Question 2. I would like to use the WHOQOL but don't know which version to choose


The WHOQOL Group was the first to develop a cross-cultural generic person-reported outcome measure (PROM) assisted by patients, healthy people from the communities and health professionals.

They incorporated topics that people found meaningful, and phrased the questions (items) that were eventually included in the questionnaires using a language that could be understood by users.


Two key WHOQOL measures can be used by people with almost any disease or condition to record their own quality of life: the WHOQOL-100 and the WHOQOL-BREF. These are sometimes referred to as 'core' measures, as modules of extra items can be added to them, once they have been developed and tested for use in particular populations.

The WHOQOL-100

The WHOQOL-100 is a highly comprehensive instrument containing 100 items. It is particularly useful where a detailed investigation of quality of life is needed, as it is possible to obtain reliable and valid results for each of the 25 facets of quality of life in a profile. These issues are important to many cultures. The WHOQOL-100 is scored in 6 domains: Physical, Psychological Independence, Social, Environmental and Spiritual quality of life. The WHOQOL-100 is widely used in research and clinical practice where a detailed and comprehensive understanding of particular facets is valuable. The English version takes about 20 minutes to complete. It is an ideal research tool and is available in many different and compatible language versions. Both instruments have been standardised for use with adults (age 18 to 65 years), in multiple cultures world-wide (The WHOQOL Group, 1995; 1998 a,b)


The WHOQOL-BREF is a shorter version of the WHOQOL-100 containing 26 items that have been extracted from it. Like the WHOQOL-100, it covers a comprehensive range of international agreed topics (facets) covering the same 25 facets of quality of life. It contains one item per facet and two general items, If you need to assess quality of life relating to a particular facet (e.g. sleep, negative feelings, social support) then you should consider using the WHOQOL-100 because 4 items assess each facet, so providing more reliable information about that facet. An example would be assessing quality of life relating to sleep for people with sleep disorders.

The WHOQOL-BREF field trial was conducted in 23 countries where data on validity and reliability are available (Skevington, Lotfy and O'Connell, 2004). Other international and national studies (e.g. Diehr et al 2006; Skevington and McCrate, 2012, Crocker, Smith and Skevington, 2015) have found that the scores are sensitive and responsive to changes over time. Over 86 different language versions are known to be available. Some newer language versions have also been developed followed the official WHOQOL Group protocol (1994) for cultural adaptation and translation.

The WHOQOL-BREF is scored in four Domains: Physical, Psychological, Social and Environmental quality of life. Due to its brevity, it is ideal for use in large-scale surveys, and in some clinical situations e.g. palliative care, where patient burden may prohibit the use of the WHOQOL-100. The English language version takes 6 minutes to complete.

WHOQOL Modules for assessing special populations

Several modules of extra items are available to complete the assessment of quality of life for certain populations. International modules have been developed and tested simultaneously in many cultures, following an internationally agreed WHOQOL protocol. Other Modules are in development or have only been developed in one culture.

By adding a module to one of the two 'core' measures i.e. the WHOQOL-100 or WHOQOL BREF, this completes the important aspects of quality of life for relevant populations. The WHOQOL-SRPB, the WHOQOL-HIV, the WHOQOL-OLD and the WHOQOL-Pain are now available for use. In the WHOQOL-SRPB, WHOQOL-HIV and WHOQOL-Pain, Module items are embedded within the 'core' version of the WHOQOL, within a block of other similar questions that use the same form of reply (response scale).


If you wish to assess people who are over 60 years of age, then you could consider adding an extra short module of questions covering the specific concerns of older adults by including the WHOQOL-OLD questions (The WHOQOL-OLD Group, 2005). WHOQOL-OLD items must be appended to the items of the WHOQOL-100 or the WHOQOL-BREF to obtain a complete assessment. By doing this, a full quality of life assessment is created for the over 60's.

The long form contains 24 items which are added as a block at the end of the WHOQOL-BREF or WHOQOL-100. The WHOQOL-OLD module has been developed and tested in 23 countries including UK and is reliable and valid. Three short-forms of the WHOQOL-OLD are available for use with the WHOQOL-BREF (Power, et al, 2013).