World Health Organization Quality of Life- BREF (WHOQOL-BREF)

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Tool Description

  • The World Health Organization Quality of Life – BREF (WHOQOL-BREF) is a self-report questionnaire which assesses 4 domains of quality of life (QOL): physical health, psychological health, social relationships, and environment. In addition, there are 2 items that measure overall QOL and general health.
  • The assessment conceptually fits with the WHO definition of QOL. WHOQOL-BREF can provide data for both research and clinical purposes. Although it is a relatively brief instrument, its structure allows one to acquire specific information covering many aspects of life.
  • The WHOQOL(Bref) is short and easy to administer.
  • This scale was not developed for individuals with SCI, therefore, it is possible that there are some questions in the scale that are not relevant.
  • The WHOQOL(Bref) is grouped into 4 domains of QOL and 2 items that measure overall QOL and general health:

1.     Physical health (raw score range: 7-35)
2.     Psychological health (raw score range: 6-30)
3.     Social relationships (raw score range: 3-15)
4.     Environment (raw score range: 8-40)

ICF Domain:

Quality of Life

You Will Need:

Approximately 10-15 minutes to complete the 26 items

Scoring:

Participants express how much they have experienced the items in the preceding 2 weeks on a 5-point Likert scale ranging from 1 (not at all) to 5 (completely).

Items scored 1-5. Raw domain score is the sum of respective item scores.

All domain scores are reported between 4 and 20 (mean scores for each multiplied by 4); for the scoring algorithm, see the User Manual (http://www.who.int/mental_health/publications/whoqol/en/index.html)

SPSS algorithm available for automatic scoring.

Equipment: None.

Interpretability

MCID: not established for SCI
SEM and MDC
SEM and MDC for the WHOQOL-Bref domains (calculated from data in Lin et al. 2007):

Domain

SEM

MDC

General Health

7.8

21.5

Physical health

5.2

14.4

Psychological

2.4

6.6

Social relationships

6.4

17.9

Environment

5.1

14.1

 

  • Norms are available for different groups; however, cut-points and norms have not been established for the SCI population.
  • Published data for the SCI population is available for comparison (see Interpretability section of the Study Details sheet).

Languages:

English, Chinese, Czech, Farsi, Indonesian, Polish, Russian and Thai.

Training Required:

None.

Availability:

Can be found at WHO website: http://www.who.int/substance_abuse/research_tools/whoqolbref/en/

Measurement Property Summary

# of studies reporting psychometric properties: 5

Reliability:

  • Intra-rater reliability is High for the total WHOQOL-Bref and its subscales (ICC range: 0.84-0.93).
  • Inter-rater reliability is Moderate to High for the total WHOQOL-Bref and its subscales (ICC range: 0.56-0.95)

[Lin et al. 2007, Jang 2004, Miller et al. 2008]

Validity:

  • Correlation of the WHOQOL-Bref subscales with the Satisfaction with Well-Being Index is Moderate to High (Psychological – Pearson’s r=0.75, Physical – Pearson’s r=0.63, Family/social – Pearson’s r=0.45, Financial/environment – Pearson’s r=0.59).
  • Correlation of WHOQOL-Bref subscales with the Chinese version of Quebec User Evaluation with Assistive Technology is Moderate (Psychological – Pearson’s r=0.344, Physical – Pearson’s r=0.508, Family/social – Pearson’s r=0.460, Financial/environment – Pearson’s r=0.567).
  • Low to High correlation between WHOQOL-BREF subscales and the Impact of Participation and Autonomy Questionnaire (IPAQ) subscales:Correlation = -0.30 to -0.65[Lin et al. 2007, Jang 2004, Miller et al. 2008, Chapin et al. 2004, Chan & Chan 2006; Suttiwong et al., 2013]

Responsiveness:

  • Stratified random sample by current employment status of 30 subjects, selected from those who had been employed before the SCI, were interviewed for a second time to recall their health related QoL at the time of the injury.
  • Effect Sizes:
    • Overall QOL and general health domain: 1.01
    • Physical Health Domain: 1.83
    • Psychological Health  Domain: 0.78
    • Social Relationship Domain: 1.16
    • Environment Domain: 0.78

[Lin et al. 2007]

Floor/ceiling effect:

  • No floor or ceiling effects were reported.

[Jang 2004, Lin et al. 2007]

Reviewer

Dr. Ben Mortenson, John Zhu, Jeremy Mak

Date Last Updated:

Feb 26, 2016

Download the measure

Download Worksheet:
Can be found at WHO website: http://www.who.int/substance_abuse/research_tools/whoqolbref/en/

Video

n/a

Scoring

  • Participants express how much they have experienced the items in the preceding 2 weeks on a 5-point Likert scale ranging from 1 (not at all) to 5 (completely).Items scored 1-5. Raw domain score is the sum of respective item scores.All domain scores are reported between 4 and 20 (mean scores for each multiplied by 4); for the scoring algorithm, see the User Manual (http://www.who.int/mental_health/publications/whoqol/en/index.html)SPSS algorithm available for automatic scoring.

Equipment Needed

None

WHOQOL-Bref:

Chan SC, Chan AP. The validity and applicability of the Chinese version of the Quebec User Evaluation of Satisfaction With Assistive Technology for people with spinal cord injury. Assist Technol 2006; 18: 25-33.
http://www.ncbi.nlm.nih.gov/pubmed/16796239

Chapin MH, Miller SM, Ferrin JM, Chan F, Rubin SE. Psychometric validation of a subjective well-being measure for people with spinal cord injury. Disability and Rehabilitation, 2004; 26(19):1135-1142.
http://www.ncbi.nlm.nih.gov/pubmed/15371026

Jang Y, Hsieh C-L, Wang Y-H, Wu Y-H. A validity study of the WHOQOL-BREF assessment in persons with traumatic spinal cord injury. Arch Phys Med Rehabil 2004;85:1890-5.
http://www.ncbi.nlm.nih.gov/pubmed/15520987

Lin M-R, Hwang H-F, Chen C-Y, Chiu W-T. Comparisons of the Brief Form of the World Health Organization Quality of Life and Short Form-36 for Persons with Spinal Cord Injuries. Am J Phys Med Rehabil 2007;86:104–113.
http://www.ncbi.nlm.nih.gov/pubmed/17075363

Miller WC, Anton HA, Townson AF. Measurement properties of the CESD scale among individuals with spinal cord injury. Spinal Cord 2008; 46: 287-292.
http://www.ncbi.nlm.nih.gov/pubmed/17909558

Skevington S, Lofty M, O'Connell K. The World Health Organisation's WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A report from the WHOQOL Group. Qual Life Res 2004;13:299-310.
http://www.ncbi.nlm.nih.gov/pubmed/15085902

Suttiwong J, Vongsirinavarat M, Vachalathiti R, Chaiyawat P. Impact on participation and autonomy questionnaire: psychometric properties of the thai version. J Phys Ther Sci. 2013;25(7):769-74.
http://www.ncbi.nlm.nih.gov/pubmed/24259849

WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 1998;28:551-558.
http://www.ncbi.nlm.nih.gov/pubmed/9626712