Quality of Life Research

, Volume 21, Issue 1, pp 161–165 | Cite as

The WHO quality of life (WHOQOL) questionnaire: Spanish development and validation studies

  • Ramona Lucas-Carrasco
Brief Communication



In the 1990s, the World Health Organization (WHO) undertook a project to develop an instrument (the WHOQOL) for measuring quality of life (QoL). The WHOQOL was developed in the framework of a collaborative project involving numerous centers in different cultural settings. This paper describes the psychometric properties of the Spanish WHOQOL during its development.


One thousand and eighty-two patients with physical health conditions, persons without any health condition, patients with schizophrenia, and family caregivers of patients with schizophrenia participated on the WHOQOL-100 and WHOQOL-BREF field trials. QoL self-assessment was completed, together with sociodemographic and health status questions. Analysis was performed using classical psychometric methods. Results: Both versions of the WHOQOL showed satisfactory psychometric properties as follows: acceptability, internal consistency, and evidence of convergent and discriminant validity.


The WHOQOL-100 and WHOQOL-BREF are suitable to use in patients with different health conditions, including schizophrenia, and in different populations, including caregivers. Spanish field trials are the first to report on use of the WHOQOL in persons with schizophrenia and caregivers. These results indicate that both versions are useful tools in assessing these groups, as the WHOQOL includes important dimensions commonly omitted from other generic QoL measures.


Spanish WHOQOL Validity Reliability Development Schizophrenia Caregivers 



We would like to thank all the participating centers, professionals who helped with recruitment, and especially all patients and families who participated during the development of the Spanish version of the WHOQOL from 1993 to 1997: Dr. P. Gonzalez, Dr. S. Juncá, Mr. D. Macfarlane, Ms. T. Roca, Mr. J. Vila. Prof. J. L. Martí-Tusquets (University of Barcelona); Dr. A. Roig (C. S. M. Horta-Guinardó); Dr. J. Berenguer, Mr. F. Rillo (Hospital de la Esperanza); Dr. C. Humet (Hospital de Barcelona); Dr. J. C. Viñeta (Hospital San Rafael); Dr. N. Barquet (C. A. P. Gracia); Dra. N.Juvenet (C. A. P. Guineueta); Dr. Mundet (C. A. P. El Carmel); Dr. A. Rivera, Dr. S. Zelich (C.A.P. Horta); Dr. T. Arranz, Dr. C. Bosque, Dr. J. M. Cebamanos, Dr. J. Pigem, Dr. L. Tiffon (Benito Menni Complejo Asistencial en Salud Mental); Dr. R. Blasi, Mr. A. García (ARAPDIS); Dr. J. Clusa, Mr. J. Besora (C. Día Pi i Molist); Dr. J. Fábregas, Mr. J. Pi, Ms. M. Trias (C. P. B.); Ms. T. Montlleó (Septimania); Dr. J. Ramos, Dr. J. M. Cantos, Dr. J. L. Segarriballi (Sant Joan de Déu Serveis de Salut Mental); Dr. R. Santamaría (Hospital Sant Gervasi); Ms. T. Vigo (C.Día Santa Eulalia); and. Ms. S. Moreno and familias from the Catalan Family Association of the Mentally Ill.


  1. 1.
    WHOQOL Group. (1993). Study protocol for the World Health Organization project to develop a quality of life assessment instrument (WHOQOL). Quality of Life Research, 2(2),153–159.Google Scholar
  2. 2.
    WHOQOL Group. (1994). Development of the WHOQOL: Rationale and current status. International Journal of Mental Health, 23, 24–56.Google Scholar
  3. 3.
    WHOQOL Group. (1995). The World Health Organization Quality of Life assessment (WHOQOL): Position paper from the World Health Organization. Social Science and Medicine, 41, 1403–1409.CrossRefGoogle Scholar
  4. 4.
    Sartorius, N., Kuyken, W. (1994) Translation of health status measures. In J. Orley & W. Kuyken (Eds.), Quality of life assessment: International perspectives. Heidelberg: Springer.Google Scholar
  5. 5.
    Szabo, S., Orley, J., Saxena, S. on behalf of the WHOQOL Group. (1997). An approach to response scale development for cross-cultural questionnaires. European Psychologist, 2, 3270–3276.Google Scholar
  6. 6.
    WHOQOL Group. (1998). The World Health Organization quality of life assessment (WHOQOL): Development and general psychometric properties. Social Science and Medicine, 46, 1569–1585.CrossRefGoogle Scholar
  7. 7.
    Power, M., Bullinger, M., Harper, A. (1999). The World Health Organization Quality of Life Group: The World Health Organization WHOQOL-100: Tests of the universality of quality of life in 15 different cultural groups worldwide. Health Psychology, 5, 495–505.Google Scholar
  8. 8.
    WHOQOL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychology Medicine, 28, 551–558.CrossRefGoogle Scholar
  9. 9.
    Lucas-Carrasco, R. (1998). Versión Española del WHOQOL. Editorial Ergón. Madrid.Google Scholar
  10. 10.
    Bentler, P. M., & Wu, E. J. (1995). EQS structural equation program manual. Encino, C.A: Multivariate Software, Inc.Google Scholar
  11. 11.
    Skevington, S. M., Lotfy, M., & O’Connell, K. A. (2004). 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. Quality of Life Research, 13, 299–310.PubMedCrossRefGoogle Scholar
  12. 12.
    Lucas-Carrasco, R., Salcedo, A., Susín, C., et al. (1997). Calidad de vida en pacientes esquizofrénicos y en parientes de esquizofrénicos. Revista de psiquiatría de la Facultad de Medicina de Barcelona, 24(6), 143–155.Google Scholar
  13. 13.
    Skevington, S. M., Carse, M. S., & Williams, A. C. (2001). Validation of the WHOQOL-100: Pain management improves quality of life for chronic pain patients. The Clinical Journal of Pain, 17(3), 264–275.PubMedCrossRefGoogle Scholar
  14. 14.
    Pibernik-Okanović, M. (2001). Psychometric properties of the World Health Organisation quality of life questionnaire (WHOQOL-100) in diabetic patients in Croatia. Diabetes Research and Clinical Practice, 51(2), 133–143.PubMedCrossRefGoogle Scholar
  15. 15.
    Bonomi, A. E., Patrick, D. L., Bushnell, D. M., & Martin, M. (2000). Validation of the United States’ version of the World Health Organization Quality of Life (WHOQOL) instrument. Journal of Clinical Epidemiology, 53(1), 1–12.PubMedCrossRefGoogle Scholar
  16. 16.
    De Vries, J., & Van Heck, G. L. (1997). The World Health Organization Quality of Life Assessment Instrument (WHOQOL-100): Validation study with the Dutch version. European Journal of Psychological Assessment, 13, 164–178.CrossRefGoogle Scholar
  17. 17.
    Tazaki, M., Nakane, Y., Endo, T., Kakikawa, F., Kano, K., Kawano, H., et al. (1998). Results of a qualitative and field study using the WHOQOL instrument for cancer patients. Japanese Journal of Clinical Oncology, 28(2), 134–141.PubMedCrossRefGoogle Scholar
  18. 18.
    Bech, P., Lucas, R., Amir, M., Bushnell, M., Martin, M., Buesching, D., et al. (2003). Association between clinically depressed subgroups, type of treatment and patient retention in the LIDO study. Psychology Medicine, 33, 1051–1059.CrossRefGoogle Scholar
  19. 19.
    Simon, G., Fleck, M., Lucas, R., Bushnell, D., for the LIDO Group. (2004). Prevalence and predictors of depression treatment in an international primary care study. American Journal of Psychiatry, 161, 1626–1634.Google Scholar
  20. 20.
    Lucas-Carrasco, R., Pascual-Sedano, B., Galán, I., Kulisevsky, J., Sastre-Garriga, J., Gómez-Benito, J. (2010) Quality of life in persons with physical disabilities caused by neurodegenerative disorders: Using the WHOQOL-DIS. Neurodegenerative diseases Dec 3 [Epub ahead of print].Google Scholar
  21. 21.
    Lucas-Carrasco, R., Skevington, S., Gómez-Benito, J., Rejas, J., March, J. (2011). Using the WHOQOL-BREF in patients with dementia: A validation study. Alzheimer Disease and Associated Disorders Feb 2 [Epub ahead of print].Google Scholar
  22. 22.
    Lucas-Carrasco, R., Laidlaw, K., Power, MJ. (In press) Suitability of the WHOQOL–BREF and WHOQOL-OLD for Spanish older adults. Ageing and Mental Health.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.Department of Methodology and Behavioral SciencesUniversity of Barcelona and SGR 822 Generalitat de CatalunyaBarcelonaSpain

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