Wisconsin Quality of Life Client Questionnaire

Abstract

The Wisconsin Quality of Life Client Questionnaire (WQLCQ) is a comprehensive, multi-dimensional self-report instrument designed to assess the subjective and objective quality of life outcomes among individuals receiving mental health services. Developed in 1996, the WQLCQ measures client satisfaction, functional status, and the perceived importance of various life domains, providing a holistic view of well-being beyond traditional symptom reduction measures. It is particularly valuable in psychiatric rehabilitation settings for treatment planning and measuring long-term recovery success.

Keywords

Quality of Life, Mental Health, Client Satisfaction, Psychiatric Rehabilitation, Functional Status, Psychological Well-being, Life Domains, Outcome Measurement.

Authors

Marion A. Becker, Bret R. Shaw, Lisa M. Reib.

Purpose

The primary purpose of the WQLCQ is to systematically measure the subjective and objective aspects of a client’s life experience, which are critical indicators of successful psychiatric treatment and community integration. The questionnaire is structured to elicit responses regarding both satisfaction levels across key life areas and the perceived importance of those areas to the individual.

By integrating measures of satisfaction, importance, and functional status, the WQLCQ allows clinicians and researchers to generate individualized profiles of Quality of Life (QoL). This data is essential for developing client-centered treatment goals, monitoring progress over time, and evaluating the effectiveness of community-based support programs.

Construct

The WQLCQ operationalizes the construct of Quality of Life (QoL) as a multi-faceted concept encompassing objective life circumstances and the individual’s subjective reaction to those circumstances. It adheres to a domain-based model, dividing QoL into several distinct yet interrelated areas of functioning and experience.

Key dimensions of the construct include external factors such as housing, income (Money/Economics), and access to care (Mental Health Services), alongside internal factors like Psychological Well-being, physical health, and social connectedness. The instrument’s unique approach is its focus on the discrepancy between what the client has achieved and what they deem important, which is central to understanding true subjective well-being.

Validity

While specific validity coefficients were not detailed in the summary provided, the structure of the WQLCQ strongly suggests high content validity. The scale covers an extensive range of domains recognized in psychiatric rehabilitation literature as fundamental to the overall functioning and well-being of clients, including social relations, daily activities, occupational status, physical health, and symptoms.

The comprehensive nature of the instrument, addressing both objective status (e.g., employment, living situation) and subjective experience (satisfaction, importance, goal attainment), ensures that the instrument measures the broad construct of QoL relevant to individuals with mental illnesses. Further evidence of construct validity is typically established through correlations between the subscales and other established measures of mental health symptoms and functional recovery.

Reliability

The internal consistency reliability of the WQLCQ subscales, measured using Cronbach’s Alpha, demonstrates acceptable to excellent reliability across its core domains, supporting its use in research and clinical settings.

The reported Cronbach’s Alpha scores for the domains are as follows:

• Social Relations / Support: .7585
• Money / Economics: .6854
• Activities of Daily Living: .6697
• Occupational Activities: .9343
• Psychological Well Being: .7938
• Symptoms: .7707
• Physical Health: .7446
• Life Satisfaction: .8250

The high alpha value for Occupational Activities (.9343) indicates strong internal homogeneity within that subscale, while other domains generally meet or approach the standard threshold of .70 for acceptable reliability in psychological instruments.

Factor Analysis

The WQLCQ is empirically structured around several distinct domains, indicating an underlying multi-factor structure designed to capture the complexity of Quality of Life. Although the specific results of an exploratory or confirmatory factor analysis were not provided in the source material, the clear demarcation into subscales—such as Symptoms, Social Relations, and Money—suggests that items group together coherently, reflecting distinct, measurable aspects of the overall QoL construct. Researchers interested in the exact factor loading and structure are advised to consult the original 1996 Quality of Life Assessment Manual.

Instrument

Test Type: Self-Report Questionnaire

Format: Mixed format utilizing checklist items, Likert-type rating scales (e.g., 7-point satisfaction scales, 5-point importance scales), and open-ended goal setting questions.

Language Available: Primarily English (as documented in the source material).

Population Group: Clients receiving mental health services.

Age Group: Typically utilized with adult populations in mental health settings.

Population Details: Individuals engaged in psychiatric treatment or rehabilitation programs, often those with serious mental illnesses (SMI).

Test Methodology: The questionnaire is administered to clients to assess their current status across multiple life domains, typically focusing on experiences and feelings over the preceding four weeks. It emphasizes the subjective evaluation of satisfaction and importance alongside objective functional measures. The manual for the scale is available online for further details: http://wqli.fmhi.usf.edu/wqli-instruments/

Keywords

WQLCQ, Client Outcome, Satisfaction Scale, Importance Rating, Activities of Daily Living, Mental Illness, Psychiatric Assessment, Reliability.

Authors

Author ORCID Identifier: Not provided in source content.

Affiliation Email addresses: [email protected] (Marion A. Becker)

Correspondence Address: Marion Becker, Ph.D., University of South Florida, Department of Community Mental Health, 13301 Bruce B. Downs Blvd., MHC 1423, Tampa, Florida 33612-3899. Telephone: (813)974-7188, Fax: (813)974-6469.

Permissions & Fee and Test Year

The WQLCQ was developed and published in 1996. For current permissions regarding use, reproduction, or adaptation of the instrument, users are directed to contact the primary author, Marion Becker, Ph.D., via the provided correspondence details. Information regarding the instrument’s availability and usage policies can often be found on the associated program website: http://wqli.fmhi.usf.edu/knowledge-base/faq.cfm.

Reference’s

• Becker, Marion A.; Reib, Lisa M.; & Shaw, Bret R. (1996). Quality of Life Assessment Manual. University of Wisconsin—Madison Mental health services. [Place of publication not identified] : [publisher not identified].

• WQLI Instruments. (n.d.). Retrieved from: http://wqli.fmhi.usf.edu/wqli-instruments/

• WQLI Knowledge Base/FAQ. (n.d.). Retrieved from: http://wqli.fmhi.usf.edu/knowledge-base/faq.cfm

Items of the Wisconsin Quality of Life Client Questionnaire

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

BACKGROUND INFORMATION (sample)

date of birth, Sex, highest school grade, current relationship/marital status, source of income, racial/ethnic background, During the past four weeks, you lived, Who would you like live with?, During the past four weeks, you lived primarily?, Where would you like to live?

SATISFACTION LEVEL (sample)

Very dissatisfied, Moderately dissatisfied, A little dissatisfied, Neither satisfied or dissatisfied, A little satisfied, Moderately satisfied, Very satisfied

1. How satisfied or dissatisfied are you when you are alone?
2. How satisfied or dissatisfied are you with your housing?
3. How satisfied or dissatisfied are you with your neighborhood as a place to live in?
4. How satisfied or dissatisfied are you with the food you eat?
5. How satisfied or dissatisfied are you with the clothing you wear?
6. How satisfied or dissatisfied are you with the mental health services you use?
7. How satisfied or dissatisfied are you with your access to transportation?
8. How satisfied or dissatisfied are you with your sex life?
9. How satisfied or dissatisfied are you with your personal safety?
10. We have asked how satisfied you are with different parts of your life. Now we would like to know how important each of these aspects of your life are.

Not at all important, Slightly important, Moderately important, Very important, Extremely important,

1. How important to you is the way you spend your time?
2. How important is it to feel comfortable when alone?
3. How important is your housing?
4. How important is your neighborhood as a place to live in?
5. How important to you is the food you eat?
6. How important to you is the clothing you wear?
7. How important to you are the mental health services you use?
8. How important to you is your access to transportation?
9. How important to you is your sex life?
10. How important to you is your personal safety?

ACTIVITIES AND OCCUPATIONS (sample)

1. During the past four weeks, you have: (Check one) …
2. What is your main activity? (Check one)…
3. How satisfied or dissatisfied are you with the main activitity that you do? (Check one)…
4. Do you feel that you are engaged in activities: (Choose one): Less than you would like, More than you would like, As much as you want
5. What would you like to have as your main activity?

PSYCHOLOGICAL WELL-BEING (sample)

Now we would like to know how you feel about things in your life. For each of the following questions, check the boxes that best describe how you have felt in the past four weeks. YES or NO

1. Pleased about ha‎ving accomplished something?
2. Very lonely or remote from other people?
3. Bored?
4. That things went your way?
5. So restless that you couldn’t sit long in a chair?
6. Proud because someone complimented you on something you had done?
7. Upset because someone criticized you?
8. Particularly excited or interested in something?
9. Depressed or very unhappy?
10. On top of the world?
11. In the past four weeks, would you say that your mental health has been: Poor, Fair, Good, Very good, Excellent

SYMPTOMS/OUTLOOK (sample)

1. During the past four weeks, you have: (Check one)…
2. There are many aspects of emotional distress including feelings of depression, anxiety, hearing voices, etc. In the past four weeks, how much distress have these symptoms caused you?: (Check one)…

In the past four weeks: Never, Occasionally, Frequently, Most of the time, Constantly

1. How much has feelings of depression, anxiety interfered, etc. with your daily life?
2. Have you felt like killing yourself?
3. Have you felt like harming others?

PHYSICAL HEALTH (sample)

1. In the past four weeks, you would best describe your physical health as: Poor, Fair, Good, Very good, Excellent
2. How do you feel about your physical health? (Check one)…
3. How important to you is your physical health? (Check one)…
4. Are you currently taking psychiatric medications? Yes No (If no, go to next page)
5. If you are currently taking psychiatric medications, do you take them as prescribed? (Check one)…
6. If you are currently taking psychiatric medications, do you take them as prescribed? (Check one), None; Slight; Mild; Moderate; Severe
7. If you take medications for mental health problems, do you feel the medication helps control your symptoms? Not at all, Some, A fair amount, Quite a bit, Eliminates all Symptoms
8. How do you feel about taking your psychiatric medications? (Check one)…

ALCOHOL & OTHER DRUGS

1. Over the past four weeks, have you drank any alcohol? Yes No
2. If yes, on how many days have you had any alcohol to drink over the past four weeks? _____ (number of days)
3. What do you think about your alcohol use? (Check one)…
4. Over the past four weeks, have you used any street drugs (cocaine, marijuana, heroin, speed, LSD, etc.)? Yes No
5. If yes, on how many days have you had any alcohol to drink over the past four weeks? _____ (number of days)
6. What do you think about your drug use? (Check one)…

SOCIAL RELATIONS / SUPPORT

Very dissatisfied, Moderately dissatisfied, A little dissatisfied, Neither satisfied or dissatisfied, A little satisfied, Moderately satisfied, Very Satisfied,

1. How satisfied or dissatisfied are you with the number of friends you have? No friends
2. How satisfied or dissatisfied are you with how you get along with your friends?
3. How satisfied or dissatisfied are you with your relationship with your family? No family
4. If you live with others, how satisfied or dissatisfied are you with the people with whom you live? Live alone
5. How satisfied or dissatisfied are you with how you get along with other people?
6. How many people do you count as your friends? none 1-2 3-5 over 5

IMPORTANCE LEVEL

Not at all important, Slightly important, Moderately important, Very important, Extremely important

1. How important is it to have an adequate number of friends?
2. How important is it to get along with your friends?
3. How important are family relationships?
4. If you live with others, how important are the people with whom you live?
5. How important is it to get along with others?
6. During the past four weeks, you have (check one)…

MONEY

1. Are you paid for working or attending school? Yes No
2. How do you feel about the amount of money you have? (check one)…
3. How satisfied are you about the amount of control you have over your money? (check one)…
4. How important to you is money? (check one)…
5. How important is it to you to have control over your money? (Check one)…
6. How often does lack of money keep you from doing what you want to do? (Check one)…

ACTIVITIES OF DAILY LIVING

1. Below are activities that you may have participated in recently. Please check YES or NO to indicate whether you have done the activity in the past four weeks.

• Gone to a restaurant or coffee shop
• Gone shopping
• Gone for a ride in a bus or car
• Prepared a meal
• Cleaned the room/apartment/home
• Done the laundry

1. During the past four weeks you: have been able to do most things on your own (such as shopping, getting around town, etc.); have needed some help in getting things done; have had trouble getting tasks done, even with help
2. In the past four weeks, how often have you had any problems with personal grooming (e.g. taking showers, brushing your teeth)? Never, Sometimes, Frequently Almost always

GOAL ATTAINMENT

1. What do you hope to accomplish as a result of your mental health treatment? Please write below up to 3 goals:

Goal 1: _____________________________________________________

How important is this goal to you? Please check the box below to indicate how important this goal is to you. (NR = No Response)? Not at all important 1 2 3 4 5 6 7 8 9 10 Extremely important, NR

To what extent have you achieved this goal? Please check the box below to indicate the extent to which you have achieved this goal. Not at all achieved 1 2 3 4 5 6 7 8 9 10 Completely achieved, NR

Goal 2: ______________________________________________________

How important is this goal to you? Not at all important 1 2 3 4 5 6 7 8 9 10 Extremely important, NR

To what extent have you achieved this goal? Not at all achieved 1 2 3 4 5 6 7 8 9 10 Completely achieved, NR

Goal 3: ______________________________________________

How important is this goal to you? Not at all important 1 2 3 4 5 6 7 8 9 10 Extremely important, NR

To what extent have you achieved this goal? Not at all achieved 1 2 3 4 5 6 7 8 9 10 Completely achieved, NR

1. Below are activities that you may have participated in recently. Please check Yes or No to indicate whether you have done the activity in the past four weeks.

• Gone for a walk
• Gone to a social group
• Gone to a movie or play
• Read a magazine or newspaper
• Watched TV
• Gone to church, synagogue, mosque
• Played cards
• Listened to a radio
• Played a sport
• Gone to a library

1. Please check the box below to indicate how you feel about your quality of life during the past four weeks. Lowest quality means things are as bad as they could be. Highest quality means things are the best they could be.

LOWEST QUALITY 1 2 3 4 5 6 7 8 9 10 HIGHEST QUALITY

1. If your quality of life is less than you hope for, how hopeful are you that you will eventually achieve your desired quality of life? (Check one) Not at all, Somewhat, Moderately, Very
2. How much control do you feel you have over the important areas of your life? (Check one)
3. How important are each of the following factors in determining your quality of life? Not at all important, Slightly important, Moderately important, Very important, Extremely important

• Work, school or other occupational activities
• Your feelings about yourself
• Your physical health
• Friends, family, people you spend time with
• ha‎ving enough money
• Ability to take care of yourself
• Your mental health
• Other, please specify: _______________________

Is there anything else you would like us to know?