title: Health and role functioning: the use of focus groups in the development of an item bank.
abstract: BACKGROUND
  Role functioning is an important part of health-related quality of life. However, assessment of role functioning is complicated by the wide definition of roles and by fluctuations in role participation across the life-span. The aim of this study is to explore variations in role functioning across the lifespan using qualitative approaches, to inform the development of a role functioning item bank and to pilot test sample items from the bank.
  
  
  METHODS
  Eight focus groups were conducted with a convenience sample of 38 English-speaking adults recruited in Rhode Island. Participants were stratified by gender and four age groups. Focus groups were taped, transcribed, and analyzed for thematic content.
  
  
  RESULTS
  Participants of all ages identified family roles as the most important. There was age variation in the importance of social life roles, with younger and older adults rating them as more important. Occupational roles were identified as important by younger and middle-aged participants. The potential of health problems to affect role participation was recognized. Participants found the sample items easy to understand, response options identical in meaning and preferred five response choices.
  
  
  CONCLUSIONS
  Participants identified key aspects of role functioning and provided insights on their perception of the impact of health on their role participation. These results will inform item bank generation.
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA. Milena.Anatchkova@umassmed.edu
authors.forename: Milena D
authors.initials: MD
authors.lastname: Anatchkova
authors.forename: Jakob B
authors.initials: JB
authors.lastname: Bjorner
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D005195:Family Relations; D005260:Female; D017144:Focus Groups; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010379:Peer Group; D010865:Pilot Projects; D011788:Quality of Life; D012237:Rhode Island; D012931:Social Environment; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult