COSMIN database

Social and emotional wellbeing assessment instruments for use with Indigenous Australians: A critical review

Le Grande, M., Ski, C. F., Thompson, D. R., Scuffham, P., Kularatna, S., Jackson, A. C., and Brown, A.
RATIONALE: There is growing recognition that in addition to universally recognised domains and indicators of wellbeing (such as population health and life expectancy), additional frameworks are required to fully explain and measure Indigenous wellbeing. In particular, Indigenous Australian wellbeing is largely determined by colonisation, historical trauma, grief, loss, and ongoing social marginalisation. Dominant mainstream indicators of wellbeing based on the biomedical model may therefore be inadequate and not entirely relevant in the Indigenous context. It is possible that "standard" wellbeing instruments fail to adequately assess indicators of health and wellbeing within societies that have a more holistic view of health.

OBJECTIVE: The aim of this critical review was to identify, document, and evaluate the use of social and emotional wellbeing measures within the Australian Indigenous community.

METHOD: The instruments were systematically described regarding their intrinsic properties (e.g., generic v. disease-specific, domains assessed, extent of cross-cultural adaptation and psychometric characteristics) and their purpose of utilisation in studies (e.g., study setting, intervention, clinical purpose or survey). We included 33 studies, in which 22 distinct instruments were used.

RESULTS: Three major categories of social and emotional wellbeing instruments were identified: unmodified standard instruments (10), cross-culturally adapted standard instruments (6), and Indigenous developed measures (6). Recommendations are made for researchers and practitioners who assess social and emotional wellbeing in Indigenous Australians, which may also be applicable to other minority groups where a more holistic framework of wellbeing is applied.

CONCLUSION: It is advised that standard instruments only be used if they have been subject to a formal cross-cultural adaptation process, and Indigenous developed measures continue to be developed, refined, and validated within a diverse range of research and clinical settings.
Soc Sci Med
Publication year:
Symptom status:
Cognitive/mental state
Emotional state
Physical state
Functional status:
Physical functioning
Role functioning
Social functioning
Overall quality of life:
Overall quality of life
Adults (18-65)
Children (0-18)
Seniors (65+)
External causes of morbidity and mortality
Factors influencing health status and contact with health services
Mental and behavioural disorders and related symptoms
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
AQOL-4D - Assessment of Quality of Life 4D
EQ-5D - EuroQoL-5 Dimensions   
GEM - Growth and Empowerment Measure
HANAA - Here and Now Aboriginal Assessment tool
HoNOS - Health of the National Outcome Scale (versions: HoNOSCA - HoNOS for Children and Adolescents)
Kessler Psychological Distress Scale (versions: K-10; K-5; K-6)
LSP - Life Skills Profile (versions: LSP-16)
MSPSS - Multidimensional Scale of Perceived Social Support
NCCN DT - National Comprehensive Cancer Network Distress Thermometer
NLES - Negative Life Events Scale
OHIP - Oral Health Impact Profile (versions: OHIP-49; OHIP-14; OHIP-20; OHIP-G - German; OHIP-G5; OHIP-G21)
Pearlin Mastery Scale
PHQ - Patient Health Questionnaire (versions: PHQ-2; PHQ-9; PHQ-9 short; PHQ-22; PHQ-8; PHQ-15)
SCNAT-IP - Supportive cancer care needs assessment tool for Indigenous people
SEIQoL - Schedule for the Evaluation of Individual Quality of Life (versions: SEIQoL-DW - SEIQoL Direct Weighting)
SF-12 - 12-item Short Form Health Survey [alias: RAND-12]
SF-36 - 36-item Short Form Health Survey [alias: RAND-36][alias: Medical Outcomes Study (MOS) SF-36]]    |  | also see:
SGRQ - St. George's Respiratory Questionnaire (versions: SGRQ-C - SGRQ-COPD)   
SSI - Strong Souls Inventory
WASC - Westerman Aboriginal Symptom Checklist (versions: WASC-Adults)