Perhaps the most successful and influential cross-national research
programme has been the World Health Organisation Quality of Life Group
(WHOQOL), established in 1991, which formed one of the initial planks of
the WeD research. It defines quality of life as ‘an individual’s perceptions of
their position in life in the context of the culture and value systems in which
they live, and in relation to their goals, expectations, standards and
concerns’ (WHOQOL Group 1995). WHOQOL developed a common international protocol to construct generic QoL profile measures. For
example, all fifteen of the original WHOQOL centres contributed to the
definition of the facets that comprised the six domains of Quality of Life23.
Questions were drafted by population focus groups, which generated ideas
within each centre as to the best way to ask locally appropriate questions
about people’s quality of life. The programme has shown that although
country populations show different levels of QoL across domains, the overall
structure has a high cross-cultural validity for all domains, suggesting a high
degree of universality (Skevington et al 2004). However, it faces several
problems: the WHOQOL is about health-related quality of life and does not
directly address the issue of autonomy; moreover, although many of the
original field centres were in developing countries or transition economies,
arguably the agenda had already been set by the ‘expert review’ which
established the six domain structure and there was little modification to this
after item development and piloting.