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Quality of life assessment instruments for adults: a systematic review of population-based studies
Open accessAbstract
Background: Against a backdrop of population aging and improving survival rates for chronic noncommunicable diseases (CNCD), researchers are placing growing emphasis on health-related quality of life (HRQoL). The aim of this study was to identify the QoL assessment instruments used in population-based studies with adults conducted around the world. Methods: A systematic review of original research published in all languages between 2008 and 2018 was conducted. Systematic reviews and meta-analyses were excluded. Results: Sixty-three articles (38.1% conducted in the Americas) fitted the eligibility criteria. Based on the AHRQ checklist for cross-sectional studies and the Newcastle-Ottawa scale for cohort studies, methodological quality was shown to be fair in the majority of studies (55.6%) and good in 44.4%. The country with the highest number of publications was Brazil (20.6%). Twelve types of generic instruments and 11 specific instruments were identified. The generic instrument SF-36 was the most frequently used measure (33.3% of studies). In-home interviewing was exclusively used by 47.6% of the studies, while 39 studies (61.9%) reported the use of self-administered questionnaires. Over two-thirds of the studies (34.9%) used questionnaires to investigate the association between chronic diseases and/or associated factors. Conclusions: It was concluded that the wide range of instruments and modes of questionnaire administration used by the studies may hinder comparisons between population groups with the same characteristics or needs. There is a lack of research on QoL and the factors affecting productive capacity. Studies of QoL in older persons should focus not only on the effects of disease and treatment, but also on the determinants of active aging and actions designed to promote it. Further research is recommended to determine which QoL instruments are best suited for population-based studies.
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![Fig. 2 Methodological quality and study characteristics. References: a. Fair quality: [8–42]. Good quality: [43–70]. b [28]. and [57]. c. Americas [8–16, 28–34, 43–49, 58], Europe [17–23, 35–38, 50–52, 57, 59–63], Asia [24–26, 39–41, 53–55, 64–69], Oceania [27, 56, 70] and Africa [42]. d. Brazil [8, 11, 13–16, 29, 33, 34, 43–45, 49], United States [9, 10, 12, 30–32, 46, 47, 58], Korea [26, 40, 41, 55, 64–68], Japan [24, 25, 53, 69], France [18, 61–63], England [19–21, 35], Germany [17, 23, 59], Denmark [37, 52, 60], Australia [27, 56, 70], Thailand [39, 54], United Kingdom [22, 57], Nigeria [42], Canada [28], Mexico [48], Laos [39], Spain [38], Sweden [36], and Switzerland [51]](/paper-figures/60253f0e0882431dac883ac3624682a1/quality-of-life-assessment-instruments-for-adults-a-systematic-review-of-figure-2.jpg)


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“Measures of quality of life are praised to be multi-dimensional and broadly applicable, but are often criticized for not being sensitive to specific aspects of quality of life for different health conditions (Pequeno et al., 2020).”
From A Systematic Review and Meta-Analysis Exploring Effects of Third-Wave Psychological Therapies on Hearing-Related Distress, Depression, Anxiety, and Quality of Life in People With Audiological Problems. (2022) · cites this paper as Pequeno et al., 2020
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Metadata
- Authors
- Pequeno, N. P. F., Cabral, N. L. D. A., Marchioni, D. M., Lima, S. C. V. C., & Lyra, C. D. O.
- Affiliations
- Universidade Federal do Rio Grande do Norte (BR)
- Universidade de São Paulo (BR)
- Corresponding author
- Pequeno, Nila Patrícia Freire
- ORCID
- Venue
- Health and Quality of Life Outcomes
- Published
- 2020-06-30
- Volume
- 18
- Issue
- 1
- Pages
- 208-208
- ISSN
- 1477-7525 (ISSN-L)
- PMC
- PMC7329518
- OpenAlex
- W3039908902
- Cited by
- 252
- References
- 91
- Citations by year
- 2026: 30 · 2025: 43 · 2024: 60 · 2023: 50 · 2022: 44 · 2021: 23 · 2020: 2
- FWCI
- 4.84
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Health and Quality of Life Outcomes (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, cc-by)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Postgraduate Program in Public Health at Federal University of Rio Grande do Norte (23077.014305/2019-29)
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance Code 001)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Nursing › Research and Theory › Health Education and Validation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- health-related quality of life, quality of life instruments, population-based study, adults, SF-36, questionnaire administration mode, non-communicable diseases, active ageing, older adults, methodological quality
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Humans, Male, Psychometrics, Quality of Life, Surveys and Questionnaires
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