Mental Health Quality of Life questionnaire

Authors

Purpose

The primary purpose of the MHQoL is to provide a brief, targeted assessment of Quality of life specifically tailored for psychiatric populations. Historically, researchers and clinicians have relied on broad health-related Quality of life inventories. However, these generalized tools often fail to capture the specific functional and psychological impairments associated with severe mental illness, and they can be overly burdensome to administer in acute clinical settings. The MHQoL fills this critical gap by offering a streamlined measure that focuses exclusively on domains highly relevant to mental health recovery.

For clinicians and researchers in Iran, the Persian validation of this scale addresses a pressing need for culturally appropriate, disease-specific assessment tools. By utilizing an instrument that accurately reflects the lived experiences of patients with Psychiatric Disorders, mental health professionals can better evaluate treatment efficacy, tailor interventions to specific areas of functional impairment, and ultimately promote a more holistic, patient-centered approach to psychiatric care.

Construct

The psychological construct measured by the MHQoL is mental health-specific Quality of life, which operationalizes well-being as a multidimensional state heavily influenced by psychiatric health. Rather than focusing solely on the absence of psychopathology, this construct encompasses how individuals perceive their position in life, their daily functioning, and their social integration. The scale breaks this broad construct down into seven distinct but interrelated facets: self-image, independence, mood, interpersonal relationships, daily activities, physical health, and future outlook.

Theoretically, this framework aligns with the biopsychosocial model of mental illness, recognizing that Psychiatric Disorders disrupt multiple spheres of human experience. For instance, the inclusion of 'future outlook' and 'self-image' captures the cognitive and existential toll of mental illness, while 'independence' and 'daily activities' reflect functional disability. Together, these dimensions provide a holistic profile of the patient's subjective reality, bridging the gap between clinical symptom severity and actual life satisfaction.

Validity

The psychometric evaluation of the Persian MHQoL demonstrated robust validity across multiple domains. Content validity was rigorously established through expert panel reviews comprising psychiatrists, psychologists, and psychiatric nurses, which yielded a perfect Scale Content Validity Index (S-CVI) of 1.0, indicating unanimous expert agreement on item relevance. Additionally, face validity was confirmed through qualitative interviews with a diverse group of Psychiatric patients, ensuring the language was accessible and culturally resonant.

Construct validity was thoroughly investigated using both exploratory and confirmatory factor analyses on a sample of 300 hospitalized patients. The data showed excellent suitability for factor extraction, evidenced by a strong Kaiser-Meyer-Olkin measure of 0.872 and a highly significant Bartlett's test of sphericity. Furthermore, item-total correlations were strong, ranging from 0.361 to 0.873, demonstrating that each individual item contributes meaningfully to the overall measurement of the Quality of life construct.

Reliability

The Persian adaptation of the MHQoL exhibited strong reliability metrics, which are essential for both cross-sectional diagnostics and longitudinal clinical monitoring. Internal consistency was evaluated through item analysis, revealing that the scale maintains high cohesion. When individual items were systematically removed during the analysis, the Cronbach's alpha values remained robust, fluctuating between 0.854 and 0.914, which suggests that the items are highly interrelated and reliably measure the same underlying construct.

In addition to internal consistency, the researchers established the temporal stability of the instrument using a test-retest methodology. By administering the questionnaire to a subset of 60 Psychiatric patients on two separate occasions with a two-week interval, the study confirmed both relative and absolute stability. The use of intraclass correlation coefficients and standard error of measurement in this phase ensures that the scale produces consistent results over time, provided the patient's clinical status remains unchanged.

Factor Analysis

To elucidate the underlying structure of the Persian MHQoL, the researchers employed a split-sample approach, dividing their 300 participants equally to conduct both exploratory (EFA) and confirmatory factor analyses (CFA). The EFA utilized a Maximum Likelihood extraction method paired with a Promax rotation, an appropriate choice given the theoretical expectation that dimensions of Quality of life are correlated. The high KMO value of 0.872 confirmed that the sample data were highly factorable.

Following the exploratory phase, the derived structural model was subjected to CFA to rigorously test how well the observed variables mapped onto the latent factors. The researchers evaluated the model's goodness-of-fit using a comprehensive suite of indices, including absolute, comparative, and parsimonious fit measures. By targeting standard psychometric thresholds—such as a chi-squared to degrees of freedom ratio below 3, a Comparative Fit Index (CFI) above 0.90, and a Root Mean Square Error of Approximation (RMSEA) of 0.06 or less—the analysis aimed to empirically validate the theoretical architecture of the instrument in a Persian-speaking clinical context.

Subscales

Instrument

Scoring & Interpretation Guidelines

Mental Health Quality of Life questionnaire Items

Sample

The study sample consisted of 300 hospitalized Psychiatric patients at Baqiyatallah Hospital in Iran. The cohort was predominantly male (61%) with a mean age of 37.74 years (SD = 11.18). Participants presented with various psychiatric diagnoses, including Major Depressive Disorder (28.7%), Bipolar Mood Disorder (27.3%), Post-Traumatic Stress Disorder (28.7%), and Schizophrenia (15.3%).

Permissions & Test Year

Written permission was obtained from the main developer of the questionnaire via email.

Test Year: 2025