Developing items for the WHOQOL: An investigation of contemporary beliefs about quality of life related to health in Britain

The aim of this study was to develop the items for a new quality of life assessment-the WHOQOL-which would simultaneously create a UK national instrument as well as contribute to an international pool of items for a cross-cultural measure. The important ways which people in contemporary Britain represent facets of their quality of life relating ro health were investigated by obtaining samples of patients, health professionals and community members who participated in extended focus group discussions. The method of using focus groups to create three types of items for the WHOQOL is described. The relevance, importance and comprehensiveness of 33 facets of quality of life, and five domains proposed for the WHOQOL, was largely confirmed. Rankings showed thar happiness was the most important aspect of quality of life, and religion and dependence on substances least important, yet highly valued by a subsection. Free-listing highlighted omissions of job insecurity fears of loss or bereavement, the need for loving relationships and specific environmental concerns like pollution. These were first considered for inclusion in the international core and then as items specific to the national instrument. This is the first stage in the development of a generic profile for international use.