Psychometric properties of the Warwick Edinburgh Mental Well-being Scale: a systematic review

Patient reported outcomes are increasingly being assessed in many studies due to the demand for reliable and valid measures that enable assessment of such outcomes and comparison of scores between different populations. The Warwick Edinburgh Mental Well-being Scale (WEMWBS) and its shorter version (SWEMWBS) are widely used questionnaires that assess subjective mental well-being at the population level. The scales have been translated into many languages and are being used in a variety of settings to assess well-being. This systematic review aimed to evaluate the psychometric properties of the available versions of the scale.

The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO registration number CRD42020149849) reports the psychometric properties reported by validation studies published until 31 December 2023. A search for 'WEMWBS' and/or 'Warwick Edinburgh Mental Well-being Scale', used in combination with 'validation', was used to search PubMed, Semantic Scholar, OpenGrey, and the first 10 pages of Google Scholar. One author screened all titles after duplicates and unrelated items were removed. The abstracts of the remaining studies (n = 142) were screened and suitable articles were selected for data extraction. Methodological quality was independently assessed by two investigators against the CONSensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) risk of bias assessment checklist. The articles were evaluated and compared based on the reported translation process, internal consistency reliability and test-retest reliability, construct validity, responsiveness to change, and discriminatory power.

Fifty-six full-text articles were included in the study and were assessed for adherence to the accepted translation protocol and reporting of reliability and validity criteria. Many studies that have translated the instrument have focused on forward and backward translation without paying much attention to the appraisal of the translation. Most reports of internal consistency were within acceptable limits. However, test-retest reliability was not often assessed. The instrument has been administered online and in person. The instrument was well received by many populations; the instrument was able to capture changes in well-being scores between subgroups and post intervention.

The WEMWBS can be used to assess mental well-being in populations; it provides reliable assessments and is responsive to change. Cognitive assessments and pretesting of the scale prior to data collection are strongly advised.

PROSPERO CRD42020149849.