QUALITY-OF-LIFE - STATUS AND CHANGE (QLSC) RELIABILITY, VALIDITY AND SENSITIVITY OF A GENERIC ASSESSMENT APPROACH TAILORED FOR DIABETES

The aim was to review the psychometric properties of a generic strateg y for assessing status and change in quality of life (QLsc) partly tai lored for patients with insulin-dependent diabetes mellitus. Quality o f life was defined as perceived well-being and life satisfaction, glob ally as well as within key domains and functions. The strategy has bee n developed iteratively and, thereby, proven psychometrically satisfac tory across groups and settings. Seventy-three consecutive outpatients were examined in 1988, after a period on multiple injection treatment by insulin pen; 66 were re-examined in 1990. In 1988 and 1990, percei ved well-being and life domain status were self-rated. Life domain cha nges attributed to pen treatment were rated retrospectively in 1988 an d subsequent general changes over 2 years rated similarly in 1990. Sho rtened parallel ratings were performed by significant others. Series o f cross-sectional and longitudinal analyses yielded convincing reliabi lity, validity and sensitivity evidence of various kinds for all ratin gs, irrespective of rater-self or significant other. As expected, a co nsistent correlational pattern emerged between status self-ratings, su ggesting 'the better/worse off' in one sense, the 'better/worse off' i n other senses assessed. Moreover, congruent change linkages, suggesti ng 'the greater change for the better/worse' according to the one type , the 'greater change for the better/worse' according to the other one , were also salient. Fourteen persons with less congruence in the disp arate, but parallel change rating parameters appeared to be in a criti cal disease phase, applying reaction formation or denial like defence mechanisms. In conclusion, the entire cohesive strategy also functione d well in the current setting. It may probably be applied in search fo r other vulnerable sub-groups and in analyses of coping strategies. It offers rich analytic options especially in evaluational contexts. The study outcome may stimulate development of methodology within this fi eld.