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PRACTICAL

WHOQOL-BREF

Aim – To assess the Quality Of Life of the participant using the WHO Quality Of Life Scale
Brief Version

Introduction

The degree to which an individual is healthy, comfortable, and able to participate in or enjoy life
events is known as quality of life. The quality of life is linked intricately to the overall quality of
the environment and maintenance of the ecosystem. One person may define quality of life
according to wealth or satisfaction with life, another person may define it in terms of capabilities
(e.g., having the ability to live a good life in terms of emotional and physical well-being). A
disabled person may report a high quality of life, whereas a healthy person who recently lost a
job may report a low quality of life.

Within the arena of health care, quality of life is viewed as multidimensional, encompassing.
WHO defines QOL as the “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.”

There are four main domains: physical health, psychological health, social relationships, and
immediate environment each with its attributes of QOL. WHO has used these attributes to
develop two instruments to measure QOL in diverse cultures and social groups. The assessment
of QOL involves two subjective dimensions: first, the relative importance of components of
everyday life and, second, the level of personal satisfaction with each component.

Quality of life of a person has a significant impact on his health and well-being. A person having
poor quality of life often is stressed, irritated and not happy with the circumstances as well as he
is not able to get out of any situation nor make the best of the present scenario.
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Review of Literature

Adams and Wrightsons (2018) did a study on quality of life with an L-VAD. meta-summary
were used to analyze the 19 studies that met the inclusion criteria. LVADs can improve HF
symptoms and some aspects of QoL. Emotional and physical adaptation involves many changes
and learning to manage the device takes time. Functional limitations still exist and patients still
lack independence. LVAD-related complications significantly impact QoL. Psychological
distress remains high after implantation. LVADs significantly impact the caregiver as well and
their perspective is not well heard in the existing evidence. It is important for providers to have
ongoing, in-depth discussions with patients and their caregivers regarding treatment options,
goals of care, anticipated end-of-life trajectories with an LVAD, possible LVAD-complications,
and the caregiver burden associated with an LVAD.

Ferriera and Perriera (2018) did a study to understand the quality of life under the covid 19
quarantine.A sample of Portugal’s population quarantined at home of 904 people filled in an
online survey comprising the Generalized Anxiety Disorder 7-item and the EQ-5D-5L and other
questions about sociodemographic characteristics, feelings, duties and activities during the
quarantine. Descriptive analyses and correlation coefficients were used to evaluate the
respondents’ anxiety and HRQoL. The results show that individuals quarantined at home
reported higher anxiety and lower HRQoL levels and that people with more anxiety tended to
have a lower HRQoL. Females and elderly individuals experienced the highest levels of anxiety
and poorest HRQoL.

Uyusal and Berbekova (2018) did a study on designing for quality of life. The paper argues that
designing for tourism is intimately related to the enhancement of quality of life; that is, designing
appropriate platforms for tourism experience settings with its actors will contribute not only to
the wellbeing of participants, but also improve the liveability of places as destinations. The
article outlines a conceptual framework with seven propositions which links tourism design and
key elements of quality of life. The paper concludes with a discussion of important areas for
future research and practical implications.
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Description of the Test

a. About the Test

• WHOQOL-BREF, a generic health-related questionnaire developed by the
WHOQOL group was selected to quantify the health-related quality of life of ESRD
patients. The WHOQOL-BREF consists of 24 facets and provides a profile of
scores on four dimensions of quality of life: physical health, psychological, social
relationships, and the environment. WHOQOL-BREF is available in both self-
administered and interviewer-administered forms.

• The WHOQOL-BREF contains a total of 26 questions. To provide a broad and

comprehensive assessment, one item from each of the 24 facets contained in the
WHOQOL-100 has been included. In addition, two items from the Overall quality
of Life and General Health facet have been included.

b. Reliability
The instrument showed good internal consistency (Cronbach’s a=0.87; p-value<0.01) as
well as good content, construct and predictive validity (pvalues<0.05).
Psychological domain had best predictive validity, whereas, social relations domain had
best content validity.

c. Validity
The instrument showed good internal consistency (Cronbach’s a=0.87; p-value<0.01) as
well as good content, construct and predictive validity (pvalues<0.05).
Psychological domain had best predictive validity, whereas, social relations domain had
best content validity.

Method

a. Subject Preliminary
i. Name – XYZ
ii. Age – 22 years
iii. Educational Qualification – undergraduate student
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iv. Gender – Female

b. Material Required
i. Pen
ii. Paper
iii. WHOQOL-BREF Questionnaire
iv. WHOQOL-BREF Scale Manual

c. Rapport Formation
The subject was made to sit comfortably and was engaged in an informal conversation and
an introduction with the experimenter to make them feel relaxed. Once it was ensured that
they are comfortable, the experiment was introduced with the reassurance that their identity
as well as their responses will be kept confidential and not shared with anyone. The subject
was also assured that if they have any queries, they could ask them without any hesitation.

d. Instructions

i. “In this booklet, there are some statements regarding the way in which we behave, feel
and act.
ii. Read each statement carefully and mark your responses on the option which suits you
best by making a cross sign on the response sheet.
iii. Do not leave any statement.
iv. Kindly provide your honest first response.
v. Your responses will be kept confidential.”

e. Administration
The subject was made to sit comfortably and rapport was formed by an informal
conversation between the experimenter and the subject. The subject was also ensured that
their responses will be kept confidential. After giving the instructions the conduction of the
practical was soon followed. No time limit was set, but the subject was told to finish the
test as soon as possible. After the test, an introspective report was collected from the
subject.
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f. Observational Report
The subject seemed excited to take the test and was very interested in knowing what the
test was all about. They did not take much time in completing the test and was quick in
their understanding of the instructions given.

g. Introspective Report
“The test was quite easy and fun to do. The questions were simple and I had no difficulty in
understanding or answering any questions. The instructor was cooperative and clear with
her instructions.”

h. Scoring
The WHOQOL-BREF produces a quality of life profile. It is possible to derive four domain
scores.

There are also two items that are examined separately: question 1 asks about an
individual’s overall perception of quality of life and question 2 asks about an individual’s
overall perception of their health. The four domain scores denote an individual’s perception
of quality of life in each particular domain.

Domain scores are scaled in a positive direction (i.e. higher scores denote higher quality of
life). The mean score of items within each domain is used to calculate the domain score.
The raw scores were converted to transformed scores. The first transformation converts
scores to a range of 4–20 and the second transformation converts domain scores to a 0–100
scale. Higher scores reflect a better quality of life.
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Result-

Table 1: Scores from the subject

DOMAIN RAW SCORE TRANSFORMATIONAL SCORE

PHYSICAL 31 88

PSYCHOLOGICAL 24 75

SOCIAL RELATIONSHIP 13 71

ENVIRONMENT 32 75

Discussion & Analysis

The aim of the practical was to assess the Quality Of Life of the participant using the WHO
Quality Of Life Scale Brief Version. The degree to which an individual is healthy, comfortable,
and able to participate in or enjoy life events is known as quality of life. The quality of life is
linked intricately to the overall quality of the environment and maintenance of the ecosystem.

The scale was administered on a 22 year old female subject who obtained a raw score of 31, 24,
13, and 32 in the Physical, Psychological, Social Relationships and Environment domains
respectively. The raw score then converted into the (0-100) transformational score, as per the
given norm table it came out to be 88, 75, 71, and 75 for the 4 respective domains i.e. Physical,
Psychological, Social Relationships and Environment. This means that the subject has a good
quality of life in all four domains.

To further enhance their quality of life the subject can focus on working in the following areas of
their life: Sleep and rest, Work Capacity, Self-esteem, Spirituality / Religion / Personal beliefs,
Thinking, learning, memory and concentration, Personal relationships, Social support, Home
environment, opportunities for recreation / leisure activities etc.
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Conclusion

In conclusion, according to the results obtained by the administration of the WHOQOL - BREF,
the subject scored has a good quality of life over all four domains of the test.

References

Ferreria, S., & Perriera, K. (2018). Quality of life under the COVID-19 quarantine. Springer
link, 3(3), 83-88.

Uysal, berbekova. (2018). Designing for Quality of life. British journal of sports medicine, 55(2)

Appendix (Questionnaire)