Abstract
Objective
To use Rasch analysis to validate the World Health Organization Quality of Life-BREF
(WHOQOL-BREF) and existing short versions in individuals with traumatic brain injury
and orthopedic injuries, with comparisons to a general population group.
Design
The Partial Credit Rasch model was applied to evaluate the WHOQOL-BREF as well as
shortened versions using a cross-sectional study design.
Setting
Regional hospital, and national electoral sample in New Zealand.
Participants
Individuals with traumatic brain injury (n=74), individuals with orthopedic injuries
(n=114), general population (n=140).
Interventions
None.
Main Outcome Measure
WHOQOL-BREF.
Results
The WHOQOL-BREF met expectations of the unidimensional Rasch model and demonstrated
good reliability (person separation index [PSI] =0.82) when domain items were combined
into physical-psychological, social, and environmental superitems. Analysis of shorter
versions, the EUROHIS-QOL-8 and World Health Organization Quality of Life-5 (WHOQOL-5),
indicated overall acceptable fit to the Rasch model and evidence of unidimensionality.
The EUROHIS-QOL-8 showed good reliability (PSI=0.81); however, reliability of the
WHOQOL-5 (PSI=0.68) was below acceptable standards for group comparisons, in addition
to demonstrating poor person-item targeting.
Conclusions
The WHOQOL-BREF and the 8-item EUROHIS-QOL-8 version are both reliable and valid in
the assessment of quality of life in both injury and general populations. Ordinal-interval
conversion tables published for these validated scales as well as for the WHOQOL-5
can be used to improve precision of assessment. The transformation of ordinal scale
scores into an interval measure of health-related quality of life also permits the
calculation of a single summary score for the WHOQOL-BREF, which will be useful in
a wide range of clinical and research contexts. Further validation work of the WHOQOL-5
is needed to ascertain its psychometric properties.
Keywords
List of abbreviations:
DIF (differential item functioning), HRQOL (health-related quality of life), PSI (person separation index), TBI (traumatic brain injury), WHOQOL-5 (World Health Organization Quality of Life-5), WHOQOL-BREF (World Health Organization Quality of Life-BREF)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 20, 2019
Footnotes
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
