Frames of Reference in Self-Reports of Health,Well-Being,Fatigue, and Pain: a Qualitative Examination

Self-reports in survey research can be affected by internal comparison standards, or Frames of Reference (FoRs), that people apply when making their ratings. The goal of this study was to determine which FoRs people naturally use when rating their health, subjective well-being, fatigue, and pain. We further examined whether FoRs varied by content domain and age group. One hundred adults from a community sample of the US general population participated in individual semi-structured qualitative interviews. Participants provided self-report ratings on two of the four content domains and were then systematically queried about FoRs. Interview responses were summarized and coded into broad FoR categories. Four broad FoR categories emerged: References to (1) Other People, (2) an Earlier Time in Life, (3) an Important Event in the Past, and (4) a Hypothetical Situation. FoRs were reported in the majority (80.5%) of responses and multiple FoRs were reported in 34% of responses. The reporting of FoRs was evident for all domains, but was more prevalent for well-being compared to pain. References to a Hypothetical Situation were only mentioned in the well-being and health domains. For health, references to Other People were more frequently reported at older compared to younger ages. Our results extend prior work by demonstrating that participants’ reporting of FoRs is evident in ratings of various content domains. They further suggest that a limited number of FoRs are used and that their identification holds promise for understanding and controlling systematic group differences in FoRs.     

Age Effects of Frames of Reference in Self-Reports of Health,Well-Being,Fatigue and Pain

Self-reports of health and well-being are central for population monitoring, so it is paramount that they are measured accurately. The goal of this study was to examine the impact of age on the use of the comparison standards or frames of reference (FoRs) in self-reports of health, life-satisfaction, fatigue, and pain, and to determine if the age-health outcome associations were affected by age differences in FoRs. Respondents (n = 2000) selected from the U.S. general population self-rated their life-satisfaction and health outcomes. Following this, they were asked to indicate if they used any comparisons (FoRs) when making their rating and the direction of these comparisons (upward, lateral or downward). Analyses examined (a) whether age groups differed in the type and direction of FoRs, and (b) whether age patterns in health, life-satisfaction, fatigue, and pain were altered when FoRs were statistically controlled. Compared to middle-aged and older people, younger respondents were more likely to compare themselves with other people when self-rating their health and life-satisfaction. They were also more likely to use a hypothetical situation when evaluating their pain and fatigue. Younger participants used lateral comparisons less often and downward comparisons more often than middle-aged and older participants. When these age differences in FoRs were statistically controlled, the observed age patterns in self-reported health outcomes were somewhat reduced. The results show that people of different ages use different FoRs when self-reporting their life-satisfaction and health outcomes.

     

Vague Quantifiers Demonstrate Little Susceptibility to Frame of Reference Effects

Applied Research in Quality of Life - Comparison standards that people use when responding to survey questions, also called Frames of Reference (FoRs), can influence the validity of self-report...