Quality of life of Chinese urban community residents: a psychometric study of the mainland Chinese version of the WHOQOL-BREF

Abstract

BackgroundThe short version of the World Health Organization's Quality of Life Instrument (WHOQOL-BREF) is widely validated and popularly used in assessing the subjective quality of life (QOL) of patients and the general public. We examined its psychometric properties in a large sample of community residents in mainland China.MethodsThe WHOQOL-BREF was administered to 1052 adult community residents in a major metropolitan city in southern China. The structural integrity of the 4-factor model in confirmatory factor analyses (CFA) and the relationship of QOL with demographic variables were examined. Validity was assessed using the known-group comparison (229 with vs. 823 without chronic illness), item-domain correlations, and CFA using the ML estimation in LISREL.ResultsInternal consistency reliability of the whole instrument (26 items) was 0.89, and the psychological, social, and environment domains had acceptable reliability (alpha = 0.76, 0.72, 0.78 respectively), while that of the physical domain was slightly lower (α = 0.67). The respective mean scores of these domains were 13.69, 14.11, 12.33 and 14.56. Item-domain correlations were much higher for corresponding domains than for non-corresponding domains, indicating good convergent validity. CFA provided a marginally acceptable fit to the a priori four-factor model when two matching content item pairs were allowed to be correlated; χ2 (244) = 1836, RMSEA = 0.088, NNFI = 0.898, CFI = 0.909. This factorial structure was shown to be equivalent between the participants with and without chronic illness. The differences in means between these two groups were significant but small in some domains; effect size = 0.55, 0.15, 0.18 in the physical, psychological, and social relationship domains respectively. Furthermore, males had significantly higher QOL scores than females in the psychological domain, while individuals with a younger age, higher income, and higher education levels also had significantly higher QOL. Compared with the international data, the Chinese in this study had relatively low QOL scores with about 5% of males and 16% of females being at risk for poor QOL.ConclusionsThis study has provided psychometric properties of the WHOQOL-BREF as used in China and should definitely be useful for researchers who would like to use or further refine the instrument.

Qualidade de vida e características associadas: aplicação do WHOQOL-BREF no contexto da Atenção Primária à Saúde

“…Regarding gender, women evidenced worse perception of QOL than men in all domains, but only for the psychological domain the difference was statistically significant. The same result was observed by other authors 19,27,35 , and the relationship between female gender and psychosocial factors is well reported in studies in the literature, where women reported having more negative feelings, low self-esteem and depression than men 36,37 . Living without partners was associated with a lower perception of QOL in the social relationship domains, as observed by other authors 12,19,38 .…”

“…In the environment domain, elderly individuals evidenced a better perception of QOL than did young adults. This result was also observed by other studies 18,27 and may be related to the provision of more adequate and safe environments for the elderly, such as long-term institutions, since adequate housing and physical environment have a positive influence on the elderly's QOL 28 . In a study by Vitorino et al 29 , elderly individuals in the community had lower QOL in the environment domain compared to the elderly in long-term institutions.…”

A study on correlation between depression, fear of fall and quality of life in elderly individuals

“…23 In India, the psychometric properties of the WHOQOL-BREF have been tested, and good reliability and validity demonstrated for elderly people. 24 Cumming and colleagues reported that low baseline FES scores in elderly people were associated with greater declines in self-reported ADL performance over a 12-month period. 25 Mendes de Leon and colleagues examined the role of falls-related self-efficacy on changes in physical functioning in elderly people in an effort to determine if self-efficacy would be protective of self-care behaviors.…”

Validade dimensional do instrumento de qualidade de vida WHOQOL-BREF aplicado a trabalhadores de saúde

“…Quanto a sua dimensionalidade, nove estudos utilizaram a abordagem confirmatória para avaliar a estrutura dimensional de 24 itens distribuídos em quatro domínios, excluindo os dois itens da faceta geral ("qualidade de vida" e "saú-de") 17,18,19,21,22,23,24,25,26,27 . Porém, pelo menos um índice de ajuste não foi adequado -comparative fit index (CFI) < 0,90 17,18,21,22,23,25,27 e root mean square error of approximation (RMSEA) > 0,08 26,27 , ou o modelo final indicou seis 6,22 ao invés de quatro fatores (Tabela 2).…”

“…Porém, pelo menos um índice de ajuste não foi adequado -comparative fit index (CFI) < 0,90 17,18,21,22,23,25,27 e root mean square error of approximation (RMSEA) > 0,08 26,27 , ou o modelo final indicou seis 6,22 ao invés de quatro fatores (Tabela 2). Análise fatorial exploratória resultou em modelos com quatro e cinco fatores ou itens agrupando-se em fatores diferentes dos sugeridos pelo grupo WHOQOL 5,20,28,29,30,31 (Tabela 2).…”