WHO Quality of Life – BREF (WHOQOL-BREF)

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The WHOQOL-BREF is a 26-item self-report instrument developed by the World Health Organization to assess overall quality of life and subjective wellbeing across four key domains: physical health, psychological health, social relationships, and environment. It is used internationally in clinical, public health, and research settings.

Recommended Frequency: Administer every 3–6 months in long-term care, recovery monitoring, or health promotion contexts; or at intake and discharge for broader wellbeing tracking.

About the WHOQOL-BREF

The WHOQOL-BREF is a short-form version of the original 100-item WHOQOL instrument. It was developed through a multinational field study and reflects cross-cultural understandings of quality of life. It captures an individual’s perceived quality of life over the previous two weeks in relation to health, autonomy, social connection, and access to resources.

It is suitable for use in medical, mental health, rehabilitation, and community settings and is available in over 20 languages.

Psychometric Properties

The WHOQOL-BREF has shown excellent internal consistency (domain α = 0.68–0.82), test-retest reliability, and cross-cultural validity. Domain scores correlate strongly with global health and wellbeing ratings.

  • Validated in over 20 countries
  • Factor structure supports 4 domains:
    1. Physical Health – energy, sleep, mobility, pain, daily activities
    2. Psychological Health – self-esteem, body image, cognition, mood
    3. Social Relationships – personal relationships, social support, intimacy
    4. Environment – safety, home, finances, health care access, leisure
Source: WHOQOL Group, 1998

The Scale

The 26 items are scored on a 5-point Likert scale (e.g., “Not at all” to “Completely”). Each domain is scored and transformed onto a 0–100 scale, with higher scores indicating better perceived quality of life.

Example item: “How satisfied are you with your ability to perform daily living activities?”

Two additional items provide global assessments of overall quality of life and general health.

Score Range

Each domain yields a separate 0–100 score:

  • 0–39: Low perceived quality of life
  • 40–69: Moderate
  • 70–100: High

There is no single cutoff; results should be interpreted in context, with attention to trends over time and comparisons across domains.

Copyright

© World Health Organization. The WHOQOL-BREF is publicly available and maintained by the WHO Department of Mental Health and Substance Use.

References

  1. WHOQOL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28(3), 551–558. https://doi.org/10.1017/S0033291798006667
  2. World Health Organization. (2004). WHOQOL-BREF: Introduction, administration, scoring and generic version of the assessment. https://www.who.int/publications/i/item/WHOQOL-BREF

Disclaimer

This summary is for informational purposes only. The WHOQOL-BREF is freely available for non-commercial use with attribution. Adaptation, translation, or commercial distribution requires written permission from the World Health Organization.

Permissions

The WHOQOL-BREF is a product of the World Health Organization and is free to use for clinical and research purposes. Translations are available in multiple languages and can be obtained through the WHO.

Frequently Asked Questions

  • Can the WHOQOL-BREF diagnose depression or anxiety?

    No. It measures subjective quality of life. Use it alongside tools like the PHQ-9 or GAD-7 for a more complete picture.

  • How often should I re-administer it?

    Every 3–6 months or at key transition points (e.g., intake, discharge, goal review).

  • Is it culturally sensitive?

    Yes. It was designed for global, cross-cultural use and has been validated in many languages and regions.

  • Is it appropriate for use in trauma-informed care?

    Yes. It focuses on lived experience and empowerment, aligning well with recovery-oriented and trauma-informed models.