Psychometric evaluation of the WHOQOL-BREF in community-dwelling older people in Taiwan using Rasch analysis

Wen Miin Liang; Chih Hung Chang; Yi Chun Yeh; Haw Yaw Shy; Hung Wei Chen; Mau Roung Lin

doi:10.1007/s11136-009-9471-5

Psychometric evaluation of the WHOQOL-BREF in community-dwelling older people in Taiwan using Rasch analysis

Wen Miin Liang, Chih Hung Chang, Yi Chun Yeh, Haw Yaw Shy, Hung Wei Chen, Mau Roung Lin^*

^*Corresponding author for this work

Medicine, General Medicine Division

Research output: Contribution to journal › Article › peer-review

36 Scopus citations

Abstract

Objective: To examine the psychometric characteristics of the brief version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire in rural-community-dwelling older people in Taiwan using Rasch analysis. Methods: This is a cross-sectional study. A total of 1200 subjects aged 65 years were recruited to complete the 26-item WHOQOL-BREF. Scale dimensionality, item difficulty, scale reliability and separation, item targeting, item-person map, and differential item functioning (DIF) were examined. Results: The four WHOQOL-BREF scales (physical capacity, psychological well-being, social relationships, and environment) were found to be unidimensional and reliable. The item-person map for each domain indicated that the spread of the item thresholds sufficiently covered the latent trait continuum being measured. However, gaps in content coverage were identified in the social domain. Analyses of the DIF revealed that one psychological item (body image) exhibited DIF across the two age groups (old-old vs. young-old) and that two social items (sexual activity and friends' support) displayed DIF across genders and the two age groups. Conclusions: Rasch analysis is a comprehensive method of psychometric evaluation of the WHOQOL-BREF and identifies areas for improvements. Three items displaying age-related DIF (body image, sexual activity, and friends' support) may potentially cause biased health-related QOL assessments, and their impacts on scores should be carefully examined.

Original language	English (US)
Pages (from-to)	605-618
Number of pages	14
Journal	Quality of Life Research
Volume	18
Issue number	5
DOIs	https://doi.org/10.1007/s11136-009-9471-5
State	Published - Jun 2009

Funding

Acknowledgments This study was supported by the National Health Research Institutes (NHRI-EX98-9805PI and NHRI-EX95-9204PP), China Medical University (CMU96-225), and the National Science Council (NSC93-2320-B-039-013 and NSC95-2314-B-038-008) of Taiwan, Republic of China. We are most grateful to all of the subjects who participated in this study.

Keywords

Health-related quality of life
Item response theory
Older people
Rasch model
WHOQOL-BREF

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health

Access to Document

10.1007/s11136-009-9471-5

Cite this

@article{4eee493c3823475f9f41240993e084df,

title = "Psychometric evaluation of the WHOQOL-BREF in community-dwelling older people in Taiwan using Rasch analysis",

abstract = "Objective: To examine the psychometric characteristics of the brief version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire in rural-community-dwelling older people in Taiwan using Rasch analysis. Methods: This is a cross-sectional study. A total of 1200 subjects aged 65 years were recruited to complete the 26-item WHOQOL-BREF. Scale dimensionality, item difficulty, scale reliability and separation, item targeting, item-person map, and differential item functioning (DIF) were examined. Results: The four WHOQOL-BREF scales (physical capacity, psychological well-being, social relationships, and environment) were found to be unidimensional and reliable. The item-person map for each domain indicated that the spread of the item thresholds sufficiently covered the latent trait continuum being measured. However, gaps in content coverage were identified in the social domain. Analyses of the DIF revealed that one psychological item (body image) exhibited DIF across the two age groups (old-old vs. young-old) and that two social items (sexual activity and friends' support) displayed DIF across genders and the two age groups. Conclusions: Rasch analysis is a comprehensive method of psychometric evaluation of the WHOQOL-BREF and identifies areas for improvements. Three items displaying age-related DIF (body image, sexual activity, and friends' support) may potentially cause biased health-related QOL assessments, and their impacts on scores should be carefully examined.",

keywords = "Health-related quality of life, Item response theory, Older people, Rasch model, WHOQOL-BREF",

author = "Liang, {Wen Miin} and Chang, {Chih Hung} and Yeh, {Yi Chun} and Shy, {Haw Yaw} and Chen, {Hung Wei} and Lin, {Mau Roung}",

note = "Funding Information: Acknowledgments This study was supported by the National Health Research Institutes (NHRI-EX98-9805PI and NHRI-EX95-9204PP), China Medical University (CMU96-225), and the National Science Council (NSC93-2320-B-039-013 and NSC95-2314-B-038-008) of Taiwan, Republic of China. We are most grateful to all of the subjects who participated in this study.",

year = "2009",

month = jun,

doi = "10.1007/s11136-009-9471-5",

language = "English (US)",

volume = "18",

pages = "605--618",

journal = "Quality of Life Research",

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T1 - Psychometric evaluation of the WHOQOL-BREF in community-dwelling older people in Taiwan using Rasch analysis

AU - Liang, Wen Miin

AU - Chang, Chih Hung

AU - Yeh, Yi Chun

AU - Shy, Haw Yaw

AU - Chen, Hung Wei

AU - Lin, Mau Roung

N1 - Funding Information: Acknowledgments This study was supported by the National Health Research Institutes (NHRI-EX98-9805PI and NHRI-EX95-9204PP), China Medical University (CMU96-225), and the National Science Council (NSC93-2320-B-039-013 and NSC95-2314-B-038-008) of Taiwan, Republic of China. We are most grateful to all of the subjects who participated in this study.

PY - 2009/6

Y1 - 2009/6

N2 - Objective: To examine the psychometric characteristics of the brief version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire in rural-community-dwelling older people in Taiwan using Rasch analysis. Methods: This is a cross-sectional study. A total of 1200 subjects aged 65 years were recruited to complete the 26-item WHOQOL-BREF. Scale dimensionality, item difficulty, scale reliability and separation, item targeting, item-person map, and differential item functioning (DIF) were examined. Results: The four WHOQOL-BREF scales (physical capacity, psychological well-being, social relationships, and environment) were found to be unidimensional and reliable. The item-person map for each domain indicated that the spread of the item thresholds sufficiently covered the latent trait continuum being measured. However, gaps in content coverage were identified in the social domain. Analyses of the DIF revealed that one psychological item (body image) exhibited DIF across the two age groups (old-old vs. young-old) and that two social items (sexual activity and friends' support) displayed DIF across genders and the two age groups. Conclusions: Rasch analysis is a comprehensive method of psychometric evaluation of the WHOQOL-BREF and identifies areas for improvements. Three items displaying age-related DIF (body image, sexual activity, and friends' support) may potentially cause biased health-related QOL assessments, and their impacts on scores should be carefully examined.

AB - Objective: To examine the psychometric characteristics of the brief version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire in rural-community-dwelling older people in Taiwan using Rasch analysis. Methods: This is a cross-sectional study. A total of 1200 subjects aged 65 years were recruited to complete the 26-item WHOQOL-BREF. Scale dimensionality, item difficulty, scale reliability and separation, item targeting, item-person map, and differential item functioning (DIF) were examined. Results: The four WHOQOL-BREF scales (physical capacity, psychological well-being, social relationships, and environment) were found to be unidimensional and reliable. The item-person map for each domain indicated that the spread of the item thresholds sufficiently covered the latent trait continuum being measured. However, gaps in content coverage were identified in the social domain. Analyses of the DIF revealed that one psychological item (body image) exhibited DIF across the two age groups (old-old vs. young-old) and that two social items (sexual activity and friends' support) displayed DIF across genders and the two age groups. Conclusions: Rasch analysis is a comprehensive method of psychometric evaluation of the WHOQOL-BREF and identifies areas for improvements. Three items displaying age-related DIF (body image, sexual activity, and friends' support) may potentially cause biased health-related QOL assessments, and their impacts on scores should be carefully examined.

KW - Health-related quality of life

KW - Item response theory

KW - Older people

KW - Rasch model

KW - WHOQOL-BREF

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SN - 0962-9343

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JF - Quality of Life Research

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ER -

Psychometric evaluation of the WHOQOL-BREF in community-dwelling older people in Taiwan using Rasch analysis

Abstract

Funding

Keywords

ASJC Scopus subject areas

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