Wisconsin Quality of Life Index for Adults Questionnaire (A-QLI)

Abstract

The Wisconsin Quality of Life Index for Adults Questionnaire (A-QLI) is a comprehensive, multidimensional instrument designed to assess the Quality of Life (QoL) among adult populations. Developed in 1996, it focuses on several key domains that contribute to an individual’s overall well-being, including physical functioning, mental health, social support, and the ability to manage daily life tasks. The A-QLI is particularly useful in clinical and research settings where a detailed, patient-reported outcome measure is required, enabling researchers and clinicians to identify specific areas needing intervention or improvement.

This instrument goes beyond mere symptom checklists by incorporating subjective satisfaction ratings regarding social relationships, living arrangements, and personal autonomy. Crucially, the final sections of the A-QLI incorporate patient goals, allowing the assessment to integrate individual priorities for self-improvement and measure progress toward achieving those personal objectives.

Keywords

Quality of Life, QoL, Adult Assessment, Physical Health, Psychological Well-Being, Functional Status, Self-Care, Pain Assessment, Social Support, Patient-Reported Outcomes.

Authors

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

Purpose

The primary purpose of the A-QLI is to provide a standardized method for measuring the subjective and objective aspects of an adult’s Quality of Life. Unlike instruments focused solely on illness symptoms, the A-QLI captures the individual’s perspective on their functional status, mental state, and social integration. It is specifically structured to capture limitations imposed by both physical and emotional difficulties over a recent four-week period, providing a contemporary snapshot of well-being.

Furthermore, the instrument serves a crucial role in clinical and rehabilitation planning by asking respondents to identify the three most important areas for improvement in their lives (e.g., Pain, Spirituality, Daily Activities) and list corresponding personal goals. This feature integrates the patient’s priorities directly into the assessment process, aligning clinical interventions with individual needs and measuring the extent to which those goals have been achieved.

Construct

The A-QLI operationalizes Quality of Life as a multidimensional construct encompassing various domains of functioning and satisfaction. The core construct is assessed through distinct sections covering objective health status, perceived self-efficacy, and satisfaction with environmental and social circumstances. Key sub-constructs measured include:

• Physical Functioning: Assessment of general health status, physical limitations in daily activities (e.g., climbing stairs, lifting groceries), and complex medication management.
• Self-Care and Independence: Evaluation of the need for assistance with basic activities of daily living (ADLs) such as bathing and eating, as well as instrumental activities (IADLs) like shopping, cooking, and utilizing transportation.
• Pain and Symptom Management: Subjective rating of pain severity, interference with normal activities, and the perceived effectiveness of pain control measures.
• Social Relations and Support: Satisfaction with relationships with family and friends, and the perceived availability of assistance during times of need.
• Psychological Well-Being: Measurement of emotional states, including feelings of pep, nervousness, peacefulness, hopefulness about the future, and perceived control over life. This section also explores difficulties related to concentration, depression, and substance use.

Validity

Detailed psychometric properties, including specific measures of validity (e.g., construct, concurrent, criterion), were not included in the provided excerpt of the Wisconsin Quality of Life Index for Adults Questionnaire (A-QLI). However, the instrument demonstrates strong face validity due to its comprehensive coverage of domains traditionally accepted as central to adult quality of life, aligning with frameworks established by the WHOQOL group and similar instruments.

The inclusion of separate sections for Physical Health, Self-Care, Pain, Social Support, and Psychological Well-Being suggests that the scale is designed to differentiate between these independent aspects of well-being, supporting its use in studies where specific functional domains must be targeted or analyzed separately.

Reliability

Information regarding the internal consistency (e.g., Cronbach’s alpha coefficients) and test-retest reliability of the A-QLI subscales is not available within the source content provided. Researchers utilizing the A-QLI are advised to consult the full official documentation published by the authors or the University of South Florida for empirical data confirming the consistency and stability of the measurements derived from this instrument.

Factor Analysis

Specific results of factor analysis (e.g., Exploratory Factor Analysis or Confirmatory Factor Analysis) used to establish the dimensional structure of the A-QLI are not detailed in this entry. Given the clear segregation of items into eight thematic areas—ranging from objective health measures to subjective psychological states and goal achievement—it is highly probable that the A-QLI is structured to yield multiple, distinct factor scores rather than a single global QoL score, reflecting its multidimensional nature.

Instrument

Test Type: Self-Report Questionnaire (Patient-Reported Outcome Measure)

Format: Structured questionnaire utilizing a variety of response formats, including multiple-choice, 5-point and 10-point Likert-type scales (measuring satisfaction and extent of achievement), frequency scales (e.g., “All Days” to “No Days”), and simple dichotomous (Yes/No) questions.

Language Available: English (as presented in the source content).

Population Group: Adults.

Age Group: Adult population.

Population Details: The instrument collects extensive background data on demographics (sex, education, marital status, race/ethnicity, religious affiliation) and socioeconomic factors (living arrangements, source of income), making it suitable for diverse adult populations, particularly those involved in community mental health or chronic illness studies.

Test Methodology: The assessment primarily uses a 4-week retrospective recall period for health status, functional limitations, pain experience, and emotional states.

Keywords

Functional Status, ADLs, IADLs, Pain Management, Social Integration, Mental Health, Health Status, Psychological Assessment, Personal Goals, Quality of Life Index.

Authors

Author ORCID Identifier: Not provided in source.

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 Wisconsin Quality of Life Index for Adults Questionnaire (A-QLI) was initially published in 1996. The provided source material indicates that the instrument is available online at the University of South Florida website dedicated to the WQLI project. Users seeking detailed licensing terms, permission to reproduce the scale, or current fee schedules should contact the corresponding author, Marion Becker, Ph.D., directly.

The full instrument and further information can be accessed online: http://wqli.fmhi.usf.edu/wqli-instruments/.

Reference’s

Becker, M. A., Shaw, B. R., & Reib, L. M. (1996). Wisconsin Quality of Life Index for Adults Questionnaire (A-QLI). University of South Florida.

Items of the Wisconsin Quality of Life Index for Adults Questionnaire (A-QLI)

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

Wisconsin Quality of Life Index for Adults Questionnaire (A-QLI)

Marion A. Becker‚ Bret R. Shaw‚ Lisa M. Reib (1996)

[email protected]

It’s not complete instrument: please see source.

BACKGROUND INFORMATION (sample)

Sex‚ highest school grade‚ current marital status‚ racial/ethnic‚ religious affiliation‚ currently live with‚ current living arrangement‚ primary source of money‚

PHYSICAL HEALTH

The following questions refer to your health status. Please check (x) the most appropriate answer.

• In general‚ would you say your physical health is: Poor‚ Fair‚ Good‚ Very Good‚ Excellent
• Compared to one year ago‚ how would you rate your health in general now? Much Worse‚ Somewhat Worse‚ About the Same‚ Somewhat Better‚ Much Better

Please choose the answer that best describes how true or false the following statements are for you.

• Compared to others my age. my health is as good as can be expected. Definitely False‚ Mostly False‚ Not Sure‚ Mostly True‚ Definitely True
• I expect my health to get worse. Definitely False‚ Mostly False‚ Not Sure‚ Mostly True‚ Definitely True
• Do you take medication for your health? ______Yes ______No
• If yes‚ how many different medications do you take? __________

(Include all medications; over the counter‚ prescribed‚ herbal‚ etc.)

• Do you require help in taking your medications correctly? ______Yes ______No
• Are you bothered by side effects from your medications? ______Yes ______No

During the past four weeks‚ have your activities been limited in any of the following ways due to problems with your physical health? Yes; completely‚ Yes; limited a lot‚ Yes; limited some‚ Yes; limited a little‚ No; not limited‚ Limited the kind

• Limited the kind could do? of activities you
• Limited the amount could do activities you would like to do?
• Limited you in performing self-care?

The following questions are about activities you might do on a typical day. In the past four weeks‚ has your health limited you in any of the following activities?

All Days‚ Most Days‚ Some Days‚ Few Days‚ No Days

• Moderate Activities‚ such as moving a table‚ pushing a vacuum cleaner‚ bowling or playing golf.
• Lifting or carrying groceries.
• Climbing several flights of stairs.
• Climbing one flight of stairs.
• Bending‚ kneeling or stooping.
• Walking several blocks.
• Walking one block.
• Walking short distances. (e.g. around your house)

SELF-CARE

These questions refer to self-care tasks. Please check (3) the most appropriate answer.

During the past four weeks…

All Days‚ Most Days‚ Some Days‚ Few Days‚ No Days

• Did you need help from another person to take a bath or shower?
• Did you need help from another person to get dressed?
• Did you need help from another person to use the toilet?
• Did you need help from another person to eat?
• Did you need help from another person to get in or out of bed?

These questions refer to other important self-care tasks. Please check (3) the most appropriate answer.

During the past four weeks…

• Have you been able to go shopping for groceries without help?
• Have you been able to prepare your own meals without help?
• Have you been able to do your own housework without help?
• Have you been able to do your own laundry without help?
• Have you been able to use public transportation or drive your own car?

PAIN AND SYMPTOMS

• How much pain have you had during the past four weeks (check one)? Very Severe‚ Severe‚ Moderate‚ Mild‚ Very Mild‚ None
• During the past four weeks‚ how much has pain interfered with your normal activities? (check one): Not at all‚ Slightly‚ Moderately‚ Very much‚ Completely interferes
• Do you take pain medication? _____Yes _____No
• If yes: Is your pain controlled by the medication you take? Not at all‚ Some‚ Moderately‚ Quite a bit‚ Completely
• Do you use other measures to control your pain? _____Yes _____No
• If yes‚ what do you use?
• Overall‚ to what degree is your pain controlled? Not at all‚ Some‚ Moderately‚ Quite a bit‚ Completely
• Given the degree to which your pain is controlled‚ do you think something more should be done to help control your pain? _____Yes _____No

SOCIAL RELATIONS / SUPPORT

Very dissatisfied‚ Somewhat dissatisfied‚ Neither satisfied nor dissatisfied‚ Somewhat satisfied‚ Very satisfied

• How satisfied or dissatisfied are you with your relationships with family or friends? _____No family or friends
• How satisfied or dissatisfied are you with the amount of support you receive from family and friends?
• During the past four weeks‚ did you feel that your family or friends would be around if you needed assistance? Always‚ Often‚ Sometimes‚ Seldom‚ Never
• During the past four weeks‚ how often did you go to a religious activity (e.g. church‚ synagogue‚ etc.) or attend a community activity? _________________ (number of times)
• During the past four weeks‚ did your physical health limit your ability to socialize with family or friends? Always‚ Often‚ Sometimes‚ Seldom‚ Never
• During the past four weeks‚ did your emotional health limit your ability to socialize with family or friends? Always‚ Often‚ Sometimes‚ Seldom‚ Never

PSYCHOLOGICAL WELL-BEING

These questions are about how you have felt during the past four weeks. How much of the time. . .

All Days‚ Most Days‚ Some Days‚ Few Days‚ No Days

• Did you feel full of pep?
• Have you been nervous?
• Did you feel down in the dumps?
• Have you felt peaceful and content?
• Did you feel your life had purpose?
• Have you felt hopeful about the future?
• Have you worried about dying?
• Did you feel life was worthwhile?
• Did you feel in control of your life?
• During the past four weeks‚ have you experienced a major loss? Yes‚ No

Please indicate below if during the past four weeks your activities have been limited in any of the following ways due to emotional difficulties.

Yes; completely limited‚ Yes; limited a lot‚ Yes; limited some‚ Yes; limited a little‚ No; not limited

• Limited the kind of activities you could do?
• Limited the amount of time you could do activities you would like to do?
• Limited you in performing self-care or attending social activities?

Now we’d like to ask you about some other areas of your life. To what extent are you experiencing difficulty in the area of:

All Days‚ Most Days‚ Some Days‚ Few Days‚ No Days

• Managing day-to-day life (making decisions‚ handling money)?
• Getting enough sleep?
• Maintaining an adequate diet?
• Concentration‚ memory or confusion?
• Depression‚ hopelessness?
• Sexual activity?
• Mood swings?
• Drinking alcoholic beverages?
• Misusing drugs (including prescription drugs)?

OTHER ISSUES

Please choose the answer that best describes how true or false the following statements are for you.

Definitely False‚ Mostly False‚ Not Sure‚ Mostly True‚ Definitely True

• I spend time in activities that nourish my spiritual life.
• I am not interested in activities that nourish my spiritual life.
• I am satisfied with my spiritual life.
• I feel that I am treated with dignity and respect.

Very dissatisfied‚ Somewhat dissatisfied‚ Neither satisfied or dissatisfied‚ Somewhat satisfied‚ Very satisfied

• How satisfied or dissatisfied are you with your living arrangements?
• How satisfied or dissatisfied are you with the amount of privacy that you have?
• How satisfied or dissatisfied are you with the choices you have (e.g. control over time and your daily activities)?
• 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 QUALITY1 2 3 4 5 6 7 8 9 10 HIGHEST QUALITY

You have answered questions about areas of your health and quality of life. These areas are listed below. Please check (x) next to the three most important areas in which you would like to see improvement in your own life. Please read all areas before marking your se‎lections.

• Physical Health _____
• Social Relations _____
• Pain _____
• Daily Activities _____
• Social Support _____
• Diet _____
• Spirituality _____
• Self-Care _____
• Your Feelings (mood/or mental health)_____
• Substance Use (drugs/alcohol)_____

PERSONAL GOALS

• Please list below the three most important personal goals that you have for improving your life.
• Goal 1: ___________________________

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

• Goal 2: __________________________________

To what extent have you achieved this goal?

ot at all achieved 1 2 3 4 5 6 7 8 9 10 Completely achieved

• Goal 3: ___________________________________

To what extent have you achieved this goal?

Not at all achieved 1 2 3 4 5 6 7 8 9 10 Completely achieved