WHO Quality of Life (WHOQOL-BREF)

WHOQOL-BREF

June 1997

U.S. Version

Emblem...Soul Catcher: a Northwest Coast Indian symbol of physical and mental well-being. Artist: Marvin Oliver

WHOQOL-BREF

About You

Before you begin we would like to ask you to answer a few general questions about yourself by circling the correct answer or by filling in the space provided.

1. What is your gender

Male

Female

2. What is your date of birth?	/	/
Day	Month	Year

3. What is the highest education you received?	None at all
	Elementary School
	High School
	College

4. What is your marital status?	Single	Separated
	Married	Divorced
	Living as Married	Widowed

5. Are you currently ill?	Yes	No
6. If something is wrong with your health, what do you think it is?		illness/problem

Instructions

This questionnaire asks how you feel about your quality of life, health, or other areas of your life. Please answer all the questions. If you are unsure about which response to give to a question, please choose the one that appears most appropriate. This can often be your first response.

Please keep in mind your standards, hopes, pleasures and concerns. We ask that you think about your life in the last two weeks. For example, thinking about the last two weeks, a question might ask:

(Please circle the number)
For office use	Not at all	A little	Moderately	Mostly	Completely
Do you get the kind of support from others that you need?	1	2	3	4	5

You should circle the number that best fits how much support you got from others over the last two weeks. So you would circle the number 4 if you got a great deal of support from others. 

(Please circle the number)
For office use	Not at all	A little	Moderately	Mostly	Completely
Do you get the kind of support from others that you need?	1	2	3	4	5

You would circle number 1 if you did not get any of the support that you needed from others in the last two weeks. 

(Please circle the number)
For office use	Not at all	A little	Moderately	Mostly	Completely
Do you get the kind of support from others that you need?	1	2	3	4	5

Please read each question, assess your feelings, and circle the number on the scale that gives the best answer for you for each question.

(Please circle the number)
For office use	Very poor		Poor	Neither poor nor good	Good	Very Good
G1 / G1.1	1. How would you rate your quality of life?	1	2	3	4	5

(Please circle the number)
For office use		Very dissatisfied	Dissatisfied	Neither satisfied nor dissatisfied	Satisfied	Very satisfied
G4 / G2.3	2. How satisfied are you with your health?	1	2	3	4	5

The following questions ask about how much you have experienced certain things in the last two weeks.

(Please circle the number)
For office use		Not at all	A little	A moderate amount	Very much	An extreme amount
F1.4 / F1.2.5	3. To what extent do you feel that physical pain prevents you from doing what you need to do?	1	2	3	4	5
F11.3 / F13.1.4	4. How much do you need any medical treatment to function in your daily life?	1	2	3	4	5
F4.1 / F6.1.2	5. How much do you enjoy life?	1	2	3	4	5

(Please circle the number)
For office use	Not at all		A little	A moderate amount	Very much	An extreme amount
F24.2 / F29.1.3	6. To what extent do you feel your life to be meaningful?	1	2	3	4	5

(Please circle the number)
For office use		Not at all	Slightly	A Moderate amount	Very much	Extremely
F5.2 / F7.1.6	7. How well are you able to concentrate?	1	2	3	4	5
F16.1 / F20.1.2	8. How safe do you feel in your daily life?	1	2	3	4	5
F22.1 / F27.1.2	9. How healthy is your physical environment?	1	2	3	4	5

The following questions ask about how completely you experience or were able to do certain things in the last two weeks.

(Please circle the number)
For office use		Not at all	A little	Moderately	Mostly	Completely
F2.1 / F2.1.1	10. Do you have enough energy for everyday life?	1	2	3	4	5
F7.1 / F9.1.2	11. Are you able to accept your bodily appearance?	1	2	3	4	5
F18.1 / F23.1.1	12. Have you enough money to meet your needs?	1	2	3	4	5

(Please circle the number)
For office use		Not at all	A little	Moderately	Mostly	Completely
F20.1 / F25.1.1	13. How available to you is the information that you need in your day-to-day life?	1	2	3	4	5
F21.1 / F26.1.2	14. To what extent do you have the opportunity for leisure activities?	1	2	3	4	5

(Please circle the number)
For office use		Very poor	Poor	Neither poor nor well	Well	Very well
F9.1 / F11.1.1	15. How well are you able to get around?	1	2	3	4	5

The following questions ask you to say how good or satisfied you have felt about various aspects of your life over the last two weeks.

(Please circle the number)
For office use	Very dissatisfied		Dissatisfied	Neither satisfied nor dissatisfied	Satisfied	Very satisfied
F3.3 / F4.2.2	16. How satisfied are you with your sleep?	1	2	3	4	5
F10.3 / F12.2.3	17. How satisfied are you with your ability to perform your daily living activities?	1	2	3	4	5
F12.4 / F16.2.1	18. How satisfied are you with your capacity for work?	1	2	3	4	5

(Please circle the number)
For office use	Very dissatisfied		Dissatisfied	Neither satisfied nor dissatisfied	Satisfied	Very satisfied
F6.4 / F8.2.2	19. How satisfied are you with yourself?	1	2	3	4	5
F13.3 / F17.2.3	20. How satisfied are you with your personal relationships?	1	2	3	4	5
F15.3 / F3.2.1	21. How satisfied are you with your sex life?	1	2	3	4	5
F14.4 / F18.2.5	22. How satisfied are you with the support you get from your friends?	1	2	3	4	5
F17.3 / F21.2.2	23. How satisfied are you with the conditions of your living place?	1	2	3	4	5
F19.3 / F24.2.1	24. How satisfied are you with your access to health services?	1	2	3	4	5
F.23.3 / F28.2.2	25. How satisfied are you with your mode of transportation?	1	2	3	4	5

The follow question refers to how often you have felt or experienced certain things in the last two weeks.

(Please circle the number)
For office use		Never	Seldom	Quite often	Very often	Always
F8.1 / F10.1.2	26. How often do you have negative feelings, such as blue mood, despair, anxiety, depression?	1	2	3	4	5

Did someone help you to fill out this form? (Please circle Yes or No)

Yes

No

How long did it take to fill out this form?

THANK YOU FOR YOUR HELP

WHOQOL-BREF, Questionnaire, June 1997, Updated 1/10/2014 8

DOMAIN SCORES

Domains	WHOQOL-100 Facets	Raw domain score	Raw score range
Domain 1: Physical	Facet 1 + Facet 2 + Facet 3	12 - 60	48
Domain 2: Psychological	Facet 4 + Facet 5 + Facet 6 + Facet 7 + Facet 8	20 – 100	80
Domain 3: Level of Independence	Facet 9 + Facet 10 + Facet 11 + Facet 12	16 – 80	64
Domain 4: Social relationships	Facet 13 + Facet 14 + Facet 15	12 – 60	48
Domain 5: Environment	Facet 16 + Facet 17 + Facet 18 + Facet 19 + Facet 20 + Facet 21+ Facet 22 + Facet 23	32 – 160	128
Domain 6: Spirituality / Religion / Personal beliefs	Facet 24	4 – 20	16

TRANSFORMATION OF SCALE SCORES

The next step involves transforming each raw scale score to a 0-100 scale using the formula shown below:

_{Transformed Scale } ^(Actual raw score - lowest possible raw score) ^ _100





^ Possible raw score range ^

where “Actual raw score” is the values achieved through summation, “lowest possible raw score” is the lowest possible value that could occur through summation (this value would be 4 for all facets), and “Possible raw score range” is the difference between the maximum possible raw score and the lowest possible raw score (this value would be 16 for all facets: 20 minus 4).

This transformation converts the lowest and highest possible scores to zero and 100, respectively. Scores between these values represent the percentage of the total possible score achieved. The WHOQOL-100 scores from other Centers may not be transformed to the 0-100 scale. The U.S.WHOQOL instruments and scoring programs have used this transformation to provide comparative data for interpretation.

Example: A Facet 1 “Pain and discomfort” raw score of 15 would be transformed as follows:

Transformed Scale  ^{(15 - 4) } 100  68.75

_ ₁₆ _

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WHOQOL-BREF Scoring

The WHOQOL-Bref, still in field trials, is a subset of 26 items taken from the WHOQOL-100. The same steps for the scoring WHOQOL-100 should be followed to achieve scores for the Bref. Although scoring the Bref is identical to scoring the WHOQOL-100, there are some differences that need to be addressed:

• The WHOQOL-Bref does not have facet scores

• Mean substitutions are recommended for Domain 1 Physical Health and Domain 4

Environment if no more than one item is coded missing

• Only three items need to be reversed before scoring

The WHOQOL-Bref (Field Trial Version) produces a profile with four domain scores and two individually scored items about an individual’s overall perception of quality of life and health. The four domain scores are scaled in a positive direction with higher scores indicating a higher quality of life. Three items of the Bref must be reversed before scoring. They can be seen in Table 9, indicated by the “- (reverse)” denotation in the Direction of scaling column.

TABLE 9. Scoring Domains of the WHOQOL-BREF

Domains and questions 236/BREF	Direction of scaling	Raw domain score	Raw item score
Overall Quality of Life and General Health		....(2-10)
G1.1/B1 How would you rate your quality of life?	+		....(1-5)
G2.3/B2 How satisfied are you with your health?	+		....(1-5)
Domain 1 Physical Health		....(7-35)
F1.2.5/B3 To what extent do you feel that physical pain prevents you from doing what you need to do?	-(reverse)		....(1-5)
F13.1.4/B4 How much do you need any medical treatment to function in your daily life?	-(reverse)		....(1-5)
F2.1.1/B10 Do you have enough energy for everyday life?	+		....(1-5)
F11.1.1/B15 How well are you able to get around?	+		....(1-5)
F4.1.1/B16 How satisfied are you with your sleep	+		....(1-5)
F12.2.3/B17 How satisfied are you with your ability to perform your daily living activities?	+		....(1-5)
F16.2.1/B18 How satisfied are you with your capacity for work?	+		....(1-5)
Domain 2 Psychological		....(6-30)
F6.1.2/B5 How much do you enjoy life?	+		....(1-5)
F29.1.3/B6 To what extent do you feel your life to be meaningful?	+		....(1-5)
F7.1.6/B7 How well are you able to concentrate?	+		....(1-5)
F9.1.2/B11 Are you able to accept your bodily appearance?	+		....(1-5)
F8.2.1/B19 How satisfied are you with yourself?	+		....(1-5)
F10.1.2/B26 How often do you have negative feelings such as blue mood, despair, anxiety, depression?	- (reverse)		....(1-5)
Domain 3 Social relationships		....(3-15)
F17.1.3/B20 How satisfied are you with your personal relationships?	+		....(1-5)
F3.2.1/B21 How satisfied are you with your sex life?	+		....(1-5)
F18.2.5/B22 How satisfied are with the support you get from your friends?	+		....(1-5)

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Domains and questions 236/BREF	Direction of scaling	Raw domain score	Raw item score
Domain 4 Environment		....(8-40)
F20.1.2/B8 How safe do you feel in your daily life?	+		....(1-5)
F27.1.2/B9 How healthy is your physical environment?	+		....(1-5)
F23.1.1/B12 Have you enough money to meet your needs?	+		....(1-5)
F25.1.1/B13 How available to you is the information that you need in your daily-to-day life?	+		....(1-5)
F26.1.2/B14 To what extent do you have the opportunity for leisure activities?	+		....(1-5)
F21.2.2/B23 How satisfied are you with the condition of your living place?	+		....(1-5)
F24.2.1/B24 How satisfied are you with your access to health services?	+		....(1-5)
F28.2.2/B25 How satisfied are you with your transport?	+		....(1-5)

If no more than one item from the Physical Health or Environment domains has been coded as missing, we recommend that a domain score be calculated by substituting a person- specific average across the completed items in the same scale. For example, if a respondent does not have a value for item B16 How satisfied are you with your sleep? in the Physical Health domain, but has answered all of the other items in that domain, then the value for item B16 would be the average of the remaining 6 items. If two or more items are coded missing in these two domains, the domain score should not be calculated, likewise if any items are coded missing in the Psychological and Social Relationships domains, a domain score for that respondent would not be calculated.

After item recoding and handling of missing data, a raw score is computed by a simple algebraic sum of each item in each of the four domains. Once complete, check the frequencies of each domain to be sure that the scores are within the correct range indicated in Table 9 Raw domain score column. The next step is to transform each raw scale score using the formula on page 32. The possible raw score ranges for each domain are as follows: Physical Health=28, Psychological=24, Social Relationships=12, and Environment=32.

SCORING EXERCISE AND TEST DATASET FOR THE WHOQOL-BREF INSTRUMENT

The purpose of this scoring exercise is to help WHOQOL-Bref users to evaluate results from each step in the process of calculating the Domain summary scores of the instrument. This exercise was created for SPSS users, but with minor modifications, can be adapted for other computer programs or can be useful for those scoring the survey manually.

A test dataset and SPSS code for scoring the WHOQOL-Bref a computer disk in this packet. The test dataset, which is called “WQ_BREF.TXT” on the disk, contains data from 64 administrations of the WHOQOL-BREF. The data can be seen in Appendix F. The enclosed diskette also provides the user with the SPSS syntax used to:

• import raw data into SPSS format [WQ_B_DL.SPS]

• derive the WHOQOL-BREF domain summaries [WQ_BREF.SPS]

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The SPSS code (called “WQ_BREF.SPS”) on the disk begins by labeling all items and checking for out-or-range values. It then recodes the 3 negatively stated items so that a higher score indicates better health. The 4 domains are then scored, labeled, and transformed to a 0 to 100 scale used to interpret and compare to other validated instrument tools such as the WHOQOL-100. A copy of the SPSS syntax is reproduced in Appendix F.

Table 10 presents statistics for the transformed domains for the WHOQOL-Bref. After scoring the test dataset, the means, standard deviations, and minimum and maximum observed values should agree with those presented in Table 10

TABLE 10. Test Dataset Descriptive Statistics: WHOQOL-BREF

Descriptive Statistics

Std.

N	Minimum	Maximum	Mean	Deviation
Physical 64	32.14	92.86	66.7969	14.5480
Psychological 64	37.50	95.83	73.5026	13.7165
Social Relations 64	25.00	100.00	73.1771	17.0891
Environment 64	28.13	100.00	72.8027	14.1592
Valid N (listwise) 64

(TRANSFORMED) (TRANSFORMED) (TRANSFORMED) (TRANSFORMED)

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