Choosing Domains In Quality Of Life Assessment And Designing Alternative Answers

Objectives: To standardize the domains of Quality of Life Assessment and provide each domain with a weight; to build up a set of alternative answer designs with equal interval features; and consequently to standardize the instruments for assessing Quality of Life in order to improve the quality of studies with related to Quality of Life Assessment. Methods: Literature review and small group discussions were employed to identify the domains of Quality of Life. The components and weight for each domain was determined by a panel (18) of experts through two series of consultations (Delphy consultation). The frequently used alternative answer designs were abstracted through literature search and frequency analysis. A total of 800 community residents of 18-45 years old and with education of more than junior high schools in Chengdu were selected purposely to complete a self-administered questionaire and score the alternative answers. An interval estimating approach based on the fuzzy mathmatics was used to calculate the score of the alternative answers and their fuzzy degrees.Results: 1. Despite the debates among the experts about the components of domains of Quality of Life, they have consistent attitudes towards the most important domains (eg. top five domains in Quality of Life);2. The general instruments for assessing Quality of Life should include the following domains: daily life activity, environment, sexual function, pain and unwell, vitality and fatigue, general health perception, social function, mental function, leisure activity, rest and sleep, self value perception, food taking, family function, and illness and impact. The top five domains with the highest weights are daily life activity (weighted 0.1235), general health perception (weighted 0.1038), mental function (weighted 0.0997), social function (weighted 0.0943), and pain and unwell (weighted 0.0856).3. A set of alternative answer designs with potential equal interval features was summarized and classified into 6 categeories (assessing, agreeing, frequency, judging, degree, time) and 17 groups.4. The scores of identical alternative answer designs appeared in different questions remained largely unchanged (p>0.05). Even for the very few with p<0.05. the differences in scores were generally less than 0.5. which indicates that the scores of alternative answer designs do not change with questions.5. Seven groups of alternative answers with equal interval features were proposed, which include: (1) "very bad" , "bad" , "neither good nor bad" , "good" , "very good" ; (2)" never","occationally ","sometimes","often ","always"; (3)"extremely disagree", "disagree" , "unsure" , "agree" , "extremely agree"; (4) "not fit at all" , "not fit" , "uncertainty" , "fit" , "fit completely" ; (5) "not match at all" , "match a little bit" , "match to a medium degree" , "match in most cases" "match absolutely" ; (6) "very little time" , "little time" , "much time" , "a majority of time" , "almost all time" ; (7) "no or little time" , "little time" , "at times" , "quite much time" , "most or always" . Conclusions: 1. The general instruments for assessing Quality of Life should include at least five domains: daily life activity, social function, mental function, general health perception, and pain and unwell. Each of the domains has different contributions to the concept of Quality of Life.2. The scores of alternative answer designs do not change with questions, which implies that the proposed alternative answer designs with equal interval features are applicable in a wider context.