The Korean version of the Multicultural Quality of Life Index (MQLI-Kr): development and validation

Validating the Five-Item World Health Organization Well-Being Index

Purpose: Research on the psychological well-being of caregivers of children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) suggests that the well-being of parents and caregivers has been negatively affected by the COVID-19 pandemic. Although the psychological well-being of caregivers is a major concern, few validated well-being measures exist for caregivers of children diagnosed with ADHD. Therefore, a valid self-report scale is needed to assess well-being during the pandemic. The brief Five-Item World Health Organization Well-Being Index (WHO-5) has previously been used in studies on caregivers. However, its validity in this population remains unknown. This study aimed to evaluate the reliability and construct validity of the WHO-5 with caregivers of children with ADHD. Methods: A cross-sectional anonymous online survey was conducted in Norway. The study recruited caregivers from a community sample during the COVID-19 pandemic. This was carried out to investigate the construct validity by exploring the relationship between well-being, quality of life, social support, self-reported psychological distress, and perceived stress. Results: The findings of unidimensionality and high internal consistency, together with the results from the hypothesis testing, demonstrate the reliability and construct validity of the Norwegian version of the WHO-5 in this population. Conclusions: This study provides the first empirical evidence of the validity and reliability of the WHO-5 from a sample of Norwegian caregivers of children diagnosed with ADHD, with excellent reliability and construct validity. The scale can be used to systematize the measurement of well-being in caregivers because of its brevity and good psychometric properties, making it a valuable resource in research settings and assisting healthcare professionals in their crucial work of caring for caregivers.

Multicultural Quality of Life Index in Relatives of People With Borderline Personality Disorder

PURPOSE

The aim of the present study was to confirm the original factor structure of the Multicultural Quality of Life Index (MQLI) and analyze its psychometric properties in a sample of caregivers of people with borderline personality disorder (BPD).

METHODS

The MQLI was administered to 233 relatives of people with BPD. Participants completed the MQLI, the Depression, Anxiety and Stress Scale (DASS-21), and the Connor-Davidson Resilience Scale (CD-RISC).

RESULTS

Factor analysis of the relatives indicated that the MQLI generated a one-factor solution. The MQLI showed good internal consistency, ϖ = 0.91 [95% CI (0.90, 0.93)] and correlated significantly and positively with the CD-RISC (r _s = 0.576) and negatively with the DASS-21 (r _s = -0.583).

CONCLUSION

Consistent with other studies, the MQLI demonstrated feasibility, strong internal consistency, and good convergent and discriminant validity, which means it is a psychometrically robust measure for the assessment of quality of life in relatives of people with BPD. Along with other validation studies, this measure will be a useful tool for assessing quality of life in relatives of people with mental disorders.

Assessment of the Quality of Life in Parents of Children With ADHD: Validation of the Multicultural Quality of Life Index in Norwegian Pediatric Mental Health Settings

Background: The brief generic Multicultural Quality of Life Index (MQLI) is a culturally informed self-report 10-item questionnaire used to measure health-related quality of life (QoL). QoL is an important outcome measure in guiding healthcare and is held as a substantial parameter to evaluate the effectiveness of healthcare. Attention Deficit Hyperactivity Disorder (ADHD) in children might negatively influence the parents' QoL. Having a validated questionnaire to measure QoL for this population will therefore be a vital first step in guiding healthcare for parents of children with ADHD. We aimed to examine the reliability and validity of the Norwegian version of the MQLI in a sample of parents of children with ADHD. Methods: In a cross-sectional study, 128 parents of children with ADHD were recruited from four outpatient clinics within the Child and Adolescents Mental Health Services (CAMHS) in Norway. They completed the MQLI along with an alternative well-being scale, the Five-item World Health Organization Well-being Index (WHO-5), and a form including demographic variables. Reliability and validity of the MQLI were examined. We conducted a factor analysis and calculated internal consistency and the correlation between the MQLI and the WHO-5. Results: Factor analysis of the parents reported MQLI yielded a one-factor solution. For the MQLI, Cronbach's alpha was 0.73. The correlation between the two measures of MQLI and WHO-5 was high (r = 0.84), reflecting convergent validity since the association between the two measures was strong. Conclusion: Results from this study support the reliability and validity of the Norwegian version of the MQLI for assessment of quality of life in parents of children with ADHD with good psychometric properties. Study findings support the use of the questionnaire in CAMHS.

Validation of the Greek translation of the multicultural quality of life index (MQLI-gr)

BACKGROUND

The aim of the current study was to examine the internal structure and convergent and discriminant validity of the Multicultural Quality of Life Index (MQLI) in a Greek sample of community-dwelling adults in a major Greek city.

METHODS

The authors developed a Greek version of the Multicultural Quality of Life Index (MQLI-Gr). It was translated following cross-cultural adaptation procedures for self-report measures and administered to community members (N = 884). Participants completed a brief demographic survey, the MQLI-Gr, and the Depression Anxiety Stress Scales (DASS-42).

RESULTS

The MQLI-Gr is brief, easy to use, and demonstrates strong internal consistency (Cronbach alpha = .90). In terms of internal structure there were mixed results. In terms of discriminant validity, statistically significant differences in mean MQLI-Gr scores were observed between two groups: those with none-mild symptoms versus those with severe symptoms of depression, anxiety, and stress (p < .05). The MQLI-Gr was also able to discriminate among groups assumed to vary on quality of life; marital status, income, and employment. In terms of convergent validity, results were in the expected direction, with participants reporting high levels of depression, anxiety, and stress, also reporting lower quality of life on the MQLI-Gr (p < .001).

CONCLUSION

Consistent with other translations, the MQLI-Gr demonstrated feasibility, strong internal consistency, and good convergent and discriminant validity. This is the first step in the development of a psychometrically sound measure to assess quality of life in a community-dwelling population in Greece. With the addition of further validation studies, this measure will be a useful tool for assessing the quality of life in the Greek community.

Psychiatry Resident Quality of Life

OBJECTIVE

The objective of this study was to evaluate psychiatry resident physician quality of life.

METHODS

A voluntary, anonymous, 10-min survey was e-mailed to residents from all 14 Accreditation Council for Graduate Medical Education (ACGME)-accredited programs in Pennsylvania, New Jersey, and Delaware. Included in the survey was the Multi-Cultural Quality of Life Inventory (MQLI).

RESULTS

Response rate was 112 (34.1%). Internal consistency of the MQLI was high (Cronbach's alpha 0.92), and follow-up exploratory factor analysis extracted only one underlying factor (60.1% variance among all 10 items). Average total MQLI score was 80.6. No significant difference in MQLI total was found for therapy status, sex, or race. Post-graduate year (PGY) 4 residents scored higher on total MQLI score (86.7) (F = 2.80, p = 0.04) and ranked occupational functioning and community and services support subscales significantly higher (occupation F = 2.73, p = 0.048, community F = 3.11, p = 0.030). Total MQLI score for residents over the age of 40 (n = 3) was significantly lower (F = 3.45, p = 0.019).

CONCLUSION

Despite the stresses of residency training, residents from a variety of programs in one geographic area report an encouraging quality of life on the MQLI. Psychiatry resident quality of life is similar to that reported in other populations of mental health professionals.

Using a brief 10-item generic measure of quality of life in English and Spanish speaking diabetic patients

OBJECTIVES

Validation of the Multicultural Quality of Life Index (MQLI), a 10-item self-rated generic multilingual quality of life (QOL) measure in ethnically-diverse diabetic patients.

METHODS

Diabetic adult patients (n = 180) in New York City completed the MQLI, English or Spanish version. Its internal consistency, factorial structure, and construct validity were analyzed. Depression screening (PHQ-9) scores were used to divide subjects into two sub-samples with presumed different QOL levels.

RESULTS

A Cronbach's alpha of 0.92 demonstrated its internal consistency (English-version = 0.90, Spanish-version = 0.94). A one-single factor structure was documented (all items loadings > or = 0.64), accounting for 59% of the items variance in the total sample; similar results were found for each language version. Correlation of the MQLI and PHQ-9 scores yielded an r = -0.58. Mild negative correlations with self-disclosed diagnosis of depression or other mental disorders, diabetes duration, and abnormal sensation on foot exam were found, but were non-significant with other diabetes aspects (e.g., HbA1c, retinopathy). A significant difference (p < 0.001) between the scores of two subsamples with presumed different levels of QOL (means = 8.02 vs. 5.84) was found.

CONCLUSIONS

The MQLI demonstrated coherence around the QOL concept. It correlated significantly with mental health (particularly depression), duration of diabetes, and possible neuropathy, but not with some diabetes-related factors. Its use in diabetic care settings is recommended, possibly supplemented by QOL diabetic-specific instruments.

The Multicultural Quality of Life Index: presentation and validation

RATIONALE AND OBJECTIVES

Quality of life has emerged as a crucial concept for the assessment of health and the planning of health care. Desirable features for the evaluation of quality of life include comprehensiveness, self-ratedness, cultural sensitivity, practicality and psychometric soundness. An attempt to meet these challenges led to the development of a brief multicultural quality of life instrument and to the appraisal of its applicability, reliability and validity.

METHODS

The development of the proposed assessment instrument was based on a wide review of the literature and the engagement of a multicultural mental health scholarly team. Its validation was conducted on samples of psychiatric patients (n = 124) and hospital professionals (n = 53) in New York City.

RESULTS

A new generic culture-informed and self-rate instrument, the Multicultural Quality of Life Index, has been developed. Its 10 items cover key aspects of the concept, from physical well-being to spiritual fulfilment. Concerning its applicability, mean time for completion was less than 3 minutes and 96% of raters found it easy to use. Test-retest reliability was high (r = 0.87). A Cronbach's α of 0.92 documented its internal consistency and a factor analysis revealed a strong structure. With regard to discriminant validity, a highly significant difference was found between the mean total scores of professionals (x = 8.41) and patients (x = 6.34) presumed to have different levels of quality of life.

CONCLUSIONS

The Multicultural Quality of Life Index is a brief and culturally informed instrument that appears to be easy to complete, reliable, internally consistent and valid.

The correlation between breastfeeding and maternal quality of life in southern Brazil

PURPOSE

This study examined the relationship between the breastfeeding efficacy and quality of life (QoL) in a sample of 89 mothers from southern Brazil. To the authors' knowledge, this is the first study to explore correlations between maternal QoL and breastfeeding efficacy in Brazil.

METHODS

Research participants completed the Portuguese version of the World Health Organization Quality of Life-BREF and Multicultural Quality of Life Index questionnaires. Breastfeeding efficacy was evaluated through the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). Correlations between the scores of the QoL instruments and the BSES-SF were examined using Pearson product-moment correlation coefficients.

RESULTS

There were significant correlations among the scores of the two QoL questionnaires and the BSES-SF. Multiple regression analysis revealed that both QoL instruments significantly predicted BSES-SF scores. Neither socioeconomic status nor level of educational attainment was a significant predictor of breastfeeding efficacy.

CONCLUSIONS

The results from the present study indicate that breastfeeding efficacy is significantly related to QoL among mothers in southern Brazil. The association between QoL and breastfeeding efficacy appears to be independent from any effect of socioeconomic status or level of educational achievement.

Using a generic measure of quality of life in patients with obstructive sleep apnea

PURPOSE

To evaluate the utility of a Multicultural Quality of Life Index (MQLI) in patients with Obstructive Sleep Apnea-Hypopnea (OSAH).

METHODS

Physical examination, MQLI and the Epworth Sleepiness Scale (ESS) were applied to participants. In addition, a polysomnography or a respiratory polygraphy was carried out.

RESULTS

A total of 221 patients participated, 186 (84%) males, mean age 48.8 ± 11.8 years. The MQLI scores 7were .73 ± 1.45 and the ESS 9.9 ± 5.2. A total of 188 (85%) patients had OSAH: 40 (21%) mild, 43 (23%) moderate, and 105 (56%) severe. The average time to answer the MQLI was 3.5 min. Cronbach's alpha index was 0.930. MQLI score in patients with and without OSAH was 7.73 versus 7.75 (p = 0.949); and by severity: non-OSAH 7.75, mild 8.04, moderate 8.14, and severe 7.44 (p = 0.023). There was a slight correlation between MQLI score and Apnea-Hypopnea Index in total population, but it disappeared when we analyzed by severity. MQLI and ESS correlation was R = -0.3256 (p < 0.0001).

CONCLUSIONS

The MQLI has limitations in identifying quality of life (QOL) alterations and a poor correlation with severity in OSAH patients. The MQLI quantifies QOL in a general way. We recommend supplementing the QOL evaluation with disease-specific instruments.

An assessment of maternal quality of life in the postpartum period in southern Brazil: a comparison of two questionnaires

OBJECTIVES

To assess maternal quality of life (QoL) during the postpartum period and to compare the performance of two QoL questionnaires across a sample of 101 women in southern Brazil. To our knowledge, this is the first study that measures maternal quality of life during the postpartum period in Brazil.

INTRODUCTION

There is limited information about postpartum maternal quality of life in Brazil. The are no Portuguese versions of instruments specifically designed to measure quality of life during the postpartum period.

METHODS

Research participants completed the Portuguese version of the World Health Organization Quality of Life Assessment-Bref (WHOQOL-BREF) and Multicultural Quality of Life Index (MQLI) questionnaires. The correlations between the MQLI and the discrete areas of WHOQOL-BREF were examined using Pearson Product-Moment Correlation Coefficients.

RESULTS

We report a significant correlation between the global MQLI and the four domains of the WHOQOL-BREF scores (p < 0.01). An analysis of variance revealed a significant difference in mean scores in the Psychological and Environment domains according to different socio-economic strata: F (3, 97) = 3.81, p = 0.012 and F (3, 97) = 4.03, p = 0.01, respectively.

DISCUSSION

The WHOQOL-BREF questionnaire may be more sensitive than the MQLI in detecting the impact of socioeconomic status on the QoL of postpartum women.

CONCLUSION

The sample of postpartum women evaluated in this study presented favorable QoL scores according to both the MQLI and WHOQOL-BREF questionnaires. Our results also indicate that the WHOQOL-BREF and the MQLI questionnaires have a significant correlation in terms of their assessments of postpartum mothers.

Development and validation of the Chinese version of the Multicultural Quality of Life Index (MQLI-Ch)

This study documents the validation study of the Multicultural Quality of Life Index, Chinese version (MQLI-Ch). This self-rated instrument is composed of ten items that correspond to multiple dimensions of the concept of quality of life. Each item is rated on a scale from 1 to 10, according to the subject's culture-informed understanding of the concept. The MQLI-Ch was tested on 144 Chinese subjects (124 psychiatric patients and 20 professionals). It was found to be quite efficient (about 3 min to be completed) and easy to use. A Cronbach's alpha of 0.94 demonstrated its internal consistency. The factor analysis of the ten items yielded one single factor, which accounted for 65.19% of the variance. The test-retest reliability correlation coefficient was 0.80. Its discriminant validity was documented by a highly significant difference (P < 0.001) between the mean scores of the two samples with presumed differences in quality of life. Thus, the MQLI-Ch showed high feasibility, internal structure, reliability and discriminant validity.