• Neuma Chaveiro
  • Soraya Bianca Reis Duarte
  • Adriana Ribeiro de Freitas
  • Maria Alves Barbosa
  • Celmo Celeno Porto
  • Marcelo Pio de Almeida Fleck

To respect diversity and assure the right to equality for all is a major challenge for society in general and particularly in the field of health care. It involves interacting with disabled people, including the deaf, which implies the need to establish an effective communication system.
Several organizations and researchers have played an important role in developing the Brazilian Sign Language (LIBRAS) version of the World Health Organization Quality of Life Questionnaire, Brief Version (WHOQOL-BREF). We specially acknowledge Drs. Marcelo Pio de Almeida Fleck, coordinator of the World Health Organization (WHO) Brazilian Center for Quality of Life (WHOQOL – Brazil), and Dr. Somnath Chaterji, coordinator of the WHOQOL Project, for their guidance and supervision. After receiving due authorization, the WHOQOL was translated following the WHO protocol by adjusting the methodology to the specificities of the deaf population.
In this communication, we will report the experience of designing the LIBRAS version of the WHOQOL- BREF and WHOQOL-DIS to evaluate the quality of life of the Brazilian deaf population. The major aim of this project was to evaluate the impact that deafness has on the quality of life of deaf people. The development of this project took place through a partnership between the Federal University of Goiás (UFG), the WHO, and the Brazilian WHOQOL Group at Federal University of Rio Grande do Sul (UFRGS).


On Chart 1, we have summarized the different steps followed for developing quality-of-life evaluation instruments in oral languages according to the WHO methodology, and the correspondent stages in developing the LIBRAS version.

Results and Discussion

The translation of the WHOQOL-BREF and WHOQOL-DIS to LIBRAS will permit to investigate and understand the many issues involving health- related quality of life of deaf
people, making it an important
tool in clinical evaluations. The methodology proposed by the WHO is very eficient, but adaptations were required so the objectives of the WHOQOL-LIBRAS project could be achieved. It was possible to establish a standard for translating and adapting instruments to sign language:

  • The team coordinating the project for the translation from oral to sign language must include individuals fluent in LIBRAS;
  • The bilingual group responsible for the first translation from oral to sign language should be composed with care, making sure that, in addition to being bilingual, members have intercultural experiences with the deaf community, thus assuring a translation that contemplates the cultural values and linguistic features of that population;
  • Before performing the back- translation, a reconciliatory version should be produced, based on the translation by the bilingual group;
  • The back-translation should involve not only the transcript to the original language, but also a synthetic and semantic linguistic analysis of each item;
  • The deaf people who will perform the signs should be carefully selected: they must be uent
  • in sign language, produce clear signs, using the signing space adequately and with good facial expression;
  • The process of developing an instrument in sign language should be video recorded to ensure the reliability and validity of the data collected.


We expect that the quality of life of the deaf population will be effectively evaluated using instruments specifically translated and adapted. The WHOQOL-BREF and WHOQOL-DIS in LIBRAS will permit deaf people to autonomously express themselves regarding their quality of life. This will permit the investigation of quality-of-life-related issues speci c to deaf people more thoroughly. Furthermore, these instruments will be included in the set of WHO instruments that evaluate quality of life. The WHOQOL/LIBRAS software developed in this study is a property of WHO and is available on the website currently for demonstration purposes only, but it will soon be accessible for the scientific community.