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

Abstract

Objectives 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. Methods 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. Results 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. Discussion 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 patterns in subjective well-being are partially accounted for by psychological and social factors associated with aging

“…Biological and environmental variables are associated with aging and one may speculate that they are involved in the residual association between age and the Cantril Ladder [ 30 ]. Additionally, it is possible that other psychological processes contribute to the gradient such as age-related differential standards for judging one’s satisfaction with life, although recent work has suggested this may not be the case [ 31 ]. Overall, we believe that this work contributes to a more complete understanding of the potential roles of social and psychological factors in well-being over the lifespan.…”

What Do Happiness Data Mean? Theory and Survey Evidence

“…Because of the wording of our introspective question ("…did you evaluate your situation as it is right this moment or over a longer period of time…"), we believe that even if past consumption or expectations about future consumption affect flow utility, as long as SWB captures only flow utility, then respondents would report that they evaluate their situation in the present period. We similarly believe that respondents would report that they evaluate their situation in the present period if they evaluate their situation relative to their life in the past or to an important past event, as found by Ross, Eyman, and Kishchuk (1986), Ralph, Palmer, and Olney (2011), and Junghaenel et al (2018).…”

“…We are aware of four prior papers that, while not using a formal framework as we do, use empirical methodologies similar to ours, asking one of several SWB questions and then asking respondents how they answered it. These papers report a rich set of findings from open-ended questions and interviews (Ross, Eyman, and Kishchuk, 1986;Ralph, Palmer, and Olney, 2011;Junghaenel et al, 2018) or brief questionnaires (Steffel and Oppenheimer, 1999) that study topics such as the frames of reference respondents use (e.g., comparisons to other people or an earlier time in life) when selecting an answer to a SWB question. Ralph et al (2011) also study various other aspects of respondents' reactions to and interpretations of the SWB question.…”

Do people with arthritis differ from healthy controls in their internal comparison standards for self-reports of health, fatigue, and pain?

“…This may matter because prior research suggests that patients’ internal comparison standards might change as a function of time since diagnosis [7]. The selection of the three internal comparison standards was based on prior qualitative work in our team [17]. It is, however, possible that an individual’s range of internal comparison standards might be broader than the ones presented in the paper and future research could examine whether there are other salient comparison standards in patients with medical conditions.…”

“…Next, they were presented with a list of internal comparison standards. These were derived from prior extensive qualitative work in our team [17]. Participants were asked to indicate which of these, if any, they were thinking about for their rating: Interpersonal comparisons (“I compared myself with another person or other people”), Historical comparisons (“I made a comparison with how I was some time ago”), Imaginary comparisons (“I thought about how I would feel if something about me or my life were different”).…”