Jolanda De Vries and Guus L.Van Heck WHO Quality of Life Assessment Instrument
The World Health Organization Quality of Life
Assessment Instrument (WHOQOL-100):
Validation Study with the Dutch Version
Jolanda De Vries and Guus L. Van Heck
Department of Psychology, Tilburg University, Tilburg, The Netherlands
In this study, we examine the reliability and validity of a new quality-of-life (QoL) instrument, the Field Trial
Version of the World Health Organization Quality of Life assessment instrument (WHOQOL-100). Two-
hundred-and-twenty persons, 147 healthy individuals, and 73 chronic fatigue syndrome (CFS) patients
completed the WHOQOL-100 and a test battery of related measures. The WHOOQL-100 has a fairly
good internal consistency and a good validity.
Keywords: Quality of life, psychometrics, assessment, health, self-esteem
Introduction
Practically all psychological research into quality of
life (QoL) is related to health. Health-related QoL
is a topic with a growing popularity in health psy-
chology. In 1985, De Haes and Van Knippenberg
noted that health-related QoL has not been defined
explicitly. Today this remark still generally holds.
Grieco and Long (1984) conceived of QoL as re-
flecting impairment in functional performance. In
1985, Kaplan used the term “quality of life” to de-
scribe the impact of disease and disability upon dai-
ly functioning. In another definition, health-related
QoL has been defined as “the end result of an adap-
tive process that begins with uncertainty in illness,
continues through appraisal of uncertainty as dan-
ger or opportunity, and incorporates coping strate-
gies to manipulate the uncertainty in the desired di-
rection” (Padilla, Mishel, & Grant, 1992, p. 156). Fi-
nally, Patrick and Erickson (1993, p. 20) defined
health-related QoL as “the value assigned to dura-
tion of life as modified by the impairments,function-
al states, perceptions, and social opportunities that
are influenced by disease, injury, treatment, or poli-
cy.”
The current popularity of QoL arises from the
fact that health-related QoL is increasingly being
recognized as an important outcome measure of
medical treatment, and as a supplement to tradi-
tional biological end-points such as mortality (Hays
& Shapiro, 1992). Information concerning health-
related QoL can add to medical knowledge ob-
tained, for instance, in the context of clinical trials
(Moinpoir et al., 1989).
Although often the term “health-related QoL” is
used, studies in this area usually focus on illness and
the impact it has on health and functional status
(Bergner, 1985). In addition, while most authors
claim that their instrument assesses health-related
QoL, most measures are, strictly speaking, predom-
inantly health-status measures that focus on the in-
fluence of disease on physical functioning (e. g., Ber-
gner, 1985; Stoker, Dunbar & Beaumont, 1992).
One problem that occurs when studying QoL
with health status measures is that lower levels of
functioning are equated with lower QoL. This con-
trasts sharply with empirical findings reflecting high
perceived QoL in spite of low levels of functioning.
Furthermore, QoL has a much wider scope than
health status. For instance, it contains more domains
than current health status measures. Moreover, QoL
encompasses the respondents’ own perception of
aspects of their life, while health status asks respon-
dents about behavior. An example of a subjective
QoL question is “How satisfied are you with the
support you get from your family?”, whereas an ex-
ample of a health status statement is “I isolate my-
self as much as I can from the rest of the family.”
In most of the health-status studies the emphasis
is typically placed on the measurement of control of
symptoms specific to the disease process (e. g., angi-
na in cardiac disease), physical functional status, and
work status (Burckhardt, Woods, Schultz, & Zie-
barth, 1989).
European Journal of Psychological Assessment, Vol. 13, Issue 3, pp. 164–178 © 1997 Hogrefe & Huber Publishers
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