Use of the SF-36 and other health-related quality of life measures to assess persons with disabilities

This article evaluates the appropriateness of existing approaches to the assessment of health-related quality of life (HRQOL) for persons with disabilities. We compare the conceptual model of HRQOL from the Medical Outcomes Study with the World Health Organization's International Classification of Functioning, Disability and Health. In addition, we examine the attitudes toward disease "burden" that arise from these 2 models. We note how values or the importance attached to domains of health can change with fluctuations in physical health. Further, we summarize arguments in favor of developing targeted measures of persons with disabilities. Finally, we discuss some methodologic issues in assessing physical functioning, attributions to health versus disability, and mode of administration. We conclude that users of "standard" HRQOL measures need to be aware of their limitations for assessing persons with disabilities.