Abstract
PurposeThe Quality of Life, Enjoyment, and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) is a recovery-oriented, self-report measure with an uncertain underlying factor structure, variously reported in the literature to consist of either one or two domains. We examined the possible factor structures of the English version in an enrolled mental health population who were not necessarily actively engaged in care.MethodsAs part of an implementation trial in the U.S. Department of Veterans Affairs mental health clinics, we administered the Q-LES-Q-SF and Veterans RAND 12-Item Health Survey (VR-12) over the phone to 576 patients across nine medical centers. We used a split-sample approach and conducted an exploratory factor analysis (EFA) and multi-trait analysis (MTA). Comparison with VR-12 assessed construct validity.ResultsBased on 568 surveys after excluding the work satisfaction item due to high unemployment rate, the EFA indicated a unidimensional structure. The MTA showed a single factor: ten items loaded on one strong psychosocial factor (α = 0.87). Only three items loaded on a physical factor (α = 0.63). Item discriminant validity was strong at 92.3%. Correlations with the VR-12 were consistent with the existence of two factors.ConclusionsThe English version of the Q-LES-Q-SF is a valid, reliable self-report instrument for assessing quality of life. Its factor structure can be best described as one strong psychosocial factor. Differences in underlying factor structure across studies may be due to limitations in using EFA on Likert scales, language, culture, locus of participant recruitment, disease burden, and mode of administration.
Highlights
Clinical, research, and administrative interest in quality of life (QOL) has increased over the past three decades
The study population consisted of Veterans who had at least two behavioral health visits in the prior year to a mental health clinic at one of the nine Veteran Affairs medical centers (VAMCs), excluding those who received a diagnosis of dementia during this interval (n = 5596 as the sample frame)
Up to 500 individuals from each VAMC were randomly selected for telephone interviews, up to 85 per site, with a total goal of 765 participants at baseline based on power calculations for the original trial
Summary
Research, and administrative interest in quality of life (QOL) has increased over the past three decades. QOL is generally defined as an individual’s subjective, holistic view of life circumstances across physical, psychological, and social domains [1,2,3,4] It is a valuable predictor of patients’ overall health status, their perceptions of health services, and how to improve those services [3, 5, 6]. The abbreviated version (Q-LES-Q-SF) consists of 14 items derived from the long form’s general activities subscale, plus two questions about medication and overall life satisfaction. Both versions are among the most frequently used QOL measures in psychopharmacology and clinical trials [10], and have been translated into several languages
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