Reliability and validity of the Dari version of the World Health Organization quality of life (WHOQOL-BREF) questionnaire in Afghanistan

Year 2021, Volume: 19 Issue: 3, 263 - 273, 02.12.2021

Nasar Ahmad Shayan , Erhan Eser , Ahmad Neyazi , Sultan Eser

https://doi.org/10.20518/tjph.910601

Cited By: 1

Abstract

Objective: The aim of this study was to culturally adapt and validate the WHOQOLBREF into Dari language of Afghanistan.Methods: This study consisted of two stages: translation stage and psychometric analyses. Reliability analyses were done by Internal consistency (alpha value) and item total correlations and validity analyses consisted of convergent validity by SF-36 scale, confirmatory factor analyses and criterion validity (multiple linear regression by overall QoL item-q1) analyses. Acceptable type 1 error was considered as 0.05 in all analyses (n=1473). Analyses were done by using Lisrel v8.05 statistical package.Results: Item-domain correlations and -if item deletedCronbach alpha values detected no problematic item. The range of alpha values is 0.79-0.80, except for the social relations domain (alpha=0.41). Confirmatory factor analyses revealed goodness of fit results as: GFI: 0.88, CFI: 0.83; and RMSEA: 0.073.
Physical and Psychological domains of the WHOQOL-BREF was highly correlated with the related domains of the SF-36 (r=0.60 and 0.64). All of the known groups’ categories were significantly sensitive to all domain scores of the WHOQOL (p<0.001). Multiple regression analysis revealed a R2 value of 35% and all domains.Conclusion:Afghan Dari version of the WHOQOL-BREF can confidently be used in clinical and population settings to assess the QoL of the people. Findings of the social relations domain should
be interpreted with caution due to its poor psychometric power. Further studies are
needed to address the social aspects of quality of life in Afghan population.

Keywords

Quality of life, World Health Organization, reliability and validity, Afghanistan

Thanks

Thanks to Ghalib University for their collaboration in making this study possible.

Dünya Sağlık Örgütü yaşam kalitesi ölçeği Afgan Dari sürümünün (WHOQOL-Bref-Dari) geçerliliği ve güvenilirliği

Abstract

Amaç: Bu çalışmanın amacı, Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği Kısa sürümünü (WHOQOL-BREF) Afganistan’ın Dari diline kültürel olarak uyarlamak ve psikometrik özelliklerini ortaya koymaktdır.Yöntem: Bu çalışma iki aşamadan oluşmaktadır: çeviri aşaması ve psikometrik çözümlemeler. Güvenilirlik, iç tutarlılık (alfa değeri) ve madde toplam korelasyonları ile araştırılmıştır. Ölçeğin geçerlilik çözümlemeleri, SF36 ölçeği ile birleşim-ayrışım geçerliliği, doğrulayıcı faktör analizleri ve ölçüt geçerliliği
(genel YK madde-q1 ile çoklu doğrusal regresyon) analizlerinden oluşmaktadır. İstatistik çözümlemelerde tip 1 hata sınırı 0.05 olarak kabul edilmiş, çözümlemeler Lisrel v8.05 ve SPSS 23 istatistik paketleri kullanılarak yapılmıştır.Bulgular: Bütün istatistik çözümlemeler Heart toplumundan gönüllülerden oluşan 1473 yetişkin birey üzerinde yürütülmüştür. Alfa değerleri aralığı, sosyal ilişkiler alanı (alfa = 0.41) dışındaki alanlarda 0.79-0.80’dir. Madde-alan korelasyonları ve-madde silininceCronbach alfa değerleri sonuçları, ölçeğin psikometrik açıdan sorunlu maddesinin olmadığını ortaya koymuştur. Doğrulayıcı faktör analizleri uyum iyiliği göstergeleri şöyledir: GFI: 0.88, CFI: 0.83; ve RMSEA: 0.073. WHOQOL-BREF’in fiziksel ve psikolojik
alanları, SF-36’nın ilgili alanlarıyla orta-yüksek oranda korelasyon göstermiştir (r = 0.60 ve 0.64). Bilinen tüm grupların kategorileri, WHOQOL’un tüm alan puanlarına önemli ölçüde duyarlıydı (p <0.001). Çoklu regresyon çözümlemesi 0.35’lik bir belirleyicilik katsayısı (R2) değeri ortaya çıkardı.Sonuç: WHOQOL-BREF’in Afgan Dari versiyonu, insanların yaşam kalitesini değerlendirmek için klinik ve nüfus ortamlarında güvenle kullanılabilir. Sosyal ilişkiler alanının bulguları, psikometrik
gücünün zayıf olması nedeniyle dikkatle yorumlanmalıdır. Afgan nüfusunda yaşam
kalitesinin sosyal yönlerini ele almak için daha fazla çalışmaya ihtiyaç vardır

Keywords

Yaşam kalitesi, Dünya Sağlık Örgütü, güvenilirlik ve geçerlilik, Afganistan

References

• Noerholm V, Groenvold M, Watt T, Bjorner JB, Rasmussen NA, Bech P. Quality of life in the Danish general population--normative data and validity of WHOQOL-BREF using Rasch and item response theory models. Qual Life Res 2004;13(2):531–40.
• Cheung YB, Yeo KK, Chong KJ, Khoo EYH, Wee HL. Measurement equivalence of the English, Chinese and Malay versions of the World Health Organization quality of life (WHOQOL-BREF) questionnaires. Health and Quality of Life Outcomes 2019;17;17(1):67.
• Lin C-Y, Lee T-Y, Sun Z-J, Yang Y-C, Wu J-S, Ou H-T. Development of diabetesspecific quality of life module to be in conjunction with the World Health Organization quality of life scale brief version (WHOQOL-BREF). Health Qual Life Outcomes 2017;23;15(1):167.
• WHO. WHOQOL - Measuring Quality of Life| The World Health Organization [online]. Available from: https://www.who.int/tools/whoqol. Accessed March 26, 2021.
• Bowden A, Fox-Rushby JA. A systematic and critical review of the process of translation and adaptation of generic health-related quality of life measures in Africa, Asia, Eastern Europe, the Middle East, South America. Soc Sci Med 2003;57(7):1289–306.
• Sreedevi A, Cherkil S, Kuttikattu DS, Kamalamma L, Oldenburg B. Validation of WHOQOL-BREF in Malayalam and Determinants of Quality of Life Among People With Type 2 Diabetes in Kerala, India. Asia Pac J Public Health 2016;28(1 Suppl):62S-69S.
• Lodhi FS, Montazeri A, Nedjat S, Mahmoodi M, Farooq U, Yaseri M, et al. Assessing the quality of life among Pakistani general population and their associated factors by using the World Health Organization’s quality of life instrument (WHOQOL-BREF): a population based cross-sectional study. Health Qual Life Outcomes 2019;14;17(1):9.
• Skevington SM, Lotfy M, O’Connell KA, WHOQOL Group. The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res 2004;13(2):299–310.
• Bonomi AE, Patrick DL, Bushnell DM, Martin M. Validation of the United States’ version of the World Health Organization Quality of Life (WHOQOL) instrument. J Clin Epidemiol 2000;53(1):1–12.
• Dalky HF, Meininger JC, Al-Ali NM. The Reliability and Validity of the Arabic World Health Organization Quality of Life-BREF Instrument Among Family Caregivers of Relatives With Psychiatric Illnesses in Jordan. J Nurs Res 2017;25(3):224–30.
• Muller AE, Skurtveit S, Clausen T. Performance of the WHOQOL-BREF among Norwegian substance use disorder patients. BMC Medical Research Methodology 2019;4;19(1):44.
• Colbourn T, Masache G, Skordis-Worrall J. Development, reliability and validity of the Chichewa WHOQOL-BREF in adults in Lilongwe, Malawi. BMC Res Notes 2012;3;5:346.
• Nedjat S, Montazeri A, Holakouie K, Mohammad K, Majdzadeh R. Psychometric properties of the Iranian interview-administered version of the World Health Organization’s Quality of Life Questionnaire (WHOQOL-BREF):A population-based study. BMC Health Services Research 2008;21;8(1):61.
• Reba K, Birhane BW, Gutema H. Validity and Reliability of the Amharic Version of the World Health Organization’s Quality of Life Questionnaire (WHOQOLBREF) in Patients with Diagnosed Type 2 Diabetes in Felege Hiwot Referral Hospital, Ethiopia. J Diabetes Res 2019;2019:3513159.
• Yao G, Chung C-W, Yu C-F, Wang J-D. Development and verification of validity and reliability of the WHOQOL-BREF Taiwan version. J Formos Med Assoc 2002;101(5):342–51.
• Ware JE, Kosinski M. SF-36 physical & mental health summary scales: a manual for users of version 1. Lincoln, RI: QualityMetric. [online]. Available at: https://www.worldcat.org/title/sf-36-physical-and-mental-health-summaryscales-a-users-manual/oclc/32249001. Accessed March 26, 2021.
• Shayan NA, Arslan UE, Hooshmand AM, Arshad MZ, Ozcebe H. The Short Form Health Survey (SF-36): translation and validation study in Afghanistan. East Mediterr Health J 2020;25;26(8):899–908.
• World Population Review. Population of Cities in Afghanistan. [online]. Available from: https://worldpopulationreview.com/countries/cities/afghanistan. Accessed March 26, 2021.
• Dorofeev S, Grant P. Statistics for Real-Life Sample Surveys: Non-Simple-Random Samples and Weighted Data. Cambridge University Press. [online]. Available at: https://www.amazon.com/StatisticsReal-Life-Sample-Surveys-Non-SimpleRandom-ebook/dp/B001OW6O12. Accessed March 26, 2021.
• Andresen EM. Criteria for assessing the tools of disability outcomes research. Arch Phys Med Rehabil 2000;81(12 Suppl 2):S15-20.
• Hooper D, Coughlan J, Mullen M. Structural Equation Modelling: Guidelines for Determining Model Fit. [online]. Available at: https://arrow.tudublin.ie/buschmanart/2. Accessed March 26, 2021.
• Nunnally JC. Psychometric Theory 3E. Tata McGraw-Hill Education. [online]. Available at: https://books.google.mv/books?id=_6R_f3G58JsC&sitesec=reviews&hl=en. Accessed March 26, 2021.
• Cohen J. Statistical Power Analysis. Curr Dir Psychol Sci. [online]. Available at: https://journals.sagepub.com/ doi/10.1111/1467-8721.ep10768783. Accessed March 26, 2021.
• Rahimzai M, Amiri M, Burhani NH, Leatherman S, Hiltebeitel S, Rahmanzai AJ. Afghanistan’s national strategy for improving quality in health care. International Journal for Quality in Health Care 2013;1;25(3):270–6.
• Meiselman H. Quality of Life, Well-Being and Wellness: Measuring Subjective Health for Foods and Other Products. Food Quality and Preference 2016;1;54.
• Krägeloh CU, Kersten P, Rex Billington D, Hsu PH-C, Shepherd D, Landon J, et al. Validation of the WHOQOL-BREF quality of life questionnaire for generaluse in New Zealand: confirmatory factor analysis and Rasch analysis. Qual Life Res 2013;22(6):1451–7.
• Redko C, Rogers N, Bule L, Siad H, Choh A. Development and validation of the Somali WHOQOL-BREF among refugees living in the USA. Qual Life Res 2015;24(6):1503–13.
• Izutsu T, Tsutsumi A, Islam A, Matsuo Y, Yamada HS, Kurita H, et al. Validity and reliability of the Bangla version of WHOQOL-BREF on an adolescent population in Bangladesh. Qual Life Res 2005;14(7):1783–9.
• Price B, Conteh J, Esliker R. Development and Validation of the Krio Version of the WHOQOL-BREF for Use in Sierra Leone. SN Comprehensive Clinical Medicine 2020;2(1):42–51.
• Erhan E, Fidaner H, Fidaner C, Eser S, Elbi H. Psychometric properties of tlte WHOQOL-100 and WHOOOL-BREF. 3P DKRCİSİ 1999;(7):33–40.
• Jaracz K, Kalfoss M, Górna K, Baczyk G. Quality of life in Polish respondents: psychometric properties of the Polish WHOQOL-Bref. Scand J Caring Sci 2006;20(3):251–60.
• Skevington SM, Lotfy M, O’Connell KA, WHOQOL Group. The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res 2004;13(2):299–310.
• Castro PC, Driusso P, Oishi J. Convergent validity between SF-36 and WHOQOLBREF in older adults. Rev Saude Publica 2014;48(1):63–7.
• Chang C-Y, Huang C-K, Chang Y-Y, Tai C-M, Lin J-T, Wang J-D. Cross-validation of the Taiwan version of the MooreheadArdelt Quality of Life Questionnaire II with WHOQOL and SF-36. Obes Surg 2010;20(11):1568–74.
• Hao Y-T, Fang J-Q, Power MJ. The Equivalence of WHOQOL-BREF among 13 Culture Versions. [The Equivalence of WHOQOL-BREF among 13 Culture Versions.]. Chinese Mental Health Journal 2006;20(2):71–5.
• Yoshitake N, Sun Y, Sugawara M, Matsumoto S, Sakai A, Takaoka J, et al. The psychometric properties of the WHOQOL-BREF in Japanese couples. Health Psychol Open 2015;5.
• da Silva WR, Bonafé FSS, Marôco J, Maloa BFS, Campos JADB. Psychometric properties of the World Health Organization Quality of Life InstrumentAbbreviated version in Portuguesespeaking adults from three different countries. Trends in Psychiatry and Psychotherapy 2018;40(2):104–13.