weighted scale (0 = death, 1 = optimal health). The 1994 revision, QWB-SA (Self-Administered), simplifies administration with a 7-day recall, reducing interviewer dependency.
The scale assesses current health state through a structured interview or self-report, taking ~10–20 minutes. Scores are calculated by combining CPX, mobility (3 levels), physical activity (3 levels), and social activity (3 levels) with weights from community preferences, yielding a single index (0–1). Validated with diverse samples (~2,000–3,000 adults, mean age ≈ 18–75 years, mixed gender, U.S.-based), it correlates with health status measures (r ≈ 0.70–0.85).
Administration, Scoring and Interpretation
- Obtain the QWB from Bush & Kaplan (1994) or UCSD Health Policy, ensuring ethical permissions.
- Explain to participants (adults 18+ in clinical or research settings) that the questionnaire assesses health-related quality of life, emphasizing confidentiality and voluntary participation.
- Administer the QWB-SA via self-report or interview, covering the past 7 days with 27 CPX items and functional status questions.
- Estimated completion time is 10–20 minutes.
- Ensure a supportive environment; provide health resources (e.g., referrals) and adapt for accessibility (e.g., large print, assistance) if needed.
Reliability and Validity
The QWB demonstrates robust psychometric properties (Kaplan, 1994). Internal consistency is moderate to high (Cronbach’s alpha ≈ 0.70–0.85, N ≈ 2,000–3,000). Test-retest reliability is strong (r ≈ 0.75–0.90 over 1–2 weeks). Inter-rater reliability is high for trained interviewers (intraclass correlation ≈ 0.85–0.95).
Convergent validity is supported by correlations with the SF-36 (r ≈ 0.70–0.85) and clinical measures. Discriminant validity is evidenced by sensitivity to health state changes. Construct validity is reinforced by its utility-based framework, validated against community preferences. The QWB reliably assesses HRQoL. Pairing with disease-specific tools like FACT enhances comprehensive assessment.
Available Versions
18-Items
Reference
Kaplan, R. M., Anderson, J. P., & Ganiats, T. G. (1993). The quality of well-being scale: rationale for a single quality of life index. In Quality of life assessment: key issues in the 1990s (pp. 65-94). Dordrecht: Springer Netherlands.
Kaplan, R. M., Sieber, W. J., & Ganiats, T. G. (1997). The quality of well-being scale: comparison of the interviewer-administered version with a self-administered questionnaire. Psychology and Health, 12(6), 783-791.
Important Link
Scale File:
Frequently Asked Questions
Q1: What does the QWB measure?
It measures health-related quality of life by combining functioning and symptoms into a single preference-weighted score.
Q2: How is the QWB used to calculate QALYs?
Multiply the QWB score (0.0–1.0) by the time spent in that health state to estimate quality-adjusted life years.
Q3: Is there a shorter version?
Yes. The QWB-SA (self-administered) version provides the same scoring algorithm with reduced administration time.
Q4: How is the QWB different from the SF-36?
The QWB is preference-weighted and produces a single utility score, whereas the SF-36 produces multiple dimension scores without preference weights.
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