Validation of the WHOQOL-Bref: psychometric properties and normative data for the Norwegian general population

Background

The World Health Organization’s Quality of Life Questionnaire (WHOQOL-Bref) is a frequently used instrument to assess the quality of life in both healthy and ill populations. Inquiries of the psychometric properties of the WHOQOL-Bref report that the validity and reliability is generally satisfactory. However, some studies fail to support a four-factor dimensionality; others report poor reliability of the social and environmental domain; and there may be some challenges of supporting construct validity across age. This paper evaluates the psychometric properties of the Norwegian WHOQOL-Bref and extends previous research by testing for measurement invariance across age, gender and education level. In addition, we provide updated normative data for the Norwegian population.

Methods

We selected a random sample of the Norwegian population (n = 654) aged 18–75 years. Participants filled out the WHOQOL-Bref, the Utrecht Work Engagement Scale and various sociodemographic variables.

Results

We found an acceptable convergent and discriminate validity and internal consistency of the physical, psychological and environmental domains, but a marginal reliability was found for the social domain. The factor loadings were invariant across gender, education and age. Some items had low factor loadings and explained variance, and the model fit for the age group 60–75 years were less satisfactory.

Conclusions

The original four-factor dimensionality of the WHOQOL-Bref displayed a better fit to the data compared to the one-factor solution and is recommended for use in the Norwegian population. The WHOQOL-Bref is suitable to use across gender, education and age, but for assessment in the oldest age group, the WHOQOL-Old module could be a good supplementary, but further studies are needed.

Determinants of Health-Related Quality of Life in Rural Elderly People of the West of Iran: A Population-Based, Cross-Sectional Study

Background and aims: World’s older population is growing, and attention is being directed to the improvement of their health-related quality of life (HRQoL). This article was conducted to investigate the HRQoL and associated factors in rural elderly residents in west of Iran. Methods: By using the multistage sampling method, 346 elders from rural areas of Shahindezh were enrolled in this population-based, cross-sectional study conducted in 2014. To assess the HRQoL of the elderly people, the Leiden-Padua (LEIPAD) questionnaire was used. The economic status was classified into 3 categories (good, moderate, and low) using the principal component analysis. Descriptive statistics, independent t test, ANOVA, and Spearman correlation coefficient were used to analyze data. Multivariate linear regression was performed to determine predictive factors. Results: The mean values and confidence intervals of total core scale and total moderator scale were 38.6 (36.7-40.6) and 31.2 (29.6-32.6), respectively. Univariate analysis showed age, marital status, economic status, occupation, income source, and ethnicity were associated with HRQoL (P<0.05). Multivariate analysis showed the married, the illiterate, widows/widowers and the divorced, people with low economic status, and the self-employed had low HRQoL with respect to total scale and total core scale models (P<0.05). Conclusion: HRQoL varies according to socioeconomic factors. Its determinants should be addressed in social and health policies designed to improve the health of older people, especially the most vulnerable groups.

Quality of Life in Australian Adults Aged 50 Years and Over: Data Using the Schedule for the Evaluation of Individual Quality of Life (SEIQOL-DW)

OBJECTIVES

This study explored unique and personal domains associated with quality of life (QOL) in 153 mid-aged and older Australian adults over age 50, using an innovative measure of individualized QOL, the Schedule for the Evaluation of Individual Quality of Life (SEIQOL-DW).

METHODS

Demographic measures as well as the SEIQOL-DW were administered. The qualitative responses on this scale were analyzed by Leximancer, a text analysis program that extracts semantic meaning and relational information automatically from text.

RESULTS

For the sample as a whole, the most important QOL domain was found to be Relationships, followed by Family, Health, Activities, Community, Security, Beliefs, Independence and finally Wellbeing. When the sample was broken down into age bands for analysis, the most important domain theme was Family (50-59 year olds), Relationships (60-69 year olds), Relationships (70-79 year olds), and Health (80+ year olds).

CONCLUSIONS

The wide range of concepts elicited in each domain via Leximancer underscores the argument for analyzing QOL in an individualized way, as it was clear from these concepts that different domains had unique meanings to each person.

CLINICAL IMPLICATIONS

Understanding QOL at the level of which domains in an individual are important to QOL in later life is critical to providing services to both healthy aged as well as those with health and mental health needs. The SEIQOL-DW affords clinicians a unique tool with which to describe an individual's unique and relevant quality of life areas, and affords a way to measure change in these areas as a result of interventions.

Use of instruments to measure quality of life among healthy and ill adults in community settings

International interest in quality of life (QoL) has been affected by patients' prolonged survival, the increasingly aging population, the increase in chronic conditions and the increasing costs of health care. This has also led to the development of QoL instruments that meet the psychometric criteria necessary for reliable and valid outcome measures in research, health policy decision-making and, increasingly, in clinical practice. Despite the proliferation of QoL instruments available to inform best practice, clinicians seldom routinely apply them. One of the barriers to using QoL instruments is the unfamiliarity nurses have with existing instruments. In order to increase community health nurses' familiarity with existing QoL assessments, the aim of this paper is to describe five instruments and modules that have been developed by the World Health Organization's Quality of Life Assessment Group for the assessment of QoL among healthy and ill adults and to describe how their applicability could enhance evidence-based practice in community nursing.

Housing Satisfaction of Older (55+) Single-Person Householders in U.S. Rural Communities

This study aims to understand the housing satisfaction of older (55+) single-person householders in U.S. rural communities using the available variables from a secondary data set, the 2011 American Housing Survey (AHS). In this study, housing satisfaction was considered to be an indicator of quality of life. Based on previous studies, we developed a model to test a hypothesized relationship between older (55+) single-person householders' (N = 1,017) housing satisfaction and their personal, physical, financial, and environmental characteristics. Multiple regression results showed that the model was supported, indicating that significant variables in housing satisfaction include age, gender, health status, age of house, structure type, and unit location. Among the significant variables, health status was revealed to be the strongest factor in housing satisfaction. Housing satisfaction was discussed as potential indicators of quality of life.

Quality of Life (QOL) and Attitudes Toward Aging in Older Adults in Şanlıurfa, Turkey

Objectives: The purpose of this study was to investigate quality of life (QOL) and attitudes toward aging in older adults in a province in Turkey. Methods: This is a quantitative and descriptive study of QOL and the attitudes toward aging in older adults. Instruments: The data measurement instruments used in this study are the World Health Organization (WHO) Quality of Life Instrument–Older Adults Module (WHOQOL-OLD) and the WHO–Attitudes to Ageing Questionnaire (AAQ). Participants: The Turkish versions of the WHOQOL-OLD and AAQ were administered to 550 older adults living in şanlıurfa Province, Turkey. Results: The results indicated a significant relationship between QOL and attitudes toward aging in older adults. Two dimensions of attitudes toward aging (physical change and psychological growth) were significant predictors of QOL in older adults. It was found that gender, literacy, social security, age, and marital status affect some dimensions of QOL and some subscales of attitudes toward aging.