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Flanagan's Quality of Life Scale

Name of Questionnaire

Flanagan's Quality of Life Scale (QOLS)


Self-administered questionnaire designed for use in patients with chronic illiness.


John C. Flanagan (deceased); modified for use in chronic illness by Carol S. Burckhardt

Instrument distribution

Carol S. Burckhardt, Ph.D., R.N.
School of Nursing
Oregon Health Sciences University
3181 S.W. Sam Jackson Park Road
Portland, OR 97201-3098


Cost & availability




Time to complete

5 minutes

Number of items


Domains & categories


Name of categories/domains

Not scored separately: physical and material well- being; relationships with other people; social, community, and civic activities; personal development and fulfillment; recreation; independence.

Scaling of items

7-point Likert-type scale ranging from "delighted" (7) to "terrible" (1)


Total scale score (possible range: 16 - 112)


a. Test-retest Reported 5
b. Internal consistency Reported 5


a. Content Flanagan's original 15-item scale was derived from 6500 critical incidents reported in interviews with 3200 American adults of all ages and health status 6 . Burckhardt added one item (independence) after interviewing 204 people with chronic illnesses (diabetes, ostomy, osteoarthritis, rheumatoid arthritis) 5
b. construct People with ostomies (stable illness) score higher than those with diabetes (unstable illness); strong correlation between QOLS and another measure of quality of life (the Life Satisfaction Inventory); low to moderate correlations with measures of health status (subscales of the Duke-UNC Health Profile and the Arthritis Impact Measurement Scales). Higher correlations are between psychological and emotional subscales and the QOLS, and mood is known to influence quality of life perceptions 5 .


Scores increase significantly after lung volume reductionsurgery2,3 (pre-op mean(SD)=78(8.2), 3 month post-op=88.5(8.3), 6 month post-op=87.8(10.5)2

Research use

Chronic obstructive pulmonary disease, lung volume reduction surgery2,3 , arthritis4 , sudden cardiac death survivors7

Used in clinical trials

Fibromyalgia Education & Exercise 8

Used in clinical setting

Fibromyalgia Patient Care9


Original: English

Translations: Swedish, Norwegian, Hebrew, Spanish, Chinese, Thai


  1. Anderson KL. The effect of chronic obstructive pulmonary disease on quality of life. Res Nurs Health 1995;18,547-556.
  2. Anderson KL, Benditt JO, Tyler ML, Albert RK, Wood DE, Lewis SL, Butler CW. Effect of lung volume reduction surgery on overall quality of life. Am J Respir Crit Care Med. reference info?
  3. Anderson KL, Benditt JO, Tyler ML, Albert RK, Wood DE, Lewis SL, Klima LD. Lung volume reduction surgery improves global quality of life. Am J Respir Crit Care Med 1996;153(Part 2):A426.
  4. Burckhardt CS. The impact of arthritis on quality of life. Nurs Res 1985;34:11-16.
  5. Burckhardt CS, Woods SL, Schultz AA, Ziebarth DM. Quality of life of adults with chronic illness: A psychometric study. Res Nurs Health 1989;12:347-354.
  6. Flanagan JC. A research approach to improving our quality of life. Am Psychologist 1978;33:138-147.
  7. Motzer SU, Stewart BS. Sense of coherence as a predictor of quality of life in persons with coronary heart disease surviving cardiac arrest. Res Nurs Health 1996;19:287-298.
  8. Burckhardt CS, Mannerkorpi K, Hedenberg L, Bjelle A. A randomized, controlled clinincal trial of education and physicial training for women with fibromyalgia. J Rheumatol 1994;21(4):714-720.
  9. Bennett RM, Burckhardt CS, Clark SR, O'Reilly CA, Wiens AN, Campbell SM. Group treatment of fibromyalgia: a 6 month outpatient program. J Rheumatol ;23(3):521-528.

Date of information

July 1998

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