Multiple Sclerosis Quality of Life

(MSQOL)-54 Instrument

For Further Information, Contact:

Barbara G. Vickrey, MD, MPH

UCLA Department of Neurology
C-128 RNRC; Box 951769
Los Angeles, CA 90095-1769
Voice: 310.206.7671
Fax: 310.794.7716

Copyright© 1995, University of California, Los Angeles

INSTRUCTIONS:

This survey asks about your health and daily activities. Answer every question by
circling the appropriate number (1, 2, 3, ...).

If you are unsure about how to answer a question, please give the best answer
you can and write a comment or explanation in the margin.

Please feel free to ask someone to assist you if you need help reading or marking the
form.

1. In general, would you say your health is:

(circle one number)

Excellent………………………………………1

Very good…………………………………….2

Good…………………………………………..3

Fair………………………………….………...4

Poor……………………………………………5

2. Compared to one year ago, how would you rate your health in general now?

(circle one number)

Much better now than one year ago....................... 1

Somewhat better now than one year ago……….2

About the same ...................................................... 3

Somewhat worse now than one year ago.............. 4

Much worse now than one year ago ...................... 5

Copyright© 1995, University of California, Los Angeles

3-12. The following questions are about activities you might do during a typical
day. Does your health limit you in these activities? If so, how much?
(Circle 1, 2, or 3 on each line)
Yes, Yes, No, Not
Limited Limited Limited
a Lot a Little at All

3. Vigorous activities, such as

running, lifting heavy
1 2 3
objects, participating in
strenuous sports

4. Moderate activities, such as

moving a table, pushing a 1
2 3
vacuum cleaner, bowling, or
playing golf

5. Lifting or carrying groceries 1 2 3

6. Climbing several flights of

1 2 3
stairs

7. Climbing one flight of stairs 1 2 3

8. Bending, kneeling, or
1 2 3
stooping

9. Walking more than a mile 1 2 3

10. Walking several blocks 1 2 3

11. Walking one block 1 2 3

12. Bathing and dressing

1 2 3
yourself

Copyright© 1995, University of California, Los Angeles

13-16. During the past 4 weeks, have you had any of the following problems with
your work or other regular daily activities as a result of your physical
health?
(Circle one number on each line)

YES NO

13. Cut down on the amount of time you could

1 2
spend on work or other activities

14. Accomplished less than you would like 1 2

15. Were limited in the kind of work or other

1 2
activities

16. Had difficulty performing the work or other

activities
1 2
(for example, it took extra effort)

17-19. During the past 4 weeks, have you had any of the following problems with
your work or other regular daily activities as a result of any emotional
problems (such as feeling depressed or anxious).
(Circle one number on each line)

YES NO

17. Cut down on the amount of time you could

1 2
spend on work or other activities

18. Accomplished less than you would like 1 2

19. Didn't do work or other activities as carefully

1 2
as usual

Copyright© 1995, University of California, Los Angeles

20. During the past 4 weeks, to what extent has your physical health or emotional
problems interfered with your normal social activities with family, friends,
neighbors, or groups?
(circle one number)

Not at all..........................................1

Slightly ............................................2

Moderately ......................................3

Quite a bit .......................................4

Extremely........................................5

Pain

21. How much bodily pain have you had during the past 4 weeks?

(circle one number)

None ...................................... 1

Very mild................................ 2

Mild ........................................ 3

Moderate................................ 4

Severe ................................... 5

Very severe............................ 6

22. During the past 4 weeks, how much did pain interfere with your
normal work (including both work outside the home and housework)?

(circle one number)

Not at all................................. 1

A little bit ................................ 2

Moderately ............................. 3

Quite a bit .............................. 4

Extremely............................... 5

Copyright© 1995, University of California, Los Angeles

 23-32. These questions are about how you feel and how things have been with you
during the past 4 weeks. For each question, please give the one answer that
comes closest to the way you have been feeling.

How much of the time during the past 4 weeks... (Circle one number on each line)
A Good
All Most Some A Little None
Bit of
of the Of the of the of the of the
the
Time Time Time Time Time
Time

23. Did you feel full of pep? 1 2 3 4 5 6

24. Have you been a very

1 2 3 4 5 6
nervous person?

25. Have you felt so down in

the dumps that nothing 1 2 3 4 5 6
could cheer you up?

26. Have you felt calm and

1 2 3 4 5 6
peaceful?

27. Did you have a lot of

1 2 3 4 5 6
energy?

28. Have you felt downhearted

1 2 3 4 5 6
and blue?

29. Did you feel worn out? 1 2 3 4 5 6

30. Have you been a happy

1 2 3 4 5 6
person?

31. Did you feel tired? 1 2 3 4 5 6

32. Did you feel rested on

1 2 3 4 5 6
waking in the morning?

Copyright© 1995, University of California, Los Angeles

33. During the past 4 weeks, how much of the time has your physical
health or emotional problems interfered with your social activities
(like visiting with friends, relatives, etc.)?

(circle one number)

All of the time..........................1

Most of the time......................2

Some of the time ....................3

A little of the time....................4

None of the time .....................5

Health in General

34-37. How TRUE or FALSE is each of the following statements for you.

(Circle one number on each line)

Definitely Mostly Not Mostly Definitely

True True Sure False False

34. I seem to get sick

a little easier
1 2 3 4 5
than other people

35. I am as healthy
as anybody I
1 2 3 4 5
know

36. I expect my
health to get
1 2 3 4 5
worse

37. My health is
excellent
1 2 3 4 5

Copyright© 1995, University of California, Los Angeles

 Health Distress

How much of the time during the past 4 weeks...

(Circle one number on each line)

A Good
All Most Some A Little None
Bit of
of the of the of the of the of the
the
Time Time Time Time Time
Time

38. Were you discouraged by

1 2 3 4 5 6
your health problems?

39. Were you frustrated about

1 2 3 4 5 6
your health?

40. Was your health a worry

1 2 3 4 5 6
in your life?

41. Did you feel weighed

down by your health 1 2 3 4 5 6
problems?

Copyright© 1995, University of California, Los Angeles

Cognitive Function

How much of the time during the past 4 weeks...

(Circle one number on each line)

A Good
All Most Some A Little None
Bit of
of the of the of the of the of the
the
Time Time Time Time Time
Time

42. Have you had difficulty

concentrating and
1 2 3 4 5 6
thinking?

43. Did you have trouble

keeping your attention
1 2 3 4 5 6
on an activity for long?

44. Have you had trouble

1 2 3 4 5 6
with your memory?

45. Have others, such as

family members or
friends, noticed that
you have trouble with
1 2 3 4 5 6
your memory or problems
with your concentration?

Copyright© 1995, University of California, Los Angeles

 Sexual Function

46-50. The next set of questions are about your sexual function and your satisfaction with
your sexual function. Please answer as accurately as possible about your function
during the last 4 weeks only.

How much of a problem was each of the following for you during the past 4
weeks?

(Circle one number on each line)

A Little of Somewhat Very
Not a a of a Much a
MEN problem Problem Problem Problem
46. Lack of sexual
interest 1 2 3 4
47. Difficulty getting
or keeping an
1 2 3 4
erection
48. Difficulty having
orgasm 1 2 3 4
49. Ability to satisfy
sexual partner 1 2 3 4

(Circle one number on each line)

A Little of Somewhat Very
Not a a of a Much a
WOMEN problem Problem Problem Problem

46. Lack of sexual

interest 1 2 3 4

47. Inadequate
lubrication 1 2 3 4
48. Difficulty having
orgasm 1 2 3 4
49. Ability to satisfy
sexual partner 1 2 3 4

Copyright© 1995, University of California, Los Angeles

50. Overall, how satisfied were you with your sexual function during the past 4 weeks?

(circle one number)

Very satisfied.................................. 1

Somewhat satisfied ........................ 2

Neither satisfied nor

dissatisfied ..................................... 3

Somewhat dissatisfied ................... 4

Very dissatisfied ............................. 5

51. During the past 4 weeks, to what extent have problems with your bowel or bladder function
interfered with your normal social activities with family, friends, neighbors, or groups?
(circle one number)

Not at all ......................................... 1

Slightly............................................ 2

Moderately ..................................... 3

Quite a bit....................................... 4

Extremely ....................................... 5

52. During the past 4 weeks, how much did pain interfere with your enjoyment of life?

(circle one number)

Not at all ......................................... 1

Slightly............................................ 2

Moderately ..................................... 3

Quite a bit....................................... 4

Extremely ....................................... 5

Copyright© 1995, University of California, Los Angeles

53. Overall, how would you rate your own quality-of-life?

Circle one number on the scale below:

54. Which best describes how you feel about your life as a whole?

(circle one number)

Terrible ......................................... 1

Unhappy......................................... 2

Mostly dissatisfied .......................... 3

Mixed - about equally

satisfied and dissatisfied ................ 4

Mostly satisfied............................... 5

Pleased ........................................ 6

Delighted ........................................ 7

Copyright© 1995, University of California, Los Angeles

Scoring Forms for Multiple Sclerosis Quality of Life (MSQOL) -54

Table 1
MSQOL-54 Scoring Form

Table 2
MSQOL-54 Physical Health Composite Score

Table 3
MSQOL-54 Mental Health Composite Score
 Table 1
MSQOL-54 Scoring Form

Response Final Score

Scale/Item Number 1 2 3 4 5 6 Subtotal 0-100 point
scale
Physical Health
3. 0 50 100 _____
4. 0 50 100 _____
5. 0 50 100 _____
6. 0 50 100 _____
7. 0 50 100 _____
8. 0 50 100 _____
9. 0 50 100 _____
10. 0 50 100 _____
11. 0 50 100 _____
12. 0 50 100 _____
Total: _____ ÷ 10 = _____

Role limitations due to

physical problems
13. 0 100 _____
14. 0 100 _____
15. 0 100 _____
16. 0 100 _____
Total: _____ ÷ 4 = _____

Role limitations due to

emotional problems
17. 0 100 _____
18. 0 100 _____
19. 0 100 _____
Total: _____ ÷ 3 = _____

Pain
21. 100 80 60 40 20 0 _____
22. 100 75 50 25 0 _____
52. 100 75 50 25 0 _____
Total: _____ ÷ 3 = _____

Emotional well-being
24. 0 20 40 60 80 100 _____
25. 0 20 40 60 80 100 _____
26. 100 80 60 40 20 0 _____
28. 0 20 40 60 80 100 _____
30. 100 80 60 40 20 0 _____
Total: _____ ÷ 5 = _____

Energy
23. 100 80 60 40 20 0 _____
27. 100 80 60 40 20 0 _____
29. 0 20 40 60 80 100 _____
31. 0 20 40 60 80 100 _____
32. 100 80 60 40 20 0 _____
Total: _____ ÷ 5 = _____
Table 1 (cont.) Response Final Score
Scale/Item Number 1 2 3 4 5 6 Subtotal 0-100 point
Health Perceptions
1. 100 75 50 25 0 _____
34. 0 25 50 75 100 _____
35. 100 75 50 25 0 _____
36. 0 25 50 75 100 _____
37. 100 75 50 25 0 _____
Total: _____ ÷ 5 = _____

Social function
20. 100 75 50 25 0 _____
33. 0 25 50 75 100 _____
51. 100 75 50 25 0 _____
Total: _____ ÷ 3 = _____

Cognitive function
42. 0 20 40 60 80 100 _____
43. 0 20 40 60 80 100 _____
44. 0 20 40 60 80 100 _____
45. 0 20 40 60 80 100 _____
Total: _____ ÷ 4 = _____

Health distress
38. 0 20 40 60 80 100 _____
39. 0 20 40 60 80 100 _____
40. 0 20 40 60 80 100 _____
41. 0 20 40 60 80 100 _____
Total: _____ ÷ 4 = _____

Sexual function*
46. 100 66.7 33.3 0 _____
47. 100 66.7 33.3 0 _____
48. 100 66.7 33.3 0 _____
49. 100 66.7 33.3 0 _____
Total: _____ ÷ 4 = _____

Change in health
2. 100 75 50 25 0 _____

Satisfaction with sexual function

50. 100 75 50 25 0 _____

Response
Overall quality of life 1 2 3 4 5 6 7
53. (multiply response by 10) _____
54. 0 16.7 33.3 50 66.7 83.3 100 _____
Total: _____ ÷ 2 = _____

Note: The total number of items in each scale is listed as the divisor for each subtotal. However, due to missing data,
the divisor might actually be less than that if not every item within a given scale has been answered. For example, if
item 38 in the Health Distress scale was left blank and the other 3 items in the scale were answered, then the “Total”
score for Health Distress would be divided by ‘3’ (instead of ‘4’) to obtain the “Final Score.”
* Males and females can be combined in the analysis even though question 47 is different for the two groups. The scale
scores can also be reported separately for males and females.
Table 2
Formula for calculating MSQOL-54 Physical Health Composite Score

MSQOL-54 Scale Final Scale Score x Weight = Subtotal

Physical function _____ x .17 = _____(a)

Health perceptions _____ x .17 = _____(b)
Energy/fatigue _____ x .12 = _____(c)
Role limitations - physical _____ x .12 = _____(d)
Pain _____ x .11 = _____(e)
Sexual function _____ x .08 = _____(f)
Social function _____ x .12 = _____(g)
Health distress _____ x .11 = _____(h)

PHYSICAL HEALTH COMPOSITE: Sum subtotals (a) through (h) = _____

Table 3
Formula for calculating MSQOL-54 Mental Health Composite Score

MSQOL-54 Scale Final Scale Score x Weight = Subtotal

Health distress _____ x .14 = _____(a)

Overall quality of life _____ x .18 = _____(b)
Emotional well-being _____ x .29 = _____(c)
Role limitations - emotional _____ x .24 = _____(d)
Cognitive function _____ x .15 = _____(e)

MENTAL HEALTH COMPOSITE: Sum subtotals (a) through (e) = _____