Designing response scales for cross-cultural use in health care: data from the development of the UK WHOQOL.

Designing response scales for use in cross-cultural situations presents several semantic and conceptual challenges. Here we report response scales designed in the UK, using a method developed collaboratively by the WHOQOL Group to tackle some of these issues. The response scales were generated for use with items established for a British version of a new cross-cultural quality of life measure for health and health care--the UK WHOQOL. A quota sample of 20 sick and well people assigned 60 descriptions to separate 100 mm lines (15 for each of 4 types of response scale) where the polar anchor points had been internationally agreed as meaningful in 10 countries. Means and standard deviations (SD) were calculated for each label appropriate to that response scale. The closest mean and smallest SD earmarked labels for each type of scale at the 25%, 50% and 75% interval. This research provides a set of contemporary, 5-point interval response scales that have the potential to be used in any number of British health and health-care questionnaires where subjective measures are needed.