Subjective judgements of quality of life: a comparison study between people with intellectual disability and those without disability.
Satisfaction alone can hide what adults with ID really value, so always pair it with importance and choice ratings.
01Research in Context
What this study did
Carr et al. (2002) asked adults with and without intellectual disability to rate their quality of life.
Each person said how satisfied they felt and how important each life area was to them.
The team then compared the two groups to see if satisfaction matched real-life conditions.
What they found
Both groups gave high life-satisfaction scores, even when money, housing, or health were poor.
Adults with ID valued areas like friends, work, and choice more than the other group, yet they felt less happy about their health.
Simple satisfaction scores, by themselves, hid these gaps.
How this fits with other research
Golubović et al. (2013) saw the same masking problem in teens: parents and youth with ID only partly agreed on QoL scores, especially on health items.
Agiovlasitis et al. (2025) later showed teacher ratings in Saudi Arabia were also moderate, with self-determination scoring lowest, echoing the value-importance mismatch E et al. found.
Whaling et al. (2025) built a new Spanish scale for primary students that now includes both importance and satisfaction items, directly fixing the 2002 blind spot.
Why it matters
If you only ask, 'How satisfied are you?' you may miss what truly counts for the person. Add a quick importance rating and ask about choice and control. These two extra questions take one minute and give you clearer priorities for goal setting and service planning.
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02At a glance
03Original abstract
The present study investigated the relationship between objective and subjective measures of quality of life (QoL), and in particular, health status and primary care services. Thirty-one people with intellectual disability (ID) were interviewed using a QoL questionnaire. Thirty-one matched controls from the general population filled in a parallel questionnaire. The results in both groups support the findings of many researchers which indicate that satisfaction with aspects of life is generally high (i.e. approximate 75% of maximum possible satisfaction). The present study also confirms previous findings which indicate that satisfaction with aspects of life does not generally correlate with objective circumstances in either group. The importance that people attach to aspects of their lives did not generally correlate with their objective circumstances or their satisfaction with life. However, people with ID attached greater importance to all aspects of their lives than those without disability. This may be linked to their aspirations, preferences and opportunities for choice, and therefore, these factors may be a more meaningful way of considering their QoL. The present findings call into question the use of satisfaction as a general measure of QoL, and also indicate that the use of importance as a mediating variable in understanding satisfaction may not be a solution. The participants with ID had poorer health than the controls, and were significantly less satisfied with their health. Contrary to other findings, the present participants with ID reported that they had received more health checks than the controls over the previous year. Half of these checks had been carried out by 'special' services rather than primary care services.
Journal of intellectual disability research : JIDR, 2002 · doi:10.1046/j.1365-2788.2002.00343.x