Validation of the WHOQOL-BREF and Shorter Versions Using Rasch Analysis in Traumatic Brain Injury and Orthopedic Populations |
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| Affiliation: | 1. School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand;2. School of Psychology, University of Waikato, Hamilton, New Zealand;1. Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA;2. Department of Occupational Therapy, College of Rehabilitation Science, Thomas Jefferson University, Philadelphia, PA;3. Shriners Hospitals for Children, Philadelphia, PA;4. Shriners Hospitals for Children, Chicago, IL;5. Rush Medical College, Chicago, IL;6. Kennedy Krieger Rehabilitation Institute, Baltimore, MD;7. Shriners Hospitals for Children, Sacramento, CA;8. MGH Institute of Health Professions, Boston, MA;1. Center for Rehabilitation Outcomes Research, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Evanston, Illinois;1. Medical School of Shihezi University, Shihezi, Xinjiang, China;2. Department of Psychology Rehabilitation, the First Affiliated Hospital of the Medical College, Shihezi University, Shihezi, Xinjiang, China;1. Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de Sao Paulo, Sao Paulo, Brazil;2. Musculoskeletal Health Sydney, School of Public Health, The University of Sydney, Sydney, Australia |
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| Abstract: | ObjectiveTo use Rasch analysis to validate the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and existing short versions in individuals with traumatic brain injury and orthopedic injuries, with comparisons to a general population group.DesignThe Partial Credit Rasch model was applied to evaluate the WHOQOL-BREF as well as shortened versions using a cross-sectional study design.SettingRegional hospital, and national electoral sample in New Zealand.ParticipantsIndividuals with traumatic brain injury (n=74), individuals with orthopedic injuries (n=114), general population (n=140).InterventionsNone.Main Outcome MeasureWHOQOL-BREF.ResultsThe WHOQOL-BREF met expectations of the unidimensional Rasch model and demonstrated good reliability (person separation index [PSI] =0.82) when domain items were combined into physical-psychological, social, and environmental superitems. Analysis of shorter versions, the EUROHIS-QOL-8 and World Health Organization Quality of Life-5 (WHOQOL-5), indicated overall acceptable fit to the Rasch model and evidence of unidimensionality. The EUROHIS-QOL-8 showed good reliability (PSI=0.81); however, reliability of the WHOQOL-5 (PSI=0.68) was below acceptable standards for group comparisons, in addition to demonstrating poor person-item targeting.ConclusionsThe WHOQOL-BREF and the 8-item EUROHIS-QOL-8 version are both reliable and valid in the assessment of quality of life in both injury and general populations. Ordinal-interval conversion tables published for these validated scales as well as for the WHOQOL-5 can be used to improve precision of assessment. The transformation of ordinal scale scores into an interval measure of health-related quality of life also permits the calculation of a single summary score for the WHOQOL-BREF, which will be useful in a wide range of clinical and research contexts. Further validation work of the WHOQOL-5 is needed to ascertain its psychometric properties. |
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| Keywords: | Psychometrics Quality of life Rehabilitation Brain injuries, traumatic Orthopedics DIF" },{" #name" :" keyword" ," $" :{" id" :" kwrd0030" }," $$" :[{" #name" :" text" ," _" :" differential item functioning HRQOL" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040" }," $$" :[{" #name" :" text" ," _" :" health-related quality of life PSI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0050" }," $$" :[{" #name" :" text" ," _" :" person separation index TBI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0060" }," $$" :[{" #name" :" text" ," _" :" traumatic brain injury WHOQOL-5" },{" #name" :" keyword" ," $" :{" id" :" kwrd0070" }," $$" :[{" #name" :" text" ," _" :" World Health Organization Quality of Life-5 WHOQOL-BREF" },{" #name" :" keyword" ," $" :{" id" :" kwrd0080" }," $$" :[{" #name" :" text" ," _" :" World Health Organization Quality of Life-BREF |
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