How appropriate is the WHOQOL-BREF for assessing the quality of life of adolescents?

Abstract

Background: Using mixed-methods research, we investigated whether the adult version of the WHOQOL-BREF was acceptable and feasible to use with adolescents (13–19), and what features might need to be changed to develop it. Differences from young adults quality of life (QoL) (20–30 years) could add justification.

Methods: Preliminary psychometric properties of the adult WHOQOL-BREF were examined in 208 adolescents and 204 young adults. Unhealthy adolescents diagnosed with acne or elevated depressive symptoms (CES-D) were compared with healthy adolescents. Cognitive interviewing used ‘think aloud’ techniques with six healthy adolescents during WHOQOL-BREF completion. Concepts and wording were thematically analysed for relevance, comprehension and comprehensiveness.

Results: Little data were missing from the WHOQOL-BREF suggesting some feasibility and acceptability to adolescents. Compared with adults, adolescents perceived greater access to information, a better home environment, worse pain, and medication dependency. Internal consistency reliability for adolescents was good (α = .89), especially psychological and environmental QoL. Content validity especially for social and environment domains was supported. Domains validly discriminated between high- and low-depressive symptoms but not acne groups. Additional new facets on autonomy, altruism and physical fitness and changed item contents are proposed.

Conclusion: The evidence indicates that developing a new adolescent version is justifiable. Cross-cultural research should build on these preliminary findings.

Keywords:

• adolescent
• quality of life
• WHOQOL
• measure
• health

Acknowledgements

We thank Dr James Hickey and Dr Amrit Darvay for clinical contributions, and Stella Protopapa, Rosie Banks, Kate Clifford, Ben Bawtree-Jobson, Jodie Evans, Clarissa Ferguson, Lara Ramsay, Laura Reynolds, Anna Ridding, Sinead Rocha, Sophia Schuwer, Anisha Tailor, Ken TszWai Tai, Rebecca Vines, and Danielle Harris for assisting data collection.

Notes

1. Stable alpha can be calculated from four items or more. Alpha automatically increases with increasing numbers of items in the scale (Cortina, 1993).