Two approaches to measuring quality of life in the HIV/AIDS population: HAT-QoL and MOS-HIV

Objectives: Reduce the number of HIV/AIDS-Targeted Quality of Life (HAT-QoL) items, assess psychometric performance of the shortened HAT-QoL, and compare psychometric performance of HAT-QoL to that of Medical Outcomes study HIV Health Survey (MOS-HIV). Design/Subjects: Convenience sample of 215 cross-sectionally studied seropositive individuals. Methods: Subjects completed the HAT-QoL, MOS-HIV, and sociodemographic and disease-specific questions. HAT-QoL and MOS-HIV responses were entered, separately, into principal components analysis (PCA). Results from PCA, internal consistency and correlation assessments were used to aid the item removal process. Dimension characteristics (e.g., score distributions, internal consistency, scaling success rates, intercorrelations, construct validity) were evaluated. Results: PCA of subjects' (80% male; 45% white; 62% gay/bisexual) responses revealed nine previously identified HAT-QoL dimensions. The measure was shortened by removing 12 items. Two HAT-QoL dimensions (HIV mastery and provider trust) had ceiling effects. All internal consistency coefficients were >0.80, except those for sexual function (0.57) and medication concerns (0.57). HAT-QoL scaling success rates were >90% for 7 of 9 dimensions, and a majority of dimensions showed minimal to low intercorrelations. Validity assessments indicated consistent, expected relationships (p0.05) for all dimensions except the medication concerns and provider trust dimensions. PCA indicated five MOS-HIV factors. Six of the 11 previously defined MOS-HIV dimensions – physical, role, social, and cognitive function, pain, and health transition – had substantial ceiling effects. MOS-HIV scaling success rates were >90% for only 2 out of 8 evaluable dimensions; three dimensions had very low (40–73%) scaling success rates. Most MOS-HIV dimensions were moderately-to-highly intercorrelated. Validity assessments indicated consistent, expected relationships for all MOS-HIV dimensions. Conclusions: Six dimensions of the shortened HAT-QoL instrument (overall function, disclosure worries, health worries, financial worries, HIV mastery, and life satisfaction) exhibited good psychometric properties, including limited ceiling effects, low dimension intercorrelations, high internal consistency, and evidence for construct validity. All multi-item MOS-HIV dimensions had high internal consistency and all dimensions revealed consistent evidence for construct validity.     

Psychometric properties of the Korean version of the effort–reward imbalance questionnaire: a study in a petrochemical company

Objective To evaluate the criterion validity, factorial validity, and internal consistency of Korean version of effort–reward imbalance (ERI) for the scales of effort, reward, and overcommitment as well as to examine the effect of psychosocial factors on physical and mental illness among petroleum refinery workers in South Korea. Methods The Korean version of ERI questionnaire was constructed using the translation and back-translation technique, and its psychometric properties were explored among 908 male workers in a large petroleum refinery in South Korea in 2002. Cronbach’s alpha coefficient was used to test internal consistency. An exploratory factor analysis was conducted on all items of the instrument. Confirmatory factor analyses were conducted on each dimension of effort, reward and overcommitment. Physical and mental health was measured by self-rated health (SF-8). The lowest tertiles of the scores were defined as illness. Multiple logistic regression models were used to test the effect of job stress on the physical and mental health (criterion validity of ERI scales). Results The Cronbach’s alpha coefficients for effort, reward, and overcommitment were 0.71, 0.86, and 0.75, respectively, indicating satisfactory internal consistency. Exploratory factor analysis found three latent factors, which closely corresponded to the theoretical structure of the ERI model. Acceptable construct validity was shown using confirmatory factor analysis. The highest tertile of effort–reward ratio was significantly associated with physical illness (OR 2.4, 95% CI 1.7–3.6) and mental illness (OR 2.9, 95% CI 2.0–4.2), compared to lower tertiles. Overcommitment was significantly associated with mental illness, but not with physical illness. Conclusions These findings contribute to the validity and reliability of the Korean ERI questionnaire. Importantly, in the context of a rapid change in the labour market, the lack of reciprocity between efforts and rewards at work is strongly associated with self-rated physical and mental health.     

Psychometric testing of the Family‐Carer Diabetes Management Self‐Efficacy Scale

The aim of this study was to develop and test the construct and content validity, internal consistency of the Family‐Carer Diabetes Management Self‐Efficacy Scale (F‐DMSES). A sample of 70 Thai individuals who cared for those living with type 2 diabetes mellitus (T2DM) in a rural community in Thailand was included in the study. Data were collected by a questionnaire survey in January 2014. The F‐DMSES was initially derived from the DMSES, with subsequent forward and backward translations from and to English and Thai languages. The psychometric properties (content, construct and internal consistency) of the Thai version were explored using the Content Validity Index approach, exploratory factor analysis and Cronbach's alpha test. The F‐DMSES initially designed with 20 items was reduced to 14 items within four factors (general diet and blood glucose monitoring, medications and complications, diet in differing situations, and weight control and physical activities), and explained 72.2% of the total variance in overarching construct. Internal consistency was supported (α = 0.89). The F‐DMSES was also able to measure change over time following an intervention, with an effect size of 0.9. The F‐DMSES is a valid and reliable self‐administered instrument that measures the diabetes management self‐efficacy of family‐carers of individuals with T2DM. This instrument can be used in practice and clinical trials to assess the impact of family‐carers on the health outcomes of individuals with T2DM.     

Evidence for reliability, validity and usefulness of the Medical Outcomes Study HIV Health Survey (MOS-HIV)

The Medical Outcomes Study HIV Health Survey (MOS-HIV) is a brief, comprehensive measure of health-related quality of life (HRQoL) used extensively in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). The 35-item questionnaire includes ten dimensions (health perceptions, pain, physical, role, social and cognitive functioning, mental health, energy, health distress and quality of life (QoL)) and takes approximately 5 minutes to complete. Subscales are scored on a 0–100 scale (a higher score indicates better health) and physical and mental health summary scores can be generated. The MOS-HIV has been shown to be internally consistent, correlate with concurrent measures of health, discriminate between distinct groups, predict future outcomes and be responsive to changes over time. Limited experience suggests acceptable reliability and validity in women, injecting drug users and African–American and lower socioeconomic status patients. The MOS-HIV is available in 14 languages and has been included as a secondary outcome measure in numerous clinical trials for all stages of disease. In several studies it has detected significant differences between treatments; in some cases concordant with conventional end-points and, in others, discordant. The interpretation of scores is facilitated by an explanation in terms meaningful to the intended audience. Research is needed to compare the MOS-HIV to other strategies for HRQoL assessment in early HIV disease.     

Validity and reliability of the Italian translation of the MOS-HIV health survey in persons with AIDS

Objectives: To evaluate the validity and reliability of the Italian version of the 35-item Medical Outcome Study HIV Health Survey (MOS-HIV) when applied to persons with AIDS. Methods: The study population consisted of 185 adults with AIDS residing in Rome and participating in a randomised controlled trial on home-care. Diagnosis was made between 1 October 1994 and 1 April 1996, and enrollment took place within 2 months of diagnosis. The MOS-HIV, which measures 10 dimensions of health-related quality of life (QoL), was administered at baseline and every 3 months thereafter during the 1-year follow-up. Tests of convergent and concurrent construct validity were conducted for all scales. Results: Of the 185 trial participants, 146 responded to the questionnaire; 82 responded at least twice (including baseline collection) during follow-up. For the role functioning, general health, and vitality scales, the distribution of scale scores was concentrated at the lower half of the range. Internal consistency reliability was adequate (>0.80) for all scales. Baseline scores tended to increase with decreasing AIDS severity and with increasing age. There were improvements over time in the role functioning, vitality, and health distress scales. Conclusions: The MOS-HIV had good reliability among persons with AIDS. There was a moderate floor effect for some of the subscales. Tests of convergent and construct validity were generally confirmed. Additional studies are needed to evaluate the responsiveness to changes over time.     

Quality of Life and Body Image in the Assessment of Psychological Impact of Lipodystrophy: Validation of the Italian Version of Assessment of Body Change and Distress Questionnaire

Lipodystrophy (LD) includes morphologic changes that are distressing to patients with HIV. We tested the validity of an Italian version of the Assessment of Body Change and Distress (ABCD) questionnaire and analysed its relationship to physical and mental aspects of Health-Related Quality of Life. Two hundred and fifty-two patients completed the questionnaires. Construct validity of the ABCD was tested against the MOS-HIV Health Survey, body mass-index (BMI) and CD4+ T-lymphocyte counts. Cronbach’s α for the ABCD total score was 0.94. The ABCD showed the hypothesized moderate correlations to MOS-HIV scales and clinical variables. Preliminary evidence supports the reliability and validity of the Italian version of the ABCD in people with HIV and LD. This questionnaire may be useful to identify people experiencing greater impact of LD, or to evaluate the impact of interventions to treat LD such as plastic surgery.     

安徽省皖北地区艾滋病病毒感染者和艾滋病病人生存质量评价

目的 了解安徽省皖北地区艾滋病病毒感染者和艾滋病病人的生存质量现状及其影响因素,为进一步改善其生存质量提供相关依据。方法 采用方便样本法选取皖北10个县（市、区）艾滋病病毒感染者和艾滋病病人,使用艾滋病病毒感染者医疗结局健康调查表简体中文版进行面对面匿名调查,均数比较采用t检验和方差分析,多因素分析采用多元线性回归方程评价其生存质量。结果 艾滋病病毒感染者和艾滋病病人的生理健康总分为（48.29±8.73）分,心理健康总分为（46.67±8.45）分。他（她）们的总体健康、躯体健康、社会功能、肌体疼痛、心理健康、活力6个维度得分均低于正常人群（均有P<0.05）。不同文化程度、职业、居住地、年收入分别与生理健康总分、心理健康总分及不同维度差异均有统计学意义（均有P<0.05）,文化程度和收入与他（她）们的生理健康总分、心理健康总分及躯体健康、认知功能、肌体疼痛、心理健康、活力均呈正相关,而打短工与他（她）们的角色功能、肌体疼痛均呈负相关。结论 艾滋病病毒感染者和艾滋病病人的生存质量低于常人,其受文化程度、职业、居住地、年收入等多因素影响,今后可通过提高他（她）们的文化程度和收入以改善其生存质量。     

A short generic measure of work stress in the era of globalization: effort–reward imbalance

Objective  We evaluate psychometric properties of a short version of the original effort–reward imbalance (ERI) questionnaire. This measure is of interest in the context of assessing stressful work conditions in the era of economic globalization. Methods  In a representative sample of 10,698 employed men and women participating in the longitudinal Socio-Economic Panel (SOEP) in Germany, a short version of the ERI questionnaire was included in the 2006 panel wave. Structural equation modeling and logistic regression analysis were applied. Results  In addition to satisfactory internal consistency of scales, a model representing the theoretical structure of the scales provided the best data fit in a competitive test (RMSEA = 0.059, CAIC = 4124.19). Scoring high on the ERI scales was associated with elevated risks of poor self-rated health. Conclusions  This short version of the ERI questionnaire reveals satisfactory psychometric properties, and can be recommended for further use in research and practice.     

The use of two measures of health-related quality of life in HIV-infected individuals: a cross-sectional comparison

Two measures of health-related quality of life in 65 HIV-infected individuals were compared in a cross-sectional design. The Quality of Well-Being Scale (QWB) results in a single score ranging from death to perfect health. The MOS-HIV Health Survey (MOS-HIV, 34-item version) gives scores in 11 dimensions. The QWB score distinguished subjects with AIDS from those who were asymptomatic (p=0.027). For the seven multi-item scales of the MOS-HIV, Cronbach's alpha ranged from 0.85–0.95, indicating good internal consistency reliability. Clinical HIV-infection status was significantly associated with the dimensions of Overall Health (p=0.002), Role Function (p=0.022), Social Function (p=0.037), Energy/Fatigue (p=0.027) and Health Distress (p=0.025). All eleven dimensions of the MOS-HIV were significantly correlated with the QWB score (Spearman's coefficient = 0.405–0.670; for all, p<0.01) and the QWB score could be predicted from the MOS-HIV dimension scores using multiple regression. The QWB and the MOS-HIV may be useful in assessing health-related quality of life in patients infected with HIV.Funding support for this study provided by the Center for Pharmaceutical Economics of the University of Arizona.     

Development of a Vietnamese version of the Short form-36 Health Survey

We aimed to test the psychometric properties of a culturally relevant translation of the medical outcomes study short form-36 health survey (SF-36) with prospective Vietnamese migrants. The translated survey was interviewer-administered to 1610 Vietnamese aged over 15 years who had applied to migrate to Australia. All but two SF-36 items had good discriminant validity, and all eight scales of the Vietnamese version of the SFS-36 had good discriminant validity, which supports the use of SF-36 constructs to assess self-reported health status among Vietnamese migrants. However, the mental health, vitality and bodily pain scales demonstrated low internal consistency. This finding is likely to be a product of the increased diversity among scale items following modifications to improve cultural relevance. Further modifications to improve the internal consistency of these scales are required.     

The World Health Organization's WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A Report from the WHOQOL Group

Quality of life (QOL) assessments that are easily administered and which do not impose a great burden on the respondent are needed for use in large epidemiological surveys, clinical settings and clinical trials. Using data from the WHOQOL-BREF field trials, the objectives of this work are to examine the performance of the WHOQOL-BREF as an integrated instrument, and to test its main psychometric properties. The WHOQOL-BREF is a 26-item version of the WHOQOL-100 assessment. Its psychometric properties were analysed using cross-sectional data obtained from a survey of adults carried out in 23 countries (n = 11,830). Sick and well respondents were sampled from the general population, as well as from hospital, rehabilitation and primary care settings, serving patients with physical and mental disorders and with respect to quotas of important socio-demographic variables. The WHOQOL-BREF self-assessment was completed, together with socio-demographic and health status questions. Analyses of internal consistency, item-total correlations, discriminant validity and construct validity through confirmatory factor analysis, indicate that the WHOQOL-BREF has good to excellent psychometric properties of reliability and performs well in preliminary tests of validity. These results indicate that overall, the WHOQOL-BREF is a sound, cross-culturally valid assessment of QOL, as reflected by its four domains: physical, psychological, social and environment.     

Feasibility, reliability and validity of the Chinese simplified version of the MOS-HIV health survey among AIDS patients in China

Purposes

To test the feasibility, reliability and validity of the Chinese simplified version of the MOS-HIV health survey among AIDS patients in China.

Methods

A cross-sectional survey of 120 patients receiving highly active antiretroviral treatment was conducted. Feasibility was assessed using the time of administration and the response rate. Reliability was estimated using Cronbach’s α. Validity was analyzed by construct and discriminant validity.

Results

The time of administration was about 12 min, and the response rate was 100%. The MOS-HIV showed a good internal reliability and Cronbach’s α of eight multi-item scales ranged from 0.75 to 0.91. Correlations between scales were all significant. The majority of the correlations between pairs of scales were within the acceptable range (0.4–0.8). The scores of role function, pain, physical health summary scales were significantly higher for patients with time on antiretroviral treatment >1 year compared to those with time ≤1 year. Patients >40 years had significantly higher scores than those of ≤40 years on energy and mental health summary scales.

Conclusions

The Chinese simplified version of MOS-HIV health survey had good feasibility, reliability and validity. It was successfully adapted for AIDS patients in rural areas and could be a valuable tool in evaluating the quality of life of AIDS patients.     

Evaluation of psychometric properties of the Spanish version of the Rotterdam Symptom Checklist to assess quality of life of cancer patients

BACKGROUND: In this work the validation of the Spanish version of the Rotterdam Symptom Checklist (RSCL) to assess quality of life in cancer patients has been approached. The main goal of this study is to evaluate the psychometric properties of the questionnaire and its equivalence with the original English questionnaire. METHODS: The questionnaire was administered to a sample of 162 terminal cancer patients and 59 cancer patients treated with chemotherapy. The internal structure, was evaluated through a confirmatory factor analysis in TCP, the discriminatory power according to clinical situation of cancer patients, the internal consistency in both samples and the responsiveness to the changes over time after chemotherapy treatment was evaluated in PQT. RESULTS: The internal structure of scales was similar in TCP to the original version. The cancer patients showed worse scores than the PQT. The reliability was > or = 0.70 for the scales and > or = 0.50 for the subscales except chemotherapy subscale. The scores of the scales were different (p < 0.05) before and after treatment, except for the psychological scale. CONCLUSIONS: These results confirm the usefulness of the spanish version of the RSCL as a subjective measure of well-being in cancer patients.     

Scale development of health status for secondary data analysis using a nationally representative survey

Objectives

Scale development of health-related quality of life (HRQOL) measures, including physical and mental health measures, among public datasets from Japan is needed for comparative studies on health conditions among different age, gender, and socio-economic subgroups. Multi-attributable scales of continuous/discrete variables on HRQOL could be more flexible for different kinds of epidemiologic and socio-econometric studies rather than single-item measures. The objectives of this study were to create multi-dimensional scales for physical, mental, and summary health measures and to describe the age-related trends of these scales in Japan.

Methods

We utilized data from the 2007 Comprehensive Survey of the Living Conditions of People on Health and Welfare (LCPHW: Kokumin Seikatsu Kiso Chosa) (n = 383,745) to measure physical health (0 = worst score, 16 = best score) by summarizing four items: general health status, bedridden status/mobility, self-care/usual activities, and pain (0 = worst score, 4 = best score for each item). Mental health was measured using a Japanese version of K6 (0 = worst score, 4 = best score, modified from original version in which 24 = worst score and 0 = best score). We then created a summary health scale using the simple sum of physical and mental health (0 = worst score, 20 = best score). The reliability and validity of the scales were evaluated and their age-related trends described.

Results

The internal consistency reliability of the physical and summary health scales was not sufficiently high (Cronbach’s α = 0.64 and 0.67, respectively) and the age-related trend was smooth and monotonous. The internal consistency reliability of the mental health scale (K6) was high (Cronbach’s α = 0.90), while the age-related trend peaked at age 65–74 years.

Conclusions

While K6 was a measure with high reliability for describing mental health, use of the physical and summary health scale in the Japanese population requires further discussion. Additional validation tests of the summary scales also need to be performed, in which our methodology is applied to other data sets that include strict diagnostic results based on a structural interview.     

Reliability and validity of the SF-36 in HIV-infected homeless and marginally housed individuals

Objective: To assess the reliability and validity of the Short-Form 36 (SF-36) health survey as a health status indicator among HIV-infected homeless and marginally housed (HMH) individuals. Methods: Between July 1996 and May 2000, a sample of HMH individuals completed interviews that included the SF-36. Responses to the SF-36 were analyzed for missing data, range, internal consistency, and construct validity. Results: Among 330 individuals interviewed, 83% were male, 43% were African-American, and the median age was 39 years. All internal consistency reliability coefficients exceeded 0.70, all item–scale correlations exceeded 0.40, all items were more strongly correlated with their hypothesized scale than any other scale, and all reliability coefficients exceeded inter-scale correlations for the same scale. Three of four physical health scales were significantly associated with CD4 cell count and HIV viral load. All scales were significantly associated with depression. Discussion: We found that scales were internally consistent, items correlated to an acceptable degree with their hypothesized scales, items were distinct from other scales, physical scales were associated with CD4 cell count and viral load, and all scales were associated with depression. These analyses provide evidence for the reliability and validity of the SF-36 as a measure of health status in HIV-positive HMH individuals.     

中国艾滋病病毒感染者生命质量测定量表的编制

目的编制用于测定中国HIV感染者生命质量的量表，评价其信度和效度。方法参考现有量表，并与相关专家、基层疾病预防控制人员、HIV感染者进行访谈以形成初始量表，在443例HIV感染者中试用。根据条目应答率、因子分析、相关系数矩阵、内部一致性分析等进行条目精简，形成最终量表。分析最终量表的信度和效度。结果形成的中国HIV感染者生命质量量表（QOL—CPLWHA）共44个条目。各维度没有严重的天花板效应和地板效应（最高为21．0％），内部一致性信度系数均≥0．70，全量表的为0．90。量表总分2周重测信度系数为0．80，有2个维度的重测信度系数低于0．6，4个维度的在0．6～0．7之间。各条目的成维率均为100％。量表总得分与SF-36总得分的spearman相关系数为0．69。结论所形成的QOL—CPLWHA量表首次引入了敌意心理趋势维度。量表具有较好的内部一致性信度、结构效度及内容效度等，可应用于中国HIV感染人群。     

Construction and validation of a quality of life instrument for young adults

Assessment of quality of life (QOL) in young adults has become an increasingly important field of research as information on the QOL of children and adults accumulates. The purpose of this study is to report on the development of the Young Adult Quality Of Life (YAQOL) instrument, a measure of QOL for young adults aged 18-25. The YAQOL, which is comprised of 14 multi-item scales that assess physical health and aspects of psychological well-being, social relationships, role function, and environmental context, was administered to a general population sample of 751 young adults. Scale structure was confirmed by item-internal consistency, item discriminant validity, and inter-scale correlations. Reliability coefficients ranged from 0.88 to 0.63 across scales (mean = 0.73). Eight YAQOL scales discriminated clearly between young adults with and without chronic physical conditions, 12 scales discriminated between young adults with and without personality disorder, and negative associations were demonstrated between YAQOL scale scores and psychiatric disorder symptoms. Demographic differences in the YAQOL scales were consistent with theoretical expectations and previous empirical work. Overall, findings support the reliability and utility of the YAQOL as a measure of QOL in young adults in the general population. Additional psychometric properties will continue to be evaluated as more data become available.     

Evaluation of theoretical accuracy, reliability, discriminative power and difficulty for physical, mental and social well-being scales in adolescents]

The purpose of this study was to develop and validate the questionnaire used to measure adolescents' wellbeing and its physical, mental and social dimensions. The questionnaire was composed of two parts: the first part contained wellbeing indicators and the second part contained criterion indicators (health disorders and harmful behaviours). Physical wellbeing scale contained the most common complaints due to psychosocial and life style factors, and was measured by three indicators: headache, abdominal pain and backache. Mental wellbeing scale contained emotional and moral dimensions that were recognised as closely connected with the physical disorders from one hands and the process of socialisation from the other hands. There were eight indicators: fatigue, stress, fear, depression, loneliness, helplessness, feeling of guilt, and low self-complacency. Five indicators: perceived social support, relationship with mother, father, friends and teacher measured social wellbeing scale. Each indicator of wellbeing is scored in three scales: dichotomise scale, five-point Likert scale and visual analogue scale. The cluster sample of 445 schoolchildren aged 14-15 years, randomly selected from the last grade of elementary schools of Warsaw was surveyed in October-November 1999. The physical, mental, social and total wellbeing scales were found to be reliable, but differing in internal consistency. The total and mental scales of wellbeing demonstrated high reliability, while the physical and social scales demonstrated moderate reliability. Analysis of correlation between criterion and tested variables showed acceptable discriminative power of the physical, mental, social and total wellbeing scales. Respondents assessed the five-point Likert scale as easier in comparison to dichotomise and visual analogue scales.     

Psychometric evaluation of a Chinese (Taiwanese) version of the SF-36 health survey amongst middle-aged women from a rural community

To test the psychometric properties of the Chinese (Taiwanese) version of the short form 36 health survey (SF-36), 1439 women, aged 40–54 years and living in Kinmen (a Taiwanese island reflecting a predominantly rural community) were recruited to participate in this survey. The rate of unavailable data points for the 36 tested items remained consistently low, and item-discriminate validity was high (95%) for all subscales. Cronbach's α coefficient remained above the 0.70 threshold criterion for all scales except for social functioning and bodily pain. Principal components analysis supported the two major dimensions of health, physical and mental, in the internal structure of the SF-36 scales, although the dimensions did not match the hypothesized association very well. Poorer health profiles were associated with physical and mental conditions. The mental health subscores in the SF-36 test correlated highly with the associated hospital anxiety and depression score (Spearman rank correlation coefficient = −0.62). In conclusion, the reliability and validity tests performed on the data collected support the cross-cultural application of the Chinese (Taiwanese) version of the SF-36 test. This revised version was published online in June 2006 with corrections to the Cover Date.     

Comparison of WHOQOL-BREF and SF-36 in patients with HIV infection

The purpose of the study was to evaluate the reliability and validity of the two generic instruments, the WHOQOL and the SF-36, for assessing health-related quality of life in 224 patients with HIV infection. The internal consistency ranged from 0.75 to 0.86 across the WHOQOL-BREF domains and from 0.72 to 0.93 across the SF-36 scales. The scores of all WHOQOL-BREF domains and SF-36 scales correlated positively with the measure of happiness, Sat-HRQOL and self-perceived health status, and correlated negatively with the number and intensity of symptoms. Patients with higher CD4 cell counts scored significantly higher on G4 (general health), three WHOQOL-BREF domains, seven SF-36 scales, and PCS (physical component summary). Patients with fewer symptoms and with less intensity of symptoms had significantly higher scores on all four domains of WHOQOL-BREF, eight scales, PCS, and MCS (mental component summary) of the SF-36 scale. The correlations between the physical, psychological, and social domains of the WHOQOL-BREF and PF (physical functioning), MH (mental health), and SF (social functioning) of the SF-36 were 0.51, 0.75, and 0.54, respectively. There is also good correlation between PCS of the SF-36 and the physical domain of the WHOQOL-BREF (r = 0.48), and between MCS and all four domains of the WHOQOL-BREF (r range = 0.60–0.75). The WHOQOL-BREF domains showed fewer floor or ceiling effect than the SF-36 scales. We concluded that both the WHOQOL-BREF and the SF-36 are reliable and valid health related quality-of-life instruments in patients with HIV infection.