Benson T, Sladen J, Liles A, Potts H. Personal Wellbeing Score (PWS) – a short version of ONS4, testing and validation in social prescribing. Research Paper 17/03, October 2017
Wellbeing is a key policy objective in health and care services. Our aim was to develop a short generic measure of personal (subjective) wellbeing for routine use as a performance measure in patient-centred care and healthcare quality improvement alongside other patient-reported outcome and experience measures.
The Personal Wellbeing Score (PWS) is a patient-reported outcome measure, based on the Office of National Statistics (ONS) four personal well-being questions (ONS4) and thresholds. PWS has the same look and feel as other measures in the R-Outcomes family of surveys. Word length and reading age were compared with eight other measures. Anonymous data from five social prescribing projects, were analysed. Internal structure was examined using distributions, intra-item correlations, Cronbach’s alpha and exploratory factor analysis. Construct validity was assessed using hypothesised associations with health status, health confidence, patient experience, age, gender and medications. Scores on referral and after referral assessed responsiveness.
Differences from ONS4 include brevity, fewer response options, positive wording and a summary score. PWS is short (42 words) with low reading age (9 years).
In this population (1,299 respondents, 60% female, average age 81 years), missing values were less than 2%. PWS showed good internal reliability (Cronbach’s alpha = 0.90). Exploratory factor analysis suggested that the four PWS items relate to a single dimension. PWS summary scores correlate positively with health confidence (r=0.60), health status (r=0.58), patient experience (r=0.30) and age group (r=0.24). PWS is responsive to social prescribing intervention.
The Personal Wellbeing Score (PWS) is a short variant of ONS4. It is easy to use with good psychometric properties, suitable for routine use in quality improvement and health services research.