As people lead longer and generally healthier lives, aspirations and expectations of health care extend to include well-being and enhanced quality of life. Several measurement scales exist to evaluate how well health care reaches these goals. However, the definitions of well-being or quality of life remain open to considerable debate, which complicates the design, validation, and subsequent choice of an appropriate measurement.
Objective: This article reviews nine measures of psychological well-being, tracing their origins in alternative conceptual approaches to defining well-being. It compares their psychometric properties and suggests how they may be used.
Methods: The review covers the Life Satisfaction Index, the Bradburn Affect Balance Scale, single-item measures, the Philadelphia Morale scale, the General Well-Being Schedule, the Satisfaction With Life scale, the Positive and Negative Affect Scale, the World Health Organization 5-item well-being index, and the Ryff's scales of psychological well-being.
Results: Scales range in size from a single item to 22; levels of reliability and validity range from good to excellent, although for some of the newer scales we lack information on some forms of validity.
Conclusion: Measures exist to assess several conceptions of psychological well-being. Most instruments perform adequately for survey research, but we know less about their adequacy for use in evaluating health care interventions. There remains active debate over how adequately the questions included portray the theoretical definition of well-being on which they are based.
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