Brazilian WHOQOL-OLD Module version: a Rasch analysis of a new instrument

Abstract

OBJECTIVE:To evaluate the Brazilian version of WHOQOL-OLD Module and to test potential changes to the instrument to increase its psychometric adequacy. METHODS:A total of 424 older adults living in a city in Southern Brazil completed the WHOQOL-OLD instrument, in 2005. Rasch analysis was used to explore the psychometric performance of the scale, as implemented by the RUMM2020 software. Item-trait interaction, threshold disorders, presence of differential item functioning and item fi t, were analyzed. RESULTS:Two ("death and dying" and "sensory abilities") out of six domains showed inadequate item-trait interactions. Rescoring the response scale and deleting the most misperforming items led to scale improvement. The evaluation of domains and items individually showed that the "intimacy" domain does perform well in contrast to the fi ndings using the classical approach. In addition, the "sensory abilities" domain does not derive an interval measure in its current format. CONCLUSIONS:Unidimensionality and local independence were seen in all domains. Changes in the response scale and deletion of problematic items improved the scale's performance. The world has been experiencing a profound and irreversible demographic shift as older people are living longer and healthier than ever before. 24 The most dramatic increases in proportions of older people are evident in the most advanced age groups (people over 80 years old) with an almost fi vefold increase from 69 million in 2000 to 377 million in 2050. 24 The World Health Organization (WHO) has described this demographic shift as a major societal achievement, and a challenge 25 . Increased longevity has been experienced in the developed and the developing world alike, but where developed countries grew rich before it grew old, developing countries are growing old before they have grown rich. 25This shift in the age pyramid due to increased elderly population demands further research specifi cally approaching the aging process. One important area to be assessed is quality of life. Although there are several studies on this issue, systematic reviews have pointed out that the instruments most frequently used in these investigations are not sufficiently comprehensive and/or are not validated for application in older adult populations. 4,11RESUMO OBJETIVO: Analisar a versão brasileira do Módulo WHOQOL-OLD, indicando alterações potenciais do instrumento para aumentar a adequação psicométrica. MÉTODOS:O total de 424 idosos residentes em Porto Alegre, RS, responderam o instrumento WHOQOL-OLD em 2005. O modelo de Rasch foi utilizado para a análise do desempenho psicométrico da escala, a partir do software RUMM2020. Foram analisadas a interação item-traço, a presença de funcionamento diferencial dos itens e a adequação dos itens ao modelo de Rasch.RESULTADOS: Dois domínios ("morte e morrer" e "funcionamento do sensório") apresentaram interação item-total insufi ciente. Remodelar a escala de resposta e excluir itens com pior performance resultou em melhora da escala. A a...

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