Abstract
BackgroundThe goal of this article was to research the psychometric properties of the WHOQOL-BREF(PT) instrument in a sample of elderly citizens residing in a rural area in their own homes or at family members’ or friends’ homes and to compare the results: (i) to those reported by the team of Portuguese researchers that undertaken the instrument's translation/validation to the Portuguese language and (ii) to those reported internationally by the World Health Organization Quality of Life group. An overall quality of life scoring (QOL24—all facets) is also proposed in this article as novelty. The correlation level between QOL24 and the instrument’s general facet was also investigated.MethodsThis was a cross-sectional study with a sample of 351 elderly citizens (46.4% males and 53.6% females) randomly selected from the official dataset of the Local Health Unit of Baixo Alentejo. All the data were collected by health professionals at the participants’ homes following the structured interview methodology and using the WHOQOL-BREF(PT) instrument. Three different structural equation models were developed: (i) a first-order confirmatory factor analysis, to assess the instrument’s psychometric properties; (ii) a hierarchical second-order confirmatory factor analysis model, to allow determining the QOL24 scoring; and (iii) a more generic structural equation model, to investigate the correlation level between QOL24 and the instrument’s general facet.ResultsThe WHOQOL-BREF(PT) showed an “almost very good” goodness of fit (comparative fit index of 0.949 and Tucker-Lewis index of 0.943), an adequate internal consistency (Cronbach’s alpha: from 0.64 to 0.90; composite reliability: from 0.59 to 0.88) and tolerable convergent validity (average variance extracted: from 0.374 to 0.614). However, discriminant validity was not reached because strong correlations between the first-order factors (four QOL domains) were obtained, together with low values of the average variance extracted. The scoring of QOL domains and QOL24, determined as weighted averages (proposed in this article as novelty) were significantly different than those determined as unweighted averages. The standardized correlation coefficient between QOL24 and the instrument’s general facet was of 0.89 (statistically highly significant).ConclusionsThe WHOQOL-BREF(PT) is a psychometrically sound instrument to assess the QOL of the considered population sample. However, the QOL domains were found strongly intertwined. More studies are necessary to validate the weighted average scoring strategy of QOL domains and QOL24. Concurrent validity between QOL24 and the instrument’s general facet was considered as “strong”.
Highlights
The goal of this article was to research the psychometric properties of the WHOQOL-BREF(PT) instrument in a sample of elderly citizens residing in a rural area in their own homes or at family members’ or friends’ homes and to compare the results: (i) to those reported by the team of Portuguese researchers that undertaken the instrument’s translation/validation to the Portuguese language and (ii) to those reported internationally by the World Health Organization Quality of Life group
Study area The Baixo Alentejo (BA) region [34] was chosen for this research because: (i) it presents a complex, worrisome and heterogeneous sociodemographic situation in regard to population aging; (ii) it has a significant rural context since it is located in the south-central area of mainland Portugal; (iii) it has a very low population density, with geographic distances between villages ranging from 25 to 120 km; and (iv) it has a limited and insufficient public transportation network, causing serious difficulties in terms of the displacement of elderly citizens living on their own means
The findings reported in the previous section seem to suggest that the WHOQOLBREF(PT) instrument showed an “almost very good” goodness of fit
Summary
The goal of this article was to research the psychometric properties of the WHOQOL-BREF(PT) instrument in a sample of elderly citizens residing in a rural area in their own homes or at family members’ or friends’ homes and to compare the results: (i) to those reported by the team of Portuguese researchers that undertaken the instrument’s translation/validation to the Portuguese language and (ii) to those reported internationally by the World Health Organization Quality of Life group. It is important to understand whether health care delivery provides "value" for the patients themselves [11], as well as to realize patients’ concerns, hopes and expectations, rather than reducing their deficiencies and disabilities adopting only a biological and functional perspective [4, 12]. This approach has motivated researchers and organizations worldwide to understand how comorbidities truly affect individuals’ life, mainly in older age groups, and how these individuals self-report their disease burden [13]
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