Measure: The MVQOLI has 26 items: one global QOL item and five subscales, symptoms, function, interpersonal, well-being, and transcendence. Each subscale contains two “assessment” items, two “satisfaction” items, and one “importance” item. Examples of the items appear in Table 2. Possible responses to the one item assessing overall QOL ranged from “worst possible”=1 to “best possible”=5. The other 25 items had possible responses of: a) “agree strongly”=-2 to “disagree strongly”=+2 for negatively focused assessment items; b) “agree strongly”=+2 to “disagree strongly”=-2 for positively focused assessment items; c) “agree strongly”=+4 to “disagree strongly”=-4 for positively focused satisfaction items; d) “agree strongly”=-4 to “disagree strongly”=+4 for negatively focused satisfaction items; and, e) “agree strongly”=5 to “disagree strongly”=1 for importance items. Weight dimensional subscale scores are calculated by multiplying the important score with the sum of average assessment plus the average satisfaction score. Weighted subscale scores range from -30 to +30, the higher the score reflected the better the QOL. The final score in each dimension reflects the overall impact of that domain on quality of life. Negative dimensions are reducing QOL and positive dimensions are increasing QOL, and the size of each dimension reflects the amount of impact. Total QOL score is calculated by the sum of the weighted dimension scores being divided by 10, then 15 is added; this is a mathematical conversion to generate total scores between 0 and 30. The total score can range from 0-30, and the higher the score reflects better QOL. The MNQOLI demonstrated internal consistency.