BackgroundQuality of life (QOL) is an important outcome measure in the treatment of heroin addiction. The Taiwan version of the World Health Organization Quality of Life assessment (WHOQOL-BREF [TW]) has been developed and studied in various groups, but not specifically in a population of injection drug users. The aim of this study was to analyze the psychometric properties of the WHOQOL-BREF (TW) in a sample of injection drug users undergoing methadone maintenance treatment.MethodsA total of 553 participants were interviewed and completed the instrument. Item-response distributions, internal consistency, corrected item-domain correlation, criterion-related validity, and construct validity through confirmatory factor analysis were evaluated.ResultsThe frequency distribution of the 4 domains of the WHOQOL-BREF (TW) showed no floor or ceiling effects. The instrument demonstrated adequate internal consistency (Cronbach’s alpha coefficients were higher than 0.7 across the 4 domains) and all items had acceptable correlation with the corresponding domain scores (r = 0.32-0.73). Correlations (p < 0.01) of the 4 domains with the 2 benchmark items assessing overall QOL and general health were supportive of criterion-related validity. Confirmatory factor analysis yielded marginal goodness-of-fit between the 4-domain model and the sample data.ConclusionsThe hypothesized WHOQOL-BREF measurement model was appropriate for the injection drug users after some adjustments. Despite different patterns found in the confirmatory factor analysis, the findings overall suggest that the WHOQOL-BREF (TW) is a reliable and valid measure of QOL among injection drug users and can be utilized in future treatment outcome studies. The factor structure provided by the study also helps to understand the QOL characteristics of the injection drug users in Taiwan. However, more research is needed to examine its test-retest reliability and sensitivity to changes due to treatment.
Background: For most HIV/AIDS patients who adhere to their medication regimens, Highly Active Antiretroviral Therapy (HAART) effectively controls viral load, reduces the incidence of AIDS diagnoses, and lowers HIVassociated mortality. Despite strong evidence that HAART effectively increases survival in people living with HIV/ AIDS, HIV-infected individuals not only need to endure the physiological changes that occur during therapy, but they may also face social and psychological problems. However, few research studies have paid attention to the quality of life of injection drug users (IDUs) living with HIV. This paper examines quality of life among IDUs living with HIV/ AIDS relative to IDUs without HIV/AIDS. Methods:A total of 71 HIV-infected IDUs from 4 methadone clinics in northern Taiwan completed a structured questionnaire that included demographics and the World Health Organization Quality of Life Scale brief version (WHOQOL-BREF). Another 71 HIV-negative IDUs were randomly sampled from 528 available methadone patients at the same 4 clinics as the control group. Scores from the WHOQOL-BREF were compared between HIV-positive and HIV-negative IDUs. Results:Results from multivariate multiple linear regression indicated that after controlling for all other demography and clinical factors, average scores in these four domains of WHOQOL-BREF were significantly higher among HIV-negative patients compared with those in HIV-positive patients. The greatest group difference appeared in the social relations domain, followed by the psychological domain and then the environmental domain, with the least difference found in the physical domain. Conclusion:The findings suggest that social relations and psychological issues are of great concerns for IDUs, especially HIV-positive patients. This indicates that understanding the impact of HIV infection on the quality of life particularly in the psychological and social relations realms is an important topic of future research.
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