Attachment 7f - WHOQOL-BREF and Scoring Instructions

WHOQOL-BREF
June 1997
U.S. Version

University of Washington
Seattle, Washington
United States of America
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.
sex

---------1. What is your gender

Male

Female

2. What is your date of birth?

/
Day

3. What is the highest education you
received?

/
Month

Year

None at all
Elementary School
High School
College

4. What is your marital status?

Single
Married
Living as Married

Separated
Divorced
Widowed

5. Are you currently ill?

Yes

No

6. If something is wrong with
your health, what do you
think it is?

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

illness/problem

2

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:
Not at all

For office
use

Do you get the kind of
support from others that
you need?

1

(Please circle the number)
A little
Moderately
Mostly

2

3

Completely

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. ο
Not at all

For office
use

Do you get the kind of
support from others that
you need?

1

(Please circle the number)
A little
Moderately
Mostly

2

3

4

Completely

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. ο
Not at all

For office
use

Do you get the kind of
support from others that
you need?

1

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

(Please circle the number)
A little
Moderately
Mostly

2

3

4

Completely

5

3

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

For office
use
G1 / G1.1

1.

How would you
rate your quality of
life?

1

Very
dissatisfied

For office
use
G4 / G2.3 2.

How satisfied are
you with your
health?

1

(Please circle the number)
Poor
Neither poor
Good
nor good

2

3

4

(Please circle the number)
Dissatisfied
Neither
Satisfied
satisfied nor
dissatisfied

2

3

Very Good

5

Very satisfied

4

5

The following questions ask about how much you have experienced certain
things in the last two weeks.
Not at all

For office
use

(Please circle the number)
A little
A moderate Very much
amount

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

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

4

Not at all

For office
use
F24.2 /
F29.1.3

6.

To what extent do
you feel your life to
be meaningful?

1

Not at all

For office
use

(Please circle the number)
A little
A moderate Very much
amount

2

3

An extreme
amount

4

(Please circle the number)
Slightly
A Moderate Very much
amount

5

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.
Not at all

For office
use

(Please circle the number)
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

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

5

Not at all

For office
use

(Please circle the number)
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

Very poor

For office
use
F9.1 /
F11.1.1

15. How well are you
able to get around?

1

(Please circle the number)
Poor
Neither poor
Well
nor well

2

3

Very well

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.
Very
dissatisfied

For office
use

(Please circle the number)
Dissatisfied
Neither
Satisfied
satisfied nor
dissatisfied

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

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

6

Very
dissatisfied

For office
use

(Please circle the number)
Dissatisfied
Neither
Satisfied
satisfied nor
dissatisfied

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

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

7

The follow question refers to how often you have felt or experienced certain
things in the last two weeks.
For office
use
F8.1 /
F10.1.2

Never

26. How often do you
have negative
feelings, such as
blue mood, despair,
anxiety,
depression?

(Please circle the number)
Quite
Very
Seldom
often
often

1

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

2

Yes

3

Always

4

5

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

12 - 60

48

Domain 1: Physical

Facet 1 + Facet 2 + Facet 3

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:

 (Actual raw score - lowest possible raw score) 
Transformed Scale = 
 × 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:
 (15 - 4) 
Transformed Scale = 
 ×100 = 68.75
 16 

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32

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

Direction of scaling

Raw domain
score

Raw item score

....(2-10)
+
+

....(1-5)
....(1-5)
....(7-35)

-(reverse)

....(1-5)

-(reverse)

....(1-5)

+
+
+
+

....(1-5)
....(1-5)
....(1-5)
....(1-5)

+

....(1-5)
....(6-30)

+
+
+
+
+
- (reverse)

....(1-5)
....(1-5)
....(1-5)
....(1-5)
....(1-5)
....(1-5)
....(3-15)

+
+
+

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....(1-5)
....(1-5)
....(1-5)

Domains and questions
236/BREF
Domain 4

Environment

F20.1.2/B8
F27.1.2/B9
F23.1.1/B12
F25.1.1/B13

How safe do you feel in your daily life?
How healthy is your physical environment?
Have you enough money to meet your needs?
How available to you is the information that you need in your
daily-to-day life?
To what extent do you have the opportunity for leisure activities?
How satisfied are you with the condition of your living place?
How satisfied are you with your access to health services?
How satisfied are you with your transport?

F26.1.2/B14
F21.2.2/B23
F24.2.1/B24
F28.2.2/B25

Direction of scaling

Raw domain
score

Raw item score

....(8-40)
+
+
+
+

....(1-5)
....(1-5)
....(1-5)
....(1-5)

+
+
+
+

....(1-5)
....(1-5)
....(1-5)
....(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 personspecific 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

N

Minimum

Maximum

Mean

Std.
Deviation

Physical
(T RANSFORMED)

64

32.14

92.86

66.7969

14.5480

Psychological
(T RANSFORMED)

64

37.50

95.83

73.5026

13.7165

Social Relations
(T RANSFORMED)

64

25.00

100.00

73.1771

17.0891

Environment
(T RANSFORMED)

64

28.13

100.00

72.8027

14.1592

Valid N (listwise)

64

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