COMPREHENSIVE QUALITYOF LIFE SCALE – SCHOOL VERSION

(Grades 7-12)

FIFTH EDITION (ComQol-S5)

Robert A. Cummins
School of Psychology Deakin University

MANUAL 1997

Correspondence to: Robert A. Cummins Ph.D., F.A.P.S. School of Psychology Deakin University 221 Burwood Highway Burwood, Melbourne Victoria 3125 AUSTRALIA e-mail: robert.cummins@deakin.edu.au ISBN 0-7300-2726-0 Published by the School of Psychology Deakin University

3

Contents

1

Introduction
1.1 1.2 1.3 1.4 1.5 Measuring and defining quality of life The Scale Prior editions of the scale ComQol-S5 Summary

2

Administration
2.1 General information

3 4

Comprehensive Quality Of Life Scale (ComQol-S5) Calculation of results
4.1 4.2 4.3 4.4 4.5 Coding the objective data Coding the subjective data Data cleaning Dealing with data skew Forms of data analysis 4.5.1 For the practitioner or service provider 4.5.2 For the researcher 4.5.3 % SM: A standardised comparison statistic Individual SQOL diagnostic data tables

4.6

5

Theoretical Issues
5.1 5.2 5.3 5.4 5.5 5.6 Why use the ‘Delighted-Terrible’ scale? Should ‘not important at all’ be scored as 1 or 0? Should ‘mixed satisfaction/dissatisfaction’ be scored as 0? Why not score the satisfaction scale from +1 to +7? Why not use the Ferrans and Powers (1985) scoring system? Why not use the Raphael et al. (1996) scoring system?

6

Alternative Forms of the Scale
6.1 6.2 Parallel versions of the scale Additional domains

4

7

Psychometric Data
Study Codes 7.1 7.2 Objective means Subjective means 7.2.1 Importance sub-scale 7.2.2 Satisfaction sub-scale 7.2.3 Importance x Satisfaction Reliability 7.3.1 Cronbach’s alpha 7.3.2 Internal reliability 7.3.3 Test-retest reliability Validity 7.4.1 Content validity 7.4.2 Construct validity

7.3

7.4

8

References to the text

APPENDIX A: Psychotropic drug names APPENDIX B: Scoring ComQol APPENDIX C: Author publications

5

Acknowledgements
The author gratefully acknowledges comments and ideas which have contributed to this fifth edition from the following people: Christine Baxter, Eleonora Gullone, Marita McCabe, Shelley Reid, Dale Fogarty, Julie Cochrane. I am also greatly indebted to the students who have worked with me to produce many of the data presented in this manual. I thank Sheryl Monteath for her able assistance with data analysis for studies A6 and A7. I also thank Rai Sahib, Julie Asquith, Trudy Wallace, Natasha Cho and Betina Gardner for word-processing this document.

This scale has been designed in parallel forms suitable for any population sub-group. ComQol – S: The scale also contains features of construction which reflect contemporary understanding of the QOL construct. health. each axis being the aggregate of seven domains: material well-being. Cummins (1996a) has recorded well over 100 instruments which purport to measure life quality in some form. intimacy. Because of this. designed for use with people who have an intellectual disability or other form of cognitive impairment. It is also notable that many QOL instruments have been developed for highly selected groups in the population. even the more general scales which have been devised cannot be used with all sectors of the population. The details of test development have been published elsewhere (Cummins. Cummins. This is an important limitation since it means that the QOL experienced by such groups cannot be norm-referenced back to the general population. designed for use with adolescents 11-18 years who are attending school. safety. 1994). McCabe. 1991. particularly in regard to scales devised to monitor medical conditions or procedures. . the Comprehensive Quality of Life Scale (ComQol) has been developed. so it is perhaps not surprising that there is neither an agreed definition nor a standard form of measurement. This is not due to a lack of ideas.1 Measuring and defining quality of life The quality of life (QOL) construct has a complex composition. Definition The scale that follows is an operationalization of the following definition of quality of life: Quality of life is both objective and subjective. Objective domains comprise culturally-relevant measures of objective well-being.6 1 Introduction 1. productivity. Subjective domains comprise domain satisfaction weighted by their importance to the individual. However. they are unsuitable for use with the general population. and emotional well-being. but each one contains an idiosyncratic mixture of dependent variables. In order to remedy this situation. community. Those created for the general adult population cannot be used with some population sub-groups such as people with cognitive impairment and children. These forms are: ComQol – A: ComQol – I: designed for use with the general adult population. Romeo and Gullone.

7 1. and to what level of complexity. For example. and emotional well-being. (c) It can be used with any section of the population. place in community. These are: Material well-being. productivity.2. ComQol-S is for use with adolescent students. health. ComQol defines life quality in terms of seven domains which together are intended to be inclusive of all QOL components. The level of importance then provides an individualised weighting factor for each domain such that the subjective QOL measurement can be expressed as Importance x Satisfaction. For example. if a respondent is only able to manage the abstract task as a choice between two levels of importance. This latter scale incorporates a pre-testing protocol to determine whether. The scale is also multi-axial in terms of its subjective measures. Evidence for the adoption of these seven domains has been presented by Cummins (1996b. This pre-testing progressively moves responding from concrete to abstract. and ends with the use of a Likert scale involving the abstract conception of ‘importance’. A discussion of additional domains is provided in 6. 1997a). Each domain is separately rated in terms of its importance to the individual as well as on its perceived satisfaction.6. the largest block corresponds with the top of a printed ladder).g. they generally have a very poor relationship to one another. 1995). one large and one small block) and can progress to a maximum of five. Two parallel versions of the adult ComQol have been developed. The contemporary literature is quite consistent in its determination that.g. safety. The first is in the separate measurement of objective and subjective components.1). progresses to a task involving block size matching to a printed ladder scale (e. then they will be provided with a version of ComQol-ID where Likert scales are presented as a binary choice.2).6. people commence with a task involving choice between two types of response (e. respondents are able to use the scale. At each stage of this testing.2 The scale ComQol incorporates a contemporary understanding of the QOL construct. It is notable that importance and satisfaction generally are moderately positively correlated with one another (see 7. even though the precise nature of these components are somewhat conjectural (Felce & Perry. There is consensus within the field that the most useful measures of life quality must incorporate the separate components which comprise this construct. physical health and perceived health are poorly correlated (see 7. intimacy. This takes two forms. while both of these axes form a part of the QOL construct. The number of response choices successfully negotiated in the final abstract task is then used to determine the Likert Scale complexity to be used with ComQol-ID. It commences with an ordering task involving differently sized printed blocks. contains the following features: As such it (a) It is multidimensional. (b) It is multi-axial. while ComQol-I is designed for people who have an intellectual disability or other form of cognitive impairment. .

(d) The scale is psychometrically sound. (e) 1. . Fifth Edition The wording of subjective items has remained unchanged. No data are available on how this new item 3c performs. The purpose of this change was to increase the discriminative power of the objective domain scores.3 Prior editions of the scale Fourth Edition While the wording of the subjective items is essentially the same as in the third edition. This meant that each objective domain score was now free to vary from 3 to 15 instead of 3 to 9 as in the third edition.5% SM (Cummins. 1. more substantial changes were made to the wording of a number of the objective items. The rating scale for each objective item also increased from three-point to five-point. This was the only item that failed to display a significant intra-domain correlation in the fourth edition.4 ComQol-S5 This is a parallel version of ComQol-A5. Pre-testing therefore ensures that each respondent is provided with a level of Likert scale complexity which approximates their discriminative capacity. It is reliable. The sum of the domain scores for satisfaction can be referenced to the ‘goldstandard’ of 75 ± 2. the wording of several items has been simplified but the sense of the items has remained. where they do not understand the task. rather than a 5-point response scale. 1996b). Within the objective scale.8 The use of this process eliminates those respondents who do not have the cognitive capacity to respond validly to the scale. In all cases this involved a clarification or elaboration of the item rather than a total change in content. will often respond either at random or in a manner they consider will please the interviewer. Item 3c has been completely changed. valid and sensitive (see Section 7). since we have found this age group to experience no difficulty in using the more complex version. This is crucial given our understanding that people who are placed in a forced-choice situation. The satisfaction questions use a 7-point . stable.

SQOL = Σ (Domain satisfaction x Domain importance). Thus. These are indicated by an asterisk (*) 1. 7. To this end comments are welcomed. 2. . 4. The first edition was compiled in 1991. Note This fifth edition of ComQol can be viewed both as a research instrument and a standardised test. 1. • Each objective (OQOL) and subjective (SQOL) axis is composed of 7 domains. 3. 6.5 Summary This instrument is based on the following propositions: • Quality of life (QOL) can be described in both objective (O) and subjective (S) terms.9 Some items have been modified to make them appropriate for the target group. Material well-being Health Productivity Intimacy Safety Place in community Emotional well-being • The measurement of each SQOL domain is achieved by obtaining a satisfaction score of that domain which is weighted by the perceived importance of the domain for the individual. It is anticipated that several further editions will be produced as new data and ideas indicate ways that the scale can be improved. 5.

Whether one. Under normal conditions these two parts show little relationship to one another. If only subjective QOL is of interest then only this part of the scale needs to be used. Hence. . it should be emphasised that there is no time limit and that people may ask for assistance with any question that they do not fully understand. ComQol takes about 15-20 minutes to complete. as objective and subjective. or both parts of the scale should be administered is a decision to be made depending on the purpose of scale administration. The subjective section alone takes about five minutes to complete. This is consistent with the broader literature on QOL which clearly indicates the independence of objective and subjective variables.10 2 Administration 2.1 General Information The scale is intended to be self-administered. It should be noted that the instrument exists in two parts. If it is given in a group situation. the full administration of the scale yields two measures of life quality which are quite separate from one another.

The next two will ask how you feel about various aspects of your life. What is your date of birth? ______/______/______ day month year What is your sex? (circle one) Male Female .11 3 ComQol-S5 This scale has three sections. Please ask for assistance if there is anything you do not understand. The first will ask you for some factual information. Please answer all the questions and do not spend too much time on any one item. To answer each question put a (√) in the appropriate box.

please give the name of their job.12 Section 1 This section asks for information about various aspects of your life. *1(a) Where do you live? A house A flat or apartment Own A room (e. in a hostel) or caravan Rent Do your parents own the place where you live or do they pay rent? *b) How many clothes and toys do you have compared with other people of your age? More than most people About average Less than most people Less than almost anyone More than almost anyone *c) Father Mother If either of your parents has paid work. Please tick the box that most accurately describes your situation. _______________________________________________________ _______________________________________________________ 2a) How many times have you seen a doctor over the past 3 months? None 1-2 3-4 (about once a month) 5-7 (about every two weeks) 8 or more (about once a week or more) .g.

). health. hearing. physical.g. visual.13 b) Do you have any on-going medical problems? (e. Yes If yes please specify: Name of medical condition e. etc. Visual Diabetes Epilepsy Extent of medical condition Require glasses for reading Require daily injections Requires daily medication No _______________________ _______________________ _______________________ ___________________________________ ___________________________________ ___________________________________ (c) What regular medication do you take each day? If none tick box or Name(s) of medication (don’t worry if you get the spelling wrong) _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ .g.

how often does someone show they care for you? Usually Sometimes Not Usually Almost never Almost always . how often do you have nothing much to do? Usually Sometimes Not Usually Almost never Almost always (c) On average.14 3(a) How many hours do you spend on the following each week? (Average over past 3 months) 0 Hours work for pay (not counting pocket money) 1-10 11-20 21-30 31-40+ Hours at school or college Hours unpaid child care 0 0 1-10 1-10 11-20 11-20 21-30 21-30 31-40+ 31-40+ (b) In your spare time. how many hours TV do you watch each day? Hours per day None 1–2 3–5 6–9 10 or more 4(a) How often do you talk with a close friend? Several times a week Once a week Once a month Less than once a month Daily (b) If you are feeling sad or depressed.

15 (c) If you want to do something special. how often does someone else want to do it with you? Usually Sometimes Not Usually Almost never Almost always 5(a) How often do you sleep well? Usually Sometimes Not Usually Almost never Almost always (b) Are you safe at home? Usually Sometimes Not Usually Almost never Almost always (c) How often are you worried or anxious during the day? Usually Sometimes Not Usually Almost never Almost always .

go to question (c) If ‘yes’. Activity Number of times per month (1) (2) (3) Go to a club/group/society Meet with friend(s) Watch live sporting events (Not on TV) Go to a place of worship Chat with neighbours Eat out Go to a movie Visit family Play sport or go to a gym __________ __________ __________ __________ __________ __________ __________ __________ __________ ___________________________________ (4) (5) (6) (7) (8) (9) (10) Other (please describe) (b) Do you hold an unpaid position of responsibility in relation to any team. or society? Yes No If no. Indicate how often in an average month you attend or do each one for your enjoyment (not employment).16 *6(a) Below is a list of leisure activities. Group President. please indicate the highest level of responsibility held: Committee Member Committee Chairperson/Convenor Secretary/Treasurer/Team Vice-captain Captain. group. club. Chairperson or Convenor .

how often do you wish you could stay in bed all day Usually Sometimes Not Usually Almost never Almost always (c) How often do you have wishes that cannot come true? Usually Sometimes Not Usually Almost never Almost always .17 (c) How often do people outside your home ask for your help or advice? Quite often Sometimes Not often Almost never Almost every day 7(a) How often can you do the things you really want to do? Usually Sometimes Not Usually Almost never Almost always (b) When you wake up in the morning.

How important to you is WHAT YOU ACHIEVE IN LIFE? Could not be more important Very important Somewhat important Slightly important Not important at all . There are no right or wrong answers.18 Section 2 How Important are each of the following life areas to you? Please answer by placing a (√) in the appropriate box for each question. How important to you is YOUR HEALTH? Could not be more important Very important Somewhat important Slightly important Not important at all 3. Please choose the box that best describes how important each area is to you. How important to you ARE THE THINGS YOU OWN? Could not be more important Very important Somewhat important Slightly important Not important at all 2. 1. Do not spend too much time on any one question.

How important to you is HOW SAFE YOU FEEL? Could not be more important Very important Somewhat important Slightly important Not important at all 6. How important to you is YOUR OWN HAPPINESS? Could not be more important Very important Somewhat important Slightly important Not important at all . How important to you are CLOSE RELATIONSHIPS WITH YOUR FAMILY OR FRIENDS? Could not be more important Very important Somewhat important Slightly important Not important at all 5. How important to you is DOING THINGS WITH PEOPLE OUTSIDE YOUR HOME? Could not be more important Very important Somewhat important Slightly important Not important at all 7.19 4.

How satisfied are you with your HEALTH? Delighted Pleased Mostly satisfied Mixed Mostly dissatisfied Unhappy Terrible 3. How satisfied are you with your CLOSE RELATIONSHIPS WITH FAMILY OR FRIENDS? Delighted Pleased Mostly satisfied Mixed Mostly dissatisfied Unhappy Terrible . How satisfied are you with the THINGS YOU OWN? Delighted Pleased Mostly satisfied Mixed Mostly dissatisfied Unhappy Terrible 2. 1. How satisfied are you with what you ACHIEVE IN LIFE? Delighted Pleased Mostly satisfied Mixed Mostly dissatisfied Unhappy Terrible 4.20 Section 3 How satisfied are you with each of the following life areas? There are no right or wrong answers. Please ( √ ) the box that best describes how satisfied you are with each area.

How satisfied are you with YOUR OWN HAPPINESS? Delighted Pleased Mostly satisfied Mixed Mostly dissatisfied Unhappy Terrible .21 5. How satisfied are you with DOING THINGS WITH PEOPLE OUTSIDE YOUR HOME? Delighted Pleased Mostly satisfied Mixed Mostly dissatisfied Unhappy Terrible 7. How satisfied are you with HOW SAFE YOU FEEL? Delighted Pleased Mostly satisfied Mixed Mostly dissatisfied Unhappy Terrible 6.

Below $10.1 Coding the objective data The following information is relevant to the scoring procedures: Missing values: Score as 9 (then get the computer to recognise ë9í as denoting a missing value).$25.000 .22 4 Calculation of results 4. MATERIAL WELL-BEING 1(a) Accommodation: house + own flat/apartment + own house + rent flat/apartment + rent Room + either =5 =4 =3 =2 =1 (b) Possessions: More than almost anyone = 5 More than most people = 4 About average =3 Estimated income: More than $56.000 .000 .000 .999 Less than most people =2 Less than almost anyone = 1 (c) =5 =4 =3 $11.999 Below $10.000 $41. Estimated income: The average adult Australian full-time wage in February 1997 was $38.063 per year. Users in other countries will need to modify the scoring of income on a pro rata basis.999 Students People who are unemployed $11.$55.$40.999 =2 =1 An estimation of the above categories can be obtained from the following occupational groupings obtained from the Year Book Australia (1994) and Castles (1992).999 Laborers and related workers .$25.999 $26.

999 School teachers Paraprofessionals Clerks Drivers Personal service workers Salespersons Tradespersons Junior academics $41. profound deafness. eyeglasses) not likely to interfere with normal life activities or routines Constant. depression. diabetes.g. significant physical disability. migraines. blindness. Parkinson’s Disease. arthritis needing regular medication. asthma when nothing is recorded under medication. limb missing) .999 Legislators & government appoint officials Managers and administrators School principals Professionals Engineers & building professionals Social professionals Business professionals 56.g.g. infertility. arthritis when nothing is recorded under medication) Disability likely to restrict social activities (e. chronic condition that interferes to some extent with daily life (e.000+ Managing directors/General managers Medical doctors Senior academics HEALTH 2(a) Doctor None = 5 1-2 = 4 3-4 = 3 Farmers & farm managers Managing supervisors Artists & related professionals Technical officers Nurses Police Plant & machine operators/drivers 5-7 = 2 8 or more visits = 1 b) 5= 4= 3= 2= Disability or medical condition No disability Minor disability (e. arthritis. asthma needing regular medication. paraplegia.000-$40.23 $26. schizophrenia. heart condition. Alzheimer's disease.000-$55.

but in the latter stages score 2. Put them into these categories unless there is some information that tells otherwise. advanced multiple sclerosis. quadriplegia) Note It is sometimes difficult to choose between categories. score 3. but is able to answer the questionnaire scores 3. sedatives. PRODUCTIVITY 3a) Number of hours 31-40+ work.24 1= Major disability likely to require daily assistance with personal care (e. They include tranquilisers. psychoses. Some of these drug names are provided in Appendix A. but if they are completely deaf. barbiturates and a host of others. because once social activities become markedly restricted they would probably not be capable of completing the questionnaire. Assume that a person who has Alzheimers. and other abnormal mental states. severe psychiatric condition. If a person has mild deafness. Eg. multiple sclerosis or Alzheimers in the early stages would probably score 3. score 2. eg.g. education or child care = 5 21-30 hours combined work/education/child care = 4 11-20 hours combined work/education/child care = 3 1-10 hours combined work/education/child care = 2 Neither work nor education nor child care = 1 Spare time (Note reverse score) Almost always = 1 Not usually Usually =2 Almost never Sometimes =3 Hours TV each day None =5 1-2 hours =4 3-5 hours =3 b) =4 =5 c) 6-9 hours 10+ hours =2 =1 . c) Medication No regular medication = 5 Single non-psychotropic medication = 4 Multiple non-psychotropic medication = 3 Psychotropic medication = 2 Psychotropic plus non psychotropic medication = 1 Note Psychotropic medication indicates drugs for the control of epilepsy. severe cognitive or physical impairment.

.e.25 INTIMACY 4a) Talk Daily Several Once a week =5 =4 =3 Once a month =2 Less than once a month = 1 b) Care Almost always = 5 Usually =4 Sometimes =3 Activity Almost always = 5 Usually =4 Sometimes =3 Not usually =2 Almost never = 1 c) Not usually = 2 Almost never = 1 SAFETY 5a) Sleep Almost always = 5 Usually =4 Sometimes =3 Safe Almost always = 5 Usually =4 Sometimes =3 Anxiety (Note reverse score) Almost always = 1 Usually =2 Sometimes =3 Not usually = 2 Almost never = 1 b) Not usually = 2 Almost never = 1 c) Not usually = 4 Almost never = 5 PLACE IN COMMUNITY 6a) (i) Activity For each separate activity calculate 0.2 x frequency) for each activity up to a maximum frequency of 4/month. i.2 + (0. Each activity is scored to a maximum of 1.0.

people write: occasionally record “1” numerous “4” sometimes “1” seldom “9” (i. the maximum score possible is 5 Additional Comments (6) (7) (8) eat out movies other “take aways” .e.g: captain of basketball team. If rather than writing how many times in last month. tennis club or yacht club should come under (i)] put them under the category that seems most appropriate. [eg. convenor of a social group = 5 Treasurer/ Secretary or other title denoting specific major area of responsibility eg: Immediate past-president.exclude “watched videos” . missing value) weekends “4” b) Responsibility Chairperson/ President/ Convenor e.26 (ii) Aggregate the total scores across all activities up to a maximum of 5 activities. vice-captain = 4 Sub-committee chairperson or other indication of minor area of responsibility or active involvement eg: Responsible for catering arrangements = 3 Committee or team member = 2 If they say they hold a position but do not state what the position is = 1 None = 1 c) Advice Almost every day = 5 Quite often =4 Sometimes =3 Not often =2 Almost never = 1 . Round all fractions to the nearest integer. i.e.exclude people sometimes write something that should come under one of the previous categories.

27 EMOTIONAL WELL-BEING 7a) Can do Almost always = 5 Usually =4 Sometimes =3 Bed (reversed scored) Almost always = 1 Usually =2 Sometimes =3 Wishes (reversed scored) Almost always = 1 Usually =2 Sometimes =3 Not usually = 2 Almost never = 1 b) Not usually = 4 Almost never = 5 c) Not usually = 4 Almost never = 5 .

28 4. the satisfaction data need to be re-coded as follows: Delighted +4 Pleased +3 Mostly Satisfied +2 Mixed +1 Mostly dissatisfied -2 Unhappy -3 Terrible -4 Following this recoding procedure each SQOL domain score is calculated as (IxS). and not included as data. In particular. 1 percent of subjects . As a result of this procedure the SQOL obtained for any domain ranges between -20 and +20. the data for each subject can be visually scanned to detect patterns of response that are consistently at the top of either the importance or satisfaction scales over the seven domains. (a) (b) An analysis of response frequency data for each variable will allow the determination that the computer is recognising '9' as a missing variable. and the overall SQOL = (IxS). 4.3 Data cleaning It is recommended that the raw data files be carefully examined prior to the implementation of analytic procedures. If a table of raw data is examined.2 Coding the subjective data IMPORTANCE Could not be more important 5 Very important 4 Somewhat important 3 Slightly important 2 Not at all important 1 Missing value 9 SATISFACTION Delighted 7 Pleased 6 Mostly Satisfied 5 Mixed 4 Mostly Dissatisfied 3 Unhappy 2 Terrible 1 Missing value 9 Note We use the score of 9 to allow computer identification of missing values. IMPORTANCE x SATISFACTION In order to calculate a meaningful subjective QOL (SQOL) score (Importance x Satisfaction) for each domain. care needs to be taken that these ‘9’ values are recognized as excluded values. In study A6 (see ComQol A5 Section 7) which included 794 adults. See Appendix B for a more detailed description. If this scheme is used.

and (b) the power of importance to weight the satisfaction scores is reduced. 4.2. In my experience of checking the effects of transformation when applying multivariate statistics. . both with and without transformation. I recommend that the data not be transformed for the following reasons: 1. For the objective QOL this involves a sum of the three component scores for each domain.1 For subjective QOL the domain scores are obtained by (Importance x Satisfaction) following the recoding of Satisfaction as described in 4. While this procedure does achieve a somewhat reduced coefficient of variation (mean/standard deviation) it is not recommended for two reasons as: (a) It does not seem to improve the data sensitivity to between-group differences.5 Forms of data analysis Note: For a step-by-step scoring procedure see Appendix B.4 Dealing with the data skew Both the importance.29 recorded this type of response. 4. the influence is very small. We have attempted to reduce this by adding (I + S). 4.1 For the practitioner or service provider The most useful level of analysis is in terms of domain scores.2 and the construction of individual diagnostic tables are described in 4. Reference data are available in section 7. satisfaction. Reference data are provided in Section 7. the most appropriate transformation is reflect and square root.5. Such data are excluded prior to analysis since they provide no variance and likely reflect a response set.5. Opinion is divided among statisticians as to whether this procedure is appropriate. A related issue concerns the increased intra-group variance that is created by forming a product of importance and satisfaction. and I X S data are typically moderately negatively skewed. Authorities such as Tabachnick and Fidell (1996) recommend against transforming data which are known to be naturally skewed. To restore normality. 2.

This cannot be made directly since importance has been scored on a 5-point scale and satisfaction on a 7-point scale. It has been found that importance and satisfaction are often fairly independent and their separate variation is likely to be of interest to any investigation of the QOL construct (see 7. The formula is as follows: % of scale maximum = (Score -1) x 100/(number of scale points -1) EXAMPLES Importance coded +1 to +5 For example.2 For the Researcher The most useful level of analysis may be at the level of the domain for all three axes. with an importance score of 4. 4.2) The calculation here requires a modified formula as: (a) POSITIVE S scores use: % sm = (b) [ (score -1) +3] x 100/6 NEGATIVE S scores use: % sm = [ (score +1) + 3] x 100/6 .5.2-1) x 100/(7-1) = 70% Satisfaction coded -4 to +4 (see 4. The comparison can be achieved by converting each to a statistic which reflects the extent to which a score approximates the maximum score which could be obtained. Note: Group I x S statistics must be based on individually calculated I x S scores.6.2 and a 7-point scale % scale max = (5. objective.0 and a 5-point scale % scale max = (4-1) x 100/(5-1) = 75% Satisfaction coded +1 to +7 For a satisfaction score of 5.5.3 % SM: A standardised comparison statistic In some circumstances it may be useful to compare the relative extent of importance and satisfaction which has been expressed in relation to a domain. importance and satisfaction.30 4.2).

c) d) An interpretation of this statistic can be made using the Cummins (1995a) paper which brought together previously published studies on overall life satisfaction.2. Section 7. The I x S score is then a standardised measure of domain quality for each client with a range +20 to -20. It reported an average 75. POSITIVE I x S scores use the formula: % scale maximum = [(score -1) + 19] x 100/38 NEGATIVE I x S scores use the formula: % scale maximum = [(score +1) + 19] x 100/38.6 Individual SQOL diagnostic data tables The following table is an example of how ComQol can be used as a diagnostic instrument for the individual.2 reports life satisfaction data using ComQol.31 Importance x Satisfaction scores For an I x S score to be expressed in this way: a) b) The S score must be recoded on a +4 to -4 scale (see 4.5 % sm. 4.0 ± 2. Each importance and satisfaction rating has been scored according to Section 4.2) Any I x S score of -1 to +1 is converted to +1 (note this is the midpoint of the recoded satisfaction scale). .

81 + 4.70 Satisfaction (S) (Coded -4 to +4) 4 1 4 3 -4 4 1 -3 2 -4 0.78 + 6.32 Table 1 Example of a client diagnostic table Material well-being Importance (I) (Coded +1 to +5) 2 3 5 1 5 5 5 3 3 5 3.35 11.8 A6 2.90 + 4.6 8.9 4.62 + 6.45 + 5.04 + 4.31 8.00 + 5.9 7.8 5.09 From the above table it can be seen that the reference group had a strong tendency to score above the scale mean of zero.44 + 4. Consequently.34 9. It can be seen that fewer than 9% of the samples obtained a negative IxS on any domain.9 2.66 7. .6 An interpretation of the above data can be made in relation to the following studies (see 7. in ComQol A5 for study descriptions).65 7.36 + 6.1 7.23 8.14 + 5.1 1.04 4.0 3.82 8.85 + 7. the presence of a negative IxS score is indicative of a poor quality domain for that person.98 + 6.50 9.92 7.D.04 10.6 3.97 + 5. In summary form the I x S results were as follows: IMPORTANCE X SATISFACTION (Coded +1 to (Coded -4 to +4) Domain Study Material Health Productivity Intimacy Safety Community Emotion % of Negative I x S Scores A1 + A2 2.4 5.29 7.6 4.8 2.51 + 6.80 Client 1 2 3 4 5 6 7 8 9 10 Mean IxS 8 3 20 3 -20 20 5 -9 6 -20 1. A1 + A2 A6 8.5 Mean + S.09 8.

for the purposes of using importance as a weighting factor. 3.1 Why use the ‘Delighted-Terrible’ scale? A major problem with QOL data is their tendency to cluster at the favorable end of any scale. Thus. Certainly they can be independently experienced.33 5 Theoretical issues 5. 2.2 “Should ‘not important at all’ be scored as 1 or 0” The importance score is used as a weighting for satisfaction (I x S) as indicated below. it would be preferable to score 'no importance at all' in a neutral way rather than in a canceling way. where only five points span the continuum of 'importance'. It might be argued that no domain could actually have a zero importance since all domains form a part of each person's continuous life experience. 5. this will not prevent the experience of being satisfied or dissatisfied in this domain. then. This allows the lowest rating of importance to have no weighting influence on the measure of satisfaction. Thus. a score of '1' is preferable to a score of '0'. even if one's material things are 'not important at all'. In logical terms this could be reasonable. This notion would be consistent with the very gross nature of the scales. Andrews & Withey (1976) have reported that the D-T scale creates a more pronounced spread of upper-end results than does the more conventional scale of 'Extremely satisfied' to 'Extremely dissatisfied'. . people who respond 'no importance at all' do still respond to the satisfaction scale. This indicates that levels of satisfaction may be experienced even though the respondent regards the domain as having no importance. It also has the advantage of allowing a greater range of I x S scores in the lowest range. Consequently if 'not important at all' was scored as '0' then the product with any S score would also be zero. There are several possible reasons for this findings as: 1. Importance and Satisfaction are largely independent constructs. However. then of 'not important at all' is of very low importance. If this argument is accepted. if a domain really does have no importance then the level of satisfaction is irrelevant and the I x S product should always be zero. The real meaning.

but not entirely eliminated. In this way the importance ‘weighting’ score would remain uninfluenced by the rating on satisfaction.4. By constructing the scale as it is. -2.4 “Why not score the satisfaction scale from +1 (Terrible) to +7 (Delighted)?” If this system was to be adopted then the I x S score interpretation would be ambiguous. It would mean the negation of any assigned score of importance and. +1. 5. -3). these ambiguities have been reduced. IxS. thereby. they are contrived approximations which are dependent on the assumption of an equal degree of psychological separation between the response points. or by 'A little bit important' x 'Somewhat happy' ( 2 x 2). and the response point on either side depicts the addition of one additional unit. or high I and low S (dissatisfaction).3. yield 50% scale maximum. (+2. For example. it would have the disadvantage of creating a zero I x S combination whenever a 'mixed' level of satisfaction was recorded. 0. One problem with this approach may be seen in terms of the mathematical logic of the resultant interval scale around the point of neutrality i. This system would create a more reasonable interval scale around the midpoint i. a score of +4 could be generated by either 'Not important at all' x "Pleased" (1 x 4). (+3. a response of ‘mixed’ satisfaction does not imply zero satisfaction. +1. It is clear that this cannot be a true interval scale. It also loses the meaning of the data.3 “Should ‘mixed satisfaction/dissatisfaction’ be scored as ‘O’?” If this was adopted. for most purposes of the scale this would not be necessary.e. the loss of discriminative data. See also the scoring of I x S (section 4. . Rather it implies a neutral level of satisfaction/dissatisfaction for which a score of ‘1’ would be more appropriate.-1. then the scale on either side could be scored (+1. Likert scales cannot conform to the strict logic of interval scales. While these could be distinguished by examining the raw data. The meaning of a zero I x S score in this context is unclear.34 5. the distinction between response satisfaction and dissatisfaction is made unequivocal by the adopted scoring system of +4 to 4.e. b) in which scores of -1 and +1 are treated as being equivalent and if substituted in formulae c and d. +2. For example. -1). However. -2). However. a score of +4 could be the combination of either low I and high S. In this case the point of neutrality (scale mid-point) is conceived as encompassing the range (+1-1). More importantly.

3. +1. 1 x 4. 3 x -4 - IxS Score 10 9 8 7 6 5 4 3 2 1 Possible Combinations Positive Negative 5x2 5 x -2 3x3 3 x -3 4 x 2. +1 -2.-2. +2. 3 x 4 4 x -3. Importance is scored +1 to +6.5 from each one. ie.5 +4 +.5 +3 -. and the lowest score for high dissatisfaction/high importance responses.If scores were not recoded. +3. a person who was very dissatisfied with an area of high importance would .5 “Why not score the satisfaction scale according to the procedure of Ferrans and Powers (1985)?” These authors use an alternative system to ComQol. 5. +3. 2 x -2 3 x 1. They claim: "This adjustment (recode) produces the highest score for items that have high satisfaction/high importance responses. 1 x 2 1 x -2 1x1 - Possible importance scores are +1. +4. Their procedure is as follows: 1. Satisfaction is scored +1 to +6. 2 x 3 3 x -2. -3. 3.5 +5 +1. --.5 +2 -1. -4 The above table is essentially symmetrical between the positive and negative combinations with the exception of I x S scores of 4. 2 x 2 1 x -4.5 +6 +2. but it seems to have no advantages.5 Importance is then multiplied by recoded S and 15 added to the product. 2 x -3 5x1 4 x 1. 1 x 3 1 x -3 2 x 1. +2. Original: Recode: 4. 2 and 1 which demonstrate a reduced number of negative combinations. The Satisfaction scores are recoded by subtracting 3. 2 x -4 3 x 2. 2.35 The possible combinations of I and S scores are as follows: IxS Score 20 19 18 17 16 15 14 13 12 11 Note (a) (b) (c) Possible Combinations Positive Negative 5x4 5 x -4 4x4 4 x -4 5x3 5 x -3 4 x 3. 2 x 4 4 x -2. +5 Possible satisfaction scores are +4.

5 0 Possible combinations 6 x 2.5 2 x -2.5 2 x 2. The F & P distribution is symmetrical around the mid-range score of 15. 5 x -.5 1 x 2. The ComQol distribution is 2. 3 x -.5.5 12 10.5 18 17.5 4 x 1.5 4 x -2.5. 6 x .5. 3 x .5 4 x -.5 5 x -2.5 21 20 19.5. however.5 6 x -1. the I x S score combinations lying just below the mid-range are less ambiguous in the case of ComQol.5 2 x .5 1 x -2.5." (p. 5 x 1. while the ComQol distribution shows a reduced number of negative combinations due to the absence of -1 as a recoded satisfaction score. The form of each distribution is roughly equivalent.5 6 x 1.5 2 x -. .5) obtained through the use of the Ferrans & Powers formula are as follows: IxS Score 30 27. 18) In fact.5 1 x -1. in terms of their composition.5. 5 x -1.5 17 16. is greatest in both distributions just above the mid-range.5 4 x 2.5 13 12.5 3 x 2. over a range of three integer units in the F & P distributions.5 3 x -2. The area of maximum I x S score ambiguity.5 3 x -1.5 4 x -1. 3.5 10 9 7.5 IxS Score 14.5 4 x .5 Possible combinations 1 x -. For example.36 receive the same item score as a person who was very satisfied with an area of low importance.5 2 x -1. Thus.5 1 x 1. 5 x .5.5 5 x 2.5 14 13. their recoding procedure does not eliminate this problem.5 to 2.5 6 5 2.5.5 6 x -2.5 1 x .5 2 x 1. eight I x S combinations are represented. 1. from scores of 12 to 14.5 A comparison of the above distribution with that previously provided for ComQol yields the following observations. with combinations bunching around the mid-point.5 25 24 22.5 16 15. 6 x -.5 3 x 1. The possible I X S scores (recoded -2.

the possible scores are: 5 Importance: Satisfaction: 1. The possible range of values is +3. Conclusion The Ferrans and Powers formula is not superior to the simpler ComQol recoding procedure. -1. Both distributions produce a few I x S combinations which are very ambiguous indeed. The authors state “This is consistent with our conceptual thinking that moderate enjoyment of an aspect of life should result in a ‘neutral’ QOL score. 0. 2 3 Conclusion This dual transformation of both importance and satisfaction data has no advantages over the ComQol procedure. The relative weighting by importance is thus reduced. whether it is important or not. (1996) scoring system? These authors have devised the 54-item Quality of Life Profile which also uses satisfaction (scored 1-5) weighted by importance (scored 1-5). 4. 4 1. 2 0.67. For example. See 5. Their formula is: QOL = (Importance score/3) x (satisfaction score -3) Thus. A satisfaction score of 3 leads to a QOL = 0 regardless of the importance score.67.369). This seems an awkward range to deal with.33.” (p.37 marginally less ambiguous with seven I x S combinations over an equivalent score-range of 2 to 4.3 for comment. . 1 0.33 to -3.33. 3 1. 5.6 Why not use the Raphael et al. 1.33 -2 The following observations can be made: 1 The differential weighting of adjacent items is reduced from ‘1’ in ComQol to 0.33.5 in the F & P distribution could be the combination of either 'lowest I x highest S' or 'second-highest I x mid-range S'. an I x S score of 17. An equivalent degree of confusion is provided by the ComQol I x S score of 4. 2.

This has been designed for people who have an intellectual disability or other form of cognitive impairment. stepwise multiple regression procedure where each (IxS) domain is regressed against the total subjective (IxS) score it has been determined that. However. productivity). if not all activities involving others may be considered useful. And as soon as some qualifier is introduced. It is concluded that it combines elements of both productivity and place in community. a major consideration in this regard is the amount of additional unique variance accounted for by the addition of new domains. It certainly includes all of the terms listed under Productivity. 2. their addition would be for the purpose of investigating the specific domain in question rather than contributing variance to the total subjective QOL score. This has been designed for the general adult population. such as ‘quality leisure’.1 Parallel versions of the scale ComQol has been designed to have three parallel versions. It is available as a separate manual. this does not apply to leisure. However. it also severely overlaps with Place in Community. 6. The additional domains that have been considered so far are as follows: 1. . it immediately overlaps with other domains (e. Unlike the other domains where generally ‘more is better’.2 Additional domains The ComQol scale can be modified through the addition of other domains. In addition to ComQol-S5 there are: ComQol-A5. LEISURE: This is a slippery concept. the seven domains are probably adequate to measure overall subjective QOL. USEFULNESS: In some ways this is a better term for Productivity. It is available as a separate manual.38 6 Alternative forms of the scale 6. Using an internal. around 80% of the variance is shared and each domain contributes only 1 to 3% of unique variance (Cummins. Thus. using the seven standard domains. in that most. To date three modifications of this type have been considered using ComQol-A and these will be described. in preparation).g. It is concluded that leisure is subsumed within emotional well-being. While other domains are able to contribute unique variance. ComQol-I5.

8 + 1.2 + 0.2 + 1. Conclusion The seven original domains are sufficient to measure subjective QOL for most purposes.4 + 1.3 79.8 67.4 IXS 7.9 72.3 62.6 + 5. Spiritual well-being may be usefully added as an eighth domain if the population under investigation is highly spiritual/religious or if this particular aspect of the QOL construct is to be examined.8 70. The main issues and findings to emerge are as follows: (a) About one-third of Australian people have neither religion or spirituality.8 + 1. A9.4 3.6 + 5.8 70. A10.2 + 1. This introduces a complication into the subsequent analysis.5 8.3 55.39 3.0 (%sm) 69.3 Unique1 Variance 4% 3.8 9.6 76.0 + 5.1 5.4 (% sm) Satisfaction 59.3 3.0 77.2 73.8 4% A7 Young Mid-age Older TOTAL 1 These estimates of unique variance have been calculated on combined sample data using an 'internal' form of multiple regression.7 + 1.3 71.9 (% sm) 71.6 + 1.0 70. A14).3 3. The square of the semi-partial correlation for each domain yields its unique variance.5 11.0 5.4 2. where each domain is regressed against the total [ (IxS)] score.8 + 1. Thus.6 + 5. “How satisfied are you with your religion or spirituality?”.1 69. and.4 + 1.3 5. In each case only the subjective axis has been explored using “How important to you are your religious or spiritual beliefs?”.0 5.item responses.1 5. the ‘satisfaction’ question must be preceded by a statement which gives respondents a choice of answering the item or not. the resultant data set for satisfaction comprises a mixture of 7. As a consequence of this.4 8. SPIRITUAL WELL-BEING: Four studies have experimented with the inclusion of this domain (A7. The data obtained are as follows: (b) Study A9 Sample Farmer Ex farmer Metro TOTAL Importance 2. .1 + 6.2 + 1.7 + 1.0 5. the domain of spiritual wellbeing adds only a small amount of unique variance when added to the usual seven domains.8 + 7.6 77. As with the other domains (see above).and 8.1 11.3 69.

8 5.0 77.2 5. Friends = 1.6 + 0.1 + 0. 1996b). Note The intimacy domain is normally rated as higher than the other domains in terms of both importance and satisfaction.9 + 1.8 4.7 + 6.6 4. the use of two 'intimacy' domains as family and friends will bias the aggregate [ (I x S)] such that it may be higher than the normative value of 75 ± 2.4 80.9 + 6. FAMILY AND FRIENDS: The fourth domain is normally stated as a combined source of intimacy involving ‘family and friends’.7 82. Consequently. under some circumstances it may be desirable to obtain separate ratings for each component.4 + 4.0 10.7 % sm 77.8 11.1 + 4. their average combined score is used in combination with the other six domains when calculating SQOL.0 68.8 (% sm) 75.2 12.3 + 0.5 Satisfaction 5.9%.5 79.1 (%sm) 76.5%.5 %SM (Cummins.40 4. the amount of unique variance contributed by each domain was: Family = 2.5 + 1.1 5.6 78. This is recommended for normal use. It is therefore recommended that.2 + 0.7 Study A10 A11 Using an internal multiple regression.7 3.3 81.7 + 0. when two separate domains of family and friends are employed.6 73. .7 + 0. However.3 76. Our data on this separation are as follows: Sample Youth Elderly (Family) (Friends) (Family) (Friends) Importance 4.8 IXS 10.

3 ± 12.8 . 1997.4 72.8 ± 13.24 6.0 52. (Bearsley. behavioral.18 9. or family problems (N=82).02 6.8 ± 14.16 12.09 + 2. The sample was drawn from 7 schools in metropolitan Melbourne and comprised 52.9% females.2 ± 4. ‘community school’ students with a high frequency of emotional.3 ± 5.01 8.02 + 1. 264 adolescents aged 14.34 + 0.3 ± 5. Study S1: (Gullone & Cummins. learning.9 26.6 years (range 12 to 18 years) completed ComQol-S3.43 + 1.8 ± 3.2 ± 5. 57. 1998. 524 adolescents aged 15. Fourth edition).29 11.8 years (range 1417y).16 + 1.5 25.19 8.4 45. Third edition).41 7 Psychometric data Study Codes The data to be reported have been drawn from the following studies: Note Additional psychometric data on adults is available from the ComQol-A5 manual.42 + 1.1 48.80 + 2. Study S2: 7.73 + 2.9 75.68 % sm 45.2% female comprised three groups as: (a) homeless and ‘at risk’ of homelessness (N=105).1 Objective means Study S1 Material Health Productivity Intimacy Safety Community Emotion MEAN 8. and non-homeless secondary school students (N=337).

6 ± 16.4 ± 10.3 ± 14.3 65.24 11.22 ± 0.3 ± 10.1 ± 17.6 ± 12.8 54.3 69.3 77.4 ± 24.4 78.2 Satisfaction (coded -4 to +4) Study S1 Raw Material Health Productivity Intimacy Safety Community Emotion MEAN 2.9 ± 16.84 2.3 ± 15.8 ± 9.16 ± 0.5 70.6 Material Health Productivity Family Friends Safety Community Emotion MEAN Study 2 % sm 74.0 70.2 ± 18.0 ± 15.5 58.1 7.4 ± 19.8 ± 7.2.74 2.5 ± 16.5 67.33 ± 0.69 8.89 ± 0.6 71.59 ± 4.2 ± 17.1 71.17 ± 6.4 66.0 70.2 73.61 + 0.89 2.8 72.9 71.9 ± 15.5 ± 16.4 73.2 ± 12.18 ± 0.34 ± 6.79 % sm 71.48 9.4± 19.35 10.12 ± 7.0 ± 13.8 ± 17.4 71.5 72.9 Material Health Productivity Family Friends Safety Community Emotion MEAN Study S2 % sm 66.2 72.4 Material Health Productivity Family Friends Safety Community Emotion MEAN Study S2 % sm 78.2 70.0 ± 15.2 76.89 ± 6.75 1.5 72.5 75.9 ± 13.9 7.78 3.84 4.91 + 0.16 + 0.80 + 0.5 72.67 ± 7.42 7.4 70.16 8.6 71.65 + 0.7 ± 12.7± 21.9± 18.3 ± 17.6 78.1 Importance (coded +1 to +5) Study S1 Raw Material Health Productivity Intimacy Safety Community Emotion MEAN 3.5 ± 16.3 Importance x Satisfaction Study 1 Raw Material Health Productivity Intimacy Safety Community Emotion MEAN 9.7 72.89 2.85 2.0 ± 19.7 ± 23.84 3.2.5 ± 11.06 + 0.59 ± 0.3 ± 15.74 ± 8.80 3.3 78.98 4.8 ± 15.8 70.2 Subjective means 7.4± 16.6 ± 16.3 ± 11.2 73.79 + 0.89 9.33 + 0.8 ± 14.29 7.7 72.7 74.8 69.6 ± 10.8 72.8 ± 11.54 % sm 66.9 71.6 68.82 3.0 69.2.7 ± 15.1 .1 72.25 ± 0.06 ± 6.2 ± 10.7 ± 22.2 76.5 ± 10.2 ± 10.9 ± 18.3 ± 11.9 ± 9.1 ± 18.8 72.85 3.7 ± 18.29 ± 0.76 2.2 64.55 % sm 72.4 ± 16.3 77.2 79.

and (3) it decreases moderately as the item communalities increase. Boyle quotes Hattie (1985) as “alpha can be high even if there is no general factor. He concludes that there is an optimum range of internal consistency/item homogeneity if significant item redundancy is to be avoided.3 to 0.2 Internal Reliabilities (Cronbach alpha) SUBJECTIVE Importance Satisfaction Importance x Satisfaction Study S1 . 3)..81 . with item intercorrelations lower than about 0.. sub-scale alphas will be sought in the range 0. 7..7. 1578).7). Such a test would have only low internalconsistency reliability. on the other hand. (2) it increases as the number of factors pertaining to each item increases.80 .3. suggests that the test is too narrow and too specific.43 7.3) For the purpose of evaluating ComQol. the results would be high internal consistency and very low validity. A higher correlation than (0. If one constructs items that are virtually paraphrases of each other.3 Reliability 7..” (p. is obtained where test items do not all correlate with each other.3 “each part of the test must be measuring something different.1 Cronbach’s alpha Boyle (1991) and Cortina (1993) strongly condemn the ‘classical’ psychometric belief that high alphas are better in terms of intra-scale reliability.76 .” (pp. since (1) it is influenced by the number of items and parallel repetitions of items..3.” Kline also states “maximum validity. p. According to Kline (1979. but where each correlates positively with the criterion..

feel safe at home . choose activities g(2) Freq.47 .04 . activities f(2) Extent comm. resp.23*** .77*** . . PRODUCTIVITY c(1) Hours per week c(2) Time on desired goals c(3) Things made.09 .58*** .44 OBJECTIVE Alpha Domain vs total objective subscale correlations Intra-domain correlations vs Item (1) vs Item (2) Item vs total domain score correlations A.62 .25*** Note Alpha for the objective sub-scale comprising the seven domain scores is .04 .73*** .67*** .17*** .34*** .42*** .14* . .09 .77*** .04 .32*** .67*** .02 .68*** . wish to stay in bed .43** .19*** . INTIMACY d(1) Freq. .41*** . MATERIAL a(1) Income a(2) Number of possessions a(3) Standard of accommod.06 .66*** . HEALTH b(1) Number visits to doctor b(2) Extent of disability b(3) Severity of medication .76*** .05 ** p < 0.18** C.17 . anxious duríg day e(3) Freq.13** .43*** .001 . etc.73*** . impossible wishes g(3) Freq.36*** E.33*** .36*** .91*** . easily fall asleep e(2) Freq. Alpha for the sub-scale comprising the 21 individual objective items is 0.23*** . others care when depressed .01 *** p < 0.29*** .03 .27*** .23*** .05 .48*** .38*** .52 .38*** .30 .61*** .07 F. talk to friends d(2) Freq.79*** . COMMUNITY f(1) Extent comm.02 . EMOTION g(1) Freq.39.47 * p < 0. SAFETY e(1) Freq.07 B.13** D. joined in activities d(3) Freq. f(3) Extent valued by comm.09 .24*** G.

It was found that their combination could be described by 75 + 2.5%SM. Cummins (1996b) demonstrated that. of 173 different domain-satisfaction names drawn from the literature. and the Fear Survey Schedule for Children . 68% of the names and 83% of the data they represented could be grouped under the 7 ComQol domains.49 .85 .II (FSSC-II.58 . From this it is concluded that content validity has been established and also that the data derived from the 7 domain satisfaction scores can be compared against the normative standard of 75 + 2.83 .40 .50 . Moreover.74 Sat .5%SM.68 . The correlations with ComQol domains were: .73 IxS .3 Test-retest Reliability Study SI: One week Objective Imp Material Health Productivity Intimacy Safety Community Emotion TOTAL .0%SM. 1985).64 . Gullone & King.4 Validity 7.70 .60 .63 .88 .1 Content validity The major validity data have been published as follows: Cummins (1995a) combined the data from 16 studies that measured ‘life satisfaction’ among large samples drawn from the general population.73 .56 .4.45 .59 .66 . 1992). when the data grouped under the 7 domains were combined they yielded an average of 73.60 .79 7. It was proposed that this statistic.2 Construct validity Study SI: Used the Revised Children’s Manifest Anxiety Scale (RCMAS: Reynolds & Richmond.48 .80%SM could be considered as the gold standard for Western populations.74 .60 .54 .76 . 1998). 7.3.40 .66 .51 .6 + 3. This statistic has subsequently been elaborated to include non-Western populations (Cummins.40 .56 .45 7. and the implied normative range of 70 .62 .4.

N.2 ± 9. emotion. Study S2: Used the Life Attitude Profile .47) with safety. emotion.1%SM) and the nonhomeless community school adolescents (67.45).13 to -. choice and responsibleness (. . Imp x Sat :Anxiety . F (2.28) with safety and emotion. 7.16). safety.280) = 10.32) with material.5%SM).3 ± 17. The non-homeless adolescents had a higher mean score (see 7.61).inverse correlations (-.46 Objective :Anxiety . existential vacuum (-. community.15 to -.3) than both the homeless and ‘at-risk’ adolescents (60. :Fear . goal seeking (.01).inverse correlations (-.5 Sensitivity Study S2: Subjective QOL was compared across the three groups. and total score.48).001. health. and intimacy. 1992) to demonstrate the following relationships with SQOL across the whole sample: Personal meaning (. :Fear . p <0. health.inverse correlations (-.2. death acceptance (-.14 to -.689.S.Revised (Reker.

12.O. & Withey S. G. (1992). M. Social indicators of well-being: Americans' perceptions of life quality. J. & Donato. Recker. 78. (1992).R. E. D. B. Life Attitude Profile-Revised. 139-164. & Powers. 987998.Adolescent version: Background.J. Kline. School of Psychology. (1985). Hattie. Journal of Applied Psychology. 33. Cortina.104. and initial validation. 9. E. 19. London: Academic Press. 291-294. Quality of life index: Development and psychometric properties. C.B. E. J. P. Quality of life: Its definition and measurement. Gullone.. see Appendix C) Andrews. Gullone. (1991). Advances in Nursing Science. Brown. (1985). (1996). Journal of Adolescent Health. F. Journal of Child Psychology and Psychiatry. 8.47 8 References to the text (for references to Cummins. (1979). Boyle. 16.. 15-24. C. CA: Western Psychological Services.. Castles. (1997). Revised Children’s Manifest Anxiety Scale (RCMAS) manual.0. & Cummins. Canada: Trent University Reynolds. Melbourne: Honours Thesis. No place called home: Quality of life and meaning in life of homeless youths. 1990 Survey of income and housing costs and amenities Australia: Persons with earned income. New York: Plenum Press. Methodology review: assessing unidimensionality of test and items.M. & Perry. The Comprehensive Quality of Life Scale . P.School version: A psychometric investigation (submitted). 98 . description. Canberra: Australian Bureau of Statistics. (1976). E. R. D. I. (1995). (1993). Psychometric evaluation of a revised fear survey schedule for children and adolescents. Psychometrics and psychology. Bearsley. Los Angeles. . Research in Developmental Disabilities. J. 366-375. What is coefficient alpha? An examination of theory and applications.J. Applied Psychological Measurement. Raphael.. Catalogue #6546. & King. Felce.. Deakin University.M. (1998)... C.T. The quality of life profile . N.. 51-74.A. Hill-Bailey.. Rukholm. I. Ferrans.J. (1992). (1985). G..E. & Richmond. Does item homogeneity indicate internal consistency or item redundancy in psychometric scales? Personality and Individual Differences.

48 Appendix A Psychotropic drug names (Both generic and trade) Acetophenazine Adapin Aldazine Alprazolam Amitriptyline Anetensol Atarax Atenoiol Ativan Aventyul Blocadren Buspar Buspirone Calmazine Carbamazepine Catapres Celontin Centrax Chlordiazepoxide Chlorpromazine Chlorprothixene Cibalith-s Clonazepam Clonidine Clorazepate Compazine Cylert Decanoate Depakene Desipramine Desyrel Dexedrine Dextroampetharnine Diazepam Dilantin Doxepin Droleptan Elavil Endep Equanil Eskalith Ethosuximide Ethotoin Fluphenazine Halazepam Haldol Haloperidol Hydroxyzine Imavate Inderal Isocarboxazid Janamine Klonopin Larquactil Librium Limbitrol Lithane Lithicarb Lithobid Lithonate Lopressor Lorazepam Loxapine Loxitane Ludiomil Maprotiline Marplan Mebaral Melleril Mephenytoin Mephobarbital Meprobamate Mesantoin Mesoridazine Methsuximide Metroprolol Milontin Miltown Moban Modecate Molindone Mutabon Mysoline Nardil Navane Neulacctil Norpramine Nortriptyline Novane Orap Oxazepam Pamelor Paradione Paramethadione Parnate Paxiparn Peganone Permoline Perphenazine Perrnitil Pertrofrane Phenelzine Phenobarbital Phensuximide Phenytoin Piperacetazine Prazepam Priadel Primidone Prochloperazine Prolixin Propanalol Quide Ritalin Serax Serenace Serentil Sinequan SK-Pramine Stelazine Surmontil Taractan Tegretol Tenormin Thioridazine Thiothixene Thorazine Timolol Tindal Tofranil Tranxene Tranylcypromine Trazodone Triavil Tridione Trifluoperazine Triflupromazine Trilafon Trimethadione Trimipramine Valium Valproic Acid Vesprin Vistaril Vivactil Zanax Zarontin .

1c) . Use scores coded 1 (Terrible) to 7 (Delighted). (c) Divide the total by 3. Call this score x. 1b. 3 Obtain overall objective score for each person (a) Sum the scores from all 21 items .g. (f) Repeat for the other domains. 6 Obtain domain satisfaction scores for each person (without importance) (a) Use non-recoded data: i. . Call this Score x. 5 Obtain overall importance score for each person (without satisfaction) (a) Sum the 7 importance scores. (d) Take the score x. 4 Obtain domain importance scores for each person (without satisfaction) (a) Take importance score for each domain. 1a. (c) Use the formula %SM = (score x-1) x 100/(7-1). (b) Add the three sub-domain scores (e. Call this score x. Call this score x. (c) Take Score x and plug into the formula % scale max = (Score x-1) x 100/(5-1) (d) This is the overall objective score expressed as %SM.this is TOTAL SCORE. (c) %SM = (mean score x-1) x 100/(5-1).This is the TOTAL DOMAIN SCORE FOR MATERIAL WELL-BEING. code items la to 7c. and plug into the formula % scale max = (score x-1) x 100/(5-1) (e) This gives you the objective score for material well-being expressed as %SM.e. (b) Divide total by 7. Call this score x. (b) Use formula % SM = (score x-1) x 100/(5-1).49 Appendix B Scoring ComQol 1 Recode satisfaction data +4 Delighted +3 Pleased +2 Mostly satisfied +1 Mixed -2 Mostly dissatisfied -3 Unhappy -4 Terrible 2 Obtain individual domain objective scores for each person (a) Following the coding procedure. (b) Take the satisfaction score for each domain. (b) Divide total score by 21.

).52-1) x 100/(5-1) = 38% . 9 Obtain average subjective scores (i x s) for each domain using grouped data (a) Recode the satisfaction score for each person as for (1. 8 Obtain an overall (I x S) score for each person (a) Sum the (IxS) domain scores for each person. This is score x. (c) Obtain an average (IxS) score for each domain. Call this score x.50 7 Obtain overall satisfaction score for each person (without importance) (a) Sum the 7 satisfaction scores (scored 1 to 7). (b) Divide total by 7. (b) Divide by 7. Call this score x. EXAMPLE 1 Overall objective score Sum 1a to 7c =53 53/21 = 2. (b) Calculate (IxS) for each domain for each subject. (c) Use formula in (5). (c) If result is positive use formula % scale maximum = [19 + (Score x-1)] x 100/38 (d) If result is negative use formula % scale maximum = [19 + (Score x+1)] x 100/38 (e) This figure is the overall subjective domain score expressed as %SM.52 % scale max = (2. (d) If result is positive use the following formula % scale maximum = [(Score x-1) + 19] x 100/38 (e) If result is negative use formula % scale maximum = [(Score x +1) + 19] x 100/38 (f) This gives the average domain subjective score across the group for each domain expressed as %SM.

5 3 Individual importance scores for each domain e.g.51 2 Overall I x S score Sum I x S scores (data for IDNUMOO1) Domain 1 2 3 4 5 6 7 TOTAL Divide 35 by 7 = 5 Result is positive so % scale maximum = [(5-1) + 19] x 100/38 = 60. from domain 1 above % scale maximum = (3-1) x 100(5-1) = 50 from domain 2 above % scale maximum = (4-1) x 100(5-1) = 75 Importance 3 4 4 5 4 4 4 28 Satisfaction +1 -3 +2 +4 +3 +3 -2 8 IxS 3 -12 8 20 12 12 8 35 .

A.Student (Grades 7-12): ComQol-S5. Australasian Evaluation Society International Conference. Italian. Cummins.. Tranquilisers and your brain. quality of life. Melbourne: Psychology Research Center. 22-30. Comprehensive Quality of Life Scale .. Interaction. A model system for the construction and evaluation of General Service Plans. Ree (Ed. C.).Intellectual Disability: ComQol-15.. Cummins. Health promotion and the Comprehensive Quality of Life Scale. Proceedings. C. R. Available translations * The adult version is available in Greek.P. A training manual for health professionals in the treatment of benzodiazepine dependence and withdrawal. (pp. C. 29th National Conference of the Australian Society for the Study of Intellectual Disability.. Brisbane: Australian Evaluation Society. (1997). (1997). Deakin University. Family and Boys Held by Young Adolescent Females. (1993). Cummins. Cummins. Proceedings.. (pp.52 Appendix c Author publications (from 1991) (as at 11/8/98) Parallel versions of the scale * Cummins. R.. Proceedings. Fourth Australian Family Research Conference.A. Attitudes of families to the Community Living Support Service.A. Spanish and Persian from the author. R. * Cummins. 2-93. Melbourne: Community Services Victoria. Deakin University. Cummins.A. Electronic Database. The Comprehensive Quality of Life Scale Intellectual disability: Results from a Victorian survey. R. Melbourne: School of Psychology. (Fifth Edition).1-82). M. Extending network support through shared family care: Impact on children with a disability and their families.. R. R. 3. R. This is the version of the scale to be self administered by school students in Grades 7 to 12. Deakin University. (1993). C.A. J. 201-211. & Baxter. Cummins. R. 6(1).A. McCabe. 93-98. Health Promotion Journal of Australia. & Gee. Cummins. In: E. Australia and New Zealand Journal of Developmental Disabilities. R. (Fifth Edition). R. Australian Institute of Family Studies. Australian Disability Review. R. Jauernig. (1993). R. Melbourne: School of Psychology. & Cummis.M. A. (1993). 64-72. On being returned to the community: Imposed ideology vs. R. D. Cummins. C. Changing Attitudes towards Self. 46-47. (1993). Cummins. Choice of outcome measures in service delivery evaluations for people with disabilities.A.A.1-306).P. (1994)... A. 19. McCabe. S. Whitmore. 6. A. A case for the inclusion of subjective quality of life data in service-delivery evaluations.. 25-26. 75-80. R. . Comprehensive Quality of Life Scale . Document #18951. Publications by the author over the past five years: Baxter.A. Polak. Evaluation Journal of Australia.. Hudson.A. & Baxter. This is the version of the scale to be used with people who have intellectual disabilities or a cognitive impairment.. (1994). M. In the Community: An Evaluation of the Community Living Support Service.. (1993). (1994). 221-231. Cummins.A. Hinchy. & Baxter. & Baxter. Y. Melbourne: TRANX.. (1993). (1993). & Romeo.

Cummins.75-102. M. 121-126. (1996). E. M. E. M.A. L. N.53 Cummins. 29th National Conference of the Australian Society for the Study of Intellectual Disability. International Journal of Disability.. (1996).. Cummins. Proceedings. McCabe. R. Proceedings. Adaptive behaviour in children and adolescents with and without intellectual disability: Relationships with fear and anxiety. 179-200. (1996). pp. 227-237. D.. (1995). experience. Self-reported fears: A comparison study of youths with and without an intellectual disability. McCabe.P. 7. 21. M. New York: Brookline Press.. 12.. Romeo. E. Directory of instruments to measure quality of life and cognate areas. N.A. A. 125-136. The domains of life satisfaction: An attempt to order chaos.. Y. 1-10. A.A.A. Y. Second edition..A. Gullone. 42. Development and Education. The sexual knowledge. R. 7-19.. Journal of Intellectual Disability Research. (1996). Cummins. & Hudson. & Gullone. Proceedings. (1997).P. 44.P. E. Cummins. R. Cummins. 38... R..A. Cummins. 109-120. M. International Journal of Disability. Journal of Family Studies. M.. Social Indicators Research. et al . & King. R.P. Personal relationships. Melbourne: School of Psychology. R. Journal of Sexuality and Disability.. 13-21. McCabe. R. (1994). (1995). Parmenter.J. integrating health outcomes measurement in routine health care conference. 31. R. (1996). R. 12. 59-70. J. 12.. & Romeo. 2.. An empirical study of the sexual abuse of people with intellectual disabilty. Educational and Psychological Measurement. S. Journal of Intellectual and Developmental Disability. The Comprehensive Quality of Life Scale: Instrument development and psychometric evaluation on College staff and students. Baxter..A. & Stancliff. 54. Education and Training in Mental Retardation and Developmental Disabilities. & Cummins. (1996). 40. Cummins. Proceedings.P. Cummins. R.. 12th World Congress. A. 227240. R. (1994)..A. T. Romeo.B. Health Outcomes and Quality of Life Measurement Conference. An evolutionary perspective on human female sexual desire.. R.A. Canberra: Australian Institute of Health and Welfare. McCabe. An international perspective on quality of life and disability. International Federation of Physical Medicine and Rehabilitation.A.A.II (FSSC-II). R. (1995). 372-832.A. R.. R. 303-332. (1994). pp. (1996). & King. C. E. & King.A. M.. Measuring the quality of life of people with an intellectual disability. In Goode.P... Y.A. S.P.152. M. R.A. Quality of life for people with disabilities: The view from Australia. S. Sexual and Marital Therapy. Cummins. Australian Institute of Health and Welfare.P. (1996). (1995).A. McCabe. Cummins. 297-306. pp. McCabe. & Polak. . Social Indicators Research .. Gullone. Cummins. Cummins. D. An initial evaluation of the Comprehensive Quality of Life Scale – Intellectual Disability. Gullone. Jauernig. Using the Comprehensive Quality of Life Scale: A comparison between elderly Australians and normative data. R. R. Development and Education.J.. Sexual abuse among people with intellectual disabilities: Fact or fiction. Cummins. A longitudinal study of parental stress and support: The influence of child disability from diagnosis to leaving school. (1994). 7-14). Behaviour Change. (1996). & Hammond.. Baxter..A.A. R. 18-24 (reprinted in Health Outcomes Bulletin.. 269-284. Reid.148 . & Cummins. Deakin University. 250-254. Fogarty. The Comprehensive Quality of Life Scale: Development and evaluation. & Waters. relationship quality and health. Research in Developmental Disabilities. N. R. Cummins. 35. (1995). feelings and needs of people with mild intellectual disability. On the trail of the gold standard for life satisfaction.. 17. McCabe.. Shaddock. C. Cummins. A model system for the construction and evaluation of Individual Program Plans. & Cummins.A. McCabe. & Reid. R... & Gullone. Fears of youth with mental retardation: Psychometric evaluation of the Fear Survey Schedule for Children .

cob. First International Conference on Quality of Life in Cities. Murray (Eds. R. (1998). http://www. Directory of Instruments to measure quality of life and cognate areas.A. R. M. Parental stress attributed to disabled family members: A longitudinal study. & Cummins.A.. Fogarty. Proceedings. The Comprehensive Quality of Life Scale (fifth edition). Proceedings. Web address: In press: Baxter. Singapore. England: Stanley Thomas. Adolescence (in press).A. Reid. (ISSN 1326-2173). (1997). Deakin University. & Cummins. (1998). Singapore. J. P.A.A. (1998).A. L. Proceedings. R. C. 43.. Baxter. Auckland: Dunmore Press.A. (1997). (1998).A. & Cummins.Intellectual Disability.. to.. 307-334. The Girl’s Guide. 10-16. P. Social Indicators Research. Bramston. Cummins. M. O'Brien.. British Journal of Clinical Psychology (in press). & Lo. & Cummins. M. Cummins. .54 Cummins. An initial evaluation of the Comprehensive Quality of Life Scale . The second approximation to an international standard of life satisfaction. G. (1998). Third Edition. The influence of disability on quality of life within families. R. (ISSN 13250752). Cummins. (1998).. International Journal of Practical Approaches to Disability.. Quality of Life Definition and Terminology. Third Edition. C. C. (1997). Y. Rapley. An international standard for life satisfaction. Blackburg.P. S.htm (pp.K. R. Proceedings. R. Melbourne: Harper Collins (pp. (1998). & Cummins R.1-111).A. R. The nature of stressors experienced by people with an intellectual disability. Cummins. & Cummins. Assessing quality of life for people with disabilities.. 1-9. & Cummins. 21. Bibliography on quality of life and cognate areas of study. International Journal of Disability Research (in press). The measurement of subjective health outcome: Issues of concern. & Waters. Clements.A. R. Melbourne: School of Psychology. & Cummins. 67-77. (1998). (1998). M.. 2-8. First International Conference on Quality of Life in Cities. A (1998). Singapore. P..A. Validation of the Lifestress Inventory for people with a mild intellectual handicap. Cummins. In: P. Sexuality and quality of life among young people. Proceedings.. Melbourne: School of Psychology. pp. Journal of Intellectual and Developmental Disability (in press).. Bramston.A. Journal of Applied Research in Intellectual Disability. Bramston. Tuck. R.edu/market/isqols/bibres. Development and Education. (pp.. O'Brien & R.A.H. Cummins.. Best.A.. Journal of Intellectual Disability Research (in press). R. Cummins. Cheltenham.A. R.. C. or with – vulnerable people and the practices of the research community. Cummins. S. R. (1997). 44. (1998). McCabe. (1997). McCabe. Evidence for domain compensation involving the homeostatic control of subjective life quality among ex-farmers in Australia. G.. Virginia: The International Society for Quality-of-Life Studies. Research in Developmental Disabilities. Journal of Applied Research in Intellectual Disability (in press). International Conference on Health Outcome. Quality of Life for Handicapped People. for. 18.. In: R. Fogarty. (in press). Brown (Ed. Deakin University. Quality of life: Its relevance to disability services..1-97). Second edition. C.). Cummins. First International Conference on Quality of Life in Cities. R. B. Best. R. (1997). (pp. 10. Singapore. Cummins.. R.A.J. L. Exploration of visual behavior in diadic relationships of people with and without a disability.). Working in Human Services. On.A. The quality of rural and metropolitan life.A. Romeo. 7-19. 435-456. Cummins. & Yiolitis.A. P. J. (1998).I. McCabe.P. R.. Stress and the move into independent accommodation..1-58). (in press). & Baxter. International Journal of Disability. (1997). R. R. 199-216. pp.116-150.1-161).vt..P.225-268.A. (1997). First International Conference on Quality of Life in Cities. Measuring quality of life for people with an intellectual disability: A review of the scales. (1998). R. R. Elkins. R. (1997). & Cummins. Cummins. Cummins.A. R.

E. Gullone.P. Subjective quality of life among Filipino-Australians (submitted). R. The contribution of spiritual well-being to quality of life (submitted). E. J. A. J.A. & Cummins. Golding. (submitted). & Hastings.A. Nistico. Cummins. McCabe. A. H. C. & Cummins... The experience of stress and quality of life among people who are disabled. Cummins. Cummins.. & Baxter. The influence of migration. R. R.. Cummins.A... F. A. Kelly. R.A. R. In preparation: Bearsley.. Fraid. R.. R.A. R. Normative life satisfaction: Measurement issues and a homeostatic model (submitted). & Cummins. Germano. M. The effects of social interaction and stress on the life quality of GreekAustralians. & Cummins. R. & Cummins. Cummins. Mallamace.A. Quality of life. An Italian-Australian comparison of life quality among intellectually disabled people living in the community (submitted). R. Monteath..A.. & Cummins. C. D. & Cummins. themselves and their families over a ten year period (submitted). R.. D. & Cummins. Foroughi. & Cummins. & Cummins. R. Simm..A. R. The gold standard for life satisfaction: Confirmation and elaboration using an imagined scale (submitted). Quality of Life as a function of participation in physical activity and self-esteem (in preparation)..P. L. stress and life quality among Italian migrants in Australia (submitted). C. Social integration. The influence of disability on quality of life within families (submitted).A. Quality of life for people with arthritis (in preparation). A.A. The concept and measurement of quality of life in psychology (submitted). (in preparation). Cummins. .P.. C. Verri.A. R. & Cummins. & Loquet.A. R.A. Vallero. E. Yiolitis. No place called home (in preparation). Spiritual well-being and quality of life (submitted). & Cummins. R... anxiety and quality of life: Adolescent self-reports (submitted). & Cummins. R. & Cummins.A.. M. & Nappi. R. The effects of social and competitive sport participation on subjective quality of life (in preparation).. McCabe. social support and social integration on the life quality of Persians in Australia (submitted). E... Cummins. Fear.A. Hutton. A. C. Misajon.. R. & Cummins. R.M..55 Submitted: Best. Construction and psychometric properties of sexuality scales (submitted). R. R. The quality of rural and metropolitan life (submitted). Gerosa.A.A.. L. & Deeks. S. M.. work and retirement (in preparation).A. D. G. The changing attitudes of adolescent females towards boys.. R. & Baxter. Mellor. R.A. Petito.A. D. Maintaining subjective well-being and avoiding depression: The role of cognitive illusions (submitted). A structural model of organisational commitment and career satisfaction (in preparation)..A. & Cummins. R.