Detailled Information

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

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.

Accordance and reproducibility of the electronic version of the WHOQOL-BREF and WHOQOL-OLD questionnaires

Adult Measures of General Health and Health-Related Quality of Life.

Quality of life in Brazil: normative values for the WHOQOL-BREF in a southern general population sample

Suitability of the WHOQOL-BREF for community-dwelling older people in Taiwan

Development and validation of the Somali WHOQOL-BREF among refugees living in the USA

The WHOQOL-BREF is a non–disease-specific quality of life measure that forms part of a suite of instruments developed by the WHOQOL Group. The WHOQOL instruments provide a broad profile of an individual's life rather than health status or HRQOL and were developed to enable a cross-cultural assessment of quality of life by considering an individual's beliefs, life situation, and environmental context. The WHOQOL-BREF also uniquely considers the degree of satisfaction with aspects of an individual's life and health that are relevant to rheumatology settings.

The instrument covers the following four domains: physical health, psychological, social relationships, and environment.

The WHOQOL-BREF was derived from the longer WHOQOL-100 quality of life instrument, using data from 15 international collaborating centers.

A score for each of the four WHOQOL-BREF domains is obtained by summing the item responses within each domain and then calculating the mean. Raw domain scores are transformed to a 4 to 20 scale but may also be converted to a 0 to 100 scale. Domain scores can also be generated using an SPSS syntax file, which is available on request.

A score cannot be calculated when more than 20% of the items have missing responses. When responses to two items or fewer within a domain are missing, the missing response can be substituted with the mean of the remaining items within the domain. When more than two items are missing, the domain score is generally not calculated (except for the three-item social relationships domain, for which calculation is only recommended if there is one missing item response or no missing responses). The social relationships domain is known to have issues with missing data, which likely reflects the inclusion of an item concerning sexual relationships. Only items 3 to 26 are used in the calculation of domain scores

The concepts covered by the WHOQOL-BREF are broadly applicable to most rheumatic conditions, and there appear to be no floor or ceiling effects, indicating that this measure can be used with both severely and mildly impacted patient groups.