Terrence Steyer, M.D.
Chair, Department of Family Medicine
The WHO Quality of Life Group (1998)
The WHOQOL-BREF was developed from the WHOQOL-100 at the same time as the WHOQOL-100. Like the WHOQOL-100 it consists of 24 facets grouped into four domains related to quality of life (Physical Health, Psychological, Social Relationships, and Environment) as well as one facet on overall quality of life and general health. One item from each facet, which best explains a large portion of the variance, was selected for inclusion in the WHOQOL-BREF. Two items were selected from the overall quality of life facet for a total of 26 items. In addition to data from the original 15 field centers used for development of the WHOQOL-100, five additional centers were also included.
Reliability was good for each of the four domains (Cronbach alpha 0.66 to 0.84). Domain scores calculated using the WHOQOL-BREF were very similar to scores calculated from the WHOQOL-100 with correlations between the two measures of 0.89 to 0.95. The WHOQOL-BREF has the same ability as the WHOQOL-100 to discriminate between healthy and sick individuals. Over a two to eight week period, test-retest reliability for the four domains was generally high (0.66 to 0.87). As with the WHOQOL-100, factor analysis confirmed the comparative fit of the 4 domain model to the global quality of life. The Physical Health domain loads most heavily on the global quality of life measure while the Social Relationships domain loads the least.
The original development (WHOQOL Group 1998) comparatively assessed data from young (18-44), middle-aged (45-64), and older (65+) populations. The survey protocol called for 50% of the individuals to be 45 years or older.
As with the WHOQOL-100, the WHOQOL-BREF was developed specifically to be a cross-cultural measurement tool. It has been tested extensively around the world in countries including the USA, several European countries, Russia, India, China, Japan, Australia, Panama, Brazil, and Zimbabwe (among others).
The WHOQOL-BREF and WHOQOL-100 were used to monitor the changes in quality of life in patients before and after liver transplants (O'Carroll et al. 2000). Both were deemed valid and reliable instruments in assessing quality of life changes after the operation.
The WHOQOL-BREF is a reliable and valid survey instrument for measuring the four domains of quality of life as well as overall global quality of life. It is much shorter than the WHOQOL-100 instrument, however its assessment of Social Relationships is weaker.
M. Power, Royal Edinburgh Hospital, Department of Psychiatry
University of Edinburgh, Edinburgh, EH10 5HF UK
O'Carroll, R.E., K. Smith, M. Couston, J.A. Cossar, and P.C. Hayes (2000) A comparison of the WHOQOL-100 and the WHOQOL-BREF in detecting change in quality of life following liver transplantation. Quality of Life Research, 9(1), 121-124.
The WHOQOL Group (1998) Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol. Med., 28, 551-558.