Who Quality Of Life Assessment

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The Constitution of the World Health Organization (WHO) defines health as "A state of complete physical, mental, and social well-being not merely the absence of disease . . .". It follows that the measurement of health and the effects of health care must include not only an indication of changes in the frequency and severity of diseases but also an estimation of well being and this can be assessed by measuring the improvement in the quality of life related to health care. Although there are generally satisfactory ways of measuring the frequency and severity of diseases this is not the case in so far as the measurement of well being and quality of life are concerned. WHO, with the aid of 15 collaborating centres around the world, has therefore developed two instruments for measuring quality of life (the WHOQOL-IOO and the WHOQOL-BREF), that can be used in a variety of cultural settings whilst allowing the results from different populations and countries to be compared. These instruments have many uses, including use in medical practice, research, audit, and in policy making.

WHO defines Quality of Life as an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. It is a broad ranging concept affected in a complex way by the person's physical health, psychological state, personal beliefs, social relationships and their relationship to salient features of their environment.

The WHOQOL-BREF instrument comprises 26 items, which measure the following broad domains: physical health, psychological health, social relationships, and environment. This version is available in approximately 19 different language versions. The WHOQOL-BREF is a shorter version of the original instrument that may be more convenient for use in large research studies or clinical trials.

Abbreviated Name: WHOQOL & WHOQOL-BREF Author(s): The WHOQOL Group, WHO, Geneva Purpose: To assess individuals' perceptions on the quality of their life Population: Adult Age Range : 18 and over Type of Instrument: Quality of life Mode of Administration:

Self-/ Interviewer-administered

WHOQOL: 10-20 minutes for the self-administered version, up to 60 minutes for the interviewer-administered version WHOQOL-BREF: 5 minutes for self-administration, 15-20 minutes for interviewer-administration Likert scale Global score Scores by dimension Higher scores show better QoL Yes

Rater:

Time required:

Response Options: Scoring:

Score Direction:

Weighting:

Number of Items: WHOQOL: 100 items / WHOQOL-BREF: 26 items Original Language: English

Existing Translations : Arabic, Bulgarian, Chinese, Croatian, Czech, Danish, Dutch, Estonian, French, German, Greek, Hungarian, Hebrew, Hindi, Italian, Japanese, Kannada, Korean, Lithuanian, Malay, Norwegian, Polish, Portuguese, Russian, Shona, Slovakian, Spanish, Swedish, Tamil, Thai, Turkish, Urdu, Zambia

Copyright: The World Health Organisation. Contact for information and permission to use: WHOQOL

Department of Mental Health World Health Organization 1211 Geneva 27, Switzerland Tel: +41 22 791 36 34 Fax: + 41 22 791 41 60 E-mail:[email protected]

Dimensions covered by the questionnaire :

WHOQOL-100 (4 items per facet):

• Psychological (5 facets)

• Level of independance (4 facets)

• Social relationships (3 facets)

• Spirituality/religion/personal beliefs (1 facet)

WHOQOL-BREF (1 item per facet of the WHOQOL-100):

• Psychological (5 items)

• Level of independance (4 items)

• Social relationships (3 items)

• Spirituality/religion/personal beliefs (1 items)

• + 2 overall QOL and general health items

Key References:

1. The WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 1998;28(3):551-8

Background: The paper reports on the development of the WHOQOL-BREF, an abbreyiated 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.

2. Szabo S (on behalf of the WHOQOL group). The World Health Organization Quality of Life (WHOQOL) assessment instrument. In: Bert Spilker (Ed). Quality of Life and Pharmacoeconomics in Clinical Trials (2nd edition). Philadelphia, New York, LippincottRaven Publishers, 1996

3. The WHOQOL Group. The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties. Soc Sci Med. 1998 Jun;46(12):1569-85.

This paper reports on the field testing, empirical derivation and psychometric properties of the World Health Organisation Quality of Life assessment (the WHOQOL). The steps are presented from the development of the initial pilot version of the instrument to the field trial version, the so-called WHOQOL-100. The instrument has been developed collaboratively in a number of centres in diverse cultural settings over several years; data are presented on the performance of the instrument in 15 different settings worldwide.

4. The WHOQOL Group. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995 Nov;41(10):1403-9.

This paper describes the World Health Organization's project to develop a quality of life instrument (the WHOQOL). It outlines the reasons that the project was undertaken, the thinking that underlies the project, the method that has been followed in its development and the current status of the project. The WHOQOL assesses individuals' perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. It has been developed collaboratively in several culturally diverse centres over four years. Piloting of the WHOQOL on some 4500 respondents in 15 cultural settings has been completed. On the basis of this data the revised WHOQOL Field Trial Form has been finalized, and field testing is currently in progress. The WHOQOL produces a multidimensional profile of scores across six domains and 24 sub-domains of quality of life.

5. The WHOQOL Group. The Development of the WHO Quality of Life Assessment Instrument (The WHOQOL) in Orley J and Kuyken W (eds). Quality of Life Assessment: International Perspectives. Berlin. Springer-Verlag. 1994; 41-57

6. The WHOQOL Group. Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Qual Life Res. 1993 Apr;2(2):153-9.

The World Health Organization (WHO) has undertaken a project to develop an instrument (the WHOQOL) for measuring quality of life. Quality of life is defined as an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. It is a broad ranging concept affected in a complex way by the person's physical health, psychological state, level of independence, social relationships, and their relationship to salient features of their environment. The instrument will be developed in the framework of a collaborative project involving numerous centres in different cultural settings. In addition, it will have proven psychometric properties of validity, responsiveness and reliability and will be sensitive to the cultural setting in which it is applied, whilst maintaining comparability of scores across different cultural settings. This paper outlines the characteristics of the planned instrument and the study protocol governing work on its development. To date steps 1 through 5 have been completed and work is progressing on step 6. It is anticipated that the instrument will be available for piloting in July 1993 and a final version available for use in June 1994.

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