Questions and answers to psychological assessment schedules: hidden troubles in 'quality of life' interviews.

Quality of life (QOL) has become a topic of much debate in the learning difficulties literature. Increasing use is made of questionnaire-driven interview schedules in an effort to find out what clients believe in their own words. However, in this paper, the authors argue that the use made of such questionnaires may actually distort interviewees' 'own words' by severely underestimating the degree to which the questions and answers are changed by the subtle dynamics of the interview. In the first ever close examination of what actually happens in a QOL assessment interview, the qualitative insights of conversation analysis are used to show that the typical administration of a well-known instrument will involve: (1) distortions of the questions brought about by the need to paraphrase complex items, and the inevitable use of pre-questions and response listing; and perhaps more disturbingly, (2) distortions of answers brought about by interviewers' pursuit of legitimate answers and non-take-up of interviewees' matters. The authors believe that these difficulties make it hard for researchers to draw conclusions from simple aggregation of recorded responses to this questionnaire, and, perhaps, to any questionnaire using a fixed-response schedule. On the other hand, the kind of close evidence used here may allow inferences to be drawn about clients' feelings of well being, but even so, these will need to be cast in terms which acknowledge the interactive and constructive nature of feeling-avowals.