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

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Overview

Purpose
Cross-cultural quality of life measurement - for clinicians to make judgments about areas in which a patient is most affected by disease
Respondents
  • Proxy
  • Person with a Disability
Administration Method
Interview
Administration Mode
In-person
Developer
World Health Organization
Item Count
26
Population
General Population

Instrument Citation(s)

WHOQOL-BREF. http://www.who.int/healthinfo/survey/whoqol-qualityoflife/en/index2.html

WHOQOL-BREF: Introduction, Administration, Scoring and Generic Version of the Assessment
http://www.who.int/mental_health/media/en/76.pdf PDF

Instrument Domains

DomainNumber of Items
Community Inclusion5
Employment1
Resources and settings to facilitate inclusion1
Social connectedness and relationships3
Meaningful activity0
Transportation0
Equity1
Equitable access and resource allocation1
Availability0
Transparency and consistency0
Holistic Health and Functioning15
Individual health and functioning15
Health promotion and prevention0
Human and Legal Rights1
Freedom from abuse and neglect1
Informed decision-making0
Optimizing the preservation of legal and human rights0
Privacy0
Supporting individuals in exercising their human and legal rights0
Caregiver Support0
Access to resources0
Family caregiver/natural support involvement0
Family caregiver/natural support wellbeing0
Training and skill-building0
Choice and Control0
Choice of services and supports0
Personal choices and goals0
Personal freedoms and dignity of risk0
Self-direction0
Consumer Leadership in System Development0
Evidence of meaningful caregiver involvement0
Evidence of meaningful consumer involvement0
System supports meaningful consumer involvement0
Fluctuation of Need0
Level of Caregiver Well-Being0
Person-Centered Planning and Coordination0
Assessment0
Coordination0
Person-centered planning0
Service Delivery and Effectiveness0
Delivery0
Person's needs met and goals realized0
System Performance and Accountability0
Data management and use0
Evidence-based practice0
Financing and service delivery structures0
Workforce0
Adequately compensated with benefits0
Culturally competent0
Demonstrated competencies when appropriate0
Person-centered approach to services0
Safety of and respect for the worker0
Staff Turnover0
Sufficient workforce numbers dispersion and availability0
Workforce engagement and participation0

Psychometric Citations

  • Skevington, S.M., Lotfy, M., & O’Connell, KA. (2004). The World Health Organization’s WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial – A report from the WHOQOL Group. Quality of Life Research, 13, 299-310.

    Type of Publication
    Peer review
    Instrument Language
    Native languages
    Sample: Age (Mean and Range)

    Mean=45 years

    Sample: Age Group

    Under 18 Years, 18-64 Years, 65+ Years

    Sample: Countries/State

    Argentina, Australia, Brazil, Bulgaria, China, Croatia, Germany, Greece, Hungary, Israel, Italy, India, Japan, Malaysia, Netherlands, Nigeria, Norway, Romania, Russia, Spain, Turkey, United Kingdom, United States

    Sample: Disability Type

    Not Reported

    Sample: Gender (%male)

    47%

    Sample: Race/Ethnicity (%)

    Not Reported

    Sample: Sampling Strategy

    Quota Sampling

    Sample: Size

    11,830

    Reliability: Internal Consistency

    Cronbach's Alphas for physical health (α= 0.82); psychological (α= 0.81);
    environment (α= 0.80); social relationships (α = 0.68)

    Validity: Construct (Convergent and Discriminant)

    t-test comparisons between sick and well respondents were significant for multiple domains (p<.05)

    multiple correlations between items and their intended domain and between domains and general QOL measures

    Confirmatory factor analysis on two random, split half samples showed an adequate model fit: Half A: CFI=.863, RCFI = .865, RMSEA = .08; Half B: CFI=.876, RCFI=.878, RMSEA=.07

    Study design
    Cross-sectional

  • Kalfoss, M.H., Low, G. & Molzahn, A.E. (2008) The suitability of the WHOQOL–BREF for Canadian and Norwegian older adults. European Journal of Ageing, 5, 77-89.

    Type of Publication
    Peer review
    Instrument Language
    English and Norwegian
    Sample: Age (Mean and Range)

    Mean=72.8 (Canada); 75.7 (Norway)

    Sample: Age Group

    65+ Years

    Sample: Countries/State

    Canada, Norway

    Sample: Disability Type

    Not Reported

    Sample: Gender (%male)

    47% (Canada); 42% (Norway)

    Sample: Race/Ethnicity (%)

    Not Reported

    Sample: Sampling Strategy

    Simple Random Sample, Stratified Random Sample

    Sample: Size

    Canada = 202;
    Norway = 490

    Reliability: Internal Consistency

    Cronbach's Alpha overall for Canada sample (α=.93); Norway sample (α= 0.92).

    Validity: Construct (Convergent and Discriminant)

    significant domain-to-domain correlations in Canadian sample (r = 0.43 to 0.65); Norwegian sample (r = 0.42 to 0.68);
    In an item-to-domain correlation matrix all items correlated highest with their parent domains in both samples;

    Confirmatory factor analysis: Canadian sample GFI = .817, CFI = .880, RMSEA = .075; Norwegian sample GFI = .841, CFI = .807, RMSEA = .082;

    Significant correlations with the WHOQOL-OLD instrument for convergent validity;

    Significant correlations with other measures for discriminant validity; Significant differences in all domain scores were observed between unhealthy and healthy older adults and those with and without morbidities in both countries

    Study design
    Cross-sectional

  • Van Esch,L., Den Oudsten, B.L., & De Vries, J. (2011). The World Health Organization Quality of Life instrument-Short Form (WHOQOL-BREF) in women with breast problems, International Journal of Clinical and Health Psychology, 11, 5-22

    Type of Publication
    Peer review
    Instrument Language
    Dutch
    Sample: Age (Mean and Range)

    Group 1 mean= 55, range=19 to 87;
    Group 2 = 53, range=19-94

    Sample: Age Group

    18-64 Years, 65+ Years

    Sample: Countries/State

    Netherlands

    Sample: Disability Type

    Not Reported

    Sample: Gender (%male)

    0%

    Sample: Race/Ethnicity (%)

    Not reported

    Sample: Sampling Strategy

    Convenience Sample

    Sample: Size

    Group 1 = 607;
    Group 2 = 549

    Reliability: Internal Consistency

    Group 1: Cronbach's Alpha Physical health (α = .77), Psychological Health (α=.72), Social Relationships (α=.67), Environment (α=.80); Group 2: Cronbach's Alpha Physical health (α = ..82), Psychological Health (α=.78), Social Relationships (α=.68), Environment (α=.82)

    Reliability: Test-retest

    Pearson's r correlations (r=.58 to .84)

    Validity: Construct (Convergent and Discriminant)

    Confirmatory factor analysis: Group 1 CFI = .88, RMSEA = .06; Group 2 CFI = .90, RMSEA = .06;

    Pearson's r Correlations with other measures (r= -.63 to -.27)

    Validity: Criterion Validity (Concurrent and Predictive)

    Adjusted r squares in predicting other constructs ranged from 04 to .21

    Study design
    Cross-sectional

  • Chung W S, Yang M C, Lee M C. Costs and cost effectiveness of directly observed therapy short-course (DOTS) for pulmonary tuberculosis in Taiwan. J Med Health 2012; 1: 33–45.

    Type of Publication
    Peer review
    Instrument Language
    Chinese
    Sample: Age (Mean and Range)

    Patients with tuberculosis group: Mean=50.13, Range=11 to 89;
    Healthy group: Mean = 47.91, Range=11 to 83

    Sample: Age Group

    Under 18 Years, 18-64 Years, 65+ Years

    Sample: Countries/State

    Taiwan

    Sample: Disability Type

    Not Reported

    Sample: Gender (%male)

    Patient with tuberculosis = 71%;
    Healthy referents = 66%

    Sample: Race/Ethnicity (%)

    Not reported

    Sample: Sampling Strategy

    Convenience Sample

    Sample: Size

    270

    Reliability: Internal Consistency

    Cronbach's Alpha for Version 1 (α = .92); Cronbach's Alpha for Version 2 (α= .92); Cronbach's Alpha for Version 3 (α= .93)

    Validity: Construct (Convergent and Discriminant)

    Patients with tuberculosis group: exploratory factor analysis resulted in 6 factors (factor loadings >.30); Healthy group = exploratory factor analysis resulted in 5 factors (factor loadings >.30)

    Patients with tuberculosis group: Pearson r correlations between domain scores (r=.56 to .74); Healthy group: Pearson r correlations between domains (r=.57 to .69); Moderate correlations found with other measures

    Significant group effect used to demonstrate discriminant validity

    Study design
    Cross-sectional

  • THE WHOQOL GROUP. (1998). Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment. Psychological Medicine, 28(3), 551-558.

    Type of Publication
    Peer review
    Instrument Language
    Not Reported
    Sample: Age (Mean and Range)

    Mean=45 years

    Sample: Age Group

    Not Reported

    Sample: Countries/State

    Multiple Countries

    Sample: Disability Type

    N/A

    Sample: Gender (%male)

    50%

    Sample: Race/Ethnicity (%)

    Not reported

    Sample: Sampling Strategy

    Quota sampling

    Sample: Size

    11053

    Reliability: Internal Consistency

    Cronbach's Alpha for physical health (α = .82 to .87); Cronbach's Alpha for psychological (α=.75 to .77); Cronbach's Alpha for social relationships (α=.66 to .69); Cronbach's Alpha for environment (α=.80)

    Reliability: Test-retest

    Pearson r correlations with physical health (r=.66); with psychological (r=.72); with social relationships (r=.76); with environment (r=.87)

    Validity: Construct (Convergent and Discriminant)

    All domains could discriminate between ill and well subjects;

    Confirmatory factor analysis: CFI = .906, .903, .901 for three samples

    Study design
    Cross-sectional