whoqol-old final manual - world health organization

WHOQOL-OLD

MANUAL

WORLD HEALTH ORGANIZATION

EUROPEAN OFFICE (COPENHAGEN)

MAY 2006

The WHOQOL-OLD module – manual

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This manual was written by Mick Power and Silke Schmidt on behalf of the WHOQOL-OLD Group. The study was funded by the European Commission Fifth Framework, QLRT-2000-00320, and was carried out under the auspices of the World Health Organization Quality of Life Group (WHOQOL Group). The WHOQOL-Old Group comprises a coordinating group and collaborating investigators in each of the following field centres: Professor M. Power, K. Quinn, K. Laidlaw, H. Toner, Univer-sity of Edinburgh, UK; Dr R. Lucas, Insititut Català de l’Envelliment, Barcelona, Spain; Professor S. Skevington, Dr F McCrate, University of Bath, UK; Dr M. Amir*, Y. Ben Ya’acov, Tal Narkiss-Guez, Department of Behavioural Sciences, Ben-Gurion Univer-sity of the Negev, Israel; Professor L. Kullman, National Institut for Medical Rehabilita-tion, Hungary; G. Bech-Anderson, Dr K. Martigny, Psychiatric Research Unit, Copenhagen, Denmark; Professor Ji-Qian Fang, Dr Yuantao Hao, Sun Yat-sen University of Medical Sciences, Guangzhou, China; Professor M.C. Angermeyer, Dr H. Matschinger, I. Winkler, Department of Psychiatry, University of Leipzig, Germany; A/Professor G. Hawthorne, Australian Centre for Posttraumatic Health, University of Melbourne, Australia; Dr M. Kalfoss, Faculty of Nursing, Menighetssosterhjemmets College, Oslo, Norway; Dr A. Leplege, INSERM, Paris, France; Dr E. Dragomirecka, Prague Psychiatric Centre, Prague, Czech Republic; Dr M. Martin, Mr D. Bushnell, Health Services Research Associates Inc, Seattle, U.S.A.; Dr M. Tazaki, Department of Science, Science University of Tokyo, Tokyo, Japan; Professor M. Eiseman, Department of Psychology, University of Tromsoe, Norway; B. Nygren, Department of Nursing, Umea University, Sweden; Dr A. Molzahn, Faculty of Human and Social Development, University of Victoria, Canada; Dr J. Ceremnych, Scientific Department of Gerontology Problems, Institute of Experimental and Clinical Medicine, Vilnius, Lithuania; Dr M. Fleck, Department de Psiquiatra e Medicina Legal, Porte Alegre, Bra-zil; Professor, K.-F. Leung, Hong Kong Hospital Authority, Kowloon, Hong Kong; Pro-fessor N. von Steinbüchel, Centre of Neurogerontopsychology, Clinic of Psychiatric Geriatrics, Geneva University Hospital, Switzerland; Assoc Professor E. Eiser, Celal Bayar University, Manisa, Turkey; Professor L. Schwartzmann, Department of Medical Psychology, Uruguay; Dr R. Killian, Department of Psychiatry, University of Ulm, Ger-many; Dr S. Schmidt, Holger Muehlan, University of Hamburg, Germany.

* We note with great sadness the death of Dr. Marianne Amir in January 2004.

Further information can be obtained from:

Professor Mick Power Section of Clinical and Health Psychology

University of Edinburgh Medical School

Teviot Place Edinburgh EH8 9AG, UK.

Email: [email protected]


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This document is not issued to the general public, and all rights are reserved by the World Health Organization (WHO). This document may not be reviewed, abstracted, quoted, reproduced, translated, referred to in bibliographical matter or cited, in part or in whole, without the prior written permission of WHO. No part of this document may be stored in a retrieval system or transmitted in any form by any means - electronic, me-chanical or other - without the prior written permission of WHO.


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Contents Introduction . . . . . . . . 5

The WHOQOL-OLD project. . . . . . . 7

Development of the WHOQOL-OLD module . . . . 7

Overview . . . . . . . . 7 Initial development . . . . . . . 8

Pilot study . . . . . . . . 9 Field Trial . . . . . . . . 10

Summary of results of questionnaire development . . . 12 The final version of the WHOQOL-OLD module . . . 13

Description of the instrument . . . . . . 14

Scale structure . . . . . . . 14 Scoring . . . . . . . . 15

Psychometric properties . . . . . . . 18

Basic statistics . . . . . . . 18 Factor analyses . . . . . . . 19

Convergent validity . . . . . . . 20 Discriminant group validity . . . . . . 22

Interpretation . . . . . . . . 23

Administration – suggested uses . . . . . . 23

References . . . . . . . . 24 Appendix . . . . . . . . 25

A I Final set of items for WHOQOL-OLD Module . . . . 26 A II Method for converting individual raw scores to transformed scores . 27 A III SPSS syntax file . . . . . . . 29 A IV Reference data . . . . . . . 32 A V List of Centres . . . . . . . 47 A VI The WHOQOL-OLD final scale . . . . . 54


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Introduction ∗ The initial development of the generic WHOQOL measures of quality of life occurred in fifteen different centres worldwide (see Table 1) with over forty centres now involved in the project. Two main generic instruments are the WHOQOL-100, which consists of 24 facets grouped into six domains, and the WHOQOL-BREF, which is a reduced 26-item version with four domains. Domains represent a high-level of organisation such as the Psychological, the Physical, and the Social. Facets are an intermediate level of orga-nisation between domains and items, for example, the psychological domain include fa-cets that focus on the self, body image, and positive and negative feelings, each of which in turn is represented by a set of four specific items in the WHOQOL-100. In addition to the WHOQOL as a generic measure of quality of life, there have been various adaptations to the assessment of quality of life in special groups, e.g. older adults. A failure to operationalise the concept of quality of life adequately for the ageing population will endanger many claims, comparisons with other populations, welfare proposals, and so on, because no acceptable or satisfactory measure will have been de-veloped on which to base such developments or comparisons. One of the first questions that arises in the generic assessment of quality of life is whe-ther or not questionnaires that have been developed in younger adult populations can be used equally validly for older populations. One or two informative studies have been carried out; thus, Brazier and colleagues (Brazier et al. 1996) found that two commonly used measures, the EuroQol and the SF-36 could be fairly satisfactorily used with older adults, though a number of issues were noted. These issues included problems about format of administration, consistency of response, and some floor effects on particular sub-scales. The sample used by Brazier et al was a relatively healthy one compared to some of the patient groups that one would also wish to assess (cf. Coast et al. 1998). From the previously published data with the WHOQOL (The WHOQOL Group 1998), a small proportion of respondents from each of the 15 Centres were 65 years or older. Re-analysis of these preliminary data shows for almost all centres that older adults re-port greater satisfaction on facets related to social support, relationships in general, fi-nances, and certain aspects of the home environment, as well as reporting lower negati-ve feelings. We obviously needed to replicate these analyses in the present study with larger numbers. Nevertheless, they are in line with some of our own (Lam & Power 1991) and others (Stewart et al. 1996) findings that older adults often report more satis-faction with relationships and report better psychological health than do younger adults, contrary to many of the stereotypes of old age. A second question arises of whether or not there are specific areas of quality of life that may be more important in older adults (cf. Baltes & Baltes 1990) and that therefore should supplement a generic adult ques-tionnaire in order to provide a broader-band and more valid general assessment. Drama-tic examples of this problem exist even for younger adults simply through the compari-son of established generic measures; for example, the WHOQOL instruments assess ∗ Note: Parts of the present manual are adapted from the main publication for the WHOQOL-OLD

module (Power, Quinn, Schmidt & The WHOQOL-OLD Group, 2005).


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Spirituality and the Environment, domains that are absent from most other instruments. Two facets (Sensory Problems, and Communication) that were originally included in the pilot WHOQOL, but dropped because of psychometric problems in a primarily younger adult population, are good examples of facets that may need to be added to an older adults module. Table 1 Centres included in development of the WHOQOL-OLD module

Centre Country Pilot study (n) Field trial (n) Edinburgh Scotland 303 116 Bath England 331 145 Leipzig Germany 433 354 Barcelona Spain 302 271 Copenhagen Denmark 467 384 Paris France 130 164 Prague Czech Republic 350 325 Budapest Hungary 304 333 Oslo Norway 372 324 Victoria Canada 430 202 Melbourne Australia 364 376 Seattle USA 235 295 Beer-Sheva Israel 312 250 Tokyo Japan 410 188 Umea Sweden 315 455 Guangzhou China 478 - Hong Kong China 319 - Porto Alegre Brazil 339 328 Montevideo Uruguay 256 248 Izmir Turkey 345 327 Geneva Switzerland 161 139 Vilnius Lithuania 445 342 WHOQOL-OLD Group Overall 7401 5566 The main aim of the study therefore was to answer both of these questions in relation to the WHOQOL: do the generic forms (the WHOQOL-100 and the WHOQOL-BREF) perform well, on a range of criteria, with an older adult population? And, second, do ad-ditional facets need to be added to the adult generic form in order to assess quality of li-fe adequately in the older adult population? The study will also ask the question of whe-ther it is possible to have a single cross-cultural Older Adults module or whether each culture requires its own culture-specific module. Although it has been possible to gene-rate a common younger adults version of the WHOQOL and this has been supported by empirical analyses (The WHOQOL Group 1998-a, 1998-b), the possibility remains that diverse attitudes across cultures towards older adults may require the production of dif-ferent older adults modules. This possibility will be carefully tested across the different centres. The feedback from the focus groups and the data analyses will also allow the


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question of how well the existing WHOQOL-100 items, which have been selected for use with younger adults, perform when used with older adults. That is, one of the key objectives of the research will be to test the question of whether the existing WHO-QOL-100 items only need to be supplemented with an additional module or whether these generic items need to be altered in some way or another. In summary, the overall aim of the WHOQOL-OLD Group was to adapt the younger adults version of the WHOQOL for use with older adults and then test its use in a series of cross-cultural field trials. This adaptation consisted of the development of a supple-mentary module that can be added to the existing WHOQOL instruments. The end point of the work however is the construction of an Older Adults WHOQOL module (WHO-QOL-OLD). To date, the work of the WHOQOL-OLD Group is partly available in writ-ten form in publications (Power, Quinn, Schmidt & The WHOQOL-OLD Group, 2005) and oral presentation. The present publication represents a manual for the use of the questionnaire and also describes briefly the development and testing of the WHOQOL-OLD module. The WHOQOL-OLD project The WHOQOL-OLD project aims at developing and testing a quality of life assessment for older people. It started in 1999, as scientific co-operation of several centres. The aim of the project was to develop and test a generic measure of quality of life in older adults for international/ cross-cultural use. The project was funded by the European Com-mission Fifth Framework, QLRT-2000-00320, and was carried out under the auspices of the World Health Organization Quality of Life Group (WHOQOL Group). The questionnaire development was conducted according to the following multi-step proce-dure: (a) the initial development of relevant quality of life questions (items) and their translation: focus group work within the collaborating centres and iterative Delphi tech-nique process between the collaborating centres for item generation; (b) the pilot testing of the questionnaire with appropriate modification (refinement, item reduction); (c) the field trial testing of the questionnaire; (d) the final analysis: statistical analysis, project report and publication of the manual . Development of the WHOQOL-OLD module Overview The WHOQOL-OLD Coordinating Field Centre produced a draft protocol based on the previous WHOQOL Group experiences in conducting international collaborative re-search for the development of the WHOQOL-100 and WHOQOL-BREF (The WHOQOL Group 1998-a, 1998-b). Following initial protocol development, it was cir-culated to each Field Centre for comment. It was iteratively revised using a Delphi tech-nique until there was agreement among the participating Centres. In summary, the steps for the development of the WHOQOL-OLD followed the published WHOQOL metho-


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dology, which consisted of focus group work in collaborating centres, item generation, pilot testing, refinement and item reduction, and then field trial testing of the instru-ment, as described below. Prior to the focus group exercise the iterative Delphi process was also used to identify gaps in the coverage of the WHOQOL-100 that might be rele-vant for older adults, and any other issues about the use of the WHOQOL with older adults. The proposed WHOQOL-OLD module underwent various steps of instrument development in a simultaneous cross-cultural approach (see Power, Quinn, Schmidt & The WHOQOL-OLD Group, 2005). After conducting focus groups and forming an international item pool, only those items were selected that pertain to older people, while age generic items were processed separately. Further steps included a translation process following international guidelines (Guillemin et al. 1993) and the pilot testing of the instrument (Bullinger et al. 2002). The field study analysis of the WHOQOL-OLD module comprises additional psychometric evaluations of both the single items and the scale structure. These analyses lead to the final version of the WHOQOL-OLD module and are reported in detail elsewhere (Power, Quinn, Schmidt & The WHOQOL-OLD Group, 2005). Initial development The protocol for conducting focus groups established a common framework for inter-preting and assessing the data reported by each Centre. Once agreed, the protocol was used in each Centre as the guide for planning and conducting focus groups for the pur-pose of eliciting the quality of life concerns of older adults, and for reporting the data back to the Edinburgh Coordinating Centre. The focus group discussions included four parts: (a) a general unstructured discussion on the dimensions of quality of life that were important for older adults; (b) a commentary on and assessment of the facets and items from the WHOQOL-100 instrument; (c) feedback on additional facets and items that had been previously suggested by Field Centres during the Delphi exercise described above; and (d) the gathering of ideas from participants for additional areas of quality of life or items that participants felt were not covered during discussion. Each Centre agreed to conduct four focus groups with older adults (with approximately equal num-bers 60 - 80 years and 80 + years, equal male and female, and equal well and ill parti-cipants), one with their carers and one group with health professionals working with ol-der adults (i.e. a minimum of six focus groups). Suggestions for additional facets and items were translated into English as the working language; equivalent items were iden-tified across the suggestions from each centre; and each centre was given feedback about the proposed items. This process eventually led to the generation of a set of 40 pi-lot items, which were grouped conceptually by the participating centres into six facets (see below; Hawthorne et al. in prep.; Winkler et al. in press). In addition, the focus group work suggested four supplementary items for existing WHOQOL-100 facets; na-mely, two items for “Sexual Activity”, and one item each for “Thinking” and for “Ho-me”.


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Pilot study Population The pilot testing was carried out in 22 different WHOQOL centres from around the world (see Table 2). Each centre was asked to test an opportunistic sample of a mini-mum of 300 older adults, but within the following sampling frame: approximately equal numbers of male and female, equal numbers aged 60 - 80 and aged > 80 years, and equal numbers of ill and well.∗ The data presented in Table 2 provide summary descrip-tions of the samples from each of the 22 centres in terms of sample size, age, gender, and health status. Table 2 General description (sample sizes, selected sociodemographic characteristics) of the

WHOQOL-OLD pilot study sample from each participating centre (N = 7401)

Centre Sample size Age Gender (Females)

Health status (“healthy”) *

n M ± SD % % Edinburgh (Scotland) 303 73.3 ± 8.2 68.5 83.8 Bath (England) 331 74.3 ± 8.0 59.5 84.5 Leipzig (Germany) 433 72.3 ± 8.2 43.6 65.6 Barcelona (Spain) 302 74.5 ± 7.5 56.6 63.6 Copenhagen (Denmark) 467 71.3 ± 8.3 52.5 83.6 Paris (France) 130 73.3 ± 8.2 55.9 93.0 Prague (Czech Republic) 350 74.1 ± 8.2 50.3 62.0 Budapest (Hungary) 304 74.7 ± 8.1 65.1 41.1 Oslo (Norway) 372 73.5 ± 6.6 74.6 73.2 Victoria (Canada) 430 74.4 ± 8.6 73.0 89.3 Melbourne (Australia) 364 74.9 ± 7.9 55.1 82.0 Seattle (USA) 235 72.8 ± 7.6 63.4 57.9 Beer-Sheva (Israel) 312 73.0 ± 8.3 52.4 71.3 Tokyo (Japan) 410 70.8 ± 8.0 55.7 78.6 Umea (Sweden) 315 73.3 ± 6.6 54.6 74.2 Guangzhou (China) 478 73.6 ± 8.5 48.5 61.5 Hong Kong (China) 319 72.5 ± 6.9 63.7 64.4 Porto Alegre (Brazil) 339 73.4 ± 8.3 56.0 57.5 Montevideo (Uruguay) 256 71.6 ± 7.4 61.3 72.3 Izmir (Turkey) 345 70.3 ± 5.8 52.2 57.4 Geneva (Switzerland) 161 74.7 ± 8.3 75.8 90.6 Vilnius (Lithuania) 445 73.3 ± 9.4 52.4 54.8 Total 7401 73.1 ± 8.0 57.8 70.1

Note: * “Healthy” or “unhealthy” as subjectively defined.

∗ The only exceptions were the Geneva and Paris centres who shared the recruitment of French-spea-

king individuals between them.


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This sample is the largest sample to date of older adults tested with the WHOQOL-100. The “health status” category in Table 2 refers to subjective assessment of health state, irrespective of objective health-related conditions; thus, 70.1 % of the sample describe themselves as healthy. Interestingly, 92 % of people with one or more co-morbid condi-tions still rate themselves as healthy despite the presence of the ‘objective’ co-morbid conditions. As would be expected, the statistics indicate that there are some inter-centre differences for these descriptive variables. Measures The purpose of the pilot testing was to collect data on the WHOQOL-OLD items for the purpose of item testing and item reduction. The measures included in the pilot study therefore were the WHOQOL-100 (The WHOQOL Group 1998-a), which is an establi-shed measure of quality of life with proven reliability and validity; a set of 40 items for the pilot WHOQOL-OLD module generated from the focus group work; a set of impor-tance questions that asked about the importance of each WHOQOL-100 and WHO-QOL-OLD facet for the respondent (The WHOQOL Group 1998-a); and a set of socio-demographic and health-related questions about co-morbid conditions. Methods The basic approach of the statistical analyses was to combine the strengths of the “clas-sical” and the modern (“probabilistic”) psychometric approaches for scale development. Following the earlier WHOQOL analytic guidelines (The WHOQOL Group 1998-b) analysis examined item response frequency distributions, missing values analysis, item and facet score correlations and reliability analyses, in particular, the use of the Multi-trait Analysis Program (MAP; Hays et al., 1988) to identify items loading on predicted factors versus non-predicted factors, and exploratory and confirmatory factor analyses. In addition, an Item Response Theory (IRT) approach that used the unidimensional Rasch measurement model (Andrich 1988) as implemented in the RUMM program (Andrich 2001) and in the WINMIRA program (von Davier, 2001) was also used. An iterative approach was taken in which the larger initial set of items was reduced through a combination of classical and IRT approaches; thus, the earlier focus group and Delphi work from which the WHOQOL-OLD items had been derived also provided an initial facet structure for the items which provided the starting point for the subsequent structu-ral analyses of the module. Field Trial The Field Trial allowed the participating centres to carry out a variety of different types of studies that ranged from epidemiological surveys to validity analyses to evaluation of longitudinal trials. Each centre however included a core dataset that could be further analysed to produce the final version of the WHOQOL-OLD module.


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Population The Field Trial analyses were conducted in a sample of N=5566 with data coming from 20 national centres (Guangzhou and Hong Kong not included). The sample size recrui-ted in each centre varied between n = 116 (Edinburgh) and n = 455 (Umea; see Table 3). Table 3 General description (sample sizes, selected sociodemographic characteristics) of the

WHOQOL-OLD Field Trial sample from each participating centre (N=5566)

Centre Sample size Age Gender (Females)

Health status (“healthy”) *

n M ± SD % % Edinburgh (Scotland) 116 77.59 ± 10.47 67.2 % 82.1 % Bath (England) 145 69.65 ± 7.10 62.8 % 91.6 % Leipzig (Germany) 354 72.73 ± 8.65 46.7 % 63.4 % Barcelona (Spain) 271 71.96 ± 7.44 59.4 % 67.4 % Copenhagen (Denmark) 384 72.35 ± 8.29 49.9 % 81.7 % Paris (France) 164 76.65 ± 8.39 47.0 % 65.8 % Prague (Czech Republic) 325 71.36 ± 7.72 59.7 % 61.1 % Budapest (Hungary) 333 73.80 ± 8.68 69.1 % 42.9 % Oslo (Norway) 324 75.14 ± 8.01 52.7 % 88.2 % Victoria (Canada) 202 72.93 ± 8.52 54.0 % 84.4 % Melbourne (Australia) 376 75.63 ± 6.92 58.2 % 83.7 % Seattle (USA) 295 72.00 ± 8.35 58.0 % 73.9 % Beer-Sheva (Israel) 250 70.32 ± 7.58 66.1 % 81.3 % Tokyo (Japan) 188 69.39 ± 5.70 53.5 % 60.7 % Umea (Sweden) 455 72.74 ± 8.21 53.4 % 76.2 % Guangzhou (China) * - - - - Hong Kong (China) * - - - - Porto Alegre (Brazil) 328 71.78 ± 7.74 67.4 % 82.3 % Montevideo (Uruguay) 248 73.19 ± 7.08 72.6 % 78.0 % Izmir (Turkey) 327 70.97 ± 5.31 52.3 % 45.3 % Geneva (Switzerland) 139 74.34 ± 7.32 55.8 % 88.5 % Vilnius (Lithuania) 342 68.66 ± 6.67 69.6 % 57.0 % Total 5566 72.52 ± 8.01 58.5 % 71.5 %

Note: ∗ Guangzhou and Hong Kong not included. The gender rates varied with particularly higher rates of females in the Edinburgh, Mon-tevideo, Budapest, Vilnius, and Porto Alegre centres. Furthermore, health status also va-ried, which was of course a function of the type of assessment, i.e. being either asses-sed by the single item on health report or by conditions on a chronic condition checklist. On the level of a single subjective health status item, Bath, Geneva, Oslo, Victoria and Melbourne showed a high proportion of people that reported to be in good health on the


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item (> 83 %), while Izmir, Budapest, and Vilnius had higher proportions of people with ill health (> 40 %). Measures The core measures included in the Field Trial were the 26-item WHOQOL-BREF (The WHOQOL Group 1998), the 33-item WHOQOL-OLD interim module, sociodemogra-phic and health status questions. The WHOQOL-BREF was used in the Field Trial be-cause its shortness allowed centres to include other measures according to local interests and local availability of questionnaires. Table 4 WHOQOL-OLD Field Trial measures by centre

Centres WHOQOL modules EAAQ GDS SF-12 -OLD -100 -BREF Edinburgh (Scotland) * - * * * - Bath (England) * - * * * - Leipzig (Germany) * - * * * * Barcelona (Spain) * - * * * * Copenhagen (Denmark) * * * * * * Paris (France) * - * * * * + Prague (Czech Republic) * - * * * - Budapest (Hungary) * - * * * - Oslo (Norway) - - - - GDS-15 - Victoria (Canada) * - * * * * Melbourne (Australia) * - * * * (4 items only) * Seattle (USA) * - * * GDS-15 - Beer-Sheva (Israel) * - * * * * Tokyo (Japan) * - * * * Umea (Sweden) * - * * GDS-15 (plus 15) * Guangzhou (China) - - - - - - Hong Kong (China) - - - - - - Porto Alegre (Brazil) * F241-4 * * * * Montevideo (Uruguay) * - * * GDS-15 - Izmir (Turkey) * - * * * - Geneva (Switzerland) * - * * - - Vilnius (Lithuania) * - * * * * Centres (n) 18 1 18 18 14 (+4) 11

Note: + = Geneva only. Summary of results of questionnaire development The two studies presented here summarise the development of an add-on module for the WHOQOL group of measures for use with older adults. The studies demonstrate the de-velopment of the module following the WHOQOL methodology (The WHOQOL


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Group 1998-a) in which a simultaneous approach to instrument development is employ-ed (Bullinger et al. 1996). That is, the starting point for the WHOQOL methodology is an intense qualitative phase of cross-cultural focus groups, which for the WHOQOL-OLD were run in 22 centres throughout the world. The summary output from these fo-cus groups was used to identify common themes and issues either absent from or poorly covered in the WHOQOL-100; these themes and issues were used to generate a set of pilot items for testing with older adults. The focus group work together with the Delphi exercise with the WHOQOL experts had suggested two possible approaches to the amendment of the WHOQOL-100 for use with older adults. There were some themes that seemed to best form additional facets, such as that of issues around Death and Dying, whereas there were other aspects or items that seemed supplementary to existing facets within the WHOQOL-100 such as for the Sexual Activity facet. However, the quantitative analyses suggested that the supplementary items were best included as part of the add-on module rather than being used to supplement or amend the scoring of an existing facet; the clearest demonstration of this point was for the Sexual Activity facet, in which the supplementary items were still problematic and added little to the existing facet. Instead, an additional set of items that focussed on Intimacy rather than Sexual Activity was written and tested at the Field Trial stage of the study and have now been included in the final version of the module as a separate facet. In terms of psychometric performance, the items selected for the WHOQOL-OLD module demonstrate good performance both on classical and modern psychometric grounds. The approach taken here shows that both classical and modern methods can be fruitfully combined in scale development. Although modern psychometric methods such as the Rasch modelling approach taken here were primarily developed for use with unidimensional ability scales, their careful use with attitude scales provides a powerful methodology for the development of valid comparable measures across key populations, especially from different cultures. In the event, the actual module developed focussed primarily on psychosocial aspects relevant to older adults. Although there are pertinent issues for example that arise in re-lation to the personal environment, general agreement was found from the focus groups that the existing scales of the WHOQOL-100 already covered the personal environment sufficiently. Instead, the new facets covered “Sensory Functioning” in the Physical Do-main, which had been originally included in the 236-item pilot version of the WHO-QOL but then dropped because of considerable ceiling effects in younger adults; and other new facets were related to the Psychological Domain (e.g. “Autonomy”) and to the Social Domain (e.g. “Intimacy”). The final version of the WHOQOL-OLD module The final version of the module contained six facets of four items each; the comparisons between the WHOQOL-100 and the WHOQOL-BREF used in the pilot and the field trial studies, respectively, suggest that the Older Adults module can be used in addition


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to either the WHOQOL-100 or the WHOQOL-BREF, whichever is the most appropria-te for a study. The scoring of the module can then consist of a profile set of six facet scores, or, as supported by the existence of a higher order factor in the confirmatory fac-tor analyses (CFA; see below), there can be a single total score based on a summation of all 24 items in the module. Description of the instrument In the following section the scale structure and the scoring procedures of the final ver-sion of the WHOQOL-OLD module are described. Scale structure The WHOQOL-OLD module consists of 24 Likert-scaled items assigned to six facets: “Sensory Abilities” (SAB), “Autonomy” (AUT), “Past, Present and Future Activities” (PPF), “Social Participation” (SOP), “Death and Dying” (DAD) and “Intimacy” (INT). Each of the facets has 4 items, thus for all facets the score of possible values can range from 4 to 20, provided all items of a facet have been completed (see Table 5). The sco-res of these six facets or the values of the 24 single items of the WHOQOL-OLD modu-le can be combined to produce a general (“overall”) score for quality of life in older adults, denoted as the WHOQOL-OLD module “total score”. As empirically supported by analyses of the measurement model via structural equation modelling (see below), quality of life is conceived as a higher-order factor, underlying the structure of the WHOQOL-OLD module. Table 5 Items included in the facets of the WHOQOL-OLD module

Facet Abbr. ∑ items Items of facets Possible range of raw score

(Min, Max) Sensory Abilities SAB 4 1 + 2 + 10 + 20 16 (4, 20) Autonomy AUT 4 3 + 4 + 5 + 11 16 (4, 20) Past, Present and Future Activities PPF 4 12 + 13 + 15 + 19 16 (4, 20) Social Participation SOP 4 14 + 16 + 17 + 18 16 (4, 20) Death and Dying DAD 4 6 + 7 + 8 + 9 16 (4, 20) Intimacy INT 4 21 + 22 + 23 + 24 16 (4, 20) Table 6 describes the main content areas of each facet of the WHOQOL-OLD module. The “Sensory Abilities” facet assesses sensory functioning and the impact of loss of sen-sory abilities on quality of life. The “Autonomy” facet refers to independence in old age and thus describes the amount of being able to live autonomously and to take own decisions. While the “Past, Present, and Future Activities” facet describes satisfaction about achievements in life and at things looking forward to, the “Social Participation” facet delineates participation in activities of daily living, especially in the community. The “Death and Dying” facet is related to concerns, worries, and fears about death and


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dying, while the “Intimacy” facet assesses being able to have personal and intimate relationships.

Table 6 Concepts and contents of the facets included in the WHOQOL-OLD module

Facet Abbr. Concept / content Sensory Abilities SAB Sensory functioning, impact of loss of sensory abilities on

quality of life Autonomy AUT Independence in old age; being able or free to live

autonomously and to take own decisions Past, Present and Future Activities PPF Satisfaction about achievements in life and at things to look

forward to Social Participation SOP Participation in activities of daily living, especially in the

community Death and Dying DAD Concerns, worries and fears about death and dying Intimacy INT Being able to have personal and intimate relationships Scoring To score the questionnaire correctly, the following scoring list has to be administered (see Table 7). Scoring the WHOQOL-OLD module involves the following steps: (a) Basically high scores represent high quality of life, low scores represent low quality of life; (b) Sorting items into the appropriate scales. For positively worded items, the above classification can be applied in which higher values represent a higher quality of life. For negatively worded items, the score has to be recoded (see below); (c) Recoding negatively worded items, that is, each item identified with a "*" in the scoring list has to be recoded so that numeric values assigned are reversed: 1 = 5, 2 = 4, 3 = 3, 4 = 2, 5 = 1. By recoding, high scores in positively worded items reflect higher quality of life. The unidirectional values can subsequently be added to yield the sum-med scores according to the scoring list of the WHOQOL-OLD module (Table 7); (d) Using the scoring list (see below) is also necessary for identifying which items be-long to a facet. Items to be recoded (see step c) are marked with an "*"; (e) Summing the items belonging to a facet yields the raw facet score (RFS). Its range lies between the lowest possible (number of items (n) x 1) and highest possible (number of items (n) x 5) value of the respective facet. For the WHOQOL-OLD module, each of the six facets comprises 4 items, thus the lowest possible and the highest possible raw score value are equal across all facets (range 4 to 20); (f) Comparing scores across facets is possible by directly comparing the raw facet sco-res. Because every facet comprises of 4 items with the same scaling and scoring format, no transformation of raw scores is needed (so long as all items per facet have been ans-wered);


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(g) If the raw facet score is divided by the number of items in the facet, the resulting standardised (mean) facet score (SFS) can have any decimal value between 1 and 5. A value of 1 represents the lowest possible quality of life rating and a value of 5 the highest possible quality of life rating for the individual; (h) Transferring a raw score to a transformed scale score (TFS) between 0 and 100 ma-kes it possible to express the scale score in percent between the lowest (0) and highest (100) possible value. To obtain the transformed facet score (0 - 100) the following transformation rule can be applied: TFS = 6.25 x (RFS - 4). (i) Producing the total score of the WHOQOL-OLD involves the addition of the facet scores of a person using all items (instead of the facet items only) of the questionnaire (again paying attention to the recoding procedure – see steps “b” and “c”). Items may be added to form a total raw score (according to step “e”, but using all items), a total standardized (mean) score (according to step “g”, but using all items) or a total transformed (0 - 100) score (according to step “h”, but using all items); (i) Accumulating the values of more than one person – e g. a special age group – simply may be done by summarising the facet and/ or total scores of each individual in that sample (on the level of raw, standardized/ mean or transformed scores) and dividing the respective result through the number of participants to produce the mean score of the respective group. The above manual scoring approach can be made easier by using a scoring mask that can be easily produced from the scoring list (see step “d”). In addition, the SPSS syntax file (enclosed in Appendix AIII) can be used for the automatic computation of facet and total scores. To work with them, individual data have to be inputted into the computer and identified by variable names and labels, which are also suggested for the enclosed program. When analysing the WHOQOL-OLD module, the facet scores and the total score must be calculated according to the following scoring list (including item num-bers for the WHOQOL-OLD module; see Table 7 following).


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Table 7 Scoring list for the WHOQOL-OLD module

Sensory Abilities (SAB) old_01* old_02* old_10* old_20 (4 items)

Autonomy (AUT) old_03 old_04 old_05 old_11 (4 items) Past, Present, and Future Abilities (PPF) old_12 old_13 old_15 old_19 (4 items)

Social Participation (SOP) old_14 old_16 old_17 old_18 (4 items)

Death and Dying (DAD) old_06* old_07* old_08* old_09* (4 items)

Intimacy (INT) old_21 old_22 old_23 old_24 (4 items)

Total Score (OLD) old_01* old_02* old_03 old_04 (24 items) old_05 old_06* old_07* old_08*

old_09* old_10* old_11 old_12 old_13 old_14 old_15 old_16 old_17 old_18 old_19 old_20

old_21 old_22 old_23 old_24

Note: * Reverse-scored items.


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Psychometric properties The psychometric properties of the WHOQOL-OLD module are based on the results of the WHOQOL-OLD Field Trial (see Table 8). Scale description and internal consistency Cronbach’s alpha as a measure of internal consistency reached satisfactory values with an acceptable range from α =.72 to α =.88 for each facet score, while the total score dis-played a consistency coefficient of α = .89 (see Table 8). Table 8 Selected psychometric properties for the facets and total score of the WHOQOL-OLD

module (WHOQOL-OLD Field Trial sample; N = 5566)

The analyses of the intercorrelations between facet scores (see Table 9) indicate that all scores show distinct correlations with each other suggesting a higher-order quality of li-fe factor (see also section “Factorial validity”). The only exception is the “Death and Dying” facet showing substantial lower association (r = .039 - .204). Table 9 Intercorrelations between facets and total score of the WHOQOL-OLD module

(WHOQOL-OLD Field Trial; N = 5566)

Facet SAB AUT PPF SOP DAD INT QoL Sensory Abilities

Autonomy .362 Past, Present and Future Activities .349 .628 Social Participation .399 .551 .669 Death and Dying .204 .136 .195 .197 Intimacy .201 .363 .501 .395 .039

Total Score (Overall) .623 .718 .798 .769 .493 .636

Facet M

(1 - 5) SD Floor

(%) Ceiling

(%) Skewness α

Sensory Abilities 3.90 .86 1.9 46.5 - .72 .84

Autonomy 3.69 .71 1.4 25.3 - .42 .72

Past, Present and Future Activities 3.57 .69 1.5 20.6 - .40 .74

Social Participation 3.64 .74 1.8 24.5 - .59 .79

Death and Dying 3.55 1.00 6.0 32.9 - .45 .84

Intimacy 3.49 .98 7.5 24.9 - .22 .88

Total Score (Overall) 3.62 .55 0.2 14.8 - .24 .89


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Factor Analyses The final measurement model of the WHOQOL-OLD module, comprising six facets of four items each, showed good fit statistics for confirmatory testing of the measurement model (CFI = 0.939; RMSEA = .052; χ2 = 3759.4, df = 237). This model includes an overall higher order factor onto which all first-order factors load; beside the intercorre-lations of the facets, also the presence of this higher order factor would suggest that the WHOQOL-OLD module could be scored to give a total score in addition to a profile of scores across the six facets.

Table 10 Fit statistics of the final version of the WHOQOL-OLD module, separate samples for all participating centres (WHOQOL-OLD Field Trial sample; N = 5566)

N χ2 Fit statistics Centre ID CMIN df p CFI RMSEA (95%-CI)

Edinburgh 116 359.48 237 (.000) .912 .067 .053 - .081Bath 145 368.862 237 (.000) .928 .062 .050 - .074Leipzig 354 457.969 237 (.000) .934 .051 .044 - .058Barcelona 271 418.845 237 (.000) .921 .053 .045 - .062Copenhagen 384 577.115 237 (.000) .920 .061 .055 - .068Paris 164 449.153 237 (.000) .841 .074 .064 - .085Prague* 325 513.878 215 (.000) .915 .066 .058 - .073Budapest 333 436.031 237 (.000) .933 .050 .043 - .058Oslo 324 541.772 237 (.000) .907 .063 .056 - .070Victoria 202 461.556 237 (.000) .914 .069 .059 - .078Melbourne 376 607.468 237 (.000) .912 .065 .051 - .078Seattle 295 565.131 237 (.000) .912 .069 .061 - .076Beer-Sheva 250 499.541 237 (.000) .891 .067 .059 - .075Tokyo 188 456.993 237 (.000) .892 .070 .061 - .080Umea 455 641.720 237 (.000) .913 .061 .056 - .067Brazil 328 447.439 237 (.000) .938 .052 .045 - .059Uruguay 248 428.244 237 (.000) .920 .057 .048 - .066Turkey 327 791.070 237 (.000) .866 .085 .078 - .091Switzerland 139 394.792 237 (.000) .891 .069 .057 - .081Lithuania 342 434.701 237 (.000) .933 .049 .047 - .052Overall 5,566 3759.410 237 (.000) .939 .052 .052 - .068

Note: * Fit statistics for the Prague subsample are estimated excluding item f295 from the measurement model.


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Convergent validity In terms of convergent validity with other subjective health related measures, the WHO-QOL-OLD module facet scores and the total score correlated significantly with several self-reported indicators of subjective health dimensions. Correlations were checked for the other modules from the WHOQOL Group (WHOQOL-BREF, WHOQOL-100), for the two domain scores of the SF-12 (“Physical” and “Mental”), and for the GDS score. It was found that the WHOQOL-OLD total score and each facet score displayed only very low correlations (range of r = -.055 - .119) with the “Physical” and the “Mental” facet scores of the SF-12 health assessment. These low correlations might reflect the different conceptualisation of the measures. As expected, the correlations of the WHOQOL-OLD total score and facet scores with the GDS measure are negatively directed and indicate substantial associations between both measures, in particular for the total score (r = - .545). Table 11 Correlation coefficients (Pearson r) for total score and facet scores of the WHOQOL-

OLD module with several health status indicators (GDS, SF-12)

The WHOQOL-100 and the WHOQOL-BREF are both multidimensional generic ins-truments to assess quality of life and have been developed by the WHOQOL Group. Strong correlations were found between the total score of the WHOQOL-OLD module and the overall score of the WHOQOL-100 (r = .665), and with all domains of the WHOQOL-BREF (r = .604 - .741) and the WHOQOL-100 (r = .550 - .737), except for the domain “Spirituality” (r = .360). High correlations between the total score of the WHOQOL-OLD module and the WHOQOL-100 can be observed on the facet-level especially for the association with the facets “Relationships” (r = .628), “Safety” (r = .640), “Leisure Opportunities” (r = .701), and “Thinking.” (r = .733). Only low to moderate correlation coefficients were found for the association between the “Death and Dying” facet of the WHOQOL-OLD module and various facets of other quality of life measures.

GDS SF-12 Physical

SF-12 Mental

Sensory Abilities - .378 .032 .052

Autonomy - .383 - .031 .086

Past, Present and Future Activities - .456 - .090 .117

Social Participation - .446 .013 .091

Death and Dying - .291 - .048 .005

Intimacy - .273 - .055 .119

Total Score (Overall) - .545 - .037 .107


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Table 12 Correlation coefficients (Pearson r) for the facet scores and the total score of WHOQOL-

OLD module with the domain and facet scores of the WHOQOL-BREF and the WHO-QOL-100

WHOQOL-BREF SAB AUT PPF SOP DAD INT QoL

Physical Health .338 .442 .477 .535 .108 .316 .655 Psychological .362 .548 .633 .574 .146 .456 .741 Social Relationships .302 .408 .530 .491 .191 .505 .604 Environment .383 .578 .616 .538 .215 .393 .678 WHOQOL-100 Domains Physical .411 .332 .427 .460 .335 .268 .550 Psychological .359 .532 .716 .659 .299 .506 .737 Independence .417 .422 .487 .558 .222 .335 .580 Social .229 .420 .597 .513 .196 .674 .653 Environment .366 .500 .636 .627 .254 .484 .683 Spiritual .150 .211 .423 .339 .112 .290 .360 WHOQOL-100 Facets Physical • Pain .314 .262 .272 .319 .340 .177 .421 • Energy .471 .403 .487 .534 .227 .359 .594 • Sleep .206 .146 .271 .260 .250 .118 .326 Psychological • Positive Feelings .320 .572 .767 .682 .157 .604 .733 • Thinking, Memory .420 .381 .474 .416 .113 .285 .503 • Self Esteem .174 .420 .576 .509 .181 .410 .536 • Body Image .205 .228 .370 .321 .317 .257 .425 • Negative Feelings .237 .356 .481 .520 .356 .327 .565 Independence • Mobility .404 .394 .373 .462 .186 .220 .489 • Activities of daily Living .381 .416 .454 .560 .187 .314 .553 • Medication .228 .231 .293 .313 .194 .204 .344 • Work Capacity .402 .404 .523 .568 .155 .383 .577 • Relationships .257 .388 .603 .535 .236 .540 .628 • Support .126 .407 .512 .458 .150 .559 .549 • Sex .234 .239 .401 .315 .116 .576 .473 Environment • Safety .323 .447 .554 .464 .256 .497 .640 • Home Environment .195 .357 .450 .385 .067 .383 .454 • Financial Resources .076 .164 .257 .236 .187 .214 .301 • Services .136 .352 .413 .368 .125 .296 .393 • Information Opportunities .363 .426 .502 .504 .185 .325 .552 • Leisure Opportunities .364 .538 .613 .704 .188 .477 .701 • Environment .305 .279 .437 .444 .194 .334 .502 • Transport .283 .266 .344 .400 .177 .233 .400 • Spirituality .150 .211 .423 .339 .112 .290 .361 Overall .310 .460 .595 .568 .239 .466 .665


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Discriminant Group Validity Facet differences according to a range of subgroups are displayed in Figures 1 and 2. In terms of age, there are lower quality of life scores on all facets in participants older than 80 years, except for the “Death and Dying” facet score where those aged 60 to 80 years have significantly more concerns about dying (see Figure 1).

WHOQOL-OLD module facet scores (M, SD) by agegroup

3.663.73.473.713.59

3.714.1

3.563.63.623.583.543.613.75

1

1.5

2

2.5

3

3.5

4

4.5

5

SAB AUT PPF SOP DAD INT GEN

57-79 years80-100 years

Figure 1 WHOQOL-OLD module facet scores (M, SD) by agegroup (WHOQOL-OLD Field Trial sample, n = 5566)

Gender effects are comparatively small, and occur mainly for the “Death and Dying” fa-cet with higher scores for males. The largest mean differences can be demonstrated for the “healthy” vs. “unhealthy” self-report variable with individuals who report themsel-ves to be healthy scoring significantly higher on all facets (see Figure 2).

WHOQOL-OLD module facet scores (M, SD) by health status

3.743.793.633.823.713.84.09

3.273.33.313.223.233.333.44

1

1.5

2

2.5

3

3.5

4

4.5

5

SAB AUT PPF SOP DAD INT GEN

Healthy

Unhealthy

Figure 2 WHOQOL-OLD module facet scores (M, SD) by health status (WHOQOL-OLD Field Trial sample, n = 5566)


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Interpretation The values achieved on the individual facet scores of the WHOQOL-OLD module and on the total score of the WHOQOL-OLD module represent an empirical assessment of older adults quality of life from the respondent’s point of view. Until the data from re-presentative national standard samples are available for the WHOQOL-OLD module, the results of the WHOQOL-OLD Field Trial (N = 5566) should be used as preliminary reference data for older people (60 years and above). For the reference values of the WHOQOL-OLD facet scores and the WHOQOL-OLD total score, all scores have been linearly transformed to a range of 0 to 100 (cf. Tables A4 – A9 in Appendix AIV). The scores are shown together and separately for males and females and for different age groups (below 80 years and greater than 80 years). How to use the questionnaire Upon completion, comprehensiveness of questionnaire completion should be checked and the identification of the form should be noted. Use of the data for research purposes is not recommended when more than 20% of the items are missing (see WHOQOL Group, 1998-a, 1998-b). Data can be computer inputted for easy scoring (in research projects) or can be scored by hand according to the scoring procedure described above. The questionnaires are available in the different project languages. Translations into a number of further languages are in preparation. Proposals for further language versions should first be sent via the Edinburgh Co-ordinating Centre to the WHOQOL-OLD Steering Group. Administration – suggested uses The WHOQOL-OLD module can be used in a wide variety of studies including cross-cultural investigations, population epidemiology, health monitoring, service develop-ment, and clinical intervention trials in which issues about quality of life are crucial. The WHOQOL-OLD module will permit the assessment of the impact of service provi-sion and of different health and social care structures on quality of life, especially in the identification of the possible consequences of policies on quality of life for older adults and a clearer understanding of investment areas to achieve best gains in quality of life. A related issue is the estimation of the impact of physical and psychological interventi-ons in a range of physical and psychiatric conditions related to old age. Cross-sectional studies between different services or treatments and longitudinal studies of interventions can be assessed with the WHOQOL-OLD. Moreover, the unique cross-cultural app-roach to the development of the measure, means that comparisons can be made between different cultures (Power et al., 1999). The exacting standards of instrument develop-ment used for the WHOQOL-OLD mean that such comparisons run less risk of cultural bias; the WHOQOL methodology (The WHOQOL Group 1998-b) provides a unique approach to instrument development that provides for cross-cultural validity for the assessment of quality of life across the adult lifespan.


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References Andrich D (1988). Rasch models for measurement. Newbury Park, CA: Sage. Andrich D (2001). RUMM2010: Rasch unidimensional measurement models. Perth: RUMM Laboratory. Baltes PB, Baltes MM (eds) (1990). Successful aging: perspectives from the behavioral sciences. Cam-

bridge: Cambridge University Press. Bullinger M, Power MJ, Aaronson NK, Cella DF, Anderson RT (1996). Creating and evaluating cross-

cultural instruments. In B Spilker B (ed), Quality of life and pharmacoeconomics in clinical trials (2nd ed). Hagerstown, MD: Lippincott-Raven.

Brazier JE, Walters SJ, Nicholl JP, Kohler B (1996). Using the SF-36 and EuroQol on an elderly popula-tion. Quality of Life Research, 5: 195 - 204.

Coast J, Peters TJ, Richards SH, Gunnell DJ (1998) Use of the EuroQol among elderly acute care Pa-tients. Quality of Life Research, 7: 1 - 10.

Hawthorne G, Davidson N, Quinn K, McCrate F, Winkler I, Lucas R, Killian R, Molzahn A, WHOQOL-OLD Group (in prep). Issues in conducting cross-cultural research: Implementation of an agreed inter-national protocol designed by the WHOQOL Group for the conduct of focus groups eliciting the qua-lity of life of older adults.

Hays RD, Hayashi T, Carson S, Ware JE (1988). User’s Guide for the Multitrait Analysis Program (MAP). Santa Monica, CA: The RAND Corporation, N-2786-RC.

Lam DH, Power MJ (1996). Social support in a general practice elderly sample. International Journal of Ge-riatric Psychiatry, 6: 89 - 93.

Power MJ, Bullinger M, Harper A, The WHOQOL Group (1999). The World Health Organization WHOQOL-100: tests of the universality of quality of life in fifteen different cultural groups world-wide. Health Psychology, 18: 495 - 505.

Stewart AL, Sherbourne CD, Brod M (1996). Measuring health-related quality of life in older and de-mented populations. In B Spilker B (Ed), Quality of life and pharmacoeconomics in clinical trials (2nd ed). Hagerstown, MD: Lippincott-Raven.

Von Davier M (2001). WINMIRA User Manual. Kiel: IPN (Institute for Science Education). The WHOQOL Group (1998-a). Development of The World Health Organization WHOQOL-BREF qua-

lity of life assessment. Psychological Medicine, 28: 551 - 558. The WHOQOL Group (1998-b). The World Health Organization quality of life assessment (WHOQOL):

development and general psychometric properties. Social Science & Medicine, 46: 1569 - 1585. The WHOQOL-OLD Group (2005). Development of the WHOQOL-OLD module. Quality of Life Re-

search, 14, 2197-2214. Winkler I, Killian R, Hawthorne G, Lucas R, McCrate F, Molzahn A, Quinn K, The WHOQOL-OLD

Group (in prep). Cross-cultural aspects of quality of life in old age: Results of an international focus group study for the development of a WHOQOL module for people in old age: the WHOQOL-OLD.


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Appendix A I Final set of items for WHOQOL-OLD Module A II Method for converting individual raw scores to transformed scores A III SPSS syntax file A IV Reference data A V List of Centres A VI The WHOQOL-OLD final scale


26

A I Final set of items for WHOQOL-OLD Module Table A1 Final set of items for the WHOQOL-OLD module

Facet I Sensory Abilities (OLD-SAB) OLD-01 Impairments to senses affect daily life OLD-02 Loss of sensory abilities affect participation in activities OLD-10 Problems with sensory functioning affect ability to interact OLD-20 Rate sensory functioning

Facet II Autonomy (OLD-AUT) OLD-03 Freedom to make own decisions OLD-04 Feel in control of your future OLD-05 People around you are respectful of your freedom OLD-11 Able to do things you’d like Facet III Past, Present and Future Activities (OLD-PPF) OLD-12 Satisfied with opportunities to continue achieving OLD-13 Received the recognition you deserve in life OLD-15 Satisfied with what you’ve achieved in life OLD-19 Happy with things to look forward to Facet IV Social Participation (OLD-SOP) OLD-14 Have enough to do each day OLD-16 Satisfied with the way you use your time OLD-17 Satisfied with level of activity OLD-18 Satisfied with opportunity to participate in community Facet V Death and Dying (OLD-DAD) OLD-06 Concerned about the way you will die OLD-07 Afraid of not being able to control death OLD-08 Scared of dying OLD-09 Fear pain before death Facet VI Intimacy (OLD-INT) OLD-21 Feel a sense of companionship in life OLD-22 Experience love in your life OLD-23 Opportunities to love OLD-24 Opportunities to be loved


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A II Method for converting individual raw scores to transformed scores Table A2 Method for converting individual raw scores to transformed scores (WHOQOL-OLD

total score)

RTS STS TTS RTS STS TTS RTS STS TTS 24 - 120 1 - 5 0 - 100 24 - 120 1 - 5 0 - 100 24 - 120 1 - 5 0 - 100

24 1.00 .00 57 2.38 34.38 90 3.75 68.75 25 1.04 1.04 58 2.42 35.42 91 3.79 69.79 26 1.08 2.08 59 2.46 36.46 92 3.83 70.83 27 1.13 3.13 60 2.50 37.50 93 3.88 71.88 28 1.17 4.17 61 2.54 38.54 94 3.92 72.92 29 1.21 5.21 62 2.58 39.58 95 3.96 73.96 30 1.25 6.25 63 2.63 40.63 96 4.00 75.00 31 1.29 7.29 64 2.67 41.67 97 4.04 76.04 32 1.33 8.33 65 2.71 42.71 98 4.08 77.08 33 1.38 9.38 66 2.75 43.75 99 4.13 78.13 34 1.42 10.42 67 2.79 44.79 100 4.17 79.17 35 1.46 11.46 68 2.83 45.83 101 4.21 80.21 36 1.50 12.50 69 2.88 46.88 102 4.25 81.25 37 1.54 13.54 70 2.92 47.92 103 4.29 82.29 38 1.58 14.58 71 2.96 48.96 104 4.33 83.33 39 1.63 15.63 72 3.00 50.00 105 4.38 84.38 40 1.67 16.67 73 3.04 51.04 106 4.42 85.42 41 1.71 17.71 74 3.08 52.08 107 4.46 86.46 42 1.75 18.75 75 3.13 53.13 108 4.50 87.50 43 1.79 19.79 76 3.17 54.17 109 4.54 88.54 44 1.83 20.83 77 3.21 55.21 110 4.58 89.58 45 1.88 21.88 78 3.25 56.25 111 4.63 90.63 46 1.92 22.92 79 3.29 57.29 112 4.67 91.67 47 1.96 23.96 80 3.33 58.33 113 4.71 92.71 48 2.00 25.00 81 3.38 59.38 114 4.75 93.75 49 2.04 26.04 82 3.42 60.42 115 4.79 94.79 50 2.08 27.08 83 3.46 61.46 116 4.83 95.83 51 2.13 28.13 84 3.50 62.50 117 4.88 96.88 52 2.17 29.17 85 3.54 63.54 118 4.92 97.92 53 2.21 30.21 86 3.58 64.58 119 4.96 98.96 54 2.25 31.25 87 3.63 65.63 120 5.00 100.00 55 2.29 32.29 88 3.67 66.67 56 2.33 33.33 89 3.71 67.71

Note: RTS = raw total score (range 24 – 120); STS = standardized (mean) total score (range 1 – 5); TTS = transformed total score (range 0 – 100).


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Table A3 Method for converting individual raw scores to transformed scores (WHOQOL-OLD facet scores)

RFS SFS TFS RFS SFS TFS RFS SFS TFS 4 - 20 1 - 5 0 - 100 4 - 20 1 - 5 0 - 100 4 - 20 1 - 5 0 - 100

4 1.00 0 10 2.50 37.50 16 4.00 75.00 5 1.25 6.25 11 2.75 43.75 17 4.25 81.25 6 1.50 12.50 12 3.00 50.00 18 4.50 87.50 7 1.75 18.75 13 3.25 56.25 19 4.75 93.75 8 2.00 25.00 14 3.50 62.50 20 5.00 100.00 9 2.25 31.25 15 3.75 68.75

Note: RFS = raw facet score (range 24 – 120); SFS = standardized (mean) facet score (range 1 – 5); TFS = transformed facet score (range 0 – 100).


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A III SPSS syntax file The attached SPSS syntax file automatically checks and recodes data and computes raw (sum), standardized (mean) and transformed (0 - 100) scores for each of the six facets and the total score of the WHOQOL-OLD module. An electronic version of the SPSS syntax file that just calculates summary scores may be obtained from Professor Mick Power, Section of Clinical and Health Psychology, Edinburgh University, Medical School, Teviot Place, Edinburgh EH8 9AG, United Kingdom (UK). Email: [email protected] *-----------------------------------------------------------------------------------------------------------------------------. *Name: WHOQOL_OLD.sps. *Function: Prepare 6 scales and one total score for the 24 items of the WHOQOL-OLD. *Syntax is prepared for unrecoded data-sets. *Name of the recoded item stays the same as for the original item. *-Missing values are initially coded as “9”----------------------------------------------------------------------------------------------------------------------------. RECODE old_01 old_02 old_03 old_04 old_05 old_06 old_07 old_08 old_09 old_10 old_11 old_12 old_13 old_14 old_15 old_16 old_17 old_18 old_19 old_20 old_21 old_22 old_23 old_24 (9=SYSMIS) . EXECUTE. *-----------------------------------------------------------------------------------------------------------------------------. *Reverse coding of the WHOQOL-OLD* *-----------------------------------------------------------------------------------------------------------------------------. RECODE old_01 old_02 old_06 old_7 old_8 old_9 old_10 (1=5) (2=4) (3=3) (4=2) (5=1). EXECUTE.


30

*-----------------------------------------------------------------------------------------------------------------------------. *Scale "sensory abilities" with 4 items. *Possible range of untransformed data: 16 (lowest and highest possible value: 4,20). *Scale will be calculated when at least 4 items of the scale have been answered. *-----------------------------------------------------------------------------------------------------------------------------. COMPUTE old_sa_s = (SUM.4(old_01,old_02,old_10,old_20)). COMPUTE old_sa_m = (MEAN.4(old_01,old_02,old_10,old_20)). COMPUTE old_sa_t = 100 * (MEAN.4(old_01,old_02,old_10,old_20)-1)/4. VARIABLE LABEL old_sa_s 'Sensory-Abilities_sum'. VARIABLE LABEL old_sa_m 'Sensory-Abilities_mean'. VARIABLE LABEL old_sa_t 'Sensory-Abilities_transformed_(0-100)'. EXECUTE. *-----------------------------------------------------------------------------------------------------------------------------. *Scale "autonomy" with 4 items. *Possible range of untransformed data: 16 (lowest and highest possible value: 4,20). *Scale will be calculated when at least 4 items of the scale have been answered. *-----------------------------------------------------------------------------------------------------------------------------. COMPUTE old_au_s = (SUM.4(old_03,old_04,old_05,old_11)). COMPUTE old_au_m = (MEAN.4(old_03,old_04,old_05,old_11)). COMPUTE old_au_t = 100 * (MEAN.4(old_03,old_04,old_05,old_11)-1)/4. VARIABLE LABEL old_au_s 'Autonomy_sum'. VARIABLE LABEL old_au_m 'Autonomy_mean'. VARIABLE LABEL old_au_t 'Autonomy_transformed_(0-100)'. EXECUTE. *-----------------------------------------------------------------------------------------------------------------------------. *Scale "past, present and future activities" with 4 items. *Possible range of untransformed data: 16 (lowest and highest possible value: 4,20). *Scale will be calculated when at least 4 items of the scale have been answered. *-----------------------------------------------------------------------------------------------------------------------------. COMPUTE old_pp_s = (SUM.4(old_12,old_13,old_15,old_19)). COMPUTE old_pp_m = (MEAN.4(old_12,old_13,old_15,old_19)). COMPUTE old_pp_t = 100 * (MEAN.4(old_12,old_13,old_15,old_19)-1)/4. VARIABLE LABEL old_pp_s 'Past-Present-and-Future-Activities_sum'. VARIABLE LABEL old_pp_m 'Past-Present-and-Future-Activities_mean'. VARIABLE LABEL old_pp_t 'Past-Present-and-Future-Activities_transformed_(0-100)'. EXECUTE. *-----------------------------------------------------------------------------------------------------------------------------. *Scale "social participation" with 4 items. *Possible range of untransformed data: 16 (lowest and highest possible value: 4,20). *Scale will be calculated when at least 4 items of the scale have been answered. *-----------------------------------------------------------------------------------------------------------------------------. COMPUTE old_sp_s = (SUM.4(old_14,old_16,old_17,old_18)). COMPUTE old_sp_m = (MEAN.4(old_14,old_16,old_17,old_18)). COMPUTE old_sp_t = 100 * (MEAN.4(old_14,old_16,old_17,old_18)-1)/4.. VARIABLE LABEL old_sp_s 'Social-Participation_sum'. VARIABLE LABEL old_sp_m 'Social-Participation_mean'. VARIABLE LABEL old_sp_t 'Social-Participation_transformed_(0-100)'. EXECUTE.


31

*-----------------------------------------------------------------------------------------------------------------------------. *Scale "death and dying" with 4 items. *Possible range of untransformed data: 16 (lowest and highest possible value: 4,20). *Scale will be calculated when at least 4 items of the scale have been answered. *-----------------------------------------------------------------------------------------------------------------------------. COMPUTE old_dd_s = (SUM.4(old_06,old_07,old_08,old_09)). COMPUTE old_dd_m = (MEAN.4(old_06,old_07,old_08,old_09)). COMPUTE old_dd_t = 100 * (MEAN.4(old_06,old_07,old_08,old_09)-1)/4. VARIABLE LABEL old_dd_s 'Death-and-Dying_sum'. VARIABLE LABEL old_dd_m 'Death-and-Dying_mean'. VARIABLE LABEL old_dd_t 'Death-and-Dying_transformed_(0-100)'. EXECUTE. *-----------------------------------------------------------------------------------------------------------------------------. *Scale "intimacy" with 4 items. *Possible range of untransformed data: 16 (lowest and highest possible value: 4,20). *Scale will be calculated when at least 4 items of the scale have been answered. *-----------------------------------------------------------------------------------------------------------------------------. COMPUTE old_in_s = (SUM.4(old_21,old_22,old_23,old_24)). COMPUTE old_in_m = (MEAN.4(old_21,old_22,old_23,old_24)). COMPUTE old_in_t = 100 * (MEAN.4(old_21,old_22,old_23,old_24)-1)/4. VARIABLE LABEL old_in_s 'Intimacy_sum'. VARIABLE LABEL old_in_m 'Intimacy_mean'. VARIABLE LABEL old_in_t 'Intimacy_transformed_(0-100)'.

EXECUTE. *-----------------------------------------------------------------------------------------------------------------------------. *Scale "total score" with 24 items. *Possible range of untransformed data: 96 (lowest and highest possible value: 24,120). *Scale will be calculated when at least 24 items of the scale have been answered. *-----------------------------------------------------------------------------------------------------------------------------. COMPUTE old_to_s = SUM.24(old_01,old_02,old_03,old_04,old_05,old_06,

old_07,old_08,old_09,old_10,old_11,old_12,old_13, old_14,old_15,old_16,old_17,old_18,old_19,old_20, old_21,old_22,old_23,old_24)).

COMPUTE old_to_m = (MEAN.24(old_01,old_02,old_03,old_04,old_05,old_06, old_07,old_08,old_09,old_10,old_11,old_12,old_13, old_14,old_15,old_16,old_17,old_18,old_19,old_20, old_21,old_22,old_23,old_24)).

COMPUTE old_to_t = 100 * (MEAN.24(old_01,old_02,old_03,old_04,old_05, old_06, old_07,old_08,old_09,old_10,old_11,old_12, old_13,old_14,old_15,old_16,old_17,old_18,old_19, old_20,old_21,old_22,old_23,old_24)-1)/4.

VARIABLE LABEL old_to_s 'Total-Score_sum'. VARIABLE LABEL old_to_m 'Total-Score_mean'. VARIABLE LABEL old_to_t 'Total-Score_transformed_(0-100)'.

EXECUTE. *-----------------------------------------------------------------------------------------------------------------------------.


32

A IV Reference data Table A4-I Reference data for the summed score (raw value) of the final 4-item “Sensory Abilities”

facet (OLD-SAB) of the WHOQOL-OLD module (Field Trial sample; N total = 5566) Table A4-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Sensory

Abilities” facet (OLD-SAB) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)

Table A5-I Reference data for the summed score (raw value) of the final 4-item “Autonomy” facet (OLD-AUT) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)

Table A5-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Autonomy” facet (OLD-AUT) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)

Table A6-I Reference data for the summed score (raw value) of the final 4-item “Past, Present, and Future Activities” (OLD-PPF) facet of the WHOQOL-OLD module (Field Trial sample; N

total = 5566) Table A6-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Past, Pre-

sent, and Future Activities” (OLD-PPF) facet of the WHOQOL-OLD module (Field Trial sample; N total = 5566)

Table A7-I Reference data for the summed score (raw value) of the final 4-item “Social Participation” (OLD-SOP) facet of the WHOQOL-OLD module (Field Trial sample; N total = 5566)

Table A7-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Social Participation” (OLD-SOP) facet of the WHOQOL-OLD module (Field Trial sample; N total

= 5566) Table A8-I Reference data for the summed score (raw value) of the final 4-item “Death amd Dying”

(OLD-DAD) facet of the WHOQOL-OLD module (Field Trial sample; N total = 5566) Table A8-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Death

amd Dying” (OLD-DAD) facet of the WHOQOL-OLD module (Field Trial sample; N total = 5566)

Table A9-I Reference data for the summed score (raw value) of the final 4-item “Intimacy” facet (OLD-INT) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)

Table A9-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Intimacy” facet (OLD-INT) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)

Table A10-I Reference data for the summed score (raw value) of the final summary/ total score (OLD-TO) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)

Table A10-II Reference data for the transformed raw score (range 0 - 100) of the final summary/ total score (OLD-TO) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)


33

Table A4-I Reference data for the summed score (raw value) of the final 4-item “Sensory Abilities” facet (OLD-SAB) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)

Male Female < 80 80 ≤ Total Centre ID M SD N M SD N M SD N M SD N M SD N Edinburgh 15.78 3.40 36 15.25 4.13 72 16.44 3.46 57 14.30 4.12 50 15.43 3.90 108

Bath 16.62 3.02 52 17.16 2.90 90 17.17 2.84 122 15.47 3.56 17 16.96 2.94 142

Leipzig 15.16 3.39 185 15.52 3.41 157 16.02 3.06 249 13.45 3.55 93 15.33 3.39 343

Barcelona 14.94 3.22 108 15.05 3.14 150 15.22 3.12 213 13.93 3.27 44 15.00 3.17 258

Copenhagen 16.19 3.10 175 16.69 2.87 178 16.88 2.69 272 14.80 3.45 71 16.45 2.98 358

Paris 13.99 3.32 74 13.60 3.85 65 13.80 3.72 80 13.81 3.40 59 13.81 3.57 139

Prague 14.21 3.86 129 14.34 3.77 191 14.89 3.54 266 11.31 3.63 54 14.29 3.80 320

Budapest 14.83 3.56 100 14.17 3.65 219 14.63 3.52 230 13.72 3.85 89 14.38 3.63 319

Oslo 15.73 2.94 142 17.05 2.82 155 17.15 2.54 183 15.28 3.17 113 16.42 2.94 299

Victoria 16.76 2.92 85 16.82 2.65 99 17.31 2.43 135 15.35 3.16 46 16.79 2.77 184

Melbourne 15.43 3.52 148 16.94 2.90 205 16.82 2.97 241 15.33 3.52 111 16.32 3.25 363

Seattle 16.23 3.33 120 16.46 3.50 167 16.97 3.05 235 13.62 3.68 52 16.36 3.42 287

Beer-Sheva 15.45 3.18 80 16.21 3.10 153 15.95 3.13 196 15.97 3.08 34 15.92 3.18 240

Tokyo 15.81 2.72 85 15.56 3.71 93 15.65 3.33 151 14.17 3.49 6 15.68 3.27 178

Umea 15.14 3.21 208 16.07 3.31 237 16.14 3.00 340 13.99 3.65 105 15.64 3.29 445

Brazil 16.45 2.66 106 16.20 3.32 220 16.57 3.02 265 15.03 3.25 61 16.28 3.12 326

Uruguay 16.40 3.08 68 17.31 2.64 167 16.91 2.96 129 15.63 2.93 30 17.04 2.80 235

Turkey 13.22 3.77 156 12.58 4.11 171 13.17 3.83 304 9.17 3.75 23 12.89 3.96 327

Switzerland 16.39 3.05 57 17.59 2.36 76 17.49 2.35 94 16.02 3.29 40 17.05 2.73 134

Lithuania 15.57 2.93 100 15.27 3.03 226 15.58 2.85 301 12.76 3.54 25 15.37 3.00 326

Overall 15.39 3.37 2214 15.75 3.51 3091 15.92 3.31 4063 14.28 3.70 1123 15.60 3.46 5331


34

Table A4-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Sensory Abilities” facet (OLD-SAB) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)


Bath 78.85 18.86 52 82.22 18.12 90 82.33 17.73 122 71.69 22.22 17 80.99 18.40 142

Leipzig 69.73 21.17 185 72.01 21.31 157 75.15 19.14 249 59.07 22.20 93 70.81 21.21 343

Barcelona 68.34 20.12 108 69.04 19.64 150 70.13 19.48 213 62.07 20.46 44 68.75 19.80 258

Copenhagen 76.18 19.34 175 79.28 17.94 178 80.47 16.82 272 67.52 21.59 71 77.81 18.64 358

Paris 62.42 20.78 74 60.00 24.07 65 61.25 23.22 80 61.33 21.26 59 61.29 22.33 139

Prague 63.81 24.11 129 64.63 23.55 191 68.07 22.15 266 45.72 22.71 54 64.30 23.74 320

Budapest 67.69 22.26 100 63.56 22.80 219 66.44 21.98 230 60.74 24.04 89 64.85 22.68 319

Oslo 73.28 18.40 142 81.57 17.62 155 82.17 15.89 183 70.52 19.83 113 77.63 18.39 299

Victoria 79.78 18.26 85 80.11 16.59 99 83.19 15.18 135 70.92 19.73 46 79.96 17.34 184

Melbourne 71.45 21.98 148 80.88 18.11 205 80.13 18.56 241 70.83 21.98 111 77.01 20.33 363

Seattle 76.46 20.81 120 77.84 21.86 167 81.06 19.09 235 60.10 23.03 52 77.26 21.40 287

Beer-Sheva 71.56 19.89 80 76.31 19.35 153 74.71 19.55 196 74.82 19.25 34 74.51 19.89 240

Tokyo 73.82 17.02 85 72.24 23.21 93 72.81 20.82 151 63.54 21.80 6 73.00 20.45 178

Umea 69.62 20.07 208 75.45 20.66 237 75.90 18.77 340 62.44 22.79 105 72.72 20.57 445

Brazil 77.83 16.64 106 76.22 20.75 220 78.54 18.90 265 68.95 20.28 61 76.74 19.50 326

Uruguay 77.48 19.26 68 83.16 16.52 167 80.72 18.49 129 72.71 18.31 30 81.52 17.50 235

Turkey 57.65 23.54 156 53.65 25.67 171 57.32 23.95 304 32.34 23.43 23 55.56 24.72 327

Switzerland 77.41 19.07 57 84.95 14.73 76 84.31 14.66 94 75.16 20.58 40 81.58 17.09 134

Lithuania 72.31 18.34 100 70.46 18.95 226 72.38 17.84 301 54.75 22.12 25 71.03 18.76 326

Overall 71.16 21.08 2214 73.45 21.94 3091 74.51 20.68 4063 64.25 23.14 1123 72.52 21.61 5331


35

Table A5-I Reference data for the summed score (raw value) of the final 4-item “Autonomy” (OLD-AUT) facet of the WHOQOL-OLD module (Field Trial sample; N total = 5566)


Bath 15.48 2.28 52 15.65 2.15 89 15.68 2.21 121 15.06 2.13 18 15.59 2.19 141

Leipzig 14.87 2.32 187 14.94 2.97 156 15.15 2.56 250 14.23 2.71 93 14.90 2.63 343

Barcelona 13.76 2.69 107 13.17 2.86 150 13.48 2.80 214 13.05 2.85 42 13.41 2.80 257

Copenhagen 15.64 2.56 180 15.62 2.62 182 15.79 2.65 280 15.10 2.38 72 15.61 2.59 367

Paris 12.74 2.91 77 12.76 3.34 63 12.93 3.16 90 12.42 3.00 50 12.75 3.10 140

Prague 14.80 3.07 129 14.47 3.15 193 14.82 3.00 268 13.52 3.47 54 14.60 3.12 322

Budapest 13.83 2.90 102 13.75 2.73 226 13.93 2.70 238 13.37 2.97 90 13.78 2.78 328

Oslo 14.38 2.97 144 14.86 2.89 159 14.95 2.77 183 14.17 3.12 119 14.63 2.92 307

Victoria 16.40 2.58 92 16.26 2.47 105 16.48 2.48 139 15.93 2.65 54 16.32 2.51 197

Melbourne 15.17 2.41 144 15.72 2.37 209 15.60 2.41 243 15.35 2.38 110 15.49 2.42 363

Seattle 15.43 2.90 122 15.66 2.81 164 15.94 2.74 234 13.87 2.69 52 15.56 2.84 286

Beer-Sheva 15.14 2.26 81 15.31 2.35 153 15.41 2.25 196 14.37 2.40 35 15.24 2.34 242

Tokyo 14.95 2.53 86 14.18 2.97 94 14.58 2.68 153 13.00 3.52 6 14.55 2.79 180

Umea 14.61 2.21 209 14.55 2.52 237 14.83 2.23 341 13.75 2.66 105 14.58 2.38 446

Brazil 14.75 2.14 107 14.90 2.92 220 14.87 2.73 266 14.77 2.51 61 14.85 2.69 327

Uruguay 12.90 3.09 67 15.17 2.82 174 14.02 3.12 130 13.43 3.48 28 14.54 3.06 241

Turkey 13.66 2.42 156 13.79 2.82 171 13.74 2.69 304 13.61 1.92 23 13.73 2.64 327

Switzerland 16.16 2.23 55 16.38 2.71 77 16.41 2.56 91 15.95 2.46 42 16.26 2.53 133

Lithuania 12.62 2.65 101 12.49 2.74 228 12.62 2.70 305 11.46 2.70 24 12.53 2.71 329

Overall 14.61 2.75 2234 14.65 2.93 3124 14.74 2.84 4104 14.17 2.89 1129 14.64 2.86 5386


36

Table A5-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Autonomy” (OLD-AUT) facet of the WHOQOL-OLD module (Field Trial sample; N total = 5566)


Bath 71.75 14.25 52 72.82 13.43 89 72.99 13.82 121 69.10 13.30 18 72.43 13.69 141

Leipzig 67.91 14.49 187 68.35 18.55 156 69.68 16.01 250 63.91 16.92 93 68.11 16.44 343

Barcelona 60.98 16.80 107 57.29 17.86 150 59.26 17.48 214 56.55 17.78 42 58.83 17.49 257

Copenhagen 72.74 16.02 180 72.60 16.39 182 73.66 16.55 280 69.36 14.88 72 72.56 16.18 367

Paris 54.63 18.20 77 54.76 20.90 63 55.83 19.74 90 52.63 18.78 50 54.69 19.39 140

Prague 67.49 19.17 129 65.45 19.67 193 67.63 18.74 268 59.49 21.71 54 66.27 19.47 322

Budapest 61.46 18.11 102 60.95 17.07 226 62.08 16.85 238 58.54 18.54 90 61.11 17.37 328

Oslo 64.89 18.54 144 67.89 18.09 159 68.44 17.34 183 63.55 19.48 119 66.45 18.27 307

Victoria 77.51 16.10 92 76.61 15.43 105 78.01 15.48 139 74.54 16.55 54 77.03 15.72 197

Melbourne 69.79 15.06 144 73.24 14.83 209 72.51 15.09 243 70.91 14.87 110 71.83 15.13 363

Seattle 71.41 18.13 122 72.87 17.53 164 74.60 17.15 234 61.66 16.79 52 72.25 17.77 286

Beer-Sheva 69.60 14.14 81 70.67 14.70 153 71.33 14.08 196 64.82 15.01 35 70.27 14.61 242

Tokyo 68.46 15.81 86 63.63 18.56 94 66.14 16.78 153 56.25 22.01 6 65.94 17.42 180

Umea 66.30 13.84 209 65.93 15.73 237 67.69 13.92 341 60.95 16.62 105 66.10 14.86 446

Brazil 67.17 13.36 107 68.12 18.24 220 67.93 17.06 266 67.32 15.66 61 67.81 16.79 327

Uruguay 55.60 19.31 67 69.79 17.61 174 62.60 19.47 130 58.93 21.75 28 65.85 19.15 241

Turkey 60.38 15.14 156 61.18 17.65 171 60.86 16.78 304 60.05 12.03 23 60.80 16.48 327

Switzerland 76.02 13.96 55 77.35 16.97 77 77.54 15.97 91 74.70 15.37 42 76.64 15.78 133

Lithuania 53.90 16.53 101 53.07 17.13 228 53.85 16.84 305 46.61 16.89 24 53.32 16.93 329

Overall 66.31 17.16 2234 66.57 18.33 3124 67.13 17.75 4104 63.54 18.06 1129 66.47 17.85 5386


37

Table A6-I Reference data for the summed score (raw value) of the final 4-item “Past, Present and Future Activities” (OLD-PPF) facet of the WHOQOL-OLD module (Field Trial sample; N total = 5566)


Bath 15.31 2.30 51 14.91 2.11 90 15.12 2.17 120 14.56 2.41 18 15.06 2.18 141

Leipzig 14.83 2.20 183 14.46 2.52 162 14.70 2.37 253 14.52 2.34 92 14.65 2.36 346

Barcelona 13.96 2.85 106 13.81 3.06 155 13.93 2.91 216 13.48 3.24 44 13.87 2.97 261

Copenhagen 14.65 2.79 185 14.43 2.55 182 14.73 2.57 284 13.85 3.03 73 14.53 2.68 372

Paris 13.05 2.65 78 13.06 2.86 62 13.27 2.87 86 12.72 2.49 54 13.06 2.73 140

Prague 13.96 2.40 130 13.66 2.57 192 13.91 2.41 268 13.13 2.86 54 13.78 2.50 322

Budapest 13.50 2.80 101 13.25 2.75 224 13.36 2.73 236 13.25 2.87 89 13.33 2.76 325

Oslo 14.56 2.25 144 14.68 2.25 156 14.75 2.34 182 14.44 2.10 117 14.62 2.24 304

Victoria 16.02 2.77 90 15.93 2.62 104 16.04 2.70 139 15.71 2.58 51 15.97 2.68 194

Melbourne 14.89 2.65 148 15.22 2.59 210 15.38 2.59 246 14.58 2.55 111 15.10 2.63 368

Seattle 15.47 2.80 122 15.49 2.78 168 15.80 2.74 236 14.11 2.59 54 15.48 2.78 290

Beer-Sheva 14.20 2.63 81 13.99 2.56 153 14.06 2.54 196 14.14 2.82 35 14.06 2.62 242

Tokyo 13.73 2.42 86 13.08 2.47 95 13.42 2.42 154 12.83 1.72 6 13.39 2.46 181

Umea 14.71 2.22 210 14.63 2.31 234 14.94 2.21 338 13.81 2.21 106 14.67 2.26 444

Brazil 14.87 2.35 107 15.33 2.60 221 15.18 2.57 267 15.21 2.35 61 15.18 2.53 328

Uruguay 13.05 3.03 60 15.28 2.55 169 14.00 2.94 120 14.23 3.76 26 14.70 2.85 229

Turkey 13.35 2.66 156 13.23 2.97 171 13.36 2.82 304 12.39 2.73 23 13.29 2.82 327

Switzerland 15.25 2.07 57 15.71 2.67 75 15.49 2.54 93 15.53 2.16 40 15.50 2.42 133

Lithuania 12.14 2.63 101 11.52 2.69 223 11.72 2.69 302 11.64 2.59 22 11.72 2.68 324

Overall 14.33 2.69 2233 14.25 2.83 3120 14.32 2.80 4099 14.06 2.69 1127 14.29 2.78 5382


38

Table A6-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Past, Present and Future Activities” (OLD-PPF) facet of the WHOQOL-OLD module (Field Trial sample; N total = 5566)


Bath 70.71 14.39 51 68.19 13.20 90 69.48 13.56 120 65.97 15.04 18 69.10 13.65 141

Leipzig 67.69 13.74 183 65.35 15.76 162 66.90 14.82 253 65.76 14.61 92 66.55 14.76 346

Barcelona 62.26 17.80 106 61.29 19.11 155 62.07 18.17 216 59.23 20.24 44 61.69 18.56 261

Copenhagen 66.55 17.45 185 65.21 15.94 182 67.08 16.05 284 61.56 18.91 73 65.83 16.75 372

Paris 56.57 16.55 78 56.65 17.89 62 57.92 17.95 86 54.51 15.57 54 56.61 17.09 140

Prague 62.26 15.02 130 60.35 16.06 192 61.94 15.08 268 57.06 17.85 54 61.12 15.65 322

Budapest 59.34 17.47 101 57.81 17.18 224 58.47 17.04 236 57.79 17.91 89 58.29 17.25 325

Oslo 66.02 14.06 144 66.75 14.07 156 67.17 14.60 182 65.28 13.14 117 66.37 14.02 304

Victoria 75.14 17.33 90 74.58 16.37 104 75.22 16.86 139 73.16 16.12 51 74.84 16.78 194

Melbourne 68.07 16.56 148 70.15 16.20 210 71.14 16.20 246 66.10 15.91 111 69.40 16.46 368

Seattle 71.67 17.50 122 71.84 17.37 168 73.73 17.10 236 63.19 16.18 54 71.77 17.39 290

Beer-Sheva 63.73 16.43 81 62.42 16.00 153 62.88 15.87 196 63.39 17.62 35 62.86 16.38 242

Tokyo 60.83 15.14 86 56.78 15.41 95 58.89 15.15 154 55.21 10.77 6 58.70 15.37 181

Umea 66.96 13.85 210 66.43 14.41 234 68.36 13.83 338 61.32 13.83 106 66.68 14.14 444

Brazil 67.93 14.70 107 70.84 16.23 221 69.85 16.04 267 70.08 14.71 61 69.89 15.78 328

Uruguay 56.56 18.96 60 70.53 15.92 169 62.50 18.39 120 63.94 23.47 26 66.87 17.82 229

Turkey 58.45 16.60 156 57.68 18.58 171 58.47 17.64 304 52.45 17.04 23 58.05 17.64 327

Switzerland 70.29 12.95 57 73.17 16.69 75 71.84 15.87 93 72.03 13.50 40 71.90 15.15 133

Lithuania 50.87 16.42 101 47.03 16.79 223 48.26 16.81 302 47.73 16.20 22 48.23 16.74 324

Overall 64.59 16.82 2233 64.06 17.71 3120 64.49 17.50 4099 62.90 16.80 1127 64.29 17.36 5382


39

Table A7-I Reference data for the summed score (raw value) of the final 4-item “Social Participation” facet (OLD-SOP) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)


Bath 15.60 2.16 53 15.75 2.62 89 15.77 2.51 121 14.89 1.84 18 15.70 2.45 142

Leipzig 15.23 2.65 183 15.39 2.54 161 15.64 2.44 252 14.38 2.79 92 15.29 2.60 345

Barcelona 14.51 2.90 109 14.84 2.51 153 14.83 2.66 217 14.05 2.69 44 14.71 2.68 262

Copenhagen 14.81 3.09 185 14.47 3.22 180 14.87 3.18 283 13.58 3.03 72 14.61 3.19 370

Paris 12.65 3.08 79 12.10 3.55 61 12.71 3.39 86 11.93 3.11 54 12.41 3.30 140

Prague 14.26 2.75 131 13.83 3.04 193 14.44 2.61 270 11.83 3.45 54 14.00 2.93 324

Budapest 14.22 2.98 100 14.14 2.84 224 14.31 2.70 236 13.78 3.30 88 14.16 2.88 324

Oslo 14.83 2.64 148 15.13 2.44 163 15.36 2.43 186 14.48 2.58 124 15.00 2.55 315

Victoria 15.81 2.93 91 15.80 2.92 107 15.91 2.77 138 15.45 3.25 56 15.81 2.91 198

Melbourne 15.08 2.92 147 15.52 2.84 211 15.59 2.75 244 14.92 2.95 113 15.34 2.86 368

Seattle 15.33 3.06 123 15.61 2.79 166 15.73 2.79 235 14.44 3.17 54 15.49 2.90 289

Beer-Sheva 14.37 3.04 81 14.73 2.99 157 14.62 2.96 200 14.71 3.17 35 14.60 3.05 246

Tokyo 13.73 2.32 86 13.46 2.65 95 13.71 2.49 154 12.83 2.64 6 13.59 2.50 181

Umea 14.72 2.47 208 14.59 2.66 234 15.02 2.40 337 13.46 2.74 105 14.65 2.57 442

Brazil 14.46 2.52 107 15.00 2.99 221 14.88 2.81 267 14.59 3.04 61 14.83 2.85 328

Uruguay 13.30 3.18 61 15.20 2.60 170 13.98 2.94 124 14.36 3.29 25 14.70 2.89 231

Turkey 12.46 2.72 156 13.01 3.36 171 12.82 2.94 304 11.83 4.57 23 12.75 3.08 327

Switzerland 15.47 2.15 59 16.04 2.56 74 15.65 2.50 93 16.05 2.17 41 15.77 2.40 134

Lithuania 14.12 2.48 99 13.70 2.86 230 13.89 2.72 305 13.08 3.08 24 13.83 2.75 329

Overall 14.48 2.89 2243 14.63 2.98 3134 14.71 2.88 4111 14.00 3.14 1140 14.57 2.95 5406


40

Table A7-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Social Participation” facet (OLD-SOP) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)


Bath 72.52 13.50 53 73.46 16.35 89 73.55 15.68 121 68.06 11.52 18 73.11 15.31 142

Leipzig 70.22 16.54 183 71.16 15.89 161 72.77 15.26 252 64.88 17.43 92 70.58 16.26 345

Barcelona 65.71 18.11 109 67.77 15.69 153 67.68 16.65 217 62.78 16.83 44 66.91 16.74 262

Copenhagen 67.53 19.29 185 65.45 20.13 180 67.95 19.89 283 59.90 18.96 72 66.30 19.91 370

Paris 54.03 19.28 79 50.61 22.21 61 54.43 21.18 86 49.54 19.46 54 52.54 20.60 140

Prague 64.12 17.17 131 61.43 18.99 193 65.23 16.31 270 48.96 21.57 54 62.52 18.30 324

Budapest 63.87 18.63 100 63.36 17.74 224 64.41 16.86 236 61.15 20.64 88 63.52 17.99 324

Oslo 67.69 16.50 148 69.59 15.25 163 71.00 15.22 186 65.47 16.11 124 68.73 15.93 315

Victoria 73.83 18.30 91 73.77 18.22 107 74.41 17.30 138 71.54 20.33 56 73.80 18.21 198

Melbourne 69.26 18.28 147 72.01 17.73 211 72.46 17.16 244 68.25 18.41 113 70.89 17.85 368

Seattle 70.78 19.11 123 72.59 17.42 166 73.32 17.44 235 65.28 19.83 54 71.82 18.15 289

Beer-Sheva 64.81 18.99 81 67.08 18.69 157 66.34 18.53 200 66.96 19.80 35 66.23 19.05 246

Tokyo 60.83 14.52 86 59.14 16.56 95 60.67 15.57 154 55.21 16.50 6 59.94 15.60 181

Umea 67.01 15.43 208 66.19 16.64 234 68.90 15.00 337 59.11 17.14 105 66.57 16.07 442

Brazil 65.36 15.77 107 68.78 18.70 221 68.00 17.59 267 66.19 19.00 61 67.66 17.84 328

Uruguay 58.09 19.87 61 70.00 16.27 170 62.35 18.37 124 64.75 20.56 25 66.86 18.03 231

Turkey 52.84 17.01 156 56.32 21.02 171 55.10 18.36 304 48.91 28.56 23 54.66 19.26 327

Switzerland 71.72 13.45 59 75.25 16.01 74 72.78 15.60 93 75.30 13.55 41 73.55 15.00 134

Lithuania 63.26 15.47 99 60.65 17.87 230 61.80 17.01 305 56.77 19.23 24 61.44 17.20 329

Overall 65.53 18.09 2243 66.47 18.65 3134 66.93 17.98 4111 62.52 19.63 1140 66.07 18.45 5406


41

Table A8-I Reference data for the summed score (raw value) of the final 4-item “Death and Dying” facet (OLD-DAD) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)


Bath 15.69 3.24 54 14.49 3.50 90 14.85 3.50 123 15.22 3.25 18 14.94 3.44 144

Leipzig 13.87 4.02 187 12.03 4.08 162 12.87 4.20 255 13.41 3.97 94 13.01 4.14 349

Barcelona 13.40 3.65 104 12.69 3.75 149 12.79 3.72 210 14.05 3.59 42 12.98 3.72 253

Copenhagen 14.70 3.21 183 13.45 3.77 179 13.97 3.50 280 14.39 3.76 71 14.08 3.57 367

Paris 15.47 3.31 79 14.17 4.26 69 15.23 3.96 90 14.29 3.56 58 14.86 3.83 148

Prague - - - - - - - - - - - - - - - Budapest 15.42 3.50 103 15.01 4.06 227 14.94 3.86 238 15.64 3.94 92 15.14 3.89 330

Oslo 14.68 3.23 141 14.08 3.80 158 14.08 3.59 181 14.82 3.45 117 14.34 3.55 303

Victoria 16.21 3.36 92 15.47 3.33 105 15.81 3.54 140 15.92 2.81 53 15.81 3.36 197

Melbourne 15.48 3.25 149 14.76 3.59 206 14.76 3.51 243 15.75 3.30 111 15.08 3.49 365

Seattle 16.67 2.98 124 15.51 3.64 165 15.91 3.32 236 16.43 3.84 53 16.01 3.42 289

Beer-Sheva 13.27 4.13 79 11.86 4.02 159 12.20 4.12 200 13.03 4.10 35 12.25 4.10 246

Tokyo 13.01 3.87 86 12.76 4.17 97 13.14 3.95 155 11.33 2.73 6 12.88 4.02 183

Umea 15.64 3.45 211 15.03 3.59 237 15.13 3.45 341 15.92 3.76 107 15.32 3.54 448

Brazil 14.52 3.80 106 14.20 4.16 221 14.32 4.13 267 14.23 3.67 60 14.30 4.04 327

Uruguay 16.90 4.13 60 13.51 4.87 168 15.17 4.83 117 16.25 4.53 28 14.40 4.91 228

Turkey 11.38 4.00 156 10.75 3.75 171 11.25 3.86 304 8.43 3.15 23 11.05 3.88 327

Switzerland 14.56 3.73 55 13.13 3.71 76 13.83 3.67 89 13.52 4.01 42 13.73 3.77 131

Lithuania 15.46 3.30 97 13.95 3.56 224 14.36 3.49 298 15.09 4.21 23 14.41 3.55 321

Overall 14.71 3.79 2103 13.82 4.07 2938 14.06 3.97 3826 14.82 3.87 1085 14.19 3.98 5068


42

Table A8-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Death and Dying” facet (OLD-DAD) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)


Bath 73.03 20.24 54 65.56 21.88 90 67.78 21.87 123 70.14 20.29 18 68.36 21.51 144

Leipzig 61.66 25.11 187 50.19 25.51 162 55.42 26.28 255 58.84 24.82 94 56.34 25.90 349

Barcelona 58.77 22.82 104 54.32 23.45 149 54.94 23.24 210 62.80 22.43 42 56.15 23.25 253

Copenhagen 66.87 20.07 183 59.04 23.59 179 62.30 21.90 280 64.96 23.49 71 62.99 22.30 367

Paris 71.68 20.70 79 63.59 26.65 69 70.21 24.77 90 64.33 22.27 58 67.91 23.92 148

Prague - - - - - - - - - - - - - - - Budapest 71.36 21.91 103 68.81 25.36 227 68.38 24.15 238 72.76 24.63 92 69.60 24.33 330

Oslo 66.76 20.19 141 62.97 23.73 158 62.98 22.46 181 67.63 21.57 117 64.62 22.17 303

Victoria 76.29 20.98 92 71.67 20.84 105 73.84 22.13 140 74.53 17.59 53 73.83 20.98 197

Melbourne 71.77 20.29 149 67.23 22.44 206 67.26 21.96 243 73.42 20.65 111 69.26 21.78 365

Seattle 79.18 18.63 124 71.93 22.74 165 74.44 20.72 236 77.71 23.97 53 75.04 21.35 289

Beer-Sheva 57.91 25.78 79 49.14 25.10 159 51.25 25.74 200 56.43 25.61 35 51.58 25.62 246

Tokyo 56.32 24.17 86 54.77 26.03 97 57.14 24.70 155 45.83 17.08 6 55.50 25.12 183

Umea 72.78 21.57 211 68.96 22.47 237 69.59 21.55 341 74.47 23.51 107 70.76 22.11 448

Brazil 65.74 23.77 106 63.74 26.00 221 64.49 25.82 267 63.96 22.91 60 64.39 25.28 327

Uruguay 80.62 25.83 60 59.45 30.45 168 69.82 30.16 117 76.56 28.34 28 65.02 30.71 228

Turkey 46.15 25.01 156 42.18 23.46 171 45.31 24.15 304 27.72 19.66 23 44.07 24.26 327

Switzerland 66.02 23.32 55 57.07 23.17 76 61.45 22.95 89 59.52 25.05 42 60.83 23.56 131

Lithuania 71.65 20.63 97 62.19 22.25 224 64.72 21.84 298 69.29 26.31 23 65.05 22.17 321

Overall 66.91 23.67 2103 61.39 25.44 2938 62.87 24.80 3826 67.63 24.20 1085 63.66 24.89 5068


43

Table A9-I Reference data for the summed score (raw value) of the final 4-item “Intimacy” facet (OLD-INT) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)

Male Female < 80 80 ≤ Total Centre ID Mean SD N Mean SD N Mean SD N Mean SD N Mean SD N Edinburgh 12.68 4.00 34 11.99 4.59 67 12.84 4.98 56 11.43 3.48 44 12.22 4.39 101

Bath 14.90 3.73 51 14.78 4.17 89 14.98 3.97 120 13.65 4.44 17 14.82 4.00 140

Leipzig 15.67 3.31 181 14.82 3.39 152 15.47 3.39 245 14.75 3.27 88 15.27 3.37 334

Barcelona 14.35 3.81 108 13.52 4.10 139 14.01 3.95 211 13.00 4.19 35 13.88 3.99 247

Copenhagen 13.72 4.05 181 14.17 3.66 175 14.19 3.79 275 13.17 4.07 71 13.94 3.86 361

Paris 13.70 2.98 76 13.07 3.53 58 13.45 3.21 85 13.39 3.31 49 13.43 3.24 134

Prague 14.24 2.92 131 14.38 3.33 189 14.44 2.95 268 13.73 4.09 52 14.32 3.16 320

Budapest 13.84 3.97 97 10.70 4.61 187 12.27 4.68 213 10.27 4.21 71 11.77 4.64 284

Oslo 15.74 2.52 145 15.71 2.54 157 15.87 2.51 182 15.50 2.56 119 15.72 2.54 304

Victoria 15.38 3.76 89 14.18 4.68 99 14.87 4.14 138 14.35 4.79 46 14.75 4.30 188

Melbourne 14.30 3.93 148 13.41 4.19 197 14.08 4.11 240 13.17 4.11 104 13.81 4.11 353

Seattle 15.49 3.81 123 14.05 4.53 169 15.05 4.28 238 12.91 3.94 54 14.66 4.30 292

Beer-Sheva 14.55 3.09 78 13.86 4.18 152 14.23 3.87 195 13.47 3.51 32 14.06 3.84 237

Tokyo 13.20 2.39 85 11.84 2.97 94 12.45 2.77 153 11.67 2.25 6 12.49 2.79 179

Umea 13.84 3.22 203 13.13 3.76 215 13.93 3.35 324 11.91 3.65 94 13.48 3.52 418

Brazil 15.82 2.76 107 14.62 3.78 219 14.98 3.56 266 15.13 3.36 60 15.01 3.52 326

Uruguay 12.52 3.68 62 16.45 3.18 170 14.90 3.77 125 12.89 4.60 28 15.40 3.75 232

Turkey 14.28 2.58 156 14.80 2.74 171 14.60 2.65 304 13.91 2.92 23 14.55 2.68 327

Switzerland 14.62 3.14 55 13.80 3.51 69 13.92 3.47 87 14.71 3.01 38 14.16 3.35 125

Lithuania 12.20 3.19 93 9.45 4.03 219 10.37 3.99 290 9.00 3.99 22 10.27 4.00 312

Overall 14.38 3.49 2203 13.62 4.18 2987 14.04 3.89 4015 13.35 4.00 1053 13.94 3.92 5214


44

Table A9-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Intimacy” facet (OLD-INT) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)

Male Female < 80 80 ≤ Total Centre ID Mean SD N Mean SD N Mean SD N Mean SD N Mean SD N Edinburgh 54.23 24.99 34 49.91 28.71 67 55.25 31.10 56 46.45 21.75 44 51.36 27.47 101

Bath 68.14 23.29 51 67.35 26.09 89 68.65 24.84 120 60.29 27.77 17 67.63 25.03 140

Leipzig 72.96 20.68 181 67.60 21.21 152 71.71 21.19 245 67.19 20.44 88 70.45 21.06 334

Barcelona 64.70 23.82 108 59.49 25.62 139 62.56 24.67 211 56.25 26.17 35 61.77 24.94 247

Copenhagen 60.74 25.31 181 63.57 22.88 175 63.66 23.70 275 57.31 25.42 71 62.12 24.14 361

Paris 60.61 18.65 76 56.68 22.09 58 59.04 20.08 85 58.67 20.68 49 58.91 20.23 134

Prague 64.03 18.28 131 64.85 20.79 189 65.23 18.42 268 60.82 25.55 52 64.51 19.78 320

Budapest 61.47 24.78 97 41.84 28.80 187 51.67 29.23 213 39.17 26.30 71 48.55 28.99 284

Oslo 73.41 15.74 145 73.17 15.89 157 74.18 15.68 182 71.90 16.00 119 73.25 15.88 304

Victoria 71.14 23.47 89 63.64 29.28 99 67.93 25.89 138 64.67 29.94 46 67.19 26.88 188

Melbourne 64.40 24.56 148 58.82 26.17 197 63.02 25.67 240 57.33 25.71 104 61.33 25.66 353

Seattle 71.80 23.82 123 62.83 28.33 169 69.09 26.76 238 55.67 24.62 54 66.61 26.85 292

Beer-Sheva 65.95 19.31 78 61.64 26.11 152 63.94 24.17 195 59.18 21.94 32 62.87 24.00 237

Tokyo 57.50 14.97 85 49.00 18.59 94 52.82 17.32 153 47.92 14.07 6 53.04 17.44 179

Umea 61.51 20.15 203 57.06 23.48 215 62.06 20.97 324 49.47 22.83 94 59.23 22.01 418

Brazil 73.89 17.27 107 66.35 23.63 219 68.66 22.27 266 69.58 20.98 60 68.83 22.01 326

Uruguay 53.23 22.99 62 77.79 19.90 170 68.15 23.58 125 55.58 28.73 28 71.23 23.41 232

Turkey 64.22 16.14 156 67.47 17.14 171 66.22 16.59 304 61.96 18.26 23 65.92 16.72 327

Switzerland 66.36 19.64 55 61.23 21.93 69 62.00 21.72 87 66.94 18.83 38 63.50 20.93 125

Lithuania 51.28 19.93 93 34.05 25.17 219 39.78 24.92 290 31.25 24.93 22 39.18 24.98 312

Overall 64.89 21.79 2203 60.12 26.11 2987 62.78 24.30 4015 58.46 24.97 1053 62.15 24.48 5214


45

Table A10-I Reference data for the summed score (raw value) of the final summary/ total score (OLD-TO) of the WHOQOL-OLD module (Field Trial samp-le; N total = 5566)


Bath 93.87 10.42 48 92.48 10.81 85 93.49 10.72 115 88.81 9.68 16 92.98 10.65 133

Leipzig 89.90 11.04 173 87.30 12.20 144 89.84 11.11 235 85.49 12.55 82 88.72 11.64 317

Barcelona 84.53 11.68 99 83.56 11.38 113 84.25 11.51 185 82.00 11.63 26 84.01 11.51 212

Copenhagen 90.30 12.90 157 88.89 12.42 162 90.56 12.78 251 85.55 11.49 58 89.52 12.77 324

Paris 81.52 10.16 54 77.68 14.19 40 81.26 13.30 58 77.67 9.70 36 79.88 12.12 94

Prague - - - - - - - - - - - - - - - Budapest 85.52 12.29 92 81.72 13.11 173 84.06 12.81 198 80.03 12.93 67 83.04 12.94 265

Oslo 90.20 11.28 125 91.81 10.39 139 92.49 10.64 169 88.64 10.70 94 90.98 10.87 265

Victoria 96.67 12.79 82 94.42 12.31 90 96.34 12.13 130 92.59 13.18 39 95.49 12.55 172

Melbourne 89.89 12.91 132 91.67 11.88 184 92.13 12.29 218 88.62 12.04 97 91.00 12.35 324

Seattle 94.39 13.95 118 92.71 13.66 157 95.24 13.38 226 85.08 12.66 49 93.43 13.79 275

Beer-Sheva 87.03 11.74 72 86.65 13.11 137 86.81 12.42 177 87.24 13.03 29 86.53 12.79 215

Tokyo 84.48 10.83 84 81.23 13.26 91 83.18 12.03 149 75.83 10.32 6 82.79 12.23 175

Umea 88.74 10.88 198 88.53 12.00 203 90.16 10.63 315 83.06 12.61 86 88.63 11.45 401

Brazil 90.87 9.71 105 90.18 12.83 217 90.77 11.98 263 88.78 11.48 59 90.41 11.89 322

Uruguay 84.04 11.22 47 94.16 10.90 133 89.52 12.32 95 87.55 12.89 20 91.52 11.82 180

Turkey 78.35 12.00 156 78.16 12.83 171 78.92 12.11 304 69.35 13.29 23 78.25 12.42 327

Switzerland 91.77 9.67 47 93.12 10.72 66 93.05 10.32 80 91.36 10.21 33 92.56 10.27 113

Lithuania 82.10 11.46 80 76.89 11.97 180 78.79 11.98 242 74.50 12.42 18 78.49 12.04 260

Overall 88.02 12.56 1901 87.24 13.45 2549 88.10 13.09 3463 85.07 12.72 880 87.57 13.10 4470


46

Table A10-II Reference data for the transformed raw score (range 0 - 100) of the final summary/ total score (OLD-TO) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)


Bath 72.79 10.85 48 71.34 11.26 85 72.38 11.17 115 67.51 10.09 16 71.86 11.09 133

Leipzig 68.64 11.50 173 65.94 12.71 144 68.59 11.57 235 64.05 13.08 82 67.41 12.12 317

Barcelona 63.05 12.17 99 62.04 11.85 113 62.76 11.99 185 60.42 12.12 26 62.51 11.99 212

Copenhagen 69.06 13.44 157 67.59 12.94 162 69.33 13.31 251 64.12 11.97 58 68.25 13.30 324

Paris 59.92 10.58 54 55.91 14.78 40 59.64 13.86 58 55.90 10.11 36 58.21 12.63 94

Prague - - - - - - - - - - - - - - - Budapest 64.09 12.80 92 60.13 13.66 173 62.56 13.35 198 58.36 13.46 67 61.50 13.48 265

Oslo 68.96 11.75 125 70.64 10.82 139 71.34 11.08 169 67.33 11.15 94 69.77 11.33 265

Victoria 75.70 13.32 82 73.36 12.82 90 75.35 12.64 130 71.45 13.73 39 74.47 13.07 172

Melbourne 68.64 13.44 132 70.49 12.38 184 70.97 12.80 218 67.31 12.55 97 69.79 12.86 324

Seattle 73.32 14.54 118 71.57 14.23 157 74.21 13.93 226 63.63 13.19 49 72.32 14.36 275

Beer-Sheva 65.65 12.23 72 65.26 13.66 137 65.42 12.94 177 65.88 13.58 29 65.14 13.32 215

Tokyo 63.00 11.28 84 59.62 13.82 91 61.65 12.53 149 53.99 10.75 6 61.24 12.74 175

Umea 67.44 11.33 198 67.22 12.50 203 68.91 11.07 315 61.52 13.14 86 67.33 11.92 401

Brazil 69.65 10.11 105 68.94 13.37 217 69.55 12.48 263 67.48 11.96 59 69.17 12.39 322

Uruguay 62.54 11.69 47 73.08 11.35 133 68.25 12.83 95 66.20 13.43 20 70.33 12.32 180

Turkey 56.62 12.50 156 56.41 13.37 171 57.21 12.62 304 47.24 13.84 23 56.51 12.94 327

Switzerland 70.59 10.07 47 72.00 11.16 66 71.93 10.75 80 70.17 10.63 33 71.41 10.70 113

Lithuania 60.52 11.94 80 55.09 12.47 180 57.07 12.48 242 52.60 12.94 18 56.76 12.54 260

Overall 66.69 13.08 1901 65.88 14.01 2549 66.77 13.64 3463 63.61 13.25 880 66.22 13.64 4470


47

Appendix V PARTICIPATING CENTRES

No Title Name Address

Telephone Fax Email

1 Prof.

Michael

Power

Section of Clinical and Health Psychology University of Edinburgh, Medical School, Teviot Place, Edinburgh, EH8 9AG, UK

44-131 651 3943

44-131 651 3971

[email protected]

Ms. Kathryn Quinn Mr Dr. Dr. Ms.

Ken Hugh Clare Christine

Laidlaw Toner Atherton Watson

44-131 651 3947 44-1334 652611

[email protected] [email protected]

2 Prof.

Suzanne

Skevington

WHO Field Centre for the Study of Quality of Life Department of Psychology University of Bath Claverton Down Bath BA2 7AY UK

44-1225-826826

44-1225-826381

[email protected]

Ms. Farah McCrate 44-1225-826826 [email protected]

3 Dr.

Reinhold

Killian

Department of Psychiatry 11 University of Ulm BKH-Gunzburg Ludwig-Heilmeyer Str. 2 89312 Gunzburg

49-8221-962861

49-8221-9628160

[email protected]

Ms. Mr

Ines Herbert

Winkler Matschinger

Klinik und Poliklinik fur Psychiatrie Johannisallee 20 Universitaet Leipzig 03417 Leipzig Germany

49 341 972 4532 49-341-972-4539 [email protected]


48

No Title Name Address

Telephone Fax Email

4. Dr.

Ramona

Lucas

Institut Catala de L’Envelliment Sant Antoni Maria Claret, 171 08041 Barcelona

34-93 4335030

34-93-433-5006

[email protected]

Dr. Rosa Monteserín Nadal

EAP Sardenya Sardenya 466. 08025 Barcelona. Spain

34 93 567 43 80 / 567 43 95 direct

/ 567 43 95 direct

[email protected]

Dr. Salvi Junca Mr Oscar Garcia 5.

Dr

Klaus

Martiny

WHO Collaborating Centre Psychiatric Research Unit Fredericksborg General Hospital DK-3400 Hillerod Denmark

45 48 29 32 52

45-48-26-38-77

[email protected]

Prof. Per Bech 45 48 29 32 53 [email protected] Ms. Gabriele Bech-

Andersen 45 48 29 32 52 [email protected]

6. Dr.

Alain

LePlege

INSERM 82 rue de General Leclerc 94276 Le Kremlin – Bicetre France

33-1-49591978

33-1-45-21-2075

[email protected]

7. Dr

Eva

Dragomirecka

Prague Psychiatric Center Psychiatric Demography unit Ustavni 91 181 03 Praha 8 -Bohnice Czech Republic

420-2-66-003142

420-2-66-003143

[email protected]

Ms. Pavla Selepova 420-2-66-003142 [email protected]

8. Prof.

Lajos

Kullmann

National institute for Medical Rehabilitation PO Box 1 1528 Budapest 123 Hungary

36-1-2008830

36-1-392-5044

[email protected] [email protected] [email protected]

Dr. Tibor Troznai 36-1-3612804 Dr. Cecilia Varju


49

Appendix V (cont.) PARTICIPATING CENTRES No Title Name Address

Telephone Fax

Email

9. Dr.

Mary

Kalfoss

Faculty of Nursing Diakonova University Linstowgate 5 0166 Oslo Norway

47 22 98 63 41

47 22 98 63 50


Ms. Ann-Christine Fritzsonn 47 22 98 63 21 47 22 98 63 50 [email protected]

Ms. Liv Halvorsrud 47 22 98 63 09 47 22 98 63 50 [email protected] Dr. Mardon Breimoen 47 22 98 63 36 47 22 98 63 50 [email protected] Mr Svein Alve 47 22 45 35 57 47 22 45 36 00 [email protected]

10. Prof.

Anita

Molzahn

Faculty of Human and Social Development University of Victoria 3800 Finnerty Road Victoria V8W 2Y2 British Columbia Canada

250-721-7958

250-721-6231

[email protected]

Ms. Janice Robinson 250-721-8050 [email protected]

11. Assoc. Prof.

Graeme

Hawthorne

Australian Centre for Posttraumatic Health Department of Psychiatry University of Melbourne Locked Bag 1 West Heidleberg Victoria 3081 Australia

61-39496-4931

61-39596-2830

[email protected]

Prof. Helen Herrman St Vincent's Mental Health Service The University of Melbourne Department of Psychiatry PO Box 2900, Fitzroy, Victoria 3065 Australia

613-9288-4751 613-9288-4802 [email protected]


50


Telephone Fax

Email

12. Mr

Don

Bushnell

Health Services Research Associates Inc. 6505 216th St SW, Suite 105 Mountlake Terrace WA 98043 USA

425-775-6565 Ext 206

425 775 6734

[email protected]

Ms. Mona Martin 425-775-6565 Ext 202

[email protected]

13. Dr. Mr Mrs

Gary Yoram Tal

Diamond Ben Ya’acov Narkiss-Guez

Department of Behavioural Science and Social Work Ben-Gurion Univeristy of the Negev 84105 Beer-Sheva Israel

972-8-6472083

982-76-472932

[email protected] [email protected] [email protected]

14. Dr

Miyako

Tazaki

Department of Science Science University of Tokyo 1-3, Kagurqzaka, Shinjuku-ku 162-8601 Tokyo, Japan

81-3-3260-4272 (ext. 2373)

81-3-3260-0322

[email protected]

Dr Yoshinoro Ebihara Keiogiyuku University 81-3-3353-1211 [email protected] Ms. Miwa Fujii Kwansai University 81-798-54-6847 81-798-51-0955 [email protected] Ms. Emiko Hasegawa Seigakuin University 81-48-725-6191 81-48-781-6891 e_hasegawa@seigakuin-

univ.ac.jp Dr Keiko Hatada Onomichi Hospital 81-95-856-1111 81-95-856-4755 [email protected]

15. Dr

Gudjon

Magnusson

Director Division of Technical Support 1 Reducing Disease Burden WHO Regional Office for Europe Scherfigsvej 8 2100 Copenhagen Denmark

45-3917-1492

45-3917-1851

[email protected]


51


Telephone Fax

Email

16. Prof.

Martin

Eisemann

Dept of Psychology University of Tromsoe N-9037 Tromsoe Norway

0047 77646279

0047 77645610

[email protected]

Mr Bjorn Nygren Department of Nursing Umea University SE-90187 Umea Sweden

46-90-786-5292 [email protected]

17. Prof.

Ji-Qian

Fang

Department of Medical Statistics School of Public Health Sun Yat-Sen University of Medical Science 74 Zhongshan Road II 510080 Guangzhou China

86-20-873-30671

86-29-873-31605

[email protected]

Mr Hao Yuan-tao 86-20-873-30671 86-29-873-30446 [email protected] 18.

Dr.

Jelena

Ceremnych

Scientific Department of Gerontology Problems Institute of Experimental and Clinical Medicine Zygimantu 9 LT-2600 Vilnius Lithuania

370-2-628636

370-5-2123073

[email protected]

Prof. Algirdas Venalis Ms. Natalija Daniliuk 370-5-2777726 370-5-2777745 [email protected] Ass.Prof. Vidmantas Alekna Dr. Vaineta Valeikiene


52

Appendix V ADDITIONAL CENTRES No.

Title Name Address

Telephone Fax Email

1. Prof.

Kwok Fai

Leung

Hong Kong Project Team on Chinese Version of WHOQOLHong Kong Hospital Authority C/O Dept of Occupational Therapy Queen Elizabeth Hospital 30 Gascoigne Road Kowloon. Hong Kong

852-29586166

852-29586719

[email protected]

Prof. David Phillips 852-29586166 [email protected] Dr. Alfred Chan 852-29586166 [email protected] Dr. Cindy Lam 852-29586166 [email protected]

2. Dr.

Marcelo

Fleck

Dept de Psiquiatria E Medicina Legal Universidade Federale Do Rio Grande Do Sul Rua Ramiro Barcelas, 2350 4 Andar Cedex 90035-003-Porte Alegre-RS Brazil

51-3316-8413

51-3330-8965

[email protected]

Dr. Eduardo Chachamovich 51-3316-8413 [email protected] Ms. Clarissa Trentini 51-3316-8413 [email protected] Dra. Neusa Sica de Rocha 51-3316-8413 [email protected]

3. Professor

Nicole

von Steinbüchel

Centre of Neurogerontolopsychology Clinic of Geriatric Psychiatriy, University Hospitals of Geneva, Belle-Idée 2 Chemin du Petit-Bel-Air, 1225 Chêne-Bourg Switzerland

+41 22 305 50 00

+41 22 305 50 44


Ms Kerstin Weber +41 22 305 50 00 [email protected] Ms Catia Beni +41 705 90 85 [email protected] Ms Parissa De Montenach +41 705 90 85 [email protected]


53

Appendix V (contd.) ADDITIONAL CENTRES No.

Title Name Address

Telephone Fax Email

4. Assoc. Prof.

Erhan

Eser

Celal Bayar Univ. Tip Fak. Halk Sagligi AD. Istasyon Mevkii 45050, Manisa Turkey

90-236-239-1319

90-236-237-6449

[email protected]

Assoc. Prof.

Caner Fidaner 90-236-239-1319 [email protected]

Dr. Sultan Eser 90-236-239-1319 [email protected] 5.

Dr.

Laura

Schwartzmann

Department of Medical Psychology Calabria 3969 Montevideo CP 11300 Uruguay

698-2622-2683

698-2622-2683

[email protected]

Ms Bettina Caporale 698-2622-2683 [email protected] Ms Adriana Suárez 698-2622-2683 [email protected]

6.

Dr.

Silke

Schmidt

Department of Medical Psychology Hamburg-Eppendorf Hospital Martinistrasse 52 20246 Hamburg Germany

40-42803-6206

40-42803-4940

[email protected]


54

Appendix VI WHOQOL-OLD

Instructions

This questionnaire asks for your thoughts and feelings about certain aspects of your

quality of life and addresses issues that may be important to you as an older member of

society.

Please answer all the questions. If you are unsure about which response to give to a

question, please choose the one that appears most appropriate. This can often be your first

response.

Please keep in mind your standards, hopes, pleasures and concerns. We ask that you think

about your life in the last two weeks.

For example, thinking about the last two weeks, a question might ask:

How much do you worry about what the future might hold?

Not at all 1

A little 2

A moderate amount

3

Very much 4

An extreme amount

5

You should circle the number that best fits how much you have worried about the future

over the last two weeks. So you would circle the number 4 if you worried about your

future “Very much”, or circle number 1 if you have worried “Not at all” about your future.

Please read each question, assess your feelings, and circle the number on the scale for each

question that gives the best answer for you.

Thank you for your help


55

The following questions ask about how much you have experienced certain things in the last two weeks, for example, freedom of choice and feelings of control in your life. If you have experienced these things an extreme amount circle the number next to “An extreme amount”. If you have not experienced these things at all, circle the number next to “Not at all”. You should circle one of the numbers in between if you wish to indicate your answer lies somewhere between “Not at all” and “Extremely”. Questions refer to the last two weeks.

1. (F25.1) To what extent do impairments to your senses (e.g. hearing, vision, taste, smell, touch) affect your daily life?

Not at all 1

A little 2

A moderate amount

3

Very much 4

An extreme amount

5

2. (F25.3) To what extent does loss of for example, hearing, vision, taste, smell or touch affect your ability to participate in activities?

Not at all 1

A little 2

A moderate amount

3

Very much 4

An extreme amount

5

3. (F26.1) How much freedom do you have to make your own decisions? Not at all

1 A little

2 A moderate

amount 3

Very much 4

An extreme amount

5

4. (F26.2) To what extent do you feel in control of your future? Not at all

1 Slightly

2 Moderately

3 Very

4 Extremely

5

5. (F26.4) How much do you feel that the people around you are respectful of your freedom?

Not at all 1

Slightly 2

Moderately 3

Very 4

Extremely 5

6. (F29.2) How concerned are you about the way in which you will die? Not at all

1 A little

2 A moderate

amount 3

Very much 4

An extreme amount

5


56

7. (F29.3) How much are you afraid of not being able to control your death? Not at all

1 Slightly

2 Moderately

3 Very

4 Extremely

5

8. (F29.4) How scared are you of dying? Not at all

1 Slightly

2 Moderately

3 Very

4 Extremely

5

9. (F29.5) How much do you fear being in pain before you die? Not at all

1 A little

2 A moderate

amount 3

Very much 4

An extreme amount

5 The following questions ask about how completely you experience or were able to do certain things in the last two weeks, for example getting out as much as you would like to. If you have been able to do these things completely, circle the number next to “Completely”. If you have not been able to do these things at all, circle the number next to “Not at all”. You should circle one of the numbers in between if you wish to indicate your answer lies somewhere between “Not at all” and “Completely”. Questions refer to the last two weeks.

10. (F25.4) To what extent do problems with your sensory functioning (e.g. hearing, vision, taste, smell, touch) affect your ability to interact with others?

Not at all 1

A little 2

Moderately 3

Mostly 4

Completely 5

11. (F26.3) To what extent are you able to do the things you’d like to do? Not at all

1 A little

2 Moderately

3 Mostly

4 Completely

5

12. (F27.3) To what extent are you satisfied with your opportunities to continue achieving in life?

Not at all 1

A little 2

Moderately 3

Mostly 4

Completely 5


57

13. (F27.4) How much do you feel that you have received the recognition you deserve in life?

Not at all 1

A little 2

Moderately 3

Mostly 4

Completely 5

14. (F28.4) To what extent do you feel that you have enough to do each day? Not at all

1 A little

2 Moderately

3 Mostly

4 Completely

5 The following questions ask you to say how satisfied, happy or good you have felt about various aspects of your life over the last two weeks . For example, about your participation in community life or your achievements in life. Decide how satisfied or dissatisfied you are with each aspect of your life and circle the number that best fits how you feel about this. Questions refer to the last two weeks.

15. (F27.5) How satisfied are you with what you have achieved in life? Very dissatisfied

1 Dissatisfied

2 Neither satisfied nor dissatisfied

3

Satisfied 4

Very satisfied 5

16. (F28.1) How satisfied are you with the way you use your time? Very dissatisfied

1 Dissatisfied


3

Satisfied 4

Very satisfied 5

17. (F28.2) How satisfied are you with your level of activity? Very dissatisfied

1 Dissatisfied


3

Satisfied 4

Very satisfied 5

18. (F28.7) How satisfied are you with your opportunity to participate in community activities?

Very dissatisfied 1

Dissatisfied 2

Neither satisfied nor dissatisfied

3

Satisfied 4

Very satisfied 5


58

19. (F27.1) How happy are you with the things you are able to look forward to?

Very unhappy 1

Unhappy 2

Neither happy nor unhappy

3

Happy 4

Very happy 5

20. (F25.2) How would you rate your sensory functioning (e.g. hearing, vision, taste, smell, touch)?

Very poor 1

Poor 2

Neither poor nor good

3

Good 4

Very good 5

The following questions refer to any intimate relationships that you may have. Please consider these questions with reference to a close partner or other close person with whom you can share intimacy more than with any other person in your life. 21. (F30.2) To what extent do you feel a sense of companionship in your life?

Not at all 1

A little 2

A moderate amount

3

Very much 4

An extreme amount

5 22. (F30.3) To what extent do you experience love in your life?

Not at all 1

A little 2

A moderate amount

3

Very much 4

An extreme amount

5 23. (F30.4) To what extent do you have opportunities to love?

Not at all 1

A little 2

Moderately 3

Mostly 4

Completely 5

24. (F30.7) To what extent do you have opportunities to be loved?

Not at all 1

A little 2

Moderately 3

Mostly 4

Completely 5

Do you have any comments about the questionnaire?

THANK YOU FOR YOUR HELP


WHOQOL-OLD (BREF FORMAT)

Instructions

This questionnaire asks for your thoughts and feelings about certain aspects of your quality of life and

addresses issues that may be important to you as an older member of society.

Please answer all the questions. If you are unsure about which response to give to a question, please

choose the one that appears most appropriate. This can often be your first response.

Please keep in mind your standards, hopes, pleasures and concerns. We ask that you think about your

life in the last two weeks.

For example, thinking about the last two weeks, a question might ask:

How much do you worry about what the future might hold?

Not at all 1

A little 2

A moderate amount

3

Very much 4

An extreme amount

5

You should circle the number that best fits how much you have worried about the future over the last

two weeks. So you would circle the number 4 if you worried about your future “Very much”, or circle

number 1 if you have worried “Not at all” about your future. Please read each question, assess your

feelings, and circle the number on the scale for each question that gives the best answer for you.

Thank you for your help


The following questions ask about how much you have experienced certain things in the last two weeks.

Not at all A little A moderate amount

Very much An extreme amount

1 (F25.1)

To what extent do impairments to your senses (e.g. hearing, vision, taste, smell, touch) affect your daily life?

1 2 3 4 5

2 (F25.3)

To what extent does loss of, for example, hearing, vision, taste, smell or touch affect your ability to participate in activities?

1 2 3 4 5

3 (F26.1)

How much freedom do you have to make your own decisions?

1 2 3 4 5

Not at all Slightly Moderately Very much Extremely 4 (F26.2)

To what extent do you feel in control of your future?

1 2 3 4 5

5 (F26.4)

How much do you feel that the people around you are respectful of your freedom?

1 2 3 4 5

Not at all A little A moderate

amount Very much An extreme

amount 6 (F29.2)

How concerned are you about the way in which you will die?

1 2 3 4 5

Not at all Slightly Moderately Very much Extremely

7 (F29.3)

How much are you afraid of not being able to control your death?

1 2 3 4 5

8 (F29.4)

How scared are you of dying? 1 2 3 4 5

Not at all A little A moderate

amount Very much An extreme

amount 9 (F29.5)

How much do you fear being in pain before you die?

1 2 3 4 5

The following questions ask about how completely you experience or were able to do certain things in the last two weeks.

Not at all A little Moderately Mostly Completely 10 (F25.4)

To what extent do problems with your sensory functioning (e.g. hearing, vision, taste, smell, touch) affect your ability to interact with others?

1 2 3 4 5

11 (F26.3)

To what extent are you able to do the things you’d like to do?

1 2 3 4 5

12 (F27.3)

To what extent are you satisfied with your opportunities to continue achieving in life?

1 2 3 4 5

13 (F27.4)

How much do you feel that you have received the recognition you deserve in life?

1 2 3 4 5

14 (F28.4)

To what extent do you feel that you have enough to do each day?

1 2 3 4 5


The following questions ask you to say how satisfied, happy or good you have felt about various aspects of your life over the last two weeks.

Very dissatisfied

Dissatisfied Neither satisfied nor dissatisfied

Satisfied Very satisfied

15 (F27.5)

How satisfied are you with what you have achieved in life?

1 2 3 4 5

16 (F28.1)

How satisfied are you with the way you use your time?

1 2 3 4 5

17 (F28.2)

How satisfied are you with your level of activity?

1 2 3 4 5

18 (F28.7)

How satisfied are you with your opportunity to participate in community activities?

1 2 3 4 5

Very

unhappy Unhappy Neither

happy nor unhappy

Happy Very happy

19 (F27.1)

How happy are you with the things you are able to look forward to?

1 2 3 4 5

Very poor Poor Neither poor

nor good Good Very good

20 (F25.2)

How would you rate your sensory functioning (e.g. hearing, vision, taste, smell, touch)?

1 2 3 4 5

The following question refer to any intimate relationships that you may have. Please consider these questions with reference to a close partner or other close person with whom you can share intimacy more than with any other person in your life.

Not at all A little A moderate amount

Very much An extreme amount

21 (F30.2)

To what extent do you feel a sense of companionship in your life?

1 2 3 4 5

22 (F30.3)

To what extent do you experience love in your life?

Not at all A little Moderately Mostly Completely 23 (F30.4)

To what extent do you have opportunities to love?

1 2 3 4 5

24 (F30.7)

To what extent do you have opportunities to be loved?

Do you have any comments about the questionnaire?

THANK YOU FOR YOUR HELP

whoqol-old final manual - world health organization

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