Assessing quality of life in older people: psychometric properties of the WHOQOL-BREF.
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SUBMITTER: von Steinbuchel N
PROVIDER: S-EPMC5546259 | biostudies-other | 2006 Jun
REPOSITORIES: biostudies-other
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Project description:BackgroundThe assessment of health-related quality of life (HRQoL) in people living with HIV (PLHIV) has become crucial to evidence-based practice. The goals of this study are to analyze the psychometric properties and evidence of the validity of the Spanish version of WHOQOL-HIV-BREF in a sample of PLHIV in Spain and to examine the more impaired HRQoL facets and dimensions and identify the PLHIV who show the most vulnerable profile.MethodsA total of 1462 PLHIV participated in an observational cross-sectional ex-post-facto study. Data were collected at 33 Spanish sites through an online survey. In addition to measuring HRQoL, the study used other tools to measure treatment adherence (CEAT-VIH 2.0 version), psychological well-being (GHQ-12) and HIV-related stigma (HSSS). Cronbach's alpha, first- and second-order confirmatory factor analysis (CFA), the Pearson coefficient and one-way ANOVA were used to evaluate reliability, construct validity and concurrent and known-group validity, respectively. Differences according to the socio-demographic and epidemiological profiles of participants were analyzed.ResultsFirst- and second-order CFAs confirmed a six-domain first-order structure of the Spanish version of WHOQOL-HIV-BREF and one second-order factor related to overall HRQoL with an acceptable fit to the data, although some minor changes would improve it. The six-domain structure showed an acceptable internal consistency (Cronbach's alpha ranged from .61 to .81). Significant moderate to large correlations between domains and overall HRQoL, adherence, psychological well-being and negative self-image were found. Significant differences were found according to participants' self-reported CD4+ cell count in several HRQoL facets and domains. Being female, heterosexual, having low socio-economic and educational statuses, having acquired HIV through an unsafe injection and living more years with HIV were related to poorer HRQoL. PLHIV older than 50 presented lower scores in 19 HRQoL facets.ConclusionsThis study demonstrates that the Spanish version of the WHOQOL-HIV-BREF is a valid instrument. It also presents the most recent data about HRQoL in PLHIV in Spain with the largest sample to date.
| S-EPMC6700970 | biostudies-literature
Project description:BACKGROUND:The WHOQOL-BREF is a frequently used instrument for the assessment of health-related quality of life. Unlike other generic instruments used for the assessment of this construct, little is known about its properties in individuals with headache disorders. The present study examines the reliability and factorial validity of the WHOQOL-BREF in individuals with chronic headache residing in Austria. METHODS:Data from a representative population-based survey on 963 individuals with chronic headache surveyed between 2013 and 2015 was used. The factorial validity was examined by means of confirmatory factor analysis. Differential item functioning related to sex was analyzed using multiple indicators multiple causes models. RESULTS:Information on 239 men and 724 women with chronic headache was available. The four-factor, 24-item baseline model showed a moderate fit (RMSEA = 0.066; CFI = 0.868; TLI = 0.852; SRMR = 0.053), which improved significantly after the addition of six error covariances (RMSEA = 0.052; CFI = 0.920; TLI = 0.908; SRMR = 0.046). Sex-related differential item functioning was observed in two items of the environment factor, two items of the psychological health factor and two items of the physical health factor. CONCLUSIONS:After some modifications to the measurement model, the WHOQOL-BREF shows a satisfactory fit among individuals with chronic headache in Austria. Because of these modifications and the questionnaire's susceptibility for differential item functioning, a latent variable framework should be employed for the analysis. Future studies need to confirm these results for other language regions and should also examine different subtypes of headache.
| S-EPMC7333387 | biostudies-literature
Project description:BACKGROUND:The worries of next of kin about their older loved ones in nursing homes can be extensive and can adversely affect their subjective experiences of their own physical, mental and social well-being. It is thus of utmost importance to measure the quality of life of next of kin in a valid and reliable way. METHODS:The design is a cross-sectional study with psychometric evaluation based on classical test theory in preparation for a planned educational intervention study on palliative care. An abbreviated version of the World Health Organization's quality-of-life self-assessment instrument WHOQOL, the Swedish WHOQOL-BREF, was completed by 254 next of kin of older persons in 30 nursing homes. Data quality was assessed via the mean, median, item response, missing values, and floor and ceiling effects. Reliability was estimated using Cronbach's alpha and corrected item-total correlations. Construct validity was estimated by Spearman's rank correlation, and model fit was assessed using confirmatory factor analysis. RESULTS:The rate of missing data was low (less than 2%). Ceiling effects ranged from 11 to 43% and were above 20% for 21 of 24 items. The corrected item-total correlations varied between 0.35 and 0.68 and were thus well above the lower limit of 0.30. Cronbach's alpha was 0.83, indicating satisfactory internal consistency. The confirmatory factor analysis indicated a fair to close model fit (comparative fit index 0.93, root mean squared error of approximation 0.06). CONCLUSIONS:The findings suggest that the WHOQOL-BREF may constitute a reliable and valid measure of quality of life for use among next of kin to older persons in nursing homes. When interpreting the results, it is important to assess the ceiling effect, as it may restrict the ability of the WHOQOL-BREF to detect true positive changes in quality of life over time. TRIAL REGISTRATION:NCT02708498.
| S-EPMC7168811 | biostudies-literature
Project description:ObjectivesThis study aims to assess the psychometric properties of the Chinese version of the WHOQOL-HIV BREF.DesignCross-sectional study.SettingCenters for Disease Control and Prevention and infectious disease hospitals in three Chinese provinces.ParticipantsSample of 1100 people living with HIV/AIDS (PLWHA).InterventionsWe recruited 1100 PLWHA to evaluate their quality of life (QOL) using the WHOQOL-HIV BREF. Of these participants, 57 were randomly selected to repeat the QOL evaluation 2 weeks later.Main outcome measuresThe reliability of the WHOQOL-HIV BREF was assessed in terms of its internal consistency and test-retest reliability. The construct, concurrent, convergent, discriminant and known-group validity were also analysed. In addition, the factorial invariance across genders was assessed.ResultsCronbach's ? coefficient for the overall scale was 0.93. Except for the spirituality domain, which had an ? below 0.70 (0.66), the other five domains showed adequate internal consistency. The test-retest reliability revealed a statistically significant intraclass correlation coefficient of 0.72-0.82 (p<0.001). Confirmatory factor analysis found that the six-domain structure produced an acceptable fit to the data. The instrument showed factorial invariance across gender groups. All domains were significantly correlated with the general items and the SF-36 (p<0.01). The correlation coefficients were >0.40 (r=0.40-0.67), except for the association between the spirituality domain and two general items (QOL: r=0.33; health status: r=0.36). Subjects with lower CD4 counts had lower scores for all domains (p<0.05). Symptomatic participants had significantly lower scores than asymptomatic participants on the physical, psychological and independence domains (p<0.05).ConclusionsThe WHOQOL-HIV BREF revealed good psychometric characteristics among Chinese PLWHA. These findings offer promising support for the use of the WHOQOL-HIV BREF as a measure of QOL among Chinese PLWHA and in cross-cultural comparative studies on QOL.
| S-EPMC5629727 | biostudies-literature
Project description:BACKGROUND:Antiretroviral therapy has prolonged the lives of those with human immunodeficiency virus (HIV), but the effects of chronic infection on their health-related quality of life (HRQoL) remain a concern. Numerous instruments have been developed to measure HRQoL, yet evidence of their cross-cultural equivalence and continued applicability is limited. We adapted the WHOQOL-HIV BREF to French and assessed its psychometric properties in a sample of community-dwelling adults living with HIV who were mostly virally suppressed. METHODS:We conducted a cross-sectional study within the ANRS CO3 Aquitaine cohort from July 2018 to May 2019. Five hundred eighty-six participants were consecutively enrolled at their HIV-consultations and completed either a web-based (n?=?406) or paper self-administered assessment (n?=?180). The means and standard deviations for items and domains were computed and the presence of floor and ceiling effects assessed. We evaluated internal consistency by calculating Cronbach's alpha coefficients per domain. We assessed construct validity by performing a Confirmatory Factor Analysis (CFA). Concurrent, convergent and discriminant validity were assessed with Pearson's correlations and known-group validity was assessed according to CD4 cell count, viral load, Centers for Disease Control and Prevention clinical categories for HIV, and hospitalization of more than 48?h within 2 years of the most recent consultation using one-way analysis of variance and independent t-tests. RESULTS:Five hundred eighty-six PLWH were included in this analysis. Their median age was 55; 73% were male; 85% were of French descent; 99% were on ART and 93% were virally suppressed. We found floor effects for one and ceiling effects for 11 items. Four of the six domains showed good internal consistency (? range: 0.63-0.79). CFA showed that the WHOQOL-HIV BREF's six-domain structure produced an acceptable fit (SRMR?=?0.059; CFI?=?0.834; RMSEA?=?0.07; 90% CI: 0.06-0.08). It showed good concurrent, convergent and discriminant validity. There was some evidence of known-group validity. The personal beliefs domain had the highest score (15.04?±?3.35) and the psychological health domain had the lowest (13.70?±?2.78). CONCLUSIONS:The French WHOQOL-HIV BREF has acceptable measurement properties. Its broad conceptualisation of HRQoL, going beyond physical and mental health, may be of particular value in our older, treatment-experienced and virally suppressed population. TRIAL REGISTRATION:ClinicalTrials.gov NCT03296202 (Archived by WebCite at http://www.webcitation.org/6zgOBArps ).
| S-EPMC7350695 | biostudies-literature
Project description:Purpose. To present the psychometric properties of a new measure of quality of life in older age, the Older People's Quality of Life (OPQOL) Questionnaire, compared with the CAPSE-19 and the WHOQOL-OLD. Design and Methods. The vehicle was three national population surveys of older people living at home in Britain, including a survey of ethnically diverse older people. Results. The OPQOL had acceptable levels of reliability and validity in British population samples of older people, but more modest in the ethnically diverse population sample. The CASP-19 and WHOQOL-OLD had acceptable levels of reliability and validity in the British population sample, but not in the ethnically diverse sample. Implications. The OPQOL has potential for use as a multidimensional population surveillance instrument for use with older populations, or as an outcome measure of multisector policy. Its strengths are that its development was embedded firmly in the perspectives of older people, integrated with theory.
| S-EPMC2819744 | biostudies-literature
Project description:BackgroundMeasuring quality of life (QOL) in a population is important for the predictions of health and social care needs. In Pakistan, health related quality of life data exist but there are no quality of life data of general population. In this study, quality of life was assessed among the Pakistani general population and their associated factors by using the World Health Organization's quality of life instrument (WHOQOL-BREF).MethodologyA population-based cross-sectional study was carried out in all 52 Union Councils of District Abbottabad, Khaber Pkutunkhua province, Pakistan from March 2015 to August 2015. Multi-stage cluster sampling technique was employed in this study. Quality of life was measured by using the validated WHOQOL-BREF instrument, along with socioeconomic, demographic, and World Bank social capital questions in this population- based study. The data were collected through households, utilizing face to face interviews. The association between socio-demographic variables and quality of life domains were determined by using both univariate and multivariate analysis. Descriptive statistics were derived, and a multilevel linear regression using backward analysis allowing to obtain final model for each domain was achieved to recognize the variables that affect quality of life score.ResultsA total of 2063 participants were included in this study (51.2% male, 48.2% female). Mean age of participants was 37.9, SD = 13.2; ranging from 18 to 90. Mean score of quality of life domains (physical, psychological, social relationship and environmental domains) were 65.0 (SD = 15.2), 67.4 (SD = 15.0), 72.0 (SD = 16.5), 55.5 (SD = 15.0), respectively. Overall, socioeconomic status was established to be the strongest predictor of poorer quality of life for all domains as a change in SES from high to low results in reduction about (β = - 5.85, β = - 9.03, β = - 8.33, β = - 9.98, p < 0.001). Similarly, type of residency was negatively associated with physical, psychological and environmental domains while age and sex were negatively associated with physical, psychological and relationship domains in final model. Furthermore social capital (β = 0.09, β = 0.13, β =0.14, β =0.15, p < 0.001) had a positive effect on Pakistani quality of life. Overall, subjective quality of life was found to be low in our population and extremely varied by socio-demographic variables.ConclusionsIncreasing age, having average and lower socioeconomic status and living in the rural area were found to be the strong predictor of poorer quality of life in all domains, while total social capital score had a positive effect on Pakistani quality of life scores.
| S-EPMC6332637 | biostudies-literature
Project description:Assessment of quality of life (QOL) of patients with end-stage renal disease has become increasingly important, both in order to evaluate the influence of the disease on patients and the type of renal replacement therapy they require. Therefore, in this study, we aimed to assess QOL in patients undergoing hemodialysis and evaluated the effects of various sociodemographic factors affecting QOL of such patients in Nepal.A cross-sectional study was conducted among 150 patients with chronic kidney disease undergoing hemodialysis at two major centers in Nepal. Demographic data including age, sex, ethnicity, educational status, marital status, employment, income, duration of illness, and duration on hemodialysis were collected. QOL was assessed using the World Health Organization Quality of life (WHOQOL-BREF) questionnaire. Four domains (physical, psychological, social, and environmental) and two items (overall perception of QOL and health) of the WHOQOL-BREF were the primary end points of this study. Bivariate relationship between sociodemographic factors and QOL scores were analyzed using independent samples t-test and one-way analysis of variance. Multiple linear regression analysis was performed to determine independent predictors of QOL.Following QOL scores were recorded: environmental domain (53.17±15.59), psychological domain (51.23±18.61), social domain (49.86±21.64), and physical domain (45.93±16.90). Older age was associated with a better QOL score in the social domain (p=0.005), and employed patients scored better in the environmental domain (p=0.019). Unemployed patients and those of the Terai/Madhesi ethnic group had significantly low scores in overall perception of health (p<0.05) as compared to other groups. Low income status and increased duration on hemodialysis were found to be the only independent negative predictors of QOL in patients with hemodialysis (p<0.05).Patients with chronic kidney disease on dialysis had overall low QOL scores in all four domains. Age, ethnicity, employment status, income, and duration on hemodialysis affected one or more domains of QOL in such patients. Low income status and increased duration on hemodialysis were the only independent negative predictors of QOL of patients on maintenance hemodialysis.
| S-EPMC5529382 | biostudies-other
Project description:This study sought to compare evidence of the factorial validity of the adapted version of the World Health Organization Quality of Life (WHOQOL-OLD) scale (three response options) with the original version of the scale. We included two populations of individuals age 60 years or older from northeast Brazil. The majority of participants were women who had an elementary-level education. The first population comprised 335 elderly persons who completed the original version of the scale, and the second was composed by 265 elderly persons who completed the shortened scale. Results indicated better adjusting on the reduced scale and showed items with lower error probability in assessment of elderly persons with lower quality of life.
| S-EPMC6967016 | biostudies-literature
Project description:BACKGROUND: This study investigates the usefulness of the nonparametric monotone homogeneity model for evaluating and constructing Health-Related Quality-of-Life Scales consisting of polytomous items, and compares it to the often-used parametric graded response model. METHODS: The nonparametric monotone homogeneity model is a general model of which all known parametric models for polytomous items are special cases. Merits, drawbacks, and possibilities of nonparametric and parametric models and available software are discussed. Particular attention is given to the monotone homogeneity model (also known as the Mokken model), and the often-used parametric graded response model. RESULTS: Data from the WHOQOL-Bref were analyzed using both the monotone homogeneity model and the graded response model. The monotone homogeneity model analysis yielded unidimensional scales for each content domain. Scalability coefficients further showed that some items have limited scalability with respect to the other items in the same scale. The parametric IRT analyses lead to the rejection of some of the items. CONCLUSIONS: The nonparametric monotone homogeneity model is highly suited for data analysis in a health-related quality-of-life context, and the parametric graded response model may add interesting features to measurement provided the model fits the data well.
| S-EPMC2238782 | biostudies-other