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Yang N, Ma H, Huang M, Lau EYY, Fong DYT, Wang M, Wang P, Xu S, Xu J, Jiang C, Luo Y, Meng R. Measurement Properties and Optimal Cutoff Point of the WHO-5 Among Chinese Healthcare Students. Psychol Res Behav Manag 2023; 16:5141-5158. [PMID: 38148776 PMCID: PMC10750781 DOI: 10.2147/prbm.s437219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/26/2023] [Indexed: 12/28/2023] Open
Abstract
Purpose The World Health Organization-Five Well-Being Index (WHO-5) is widely used to assess subjective well-being. Nevertheless, measurement invariance and optimal cutoff point of the WHO-5 have not been examined in Chinese samples. We aimed to assess measurement properties of the Chinese version of the WHO-5 (WHO-5-C) among healthcare students. Patients and Methods A two-wave longitudinal assessment was conducted among 343 Chinese healthcare students from September to November 2022. Measurement properties of the WHO-5-C were assessed through structural validity using confirmatory factor analysis (CFA), measurement invariance using multigroup CFA (MGCFA) and longitudinal CFA (LCFA), convergent validity using correlation analysis with the Self-Rated Health Questionnaire (SRHQ) and Patient Health Questionnaire-4 (PHQ-4), reliability using internal consistency and test-retest reliability, and optimal cutoff point using receiver operating characteristic (ROC) analysis. Results The WHO-5-C demonstrated satisfactory structural validity with comparative fit index (CFI) of 0.968 at baseline and 0.980 at follow-up, and adequate measurement invariance in different sociodemographic variables at baseline (gender, age, major, home location, being only child, monthly household income, part-time job, physical exercise, hobby, frequency of visiting home, and stress coping strategy) (CFI changes [ΔCFI] = -0.009-0.003) and over a week (ΔCFI = -0.006-0.000). The WHO-5-C also had good internal consistency (Cronbach's α = 0.907-0.934; McDonald's ω = 0.908-0.935) and test-retest reliability (intraclass correlation coefficient [ICC] = 0.803). Convergent validity was supported by moderate correlations of the WHO-5-C with the SRHQ and PHQ-4. The optimal cutoff point of the WHO-5-C was found to be 50, with an area under the ROC curve of 0.882 at baseline data, with sensitivity of 0.803 and specificity of 0.762 at follow-up. Conclusion The WHO-5-C demonstrated adequate measurement properties, especially concerning cross-sectional and longitudinal measurement invariance, with a recommended optimal cutoff point of ≥ 50 for assessing adequate level of psychological well-being in healthcare students.
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Affiliation(s)
- Nongnong Yang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
| | - Haiyan Ma
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, People’s Republic of China
| | - Mengyi Huang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
| | - Esther Yuet Ying Lau
- Sleep Laboratory, Department of Psychology, The Education University of Hong Kong, Hong Kong, People’s Republic of China
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, People’s Republic of China
- Centre for Religious and Spirituality Education, The Education University of Hong Kong, Hong Kong, People’s Republic of China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People’s Republic of China
| | - Meng Wang
- Ophthalmology Center, Ningbo Yinzhou No.2 Hospital, Ningbo, Zhejiang, People’s Republic of China
| | - Pengqiao Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
| | - Siyi Xu
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
| | - Jiale Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
| | - Chen Jiang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yi Luo
- School of Nursing, Ningbo College of Health Sciences, Ningbo, Zhejiang, People’s Republic of China
| | - Runtang Meng
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, People’s Republic of China
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