About the WHO Field Centre for the Study of Quality of Life
On this website you will find information about some of the international and national research on quality of life that has been carried out by the members of the UK centre, past and present.
The
WHOQOL group is an international collaboration of medical, health and social
scientists, first convened in 1991. Originally working in 15 countries simultaneously,
there are now over 50 different language versions worldwide.
Under the Directorship of Professor Skevington, the University of Bath was designated as the UK Centre for the research program to develop the WHOQOL. The Bath Centre provides advice to potential users and gives permission to use all the UK WHOQOL instruments.
The WHOQOL assessments are now available in two versions in Britain, following an extended program of psychometric assessment using a novel, consensually agreed international protocol. Two core instruments that cover 25 aspects (facets) of quality of life have been designed for use with sick and well populations, where people are able to answer the questions for themselves. The use of the WHOQOL-100 is valued where a detailed, comprehensive and holistic assessment is needed. A 26-item short form - the WHOQOL-Bref - is useful in large-scale surveys and in situations where patients might be burdened by longer assessment. Internationally, the WHOQOL has been tested using rigorous psychometric procedures and shows high levels of reliability, validity and good sensitivity to clinical changes (e.g. The WHOQOL Group, 1995,1998a,b, Skevington, Lotfy & O’Connell, 2004).
Quality of life in older adults
Several other major international projects have subsequently arisen from the WHOQOL group collaboration. The original WHOQOL scales (above) were designed for adult use, up to the age of 65 years. The WHOQOL-Old project (European Union funding), which is currently concluding in 23 countries, will be available soon to assess the quality of life of older adults. A particular focus in Britain is on active ageing and well-being in the over 60’s (Mc Crate & Skevington, 2004).
Spirituality, religion, personal beliefs and health
Spirituality, religion and personal beliefs (SRPB) have become the focus for a 17 countries initiative looking at their relevance to health-related quality of life. From this work, several new facets of quality of life have been confirmed as having international importance. This SRPB module of items extends and elaborates the original spirituality domain in the WHOQOL-100. It is currently being validated in 6 countries and publications are in progress.
Measuring quality of life in HIV & Aids
Interest
in the quality of life of people with HIV and Aids has lead to members of
the Centre working with UNAIDS and WHO (Lamboray & Skevington,2001; Skevington
& O‘Connell, 2003). Through asking people with and without symptoms
about their quality of life, an additional module specific to people infected
with HIV and Aids had been developed in 9 countries. The UK Centre completed
the qualitative and psychometric analysis (WHOQOL-HIV Group, 2003; 2004).
The full version can be used with the WHOQOL-100 and a WHOQOL-HIV Bref has
been recently made available by WHO. A theoretical model for this work is
currently in progress (Skevington, Norweg
and the WHOQOL Group, 2004)
Using quality of life information to improve treatment and communications
Using quality of life questionnaires in clinics to improve the quality of life of individuals seeking treatment is a developing theme of the research in Britain. New ways of delivering and processing this information are in progress. We are interested in whether patients want to know about their quality of life and to tell a health professional about it. Also whether doctors find this information relevant, important and useful (Skevington, Day, Chisholm & Truman, 2004,
Poverty
and inequality
A consideration of poverty, inequality and quality of life is a relatively new interdisciplinary departure. Funded by the Economic and Social Research Council, this work is concerned with well-being in the developing world. Collaborating teams in Bangladesh, Ethiopia, Peru and Thailand are working with researchers at University of Bath to establish how this relates to needs and material resources in rural and urban situations.
Quality of Life of People in Britain
In Britain, the research has been carried out in collaboration with medical practitioners, and health and social scientists in more than 50 sites around the country. Heterogeneous and representative samples of sick and well people completed the WHOQOL-100 and excellent internal consistency reliability, construct validity and content validity were confirmed (Skevington, 1999). Two national items representing important issues in Britain are included in the UK WHOQOL-100, to round out the concept for local users. Aspects of validity have been demonstrated through studies of depressed patients in primary care taking anti-depressant medication (Skevington & Wright, 1999), in chronic pain patients engaged in a pain management program (Skevington, Carse & Williams,2001) and in psoriasis patients receiving topical treatment (Skevington, Bradshaw et al, 2004) . The UK WHOQOL-Bref also shows similar excellent properties (Skevington, Lifford & McCrate, 2004).
In addition to this international and national standardisation work, the Centre has particular interests in defining the concept of quality of life and in its theoretical underpinnings (Skevington, Sartorius & Amir, 2004; Skevington, 2002). This has been achieved through qualitative studies of patients, health professionals and community members (e.g. Skevington, 1994; Skevington, Mac Arthur & Somerset, 1997; Skevington, 2002). Related to this is quantitative work looking at how different facets of quality of life are organised conceptually, and utilising this information in the selection of any national items (Skevington, Bradshaw & Saxena, 1999).Recent research has looked at the importance of different dimensions of quality of life to participants in diverse countries. Importance may be one key to identifying which people have the very poorest quality of life (Skevington & O’Connell, 2004; Stenner, Cooper & Skevington, 2003).
Members
of the Centre have expertise with particular groups and conditions. Chronic
pain affects quality of life and is connected with response to treatment (Skevington,
1998; Skevington, Carse & Williams, 2001) and a WHOQOL module for use
with chronic pain patients in UK is approaching completion (Mason, Skevington
& Osborn, 2004).
We have developed a children’s quality of life assessment based on the WHOQOL concept, and this is standardised for use with 5 to 8 year olds in Thailand (Jirojanakul & Skevington, 2000; Jirojanakul. Skevington & Hudson 2002).
Relating to the work on ageing, we have been working on a subjective assessment of quality of life for use by people with mild or moderate dementia – the BASQID. This instrument will be available shortly (Trigg, Jones & Skevington forthcoming). This research was funded by the Alzheimers Society of Great Britain.
The References cited on this page are to be found in full on this website under Publications.
