title: 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.
  
  
  CONCLUSIONS
  The evidence indicates that developing a new adolescent version is justifiable. Cross-cultural research should build on these preliminary findings.
authors.affiliation: a Faculty of Medicine, School of Psychological Sciences, Manchester Centre for Health Psychology , University of Manchester , Manchester , UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Skevington
authors.forename: S
authors.initials: S
authors.lastname: Dehner
authors.forename: F B
authors.initials: FB
authors.lastname: Gillison
authors.forename: E J
authors.initials: EJ
authors.lastname: McGrath
authors.forename: C R
authors.initials: CR
authors.lastname: Lovell
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult