Calculating PozQoL scores

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Process for using PozQoL

IMPORTANT: PozQoL should only be used with people living with HIV (PLHIV).

Step 1: Administering PozQoL
Step 2: Calculating scores
Step 3: Interpreting scores
Step 4a: Using scores (individual)
Step 4b: Using scores (group)

📚 Related resource: PozQoL Implementation Kit (pdf download)

Calculating PozQoL scores

Calculating PozQoL scores is a 2-part process:

  1. Code items — Ensures that for all items, higher scores indicate higher quality of life (QoL)
  2. Calculate the scores — Produces scores for each QoL domain and a score for overall QoL

The information on this page explains how to do this manually.

The PozQoL team has also developed tools to do this for you.

📚 Related resources: PozQoL Score Calculator for Individuals (.xlsx download) and PozQoL Score Calculator for Groups and Comparisons (.xlsx download)

Part 1: Coding PozQoL Items

Coding is when you take your client’s responses to the PozQoL scale and give them a number value that you can use for calculations.

When someone completes PozQoL, they indicate how strongly they agree with a statement on a scale from 1 (not at all) to 5 (extremely).

Some of the items indicate positive feelings; for example, “I am enjoying life”. Agreeing with this statement is an indication good quality of life. So, a response of 4 or 5 would indicate good quality of life.

Other items indicate negative feelings; for example, “I worry about my health”. Agreeing with this statement might indicate poor quality of life. So, a response of 4 or 5 would indicate a poor quality of life.

To calculate PozQoL scores, we need to “code” responses in such a way that higher numbers always indicate better quality of life.

The following steps illustrate how this is done.

Start with a completed PozQoL Scale

Here is an example of a completed PozQoL Scale.

The response options for each item are:

  1. Not at all
  2. Slightly
  3. Moderately
  4. Very
  5. Extremely

These numbered responses are used to score the scale.

The image shows an example of a completed PozQoL Scale. The responses that will be used for calculating PozQoL Scores are as follows: Item 1: I am enjoying life. Response: 4, Very. Item 2: I worry about my health. Response: 3, Moderately. Item 3: I lack a sense of belonging with people around me. Response: 1, Not at all. Item 4: I feel that HIV prevents me from doing as much as I would like. Response: 3, Moderately. Item 5: I feel good about myself as a person. Response: 5, Extremely. Item 6: Having HIV limits my opportunities in life. Response: 3, Moderately. Item 7: I worry about the impact of HIV on my health. Response: 2, Slightly. Item 8: I feel in control of my life. Response: 4, Very. Item 9: I am afraid that people may reject me when they learn I have HIV. Response: 3, Moderately. Item 10: Managing HIV wears me out. Response: 1, Not at all. Item 11: I feel that HIV limits my personal relationships. Response: 2, Slightly. Item 12: I fear the health effects of HIV as I get older. Response: 4, Very. Item 13: I am optimistic about my future. Response: 3, Moderately.

Code the positively worded items

Four (4) items are positively worded. These are Items 1, 5, 8, and 13.

The coding for positively answered items is the same as the response numbers:

  1. Not at all = 1
  2. Slightly = 2
  3. Moderately = 3
  4. Very = 4
  5. Extremely = 5
The image shows the same example of a completed PozQoL Scale as in the previous image. The positively worded questions are highlighted. They are coded and ready for accurately calculating PozQoL Scores. Coding is as follows: Item 1: I am enjoying life. Response: 4, Very. Code = 4. Item 5: I feel good about myself as a person. Response: 5, Extremely. Code = 5. Item 8: I feel in control of my life. Response: 4, Very. Code = 4. Item 13: I am optimistic about my future. Response: 3, Moderately. Code = 3.

Code the negatively worded items

Nine (9) items are negatively worded. These are Items 2, 3, 4, 6, 7, 9, 10, 11, and 12.

The coding for negatively answered items is the reverse of the response numbers:

  1. Not at all = 5
  2. Slightly = 4
  3. Moderately = 3
  4. Very = 2
  5. Extremely = 1
The image follows on with the same example as previously. The negatively worded questions have been highlighted and coded. Now it is ready for calculating the PozQoL Scores. The new coding is as follows: Item 2: I worry about my health. Response: 3, Moderately, Code = 3. Item 3: I lack a sense of belonging with people around me. Response: 1, Not at all. Code = 5. Item 4: I feel that HIV prevents me from doing as much as I would like. Response: 3, Moderately. Code = 3. Item 6: Having HIV limits my opportunities in life. Response: 3, Moderately. Code = 3. Item 7: I worry about the impact of HIV on my health. Response: 2, Slightly. Code = 4. Item 9: I am afraid that people may reject me when they learn I have HIV. Response: 3, Moderately. Code = 3. Item 10: Managing HIV wears me out. Response: 1, Not at all. Code = 5. Item 11: I feel that HIV limits my personal relationships. Response: 2, Slightly. Code = 4. Item 12: I fear the health effects of HIV as I get older. Response: 4, Very. Code = 2.

Part 2: Calculating the PozQoL Scores

PozQoL Scores can be calculated for overall quality of life (PozQoL score), and for each domain (PozQoL domain scores).

The following table details which items are used to calculate each type of score.

ScaleNumber of itemsItems to score
PozQoL score (overall QoL)13All (1 – 13)
Psychological domain41, 5, 8, 13
Social domain33, 9, 11
Health concerns domain32, 7, 12
Functional domain34, 6, 10

Scores can be calculated either as an average or as a sum. Average scores are preferable, but summary scores are easier to calculate manually.

Calculating average PozQoL and PozQoL domain scores

Average scores are preferred because they are valid even if some items are left blank. That said, we do not recommend calculating average scores for specific domains if more than one item from that domain is blank.

To calculate the PozQoL score, find the average of the scores from all 13 items.

To calculate the PozQoL domain scores, find the average the scores of each domain’s items.

Scores can range from 1 to 5.

Remember, we do not recommend calculating average PozQoL domain scores if more than one item is left blank.

Calculating Summary PozQoL and PozQoL Domain Scores

Summary scores are easier to calculate when administering PozQoL as a pen-and-pencil copy in one-on-one consultations. However, summary scores are only valid if all items are answered.

Add the scores from all 13 items to find the overall quality of life score. Add the scores of each domain’s items to find the domain scores. Higher scores indicate better quality of life.

  • PozQoL (overall quality of life) score can range from 13 to 65
  • Psychological domain scores can range from 4 to 20
  • All other domain scores can range from 3 to 15

Remember, summary scores are only meaningful when all of the relevant items have been answered.

Example calculations

The following example uses the coded scores we worked out previously to calculate our example client’s PozQoL Scores.

Their coded PozQoL scale is shown here. The colours indicate which item belongs to each domain.

  • Psychological domain items (blue) include items 1, 5, 8, and 13.
  • Social domain items (red) include items 3, 9, and 11.
  • Health concerns domain items (green) include items 2, 7, and 12.
  • Functional domain items (yellow) include items 4, 6, and 10.
The image follows on with the same example as previously. The items have been colour-coded according to their domain. Psychological Domain Items are coloured blue and include Item 1 (I am enjoying life), Item 5 (I feel good about myself as a person), Item 8 (I feel in control of my life), and Item 13 (I am optimistic about my future). Social Domain Items are coloured red and include Item 3 (I lack a sense of belonging with people around me), Item 9 (I am afraid that people may reject me when they learn I have HIV), and Item 11 (I feel that HIV limits my personal relationships). Health Concerns Domain Items are coloured green and include Item 2 (I worry about my health), Item 7 (I worry about the impact of HIV on my health), and Item 12 (I fear the health effects of HIV as I get older). Functional Domain Items are coloured yellow and include Item 4 (I feel that HIV prevents me from doing as much as I would like), Item 6 (Having HIV limits my opportunities in life), and Item 10 (Managing HIV wears me out).

Because this client did not leave any items blank, we can use whichever method is easiest to for calculating their PozQoL scores.

Their PozQoL scores are:

PozQoL Score TypeSummary ScoreAverage Score
Psychological Domain164.00
Social Domain124.00
Health Concerns Domain93.00
Functional Domain113.67
PozQoL Score (Overall)483.69

The information below shows in detail how these scores were calculated.

Calculating domain scores

Using the same scores that we coded earlier, we see here that the scores for the items the different domains.

Psychological domain scores

The scores for the four (4) items in the psychological domain are 4, 5, 4, and 3.

The sum of these scores is 16 and the average is 4.00.

Therefore, this client’s psychological domain scores are:

  • Summary score = 16
  • Average score = 4.00
The image follows on with the same example as previously. It shows the working for calculating PozQoL Scores for the psychological domain. Only the items and coded scores from the psychological domain are shown. There are 4 items (Items 1, 5, 8, and 13). The items are: 1. I am enjoying life. 5. I feel good about myself as a person. 8. I feel in control of my life. 13. I am optimistic about my future. Their scores are 4, 5, 4, and 3, respectively. 4 + 5 + 4 + 3 = 16. Therefore, the PozQoL summary score for the psychological domain is 16. To find the average Score, you divide 16 by 4 (because there were 4 items). 16 divided by 4 = 4. Therefore, the average PozQoL score for the psychological domain is 4.00.
Social domain scores

The scores for the three (3) items in the social domain are 5, 3, and 4.

The sum of these scores is 12, and the average is 4.00.

Therefore, this client’s social domain scores are:

  • Summary score = 12
  • Average score = 4.00
The image follows on with the same example as previously. It shows the working for calculating PozQoL scores for the social domain. Only the items and coded scores from the social domain are shown. There are 3 items (Items 3, 9, and 11). The items are: 3, I lack a sense of belonging with people around me. 9, I am afraid that people may reject me when they learn I have HIV. And 11, I feel that HIV limits my personal relationships. Their scores are 5, 3, and 4, respectively. 5 + 3 + 4 = 12. Therefore, the PozQoL summary score for the social domain is 12. To find the average score, you divide 12 by 3 (because there were 3 items). 12 divided by 3 = 4. Therefore, the average PozQoL score for the social domain is 4.00.
Health concerns domain scores

The client’s scores for the three (3) items in the health concerns domain are 3, 4, and 2.

The sum of these scores is 9 and the average is 3.00.

Therefore this client’s health concerns domain scores are:

  • Summary score = 9
  • Average score = 3.00
The image follows on with the same example as previously. It shows the working for calculating PozQoL Scores for the Health Concerns Domain. Only the items and coded scores from the Health Concerns Domain are shown. There are 3 items (Items 2, 7, and 12). The items are: 2, I worry about my health. 7, I worry about the impact of HIV on my health. And 12, I fear the health effects of HIV as I get older. Their scores are 3, 4, and 2, respectively. 3 + 4 + 2 = 9. Therefore, the PozQoL Summary Score for the Social Domain is 9. To find the average Score, you divide 9 by 3 (because there were 3 items). 9 divided by 3 = 3. Therefore, the Average PozQoL Score for the Health Concerns Domain is 3.00.
Functional domain scores

The client’s scores for the three (3) items in the functional domain are 3, 3, and 5.

The sum of these scores is 11, and the average is 3.67.

Therefore, this client’s functional domain scores are:

  • Summary score = 11
  • Average score = 3.67
The image follows on with the same example as previously. It shows the working for calculating PozQoL scores for the functional domain. Only the items and coded scores from the functional domain are shown. There are 3 items (Items 4, 6, and 10). The items are: 4, I feel that HIV prevents me from doing as much as I would like. 6, Having HIV limits my opportunities in life. And 10, Managing HIV wears me out. Their scores are 3, 3, and 5, respectively. 3 + 3 + 3 = 11. Therefore, the PozQoL summary score for the functional domain is 11. To find the average Score, you divide 11 by 3 (because there were 3 items). 11 divided by 3 = 3.67. Therefore, the average PozQoL score for the functional domain is 3.67.

Calculating the overall PozQoL score

The sum of the scores for all 13 items is 48.

We get this from adding all 13 scores together.

The average of these scores is their sum (48) divided by the total number of items (13), which is 3.69.

Therefore, this client’s overall PozQoL score are:

  • Summary score = 48
  • Average score = 3.69
The image follows on with the same example as previously. It shows the working for calculating the overall PozQoL score. All the items and coded scores from the whole scale are shown. The sum of all of the item scores is 48. (This was obtained by adding them all together). To find the average score, you divide 48 by 13 (because there were 13 items). 48 divided by 13 = 3.69. Therefore, this client's overall PozQoL score was 3.69.