Psychology RootsDisability and Distress Scale
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About Disability and Distress Scale
Scale Name
Disability and Distress Scale (Rosser’s Scale)
Author Details
Rachel M. Rosser
Translation Availability
English
Background/Description
The Disability and Distress Scale, also called Rosser’s Scale, is a validated measure designed to quantify health status for use in economic evaluation and health service research. It produces a numerical index of health status that can be incorporated into calculations of quality-adjusted life years (QALYs).
Rosser developed the scale to measure the output of hospitals as systems—by comparing patients’ health states at admission and discharge, hospitals could quantify improvements or declines. By allowing comparisons across treatments and medical conditions, the scale helps evaluate, plan, and allocate health care resources (Rosser et al., 1978).
Based on extensive consultation with doctors, economists, and administrators, Rosser identified two dimensions—disability and distress—as the core attributes for defining severity of a health state.
Administration, Scoring and Interpretation
- Format: Clinician-administered rating or self-completed questionnaire.
- Dimensions Rated:
- Disability: Eight categories from no disability to unconscious. Covers mobility, self-care, and social functioning.
- Distress: Four categories of subjective distress.
- Classification:
- Patients in the first seven disability categories are rated on the distress scale (yielding 28 possible combinations).
- An additional “unconscious” category is included (assumed free of distress), making 29 categories total.
- Basis for Rating: Observation, interview, chart review, or other health status measurements.
- Time Required: A few minutes; depends on patient condition and rater familiarity.
Reliability and Validity
- Content validity: Based on expert input (doctors, economists, health administrators) and reflects widely recognized determinants of health status (Rosser et al., 1978).
- Construct validity: The two-dimensional classification correlates with clinical judgments of severity and with other health status indices used in QALY research (Kind & Rosser, 1980).
- Practicality: Designed for use at the health-service level, allowing aggregation of data across patient groups.
Available Versions
02-Items
Reference
Rosser, R., & Kind, P. (1978). A scale of valuations of states of illness: is there a social consensus?. International journal of epidemiology, 7(4), 347-358.
Important Link
Scale File:
Frequently Asked Questions
Q1: What does the Disability dimension include?
It covers mobility, social functioning, and self-care abilities—eight categories from no disability to unconscious.
Q2: How is Distress measured?
Patients are rated on four levels of subjective distress (none to severe). Unconscious patients are assumed free of distress.
Q3: What is the main application of the Rosser Scale?
It is primarily used in health economics to derive QALY weights and to compare outcomes across treatments or health services.
Q4: Can patients complete it themselves?
Yes. It can be self-completed or clinician-rated based on observation and records.
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