Bach et al developed a 10-item index for patients with diabetes based on the 28-item and 22-item (Bradley) WHO/EURO questionnaires. This can be useful when a uni-dimensional scale for well-being is desired. The authors are from the World Health Organization.

The instrument consists of 10 statements

(1) depression

(2) calm.

(3) energetic, vigorous

(4) waking up feeling fresh

(5) happy with personal life

(6) feel well-adjusted

(7) living the life desired

(8) eager to work

(9) ability to cope with serious problem

(10) life interesting



"None of the Time" Positive

"None of the Time" Negative

all of the time (always)



most of the time (usually)



some of the time (occasional)



none of the time (never)




Questions with "none" positive: 10

Questions with "none" negative: 1, 2, 3, 4, 5, 6, 7, 8, 9


total score =

= SUM(points for all 10 items)



• minimum score: 0

• maximum score: 30

• The higher the score the greater the patient's sense of well-being.



• Loevinger's coefficient of homogeneity is 0.40.

• Discussions on the internal and external validity are on pages 185-188 of Bech et al.

• The scale was evaluated in multiple European centers and has been translated into different languages.

• Bradley felt that results of the 10-item scale could be misleading for measuring both positive and negative aspects of diabetes, tending to focus on positive well-being and energy.

• A response by Bech et al to Bradley reported that the Cronbach alpha for the 10-item scale was 0.85 vs 0.90 for the 22-item scale and 0.92 for the 28-item scale.

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