Use of SEIQoL as an Alternative Approach to Measure the Effects of Human Services Interventions

Abstract

The paper introduces the SEIQoL (Schedule for the Evaluation of Individual Quality of Life), a tool for evaluating the quality of life from a subjective perspective. The contribution turns the attention to quality of life as an important aspect of interventions impact and their evaluation. It offers practical experiences with SEIQoL administration and provides a balanced combination of practicalities and underlying conceptual explanations. Attention is also paid to selected methodological issues such as the dynamic nature of quality of life, administrators´ bias, or usability for evaluation of human services interventions. SEIQoL provides a useful insight into the impacts of human services interventions on individual quality of life. Moreover, being open to subjective “cues”, i.e., the areas that individuals consider important for their quality of life, and following the participatory approach, SEIQoL can help to reshape the knowledge about the needs of beneficiaries.

Full text

JIRI REMR

ACKNOWLEDGMENT
The presentation was created within the project
“SETTING THE CONDITIONS AND ENVIRONMENT FOR
INTERNATIONAL AND INTERSECTORAL COOPERATION”,
reg. no. CZ.02.2.69/0.0/0.0/18_054/0014660, which
is co-financed by the European Union.

ABSTRACT
The paper introduces the SEIQoL (Schedule for the Evaluation of Individual Quality of Life), a tool for
evaluating the quality of life from a subjective perspective. The contribution turns the attention to quality
of life as an important aspect of interventions impact and their evaluation. It offers practical experiences
with SEIQoL administration and provides a balanced combination of practicalities and underlying
conceptual explanations. Attention is also paid to selected methodological issues such as the dynamic
nature of quality of life, administrators´bias, or usability for evaluation of human services interventions.
SEIQoL provides a useful insight into the impacts of human services interventions on individual quality of
life. Moreover, being open to subjective “cues”, i.e., the areas that individuals consider important for their
quality of life, and following the participatory approach, SEIQoL can help to reshape the knowledge about
the needs of beneficiaries.
Keywords: quality of life; SEIQoL; counseling; participatory approach; human services intervention

THE QUALITY OF LIFE (QoL) MEASURES
There are various approaches to its evaluation, for instance,
WHOQoL-BREF, SF-36, HRQoL, QoLS, MQoL, etc. Most of the
existing measures are health-related; they have been designed
to assess the impact of illness and treatment on the QoL of
patients/clients.
2
Results are presented as group statistics. They provide little or
no individual-level data on the QoL.
3
QoL is a multi-dimensional construct. It is a individuals´
perception of their position in life in the context of culture and
value systems in which they live and in relation to their goals,
expectations, standards and concerns (WHOQOL Group, 1995)
1

THE QUALITY OF LIFE (QoL) MEASURES
0101 Pre-ordinate design and dimensions focused on limitations
and impediments (for some participants irrelevant)
0202 High number of items neglecting the variation of their
importance (obtrusive, cognitively demanding)
0303 Heavy on analysis (not suitable for having real-time results)

SCHEDULE FOR EVALUATION OF INDIVIDUAL
QUALITY OF LIFE (SEIQoL)
SEIQoL
SEIQoL in contrast to other approaches does not
determine what and how the participant should
consider important with respect to the quality of life.
Individuals take ownership of the QoL concept.
Takes into account the plurality of perceptions and
perspectives of participants, their personal values.
It is a person-centered measure, not a health-based one.
Semi-structured interview is a typical mode of data
collection resulting in qualitative and quantitative
outcomes.

HOW DOES SEIQoL MEASURE THE QoL?
Participants are free to come-up with areas of their life (cues) that they
consider important. Personal cues are defined spontaneously.
Evaluation of the degree of satisfaction with the indicated cues
in percentages on a scale from 0 to 100.
The relative importance of each cue that the participant evaluates
proportionally by dividing 100 % among the cues.

1
First session Other sessions;
continued therapy
or counseling
Final session
32
CONTEXT OF SEIQoL USAGE
SEIQoL DEPLOYMENT
(PRE-TEST)
SEIQoL DEPLOYMENT
(POST-TEST)

THE COURSE OF SEIQoL ADMINISTRATION
Introduction
Eliciting the five most important areas of life (the cues)
Determining levels of satisfaction
Elicit importance rating of present life
QoL scoring
01.
02.
03.
04.
05.

1.
2.
3.
4.
5.
TOTAL = 100%
HEALTH 15%
WORK 45%
PARTNERSHIP 15%
TRAVELLING 15%
PERSONAL DEVELOPMENT 10%
LIFE GOALS IMPORTANCESATISFACTION
75%
85%
90%
75%
60%
75 x 15 = 1125
85 x 45 = 3825
90 x 15 = 1350
75 x 15 = 1125
60 x 10 = 600
SUM 8025
SEIQoL = 80.25%
COMPUTATION OF SEIQoL INDEX

The SEIQoL measures the QoL on an individual level. Individual measures
are derived from an idiographic approach reflecting the uniqueness of
human experience.
Summary index can still be produced when group comparisons
are required.
As the index is a continuous measure (ranging from 0 to 100) it can be
analyzed using parametric statistical methods.
SUMMARY

CASE EXAMPLE

CASE EXAMPLE
Source: INESAN (2021–2022)
TARGET GROUP
I N T E R V E N T I O N
94 clients
SEIQoL (PRE-TEST)
59 clients
SEIQoL (POST-TEST)
63 clients
47 clients passed both, the pre-test and the post-test

CASE EXAMPLE
SEIQoL
(PRE-TEST)
average duration
12 minutes
SEIQoL
(POST-TEST)
range
5-30 minutes
Source: INESAN (2021–2022)
average duration
14 minutes
range
5-40 minutes
SEIQoL
(PRE-TEST)
average time-lag:
275 days
SEIQoL
(POST-TEST)
range:
92-517 days

83%
81%
72%
45%
45%
23%
30%
17%
26%
91%
81%
68%
38%
47%
15%
32%
19%
30%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
health
family relationships
education
friendly relations
partnership
relax and hobby
sport
personal development
relation to self
pre-test
post-test
CASE EXAMPLE –Elicited cues (pre AND post only)
Data show the percentage of participants who nominated any cue.
Source: INESAN (2021–2022, n=47/47)

CASE EXAMPLE –Rating of the elicited cues
(average satisfaction)
Source: INESAN (2021–2022, n=8-41/6-42)
53
52
50
48
45
44
37
33
28
67
58
55
58
63
63
61
67
60
020 40 60 80 100
relax and hobby
education
sport
friendly relations
partnership
family relationships
health
personal development
relation to self
Percents
pre-test
post-test
14
6
5
10
18
19
24
34
32
Percentage points
difference
(p=0.105)
(p=0.149)
(p=0.462)
(p=0.145)
(p=0.011)
(p=0.000)
(p=0.000)
(p=0.000)
(p=0.000)
Note: t-test

CASE EXAMPLE –Direct weighting of the cues
(average weight)
31
30
23
22
19
17
15
13
10
28
30
23
22
16
18
13
14
10
010 20 30 40
relation to self
health
partnership
family relationships
sport
personal development
friendly relations
education
relax and hobby
Percents
pre-test
post-test
-2,6
-0,5
-0,2
-0,1
-2,8
1,1
-1,9
0,7
-0,2
Percentage points
difference
(p=0.626)
(p=0.850)
(p=0.944)
(p=0.969)
(p=0.441)
(p=0.831)
(p=0.568)
(p=0.732)
(p=0.947)
Source: INESAN (2021–2022, n=8-41/6-42)
Note: t-test

CASE EXAMPLE –SEIQoL index (total sample)
Source: INESAN (2021–2022, n=47)
Note: 0 = the worst QoL, 100 = the best QoL
pre-test post-test
Mean Median Std.
Deviation
Range
pre
-test 43.1 45 18.07
7.5
-
89.0
post
-test 61.5 59 11.82
35.0
-
94.8
[t=
-5.610, df=82, p=0.000]

CASE EXAMPLE –SEIQoL index (comparison)
Source: INESAN (2021–2022, n=14/33)
Note: 0 = the worst QoL, 100 = the best QoL
pre-test post-test pre-test post-test
Therapist #1 Therapist #2

SEIQoL
REFLECTION

ADVANTAGES OF SEIQoL
SEIQoL might serve as an ice-breaker; facilitates the start of the
interview between a participant (client, patient) and the interviewer
(counsellor, therapist, social worker, expert). Moreover, it helps to focus
the subsequent help or therapy, and build a trust.
SEIQoL was proved as a feasible, reliable and valid instrument.
SEIQoL can be used repeatedly (pre-test and post-test); in many
studies, it has been shown to be sensitive to change. Moreover, it
allows for benchmarking.
SEIQoL is suitable for different populations or target groups; burden on
participants is low.

ISSUES RELATED TO SEIQoL ADMINISTRATION
SEIQoL
Nominating the cues:
Some participants could not think of five cues and the
use of prompts was necessary.
Other participants provided more than five cues, so their
prioritization had to be done.
Poor recall of self-evident cues (e.g., health).
Pre/post change in cues might indicate the QoL
reconceptualization (response shift).

ISSUES RELATED TO SEIQoL ADMINISTRATION
SEIQoL
Determining cue levels:
Some participants reflected the importance of the
particular cue rather than how the cue is for them at the
given moment.
Cue functioning is interchanged with its satisfaction.
Determining cue weights:
The participants conceive the task as dividing up the pie
in terms of current functioning in that area.
Pre/post change in cues might indicate the value change.

IMPORTANT TAKE-AWAY
An interviewer (administrator) must be properly trained and engaged.
Identification of cues is demanding and critical part of SEIQoL. The administrators
(typically counsellors or therapists) should incorporate SEIQoL into their routines.

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REFERENCES

Jiri REMR
Institute for Evaluations and Social Analyses
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www.inesan.eujiri.remr@inesan.eu
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