Psychological Medicine

Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment



Background. The paper reports on the development of the WHOQOL-BREF, an abbreviated version of the WHOQOL-100 quality of life assessment.

Method. The WHOQOL-BREF was derived from data collected using the WHOQOL-100. It produces scores for four domains related to quality of life: physical health, psychological, social relationships and environment. It also includes one facet on overall quality of life and general health.

Results. Domain scores produced by the WHOQOL-BREF correlate highly (0·89 or above) with WHOQOL-100 domain scores (calculated on a four domain structure). WHOQOL-BREF domain scores demonstrated good discriminant validity, content validity, internal consistency and test–retest reliability.

Conclusion. These data suggest that the WHOQOL-BREF provides a valid and reliable alternative to the assessment of domain profiles using the WHOQOL-100. It is envisaged that the WHOQOL-BREF will be most useful in studies that require a brief assessment of quality of life, for example, in large epidemiological studies and clinical trials where quality of life is of interest. In addition, the WHOQOL-BREF may be of use to health professionals in the assessment and evaluation of treatment efficacy.

c1 Address for correspondence: Professor Mick Power, Department of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh EH10 5HF.


1 This paper was written by Alison Harper and Mick Power on behalf of the WHOQOL Group.

2 The WHOQOL Group comprises a coordinating group, collaborating investigators in each of the field centres and a panel of consultants. Dr J. Orley directs the project. The work reported on here was carried out in the 15 initial field centres in which the collaborating investigators were: Professor H. Herrman, Dr H. Schofield and Ms B. Murphy, University of Melbourne, Australia; Professor Z. Metelko, Professor S. Szabo and Mrs M. Pibernik-Okanovic, Institute of Diabetes, Endocrinology and Metabolic Diseases and Department of Psychology, Faculty of Philosophy, University of Zagreb, Croatia; Dr N. Quemada and Dr A. Caria, INSERM, Paris, France; Dr S. Rajkumar and Mrs Shuba Kumar, Madras Medical College, India; Dr S. Saxena and Dr K. Chandiramani, All India Institute of Medical Sciences, New Delhi, India; Dr M. Amir and Professor D. Bar-On, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Dr Miyako Tazaki, Department of Science, Science University of Tokyo and Dr Ariko Noji, Department of Community Health Nursing, St Luke's College of Nursing, Japan; Professor G. van Heck and Dr J. De Vries, Tilburg University, The Netherlands; Professor J. Arroyo Sucre and Professor L. Picard-Ami, University of Panama, Panama; Professor M. Kabanov, Dr A. Lomachenkov and Dr G. Burkovsky, Bekhterev Psychoneurological Research Institute, St Petersburg, Russia; Dr R. Lucas Carrasco, University of Barcelona, Spain; Dr Yooth Bodharamik and Mr Kitikorn Meesapya, Institute of Mental Health, Bangkok, Thailand; Dr S. Skevington, University of Bath, United Kingdom; Professor D. Patrick, Ms M. Martin and Ms D. Wild, University of Washington, Seattle, USA; and, Professor W. Acuda and Dr J. Mutambirwa, University of Zimbabwe, Harare, Zimbabwe.Data were also taken from new centres field testing the WHOQOL-100 in which collaborating investigators were: Dr S. Bonicaato, FUNDONAR, Fundacion Oncologica Argentina, Argentina; Dr G. Yongping, St Vincent's Hospital, Victoria, Australia; Dr M. Fleck, University of the State of Rio Grande do Sul, Brazil; Professor M. C. Angermeyer and Dr R. Kilian, Universitätsklinikum Klinik und Poliklinik für Psychiatrie, Leipzig, Germany; and Mr L. Kwok-fai, Queen Elizabeth Hospital, Kowloon, Hong Kong.In addition to the expertise provided from the centres, the project has benefited from considerable assistance from: Dr R. Billington, Dr M. Bullinger, Dr A. Harper, Dr W. Kuyken, Professor M. Power and Professor N. Sartorius.