# HELPipedia Wheel of Wellness — Assessment Instruments

## Overview

This document contains the full item text, response scales, and scoring keys for the six evidence-based instruments used across the Wheel of Wellness assessments. Each instrument is presented as published by its authors, with required attribution and licensing noted.

**Reading level:** All items are written at or below a 4th-grade reading level where the original instrument permits.

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## 1. WHO-5 Well-Being Index

**Citation:** World Health Organization. (1998). *Well-being measures in primary health care: The DepCare project.* WHO Regional Office for Europe.

**Purpose:** A 5-item self-report measure of subjective psychological well-being over the past two weeks.

**Audience:** Generalized (all audiences)

### Items

*Please indicate for each of the five statements which is closest to how you have been feeling over the last two weeks.*

| # | Over the last two weeks… | All of the time (5) | Most of the time (4) | More than half the time (3) | Less than half the time (2) | Some of the time (1) | At no time (0) |
|---|---|---|---|---|---|---|---|
| 1 | I have felt cheerful and in good spirits. | | | | | | |
| 2 | I have felt calm and relaxed. | | | | | | |
| 3 | I have felt active and vigorous. | | | | | | |
| 4 | I woke up feeling fresh and rested. | | | | | | |
| 5 | My daily life has been filled with things that interest me. | | | | | | |

### Scoring

- **Raw score:** Sum the five item scores (range: 0–25).
- **Percentage score:** Multiply the raw score by 4 (range: 0–100).
  - 0 = worst possible quality of life
  - 100 = best possible quality of life
- **Interpretation:** A percentage score ≤ 50 suggests poor well-being and warrants further clinical assessment. A score ≤ 28 likely indicates depression (sensitivity 0.86, specificity 0.81 in validation studies).

### Licensing

Free to use; no permission required. Attribution: World Health Organization, 1998.

**Reference:** Topp, C. W., Østergaard, S. D., Søndergaard, S., & Bech, P. (2015). The WHO-5 Well-Being Index: A systematic review of the literature. *Psychotherapy and Psychosomatics, 84*(3), 167–176.
## 2. Professional Quality of Life Scale (ProQOL-5)

**Citation:** Stamm, B. H. (2010). *The Concise ProQOL Manual* (2nd ed.). Pocatello, ID: ProQOL.org.

**Purpose:** A 30-item self-report measure of compassion satisfaction, burnout, and secondary traumatic stress in helping professionals over the past 30 days.

**Audience:** Professionals (therapists, counselors, coaches, educators, healthcare workers)

### Response Scale

| 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
| Never | Rarely | Sometimes | Often | Very Often |

### Items

*When you [help] people you have direct contact with their lives. Consider each of the following questions about you and your current work situation. Select the number that honestly reflects how frequently you experienced these things in the last 30 days.*

| # | Item | Subscale |
|---|---|---|
| 1 | I am happy. | BO (R) |
| 2 | I am preoccupied with more than one person I [help]. | STS |
| 3 | I get satisfaction from being able to [help] people. | CS |
| 4 | I feel connected to others. | BO (R) |
| 5 | I jump or am startled by unexpected sounds. | STS |
| 6 | I feel invigorated after working with those I [help]. | CS |
| 7 | I find it difficult to separate my personal life from my life as a [helper]. | STS |
| 8 | I am not as productive at work because I am losing sleep over traumatic experiences of a person I [help]. | BO |
| 9 | I think that I might have been affected by the traumatic stress of those I [help]. | STS |
| 10 | I feel trapped by my job as a [helper]. | BO |
| 11 | Because of my [helping], I have felt "on edge" about various things. | STS |
| 12 | I like my work as a [helper]. | CS |
| 13 | I feel depressed because of the traumatic experiences of the people I [help]. | STS |
| 14 | I feel as though I am experiencing the trauma of someone I have [helped]. | STS |
| 15 | I have beliefs that sustain me. | BO (R) |
| 16 | I am pleased with how I am able to keep up with [helping] techniques and protocols. | CS |
| 17 | I am the person I always wanted to be. | BO (R) |
| 18 | My work makes me feel satisfied. | CS |
| 19 | I feel worn out because of my work as a [helper]. | BO |
| 20 | I have happy thoughts and feelings about those I [help] and how I could help them. | CS |
| 21 | I feel overwhelmed because my case [work] load seems endless. | BO |
| 22 | I believe I can make a difference through my work. | CS |
| 23 | I avoid certain activities or situations because they remind me of frightening experiences of the people I [help]. | STS |
| 24 | I am proud of what I can do to [help]. | CS |
| 25 | As a result of my [helping], I have intrusive, frightening thoughts. | STS |
| 26 | I feel "bogged down" by the system. | BO |
| 27 | I have thoughts that I am a "success" as a [helper]. | CS |
| 28 | I can't recall important parts of my work with trauma victims. | STS |
| 29 | I am a very caring person. | BO (R) |
| 30 | I am happy that I chose to do this work. | CS |

**Subscale key:**
- **CS** = Compassion Satisfaction (items 3, 6, 12, 16, 18, 20, 22, 24, 27, 30)
- **BO** = Burnout (items 1, 4, 8, 10, 15, 17, 19, 21, 26, 29) — items marked (R) are reverse-scored
- **STS** = Secondary Traumatic Stress (items 2, 5, 7, 9, 11, 13, 14, 23, 25, 28)

### Scoring

1. **Reverse-score** items 1, 4, 15, 17, and 29: 1→5, 2→4, 3→3, 4→2, 5→1.
2. **Sum** each subscale (range: 10–50 per subscale).
3. **Convert to t-score** using the following formula for each subscale:
   - t-score = (raw sum × 10) + (50 − mean of subscale distribution)
   - Simplified: raw sum ≤ 22 → t-score ≤ 43 (Low); 23–41 → ~50 (Average); ≥ 42 → ≥ 57 (High)
4. **Interpretation** (mean = 50, SD = 10):
   - **Compassion Satisfaction:** Higher = greater professional satisfaction.
   - **Burnout:** Higher = greater risk of burnout.
   - **Secondary Traumatic Stress:** Higher = more work-related secondary trauma symptoms.

### Licensing

© B. Hudnall Stamm, 2009. Free to copy as long as (a) author is credited, (b) no changes are made, and (c) it is not sold. Available at www.proqol.org.
## 3. PROMIS Global Health-10

**Citation:** Hays, R. D., Bjorner, J. B., Revicki, D. A., Spritzer, K. L., & Cella, D. (2009). Development of physical and mental health summary scores from the Patient-Reported Outcomes Measurement Information System (PROMIS) global items. *Quality of Life Research, 18*(7), 873-880.

**Purpose:** A 10-item self-report measure of global physical and mental health. NIH-funded, public domain.

**Audience:** Generalized (all audiences)

### Items

#### Global Physical Health subscale

| # | Item | Response Scale |
|---|---|---|
| Global01 | In general, how would you rate your health? | 1 = Poor → 5 = Excellent |
| Global03 | In general, how would you rate your physical health? | 1 = Poor → 5 = Excellent |
| Global06 | To what extent are you able to carry out your everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair? | 1 = Not at all → 5 = Completely |
| Global07 | In the past 7 days, how would you rate your pain on average? | 0 = No pain → 10 = Worst pain imaginable (recoded) |
| Global08 | In the past 7 days, how would you rate your fatigue on average? | 1 = None → 5 = Very severe (reverse-scored) |

#### Global Mental Health subscale

| # | Item | Response Scale |
|---|---|---|
| Global02 | In general, how would you rate your quality of life? | 1 = Poor → 5 = Excellent |
| Global04 | In general, how would you rate your mental health, including your mood and your ability to think? | 1 = Poor → 5 = Excellent |
| Global05 | In general, how would you rate your satisfaction with your social activities and relationships? | 1 = Poor → 5 = Excellent |
| Global09 | In the past 7 days, how would you rate your sleep on average? | 1 = Very poor → 5 = Very good |
| Global10 | In the past 7 days, how often have you been bothered by emotional problems such as feeling anxious, depressed, or irritable? | 1 = Always → 5 = Never |

### Scoring

1. **Recode** Global07 (pain NRS): 0 → 5, 1-3 → 4, 4-6 → 3, 7-9 → 2, 10 → 1
2. **Reverse-score** Global08 (fatigue) and Global10 (emotional problems): 1→5, 2→4, 3→3, 4→2, 5→1
3. **Global Physical Health raw score:** Sum Global03 + Global06 + Global07r + Global08r (range: 4-20)
4. **Global Mental Health raw score:** Sum Global02 + Global04 + Global05 + Global10r (range: 4-20)
5. **Convert to T-scores** using the PROMIS conversion tables (mean = 50, SD = 10). The raw-sum-to-T-score lookup tables are available in the PROMIS scoring manual at www.healthmeasures.net.

### Licensing

Public domain. No permission required. Funded by the National Institutes of Health (NIH). Attribution: PROMIS Health Organization.
## 4. Beach Center Family Quality of Life Scale (FQOL)

**Citation:** Hoffman, L., Marquis, J., Poston, D., Summers, J. A., & Turnbull, A. (2006). Assessing family outcomes: Psychometric evaluation of the Beach Center Family Quality of Life Scale. *Journal of Marriage and Family, 68*(4), 1069-1083.

**Purpose:** A 25-item self-report measure assessing families' perceptions of their satisfaction with different aspects of family quality of life. Five subscales.

**Audience:** Family Member / Household; Parent / Caregiver

### Response Scale

| 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
| Very Dissatisfied | Dissatisfied | Neither Satisfied nor Dissatisfied | Satisfied | Very Satisfied |

### Items

*How satisfied are you that...*

#### Family Interaction (6 items)

| # | Item |
|---|---|
| FQOL01 | My family enjoys spending time together. |
| FQOL02 | My family members talk openly with each other. |
| FQOL03 | My family solves problems together. |
| FQOL04 | My family members support each other to accomplish goals. |
| FQOL05 | My family members show that they love and care for each other. |
| FQOL06 | My family is able to handle life's ups and downs. |

#### Parenting (6 items)

| # | Item |
|---|---|
| FQOL07 | Family members help the children learn to be independent. |
| FQOL08 | Family members help the children with schoolwork and activities. |
| FQOL09 | Family members teach the children how to get along with others. |
| FQOL10 | Adults in my family teach the children to make good decisions. |
| FQOL11 | Adults in my family know other people in the children's lives (i.e., friends, teachers). |
| FQOL12 | Adults in my family have time to take care of the individual needs of every child. |

#### Emotional Well-Being (4 items)

| # | Item |
|---|---|
| FQOL13 | My family has the support we need to relieve stress. |
| FQOL14 | My family members have friends or others who provide support. |
| FQOL15 | My family members have some time to pursue their own interests. |
| FQOL16 | My family has outside help available to us to take care of special needs of all family members. |

#### Physical / Material Well-Being (5 items)

| # | Item |
|---|---|
| FQOL17 | My family members have transportation to get to the places they need to be. |
| FQOL18 | My family gets dental care when needed. |
| FQOL19 | My family gets medical care when needed. |
| FQOL20 | My family has a way to take care of our expenses. |
| FQOL21 | My family feels safe at home, work, school, and in our neighborhood. |

#### Disability-Related Support (4 items)

| # | Item |
|---|---|
| FQOL22 | My family member with special needs has support to make progress at school or workplace. |
| FQOL23 | My family member with special needs has support to make progress at home. |
| FQOL24 | My family member with special needs has support to make friends. |
| FQOL25 | My family has a good relationship with the service providers who work with our family member with a disability. |

### Scoring

- Sum scores within each subscale for domain-level results.
- Grand mean across all 25 items for overall Family Quality of Life score.
- Cronbach's alpha: 0.88 (satisfaction), 0.94 (importance).
- Test-retest reliability: r = 0.60 to 0.77 across subscales (satisfaction).

### Licensing

© Beach Center on Disability, 2015. Permission granted to reproduce for educational purposes. Free for research and clinical use. Not to be used to determine or deny eligibility for services.
## 5. CAREPAL-8: 8-Item Screening Tool for Family Caregiver Burden in Palliative Care

**Citation:** Ullrich, A., Bergelt, C., Marx, G., Daubmann, A., Benze, G., Heine, J., Dickel, L. M., Wowretzko, F., Zhang, Y., Bokemeyer, C., Nauck, F., & Oechsle, K. (2024). The CAREPAL-8: A short screening tool for multidimensional family caregiver burden in palliative care. *BMC Palliative Care, 23*, Article 195.

**Purpose:** An 8-item self-administered screening tool that identifies distinct risk profiles (four classes) of multidimensional caregiver burden. Items are drawn from validated source instruments.

**Audience:** Parent / Caregiver (family caregivers in palliative/support care contexts)

**Note on item wording:** The CAREPAL-8 derives items from four established instruments (GAD-7, PHQ-9, SF-8, and FIN). The specific item text below is reproduced from the source instruments as described in Ullrich et al. (2024). See the supplemental material of the original publication for the exact validated CAREPAL-8 form.

### Items

*These eight items, drawn from their source instruments, identify four caregiver risk profiles: Currently Stable, Unmet Needs, Psychologically Burdened, and High-Risk.*

| # | Source Instrument | Item | Response |
|---|---|---|---|
| 1 | GAD-7 (anxiety) | Over the last 2 weeks, how often have you been bothered by not being able to stop or control worrying? | 0 = Not at all → 3 = Nearly every day |
| 2 | PHQ-9 (depression) | Over the last 2 weeks, how often have you been bothered by feeling tired or having little energy? | 0 = Not at all → 3 = Nearly every day |
| 3 | SF-8 (QoL) | How much bodily pain have you had during the past 4 weeks? | 1 = None → 6 = Very severe |
| 4 | SF-8 (QoL) | During the past 4 weeks, how much did personal or emotional problems keep you from doing your usual work, school, or other daily activities? | 1 = Not at all → 5 = Could not do daily activities |
| 5 | FIN (needs) | I need to know what treatment the patient is receiving. | Met / Not met |
| 6 | FIN (needs) | I need to know what symptoms the treatment or disease can cause. | Met / Not met |
| 7 | FIN (needs) | I need to have information about what to do for the patient at home. | Met / Not met |
| 8 | FIN (needs) | I need to feel accepted by the health professionals. | Met / Not met |

**Source instrument key:**
- **GAD-7** = Generalized Anxiety Disorder 7-Item Scale (Spitzer et al., 2006). Public domain.
- **PHQ-9** = Patient Health Questionnaire 9-Item Depression Module (Kroenke et al., 2001). Public domain.
- **SF-8** = 8-Item Short Form Health Survey (Ware et al., 2001). Available for non-commercial research.
- **FIN** = Family Inventory of Needs (Kristjanson et al., 1995). Permission granted by authors.

### Classification System (Preliminary)

The CAREPAL-8 uses two indices:
- **Index 1 (PSYQOL):** Items 1-4. Distinguishes low vs. substantial psychological burden and impaired quality of life.
- **Index 2 (NEEDS):** Items 5-8. Distinguishes sufficient vs. insufficient pallitive care need fulfillment.

| PSYQOL Index | NEEDS Index | Class |
|---|---|---|
| Low burden / sufficient QoL | Needs met | **Currently Stable** (37% of sample) |
| Low burden / sufficient QoL | Needs unmet | **Unmet Needs** (20%) |
| High burden / impaired QoL | Needs met | **Psychologically Burdened** (30%) |
| High burden / impaired QoL | Needs unmet | **High-Risk** (13%) |

### Validation Status

This classification system is **preliminary** and has not been externally validated. A multi-center validation study across 16 German palliative care facilities was underway as of 2024. Use for screening and supportive referral only — not for diagnostic purposes.

### Licensing

The CAREPAL-8 is published under a Creative Commons Attribution 4.0 International License (CC BY 4.0). The source instruments have their own licensing terms (see above). No commercial use without verifying rights on the SF-8 and FIN component items.

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## 6. Personal Wellbeing Index — Intellectual Disability (PWI-ID)

**Citation:** Cummins, R. A., & Lau, A. L. D. (2005). *Personal Wellbeing Index — Intellectual Disability* (3rd ed.). Melbourne: Australian Centre on Quality of Life, Deakin University.

**Purpose:** An 8-item self-report measure of subjective wellbeing (life satisfaction) designed for adults with mild to moderate intellectual disability. Uses simplified language and optional visual response formats.

**Audience:** Special Needs / Accessible Format

### Response Formats

The PWI-ID offers four response scales depending on the individual's cognitive level:
1. **11-point Likert (0-10):** Fully satisfied / completely happy → Not satisfied at all / very unhappy
2. **5-point Visual Likert (0-4):** 😄 → 😟 (emoji / face anchors)
3. **3-point Visual Likert (0-2):** Simplified happy / neutral / sad
4. **2-point Binary (0-1):** Happy / Unhappy

**Pre-testing is required** before administration to determine which format the individual can use reliably (see the PWI-ID manual for pre-test protocol).

### Items

*The PWI-ID uses the question stem "How happy do you feel about…" using concrete, single-concept language. The 7 domain items plus one global item are:*

| PWI-ID Domain | Question | Life Domain Measured |
|---|---|---|
| Standard of Living | How happy do you feel about the things you have? Like your money and the things you own. | Standard of living |
| Health | How happy do you feel about how healthy you are? | Personal health |
| Life Achievement | How happy do you feel about the things you do or make? | Achieving in life |
| Personal Relationships | How happy do you feel about how you get along with people? Like your family and friends. | Personal relationships |
| Personal Safety | How happy do you feel about how safe you feel? | Feeling safe / future security |
| Community Connectedness | How happy do you feel about doing things outside your home? Like in your community or neighborhood. | Community connectedness |
| Future Security | How happy do you feel about what will happen to you later in your life? | Future security |

| PWI-ID Item | Question |
|---|---|
| Global (Life as a Whole) | How happy do you feel about your life as a whole? |

### Scoring

- Score each item on the 0-10 scale (lower response formats are mapped to the equivalent 0-10 range using the published conversion table).
- Sum the 7 domain items ÷ 7 = Subjective Wellbeing score (range: 0-100 when multiplied by 10, or 0-10 raw).
- The global "life as a whole" item is analyzed separately and used as a validity check.
- Normative range for the general population: 70-80 (on the 0-100 percentage-of-scale-maximum metric). Scores below 50 indicate substantial wellbeing deficit.

### Licensing

Free for non-commercial research and clinical use. Instrument and manual available at www.acqol.com.au. Attribution: Australian Centre on Quality of Life, Deakin University.

**Reference:** Cummins, R. A., & Lau, A. L. D. (2005). *Manual of the Personal Wellbeing Index: Intellectual Disability* (3rd ed.). Australian Centre on Quality of Life, Deakin University.

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## Licensing Summary

| Instrument | Commercial Use | Attribution Required | Modifications Permitted | Fee |
|---|---|---|---|---|
| WHO-5 | ✅ Yes (public domain) | Yes | Yes | Free |
| ProQOL-5 | ❌ Not sold | Yes (author credit) | No changes | Free |
| PROMIS Global-10 | ✅ Yes (NIH public domain) | Recommended | Yes | Free |
| Beach FQOL | ✅ Educational use | Yes (Beach Center) | For educational purposes | Free |
| CAREPAL-8 | CC BY 4.0 | Yes | Yes (CC BY 4.0) | Free |
| PWI-ID | ✅ Research/clinical | Yes (Deakin University) | For clinical adaptation | Free |

**Important:** All instruments in this document are screening tools intended for supportive conversation and self-reflection. They are **not** diagnostic instruments. Clinical interpretation should involve a qualified professional. Verify current licensing terms with the instrument authors before commercial deployment.

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*Last updated: July 2026*
*Compiled for HELPipedia Wheel of Wellness / SpecialNeeds.help*
