Psychometric properties of the Chinese version of the WHOQOL-HIV BREF to assess quality of life among people living with HIV/AIDS: a cross-sectional study

Abstract

ObjectivesThis study aims to assess the psychometric properties of the Chinese version of the WHOQOL-HIV BREF.DesignCross-sectional study.SettingCenters for Disease Control and Prevention and infectious disease hospitals in three Chinese provinces.ParticipantsSample of 1100 people living with HIV/AIDS (PLWHA).InterventionsWe recruited 1100 PLWHA to evaluate their quality of life (QOL) using the WHOQOL-HIV BREF. Of these participants, 57 were randomly selected to repeat the QOL evaluation 2 weeks later.Main outcome measuresThe reliability of the WHOQOL-HIV BREF was assessed in terms of its internal consistency and test–retest reliability. The construct, concurrent, convergent, discriminant and known-group validity were also analysed. In addition, the factorial invariance across genders was assessed.ResultsCronbach’s α coefficient for the overall scale was 0.93. Except for the spirituality domain, which had an α below 0.70 (0.66), the other five domains showed adequate internal consistency. The test–retest reliability revealed a statistically significant intraclass correlation coefficient of 0.72–0.82 (p<0.001). Confirmatory factor analysis found that the six-domain structure produced an acceptable fit to the data. The instrument showed factorial invariance across gender groups. All domains were significantly correlated with the general items and the SF-36 (p<0.01). The correlation coefficients were >0.40 (r=0.40–0.67), except for the association between the spirituality domain and two general items (QOL: r=0.33; health status: r=0.36). Subjects with lower CD4 counts had lower scores for all domains (p<0.05). Symptomatic participants had significantly lower scores than asymptomatic participants on the physical, psychological and independence domains (p<0.05).ConclusionsThe WHOQOL-HIV BREF revealed good psychometric characteristics among Chinese PLWHA. These findings offer promising support for the use of the WHOQOL-HIV BREF as a measure of QOL among Chinese PLWHA and in cross-cultural comparative studies on QOL.

Psychometric assessment of translated Urdu version of WHOQOL-HIV BREF among patients living with HIV

“…Overall, Cronbach's alpha value is greater than 0.93 which indicates excellent internal consistency (47). Individual domains and each question's internal consistency was more than 0.9, which is highly acceptable, and these ndings are in line with the Iranian, Brazilian and Chinese studies (18,24,31). The skewness and kurtosis value of almost all the items fall within the acceptable range (-1.00 to 1.00) which are consistent with the ndings of the study conducted among Taiwanese and older Portuguese patients infected with HIV (26,27).…”

“…Known group comparison shows the Urdu version of WHOQOL HIV Bref is a exible tool for measuring the HIV care-related quality of life, as the questionnaire signi cantly differentiates btween patients with different levels of CD4 T cells; the higher the CD4 T cell levels, the better quality of life. These results are comparable to the ndings of a study conducted in Chinese PLWH (18). Of note, the difference in social relationship and spirituality facets (larger standard deviation) among PLWH with different HIV stages, indicates that though AIDS is a non-mortal disease at present, the level of affected emotional distress remains the same even at entirely different stage of HIV.…”

“…Reliability coe cients (ICC values) of the Urdu version of the WHOQOL HIV Bref instrument ranging from 0.872 to 0.992; these ndings are consistent with psychometric evaluation studies conducted in China and Malaysia (18,22,29). The time interval was 12 to 16 days between the rst and second ratings as proposed by Anne Anastasi and Susana Urbina (48).…”

“…Generic questionnaires like the frequently utilized EQ-5D, WHOQOL, HUI, M-QOL, SF-12, and SF-36 have the advantage of allowing comparison of HRQoL across different disease population. However, HIV-speci c instruments such as WHOQOL-HIV Bref, HIV-QL-31, MOS-HIV, ACTG-21, AIDS-HAQ, MQOL-HIV, FAHI, PROQOL-HIV, and HIV-SQUAD, evidenced greater sensitivity than generic ones (17,18).…”

“…(22). This instrument has not been translated into Urdu, although it has been translated into many other languages (18,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). Hence, the current study aimed to assess the psychometric properties and cultural adaptability of the Urdu version of WHOQOL-HIV Bref in PLWHA in Pakistan.…”