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Health-Related Quality of Life Scale
Measuring Mobility Toolkit > Measure Selector > Health-Related Quality of Life Scale
Health-Related Quality of Life Scale
Factor: Power and Autonomy
Age: Adult
Duration: 3-5 minutes
Reading Level: Effectively less than 6th grade if delivered verbally, since reading is not involved; 9th-12th grade if delivered in writing.
What
Developed by the Centers for Disease Control and Prevention, the Health-Related Quality of Life (HRQOL-14) scale has 14 items that give a complete overview of a person’s health and wellbeing.
Who
Researchers have used the HRQOL-14 in surveys that include Americans living on a low income and a diverse set of racial and ethnic groups, including White, Black, Asian (Vann et al., 2015), and Latinx (Brown et al., 2004).
How
INSTRUCTIONS
Researchers usually administer the Health-Related Quality of Life scale verbally, reading the questions aloud and writing down respondents’ answers.
The scale consists of three modules. The Core Healthy Days module contains one item that asks respondents to rate their general health on a 5-point scale (1 = excellent; 3 = good; 5 = poor). The module also has three items that ask respondents how many days their physical health was not good, their mental health was not good, and their health interfered with their daily activities.
Researchers compute an unhealthy days score by adding the number of physically unhealthy and mentally unhealthy days. The maximum score is 30 unhealthy days, even if the number of unhealthy days totals more than 30.
For example, 16 physically unhealthy days and 18 mentally unhealthy days makes 36 unhealthy days, but researchers would still record the score as 30 because there are not 36 days in a month. Researchers can also calculate a healthy days score by subtracting the number of unhealthy days from 30.
The Activity Limitations module contains five items. Scored using different response formats (see this Google document for instructions), this section asks respondents whether or not a health problem limits their daily activities, what kind of health problem limits these activities, how long they’ve been limited in their daily activities, and whether or not they need help completing their daily activities.
The Healthy Days Symptoms module contains five items that prompt respondents to indicate how many days they have felt different ways (e.g., “worried, tense, and anxious” or “very healthy and full of energy”). Researchers score each item separately.
RESPONSE FORMAT
This survey uses multiple response formats.
The Core Healthy Days Module subscale contains Q1. The answer format for this question is: 1 = excellent; 2 = very good; 3 = good; 4 = fair; 5 = poor.
The Core Healthy Days Module subscale also contains Q2, Q3, and Q4. The answer format for these questions is: 1 = number of day (fill in the blank); 2 = none.
The Activity Limitations Module subscale contains Q5. The answer format for this question is: 1 = yes; 2 = no.
The Activity Limitations Module subscale also contains Q6. The answer format for this question is: 1 = arthritis/rheumatism; 2 = back or neck problem; 3 = fractures, bone/joint injury; 4 = walking problem; 5 = lung/breathing problem; 6 = hearing problem; 7 = eye/vision problem; 8 = heart problem; 9 = stroke problem; 10 = hypertension/high blood pressure; 11 = diabetes; 12 = cancer; 13 = depression/anxiety/emotional problem; 14 = other impairment/problem.
The Activity Limitations Module subscale also contains Q7. The answer format for this question is fill in the blank.
To calculate the unhealthy days score for each participant, sum the number of physically unhealthy and mentally unhealthy days. The maximum score is 30 unhealthy days, even if the number of unhealthy days totals more than 30. To calculate a healthy days score, subtract the number of unhealthy days from 30.
Core Healthy Days Module
1. Would you say that in general your health is:
2. Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?
3. Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?
If you answered “none” to questions 2 and 3, skip question 4 below:
4. During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?
Activity Limitations Module
Instructions: These next questions are about physical, mental, or emotional problems or limitations you may have in your daily life.
5. Are you LIMITED in any way in any activities because of any impairment or health problem?
If the answer is no, skip to “Healthy Days Symptoms Module.”
6. What is the MAJOR impairment or health problem that limits your activities?
7. For HOW LONG have your activities been limited because of your major impairment or health problem?
8. Because of any impairment or health problem, do you need the help of other persons with your PERSONAL CARE needs, such as eating, bathing, dressing, or getting around the house?
9. Because of any impairment or health problem, do you need the help of other persons in handling your ROUTINE needs, such as everyday household chores, doing necessary business, shopping, or getting around for other purposes?
Healthy Days Symptoms Module
10. During the past 30 days, for about how many days did PAIN make it hard for you to do your usual activities, such as self-care, work, or recreation?
11. During the past 30 days, for about how many days have you felt SAD, BLUE, or DEPRESSED?
12. During the past 30 days, for about how many days have you felt WORRIED, TENSE, or ANXIOUS?
13. During the past 30 days, for about how many days have you felt you did NOT get ENOUGH REST or SLEEP?
14. During the past 30 days, for about how many days have you felt VERY HEALTHY AND FULL OF ENERGY?
Why It Matters
The Core Healthy Days subscale predicts mortality, hospitalization, and use of healthcare services (Moriarty, Zach, & Kobau, 2003). The HRQOL-14 can help health practitioners predict rates of various diseases, injuries, and disabilities in different communities (CDC, 2000), and assist them in offering better services.
For instance, surveys using the HRQOL-14 have shown that Americans without a high school education tend to have worse health than Americans with more education (CDC, 1998). Because disease and disability can make it hard for people to find and maintain employment, the HRQOL is valuable to measure in communities living on a low income.
HEADS UP
Though it is plausible that increasing health-related quality of life could contribute to mobility from poverty, no research has directly tested this hypothesis.
References
Brown, D. W., Brown, D. R., Heath, G. W., Balluz, L., Giles, W. H., Ford, E. S., & Mokdad, A. H. (2004). Associations between physical activity dose and health-related quality of life. Medicine & Science in Sports & Exercise, 36(5), 890-896.
Centers for Disease Control and Prevention (CDC. (1998). State differences in reported healthy days among adults — United States, 1993-1996. MMWR. Morbidity and Mortality Weekly Report, 47(12), 239-243.
Centers for Disease Control and Prevention. (2000). Measuring Healthy Days. Atlanta, Georgia: CDC.
Centers for Disease Control and Prevention. (2016, May). Health-related quality of life (HRQOL). Retrieved from: https://www.cdc.gov/hrqol/methods.htm.
Moriarty, D. G., Zack, M. M., & Kobau, R. (2003). The Centers for Disease Control and Prevention’s Healthy Days Measures – Population tracking of perceived physical and mental health over time. Health and Quality of Life Outcomes, 1(1), 37.
Vann, J. C. J., Hawley, J., Wegner, S., Falk, R. J., Harward, D. H., & Kshirsagar, A. V. (2015). Nursing intervention aimed at improving self-management for persons with chronic kidney disease in North Carolina Medicaid: A pilot project. Nephrology Nursing Journal, 42(3), 239-256.
