Psychometric evaluation of the 12-item Well-being Questionnaire for use with people with macular disease


This paper reports the evaluation of a generic measure of psychological well-being, the 12-item Well-being Questionnaire (W-BQ12), for use with people who have the chronic eye condition, macular disease (MD). The W-BQ12 was incorporated in a self-administered questionnaire which was completed by 1421 members of the Macular Disease Society (MD Society). Unforced factor analysis elicited the expected three factors representing constructs of positive well-being, energy and negative well-being. A forced single-factor solution supported use of the whole scale to measure total general well-being. High Cronbach's α coefficients demonstrated good internal consistency reliability in the entire scale (α = 0.87) and in subscales (α > 0.78). The factor structure matched that found in samples of people with diabetes for whom the W-BQ12 was first developed, indicating construct validity. Expected subgroup differences in the MD sample indicated significantly poorer well-being in women than in men and also in participants who were registered blind or partially sighted compared to those who were not registered. The W-BQ12 will be useful in measuring outcomes in rehabilitative and medical interventions and in researching factors affecting adjustment to MD.

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  1. 1.

    O'Shea JG. Age-related macular degeneration. Postgraduate Med J 1998; 74: 203–207.

    Article  Google Scholar 

  2. 2.

    Mitchell P, Smith W, Attebo K, Wang JJ. Prevalence of age-related maculopathy in Australia: The Blue Mountains eye study. Ophthalmology 1995; 102: 1450–1460.

    PubMed  CAS  Google Scholar 

  3. 3.

    Klein R, Klein BEK, Linton KLP. Prevalence of age-related maculopathy: The Beaver Dam eye study. Ophthalmology 1992; 99: 933–943.

    PubMed  CAS  Google Scholar 

  4. 4.

    Vingerling JR, Dielemans I, Hofman A, et al. The prevalence of age-related maculopathy in the Rotterdam study. Ophthalmology 1995; 102: 205–210.

    PubMed  CAS  Google Scholar 

  5. 5.

    Evans J, Wormald R. Is the incidence of registrable age-related macular degeneration increasing? Br J Ophthalmol 1996; 80: 9–14.

    PubMed  CAS  Google Scholar 

  6. 6.

    Evans JR. Causes of Partial Sight and Blindness in England and Wales 1990–1991. Studies on Medical and Population Subjects 57. London: HMSO, 1995.

    Google Scholar 

  7. 7.

    Davis C, Lovie-Kitchen J, Thompson B. Psychosocial adjustment to age-related macular degeneration. J Vis Impair Blind 1995; 1: 16–27.

    Google Scholar 

  8. 8.

    Williams RA, Brody BL, Thomas RG, Kaplan RM, Brown SI. The psychosocial impact of macular degeneration. Arch Ophthalmol 1998; 116: 514–520.

    PubMed  CAS  Google Scholar 

  9. 9.

    Mangione CM, Gutierrez PR, Lowe G, Orav EJ, Seddon JM. Influence of age-related maculopathy on visual functioning and health-related quality of life. Am J Ophthalmol 1999; 128: 45–53.

    PubMed  CAS  Article  Google Scholar 

  10. 10.

    Bradley C. The Well-being Questionnaire. In: Bradley C (ed), The Handbook of Psychology and Diabetes: A Guide to psychological Measures in Diabetes Research and Practice, Chur, Switzerland: Harwood Academic Press, 1994; 89–109.

    Google Scholar 

  11. 11.

    Warr PB, Banks MH, Ullah P. The experience of unemployment among black and white urban teenagers. Br J Psychol 1985; 76: 75–87.

    PubMed  Google Scholar 

  12. 12.

    Zung WWK. A self-rating depression scale. Arch Gen Psychiatry 1965; 12: 63–70.

    PubMed  CAS  Google Scholar 

  13. 13.

    McMillan C. Growth hormone deficiency in adulthood: A psychometric evaluation of measures of quality of life and related health outcomes. PhD thesis, 2001. University of London.

  14. 14.

    Bradley C. The 12–item Well-being Questionnaire. Diabetes Care 2000; 23(6): 1.

    Google Scholar 

  15. 15.

    Plowright R, Witthaus E, Bradley C. Evaluating the 12–item Well-being Questionnaire for use in multinational trials. Qual Life Res 1999; 8(7): 650.

    Google Scholar 

  16. 16.

    Pouwer F, Snoek FJ, van der Ploeg HM, Ader HJ, Heine RJ. The Well-being Questionnaire: Evidence for a 3–factor structure with 12 items (W-BQ12). Psychol Med 2000; 30: 455–462.

    PubMed  CAS  Article  Google Scholar 

  17. 17.

    Pouwer F, van der Ploeg HM, Ader HJ, Heine RJ, Snoek FJ. The 12–item Well-being Questionnaire: An evaluation of its validity and reliability in Dutch people with diabetes. Diabetes Care 1999; 22(12): 2004–2010.

    PubMed  CAS  Google Scholar 

  18. 18.

    Bradley C, Todd C, Gorton T, Symonds E, Martin A, Plowright R. The development of an individualized questionnaire measure of perceived impact of diabetes on quality of life: The ADDQoL. Qual Life Res 1999; 8: 79–91.

    PubMed  CAS  Article  Google Scholar 

  19. 19.

    Cullinan T. Visual Disability in the Elderly. Beckenham: Croom Helm, 1986.

    Google Scholar 

  20. 20.

    Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika 1951; 16: 297–334.

    Article  Google Scholar 

  21. 21.

    Tabachnick BG, Fidell LS. Using Multivariate Statistics. 3rd ed. New York: Harper Collins, 1996.

    Google Scholar 

  22. 22.

    Bradley C. Well-being Questionnaire (W-BQ): Translation and development of a Japanese version, the W-BQ12 (Japanese). Report to Wada M, Eli Lilly, Japan KK, 1996.

  23. 23.

    Loewenthal KM. An Introduction to Psychological Tests and Scales. London: UCL Press, 1996.

    Google Scholar 

  24. 24.

    Speight J, Barendse S, Bradley C. Impact of positively-vs-negatively-worded items on the factor structure of three psychosocial measures: W-BQ22, W-BQ12 and HADS. Proc Brit Psychol Soc 2000; 8(1): 21.

    Google Scholar 

  25. 25.

    Bradley C, Lewis KS. Measures of psychological well-being and treatment satisfaction developed from the responses of people with tablet-treated diabetes. Diabetic Med 1990; 7: 445–451.

    PubMed  CAS  Article  Google Scholar 

  26. 26.

    Fitzgerald RG, Ebert JN, Chambers M. Reactions to blindness: A four-year follow-up study. Perceptual Motor Skills 1987; 64: 363–378.

    CAS  Google Scholar 

  27. 27.

    Dahlin-Ivanoff S, Sjöstrand K, Klepp KI, Axelsson-Lind L, Lundgren-Lindqvist B. Planning a health education programme for the elderly visually impaired person: A focus group study. Disabil Rehabil 1996; 18(10): 515–522.

    Article  Google Scholar 

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Mitchell, J., Bradley, C. Psychometric evaluation of the 12-item Well-being Questionnaire for use with people with macular disease. Qual Life Res 10, 465 (2001).

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  • Macular disease
  • Psychometric evaluation
  • Quality of life
  • Well-being