Psychometric properties of the WHOQOL-BREF among next of kin to older persons in nursing homes

Abstract

Background: The worries of next of kin about their older loved ones in nursing homes can be extensive and can adversely affect their subjective experiences of their own physical, mental and social well-being. It is thus of utmost importance to measure the quality of life of next of kin in a valid and reliable way. Methods: The design is a cross-sectional study with psychometric evaluation based on classical test theory in preparation for a planned educational intervention study on palliative care. An abbreviated version of the World Health Organization's quality-of-life self-assessment instrument WHOQOL, the Swedish WHOQOL-BREF, was completed by 254 next of kin of older persons in 30 nursing homes. Data quality was assessed via the mean, median, item response, missing values, and floor and ceiling effects. Reliability was estimated using Cronbach's alpha and corrected item-total correlations. Construct validity was estimated by Spearman's rank correlation, and model fit was assessed using confirmatory factor analysis. Results: The rate of missing data was low (less than 2%). Ceiling effects ranged from 11 to 43% and were above 20% for 21 of 24 items. The corrected item-total correlations varied between 0.35 and 0.68 and were thus well above the lower limit of 0.30. Cronbach's alpha was 0.83, indicating satisfactory internal consistency. The confirmatory factor analysis indicated a fair to close model fit (comparative fit index 0.93, root mean squared error of approximation 0.06). Conclusions: The findings suggest that the WHOQOL-BREF may constitute a reliable and valid measure of quality of life for use among next of kin to older persons in nursing homes. When interpreting the results, it is important to assess the ceiling effect, as it may restrict the ability of the WHOQOL-BREF to detect true positive changes in quality of life over time. Trial registration: NCT02708498.

Multidimensional Inventory of Students Quality of Life—MIS-QOL

“…It is hard to trust results based on a single question-it is possible to assess the general score, but not the one connected with a given dimension. The WHO-QOL questionnaire consists of four dimensions [54][55][56]. In those dimensions, free time is assessed in one question, and finance, family, and friend dimensions are assessed in two questions.…”

Exploring the Psychometric Properties of the Questionnaire on Family Members Adapting to an Older Adult’s Admission to a Nursing Home (CAFIAR-15) in a Colombian Sample

“…The evaluation with standardized tools of the adaptation of the family member is practically absent in the literature. Only two studies have been found: one by Rosén et al [ 22 ] who evaluated quality of life using the World Health Organization’s quality-of-life self-assessment instrument (WHOQOL) in a sample of 254 family members in Sweden, and another work by Pérz-Dorado et al [ 23 ], who applied the “Zarit-caregiver burden scale” to a sample of 20 elderly relatives from a nursing home in Seville. However, quality of life is a broader concept than the adaptation of the family members, although they are interrelated and in the Spanish study with Zarit they found that, according to family members, there was no burden since the care for the elderly was in the hands of the nursing home staff; hence this questionnaire is of little use.…”

Instrumentos para la evaluación de la calidad de vida de adultos mayores. Un estudio de revisión bibliográfica

“…El cuestionario de Calidad de Vida de la Organización Mundial de la Salud en su versión corta (WHOQOL-BREF) fue desarrollado por el "WHOQOL Group" en el año de 1993, con la finalidad de medir la percepción de la persona, con o sin enfermedad, sobre su calidad de vida en general (global) y la satisfacción percibida en relación a su salud física, salud psicológica, relaciones sociales y el ambiente; su versión al español fue aprobada en el año de 1998, por el mismo grupo, su versión en sueco fue utilizada en una investigación con 254 familias de adultos mayores que viven en residencias, demostrando ser fiable 2675-5459 y con buena consistencia interna (Rosén, Ahlström & Lexén, 2020), existen otros estudios encontrados en versión pakistaní (Saquib-Lodhi et al, 2017), inglés, chino y malayo (Cheung et al, 2017), amárico (Reba, Birhane & Gutema, 2019), taiwanés (Lin et al, 2019). Para la validación del WHOQOL-BREF se aplicó la prueba a población en general, pacientes ambulatorios, pacientes con esquizofrenia y a sus cuidadores (Lucas, 1998); además, existen estudios que ilustran la validez del instrumento, aplicándolo a una muestra de 250 personas adultas mayores, quienes reflejaron satisfacción en las cuatro áreas específicas que mide la prueba, los resultados fueron: 62.72% para salud física, 62.78% para salud psicológica, 63.89% para relaciones interpersonales y 63.29% para el ambiente (Robles, 2017); en otro estudio, se evidenció una satisfacción global de 54.45% de los participantes y para el cálculo de las dimensiones se alcanzaron medias porcentuales de 39.32%, 42.67%, 39.30% y 37.40% respectivamente (Flores-Herrera et al, 2018).…”