The psychometric properties of the German version of the WHOQOL-OLD in the German population aged 60 and older

Health and Quality of Life Outcomes

Reinhold Kilian³  Carolin von Gottberg³  Steffi Riedel-Heller¹  Herbert Matschinger²  Ines Conrad¹ 

[1] Institute for Social Medicine, Occupational Health and Public Health, University of Leipzig, Medical Faculty, Philipp-Rosenthal-Str. 55, Leipzig, 04103, Germany;Institute of Health Economics and Health Service Research, University of Hamburg, Hamburg Center for Health Economics, Martinistr. 52, Hamburg, 20246, Germany;Department of Psychiatry and Psychotherapy II, Ulm University, Ludwig-Heilmeyer-Str. 2, Günzburg, 89312, Germany

关键词: Psychometric properties;    Representative survey;    WHOQOL-OLD;    Old age;    Quality of life;   

Others  :  1164527
DOI  :  10.1186/s12955-014-0105-4

 received in 2014-02-24, accepted in 2014-06-19,  发布年份 2014

【 摘 要 】

Background

The WHOQOL-OLD is an instrument for the assessment of subjective quality of life in elderly people. It is based on the WHO definition of quality of life and is available in more than 20 languages. However, in most countries, the psychometric properties of the WHOQOL-OLD have been assessed only on the basis of small local samples and not in representative studies. In this study, the psychometric properties of the WHOQOL-OLD are evaluated based on a representative sample of Germany¿s elderly population.

Methods

Face-to-face interviews with 1133 respondents from the German population aged 60 years and older were conducted. Quality of life was assessed by means of the WHOQOL-BREF, the WHOQOL-OLD and the SF12. Moreover, the GDS, the DemTect and the IADL were applied for the assessment of depressive symptoms, cognitive capacities and capacity for carrying out daily activities. Psychometric properties of the WHOQOL-OLD were evaluated by means of classical and probabilistic test theory, confirmatory factor analysis and multivariate regression model.

Results

Cronbach¿s alpha was found to be above 0.85 for four and above .75 for two of the six facets of the WHOQOL-OLD. IRT analyses indicated that all items of the WHOQOL-OLD contribute considerably to the measurement of the associated facets. While the six-facet structure of the WHOQOL-OLD was well supported by the results of the confirmatory factor analysis, a common latent factor for the WHOQOL-OLD total scale could not be identified. Correlations with other quality of life measures and multivariate regression models with GDS, IADL and the DemTect indicate a good criterion validity of all six WHOQOL-OLD facets.

Conclusions

Study results confirm that the good psychometric properties of the WHOQOL-OLD that have been found in international studies could be replicated in a representative study of the German population. These results suggest that the WHOQOL-OLD is an instrument that is well suited to identify the needs and the wishes of an aging population.

【 授权许可】

   
2014 Conrad et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]World population ageing 1950¿2021. United Nations, New York; 2002.
• [2][http:/ / www.census.gov/ Press-Release/ www/ releases/ archives/ facts_for_features_special_editions / 004210.html] webcite U.S. Census Press Release: Retrieved February 11, 2008 from. 2005, .
• [3]Maintaining prosperity in an ageing society. OECD, Paris; 1999.
• [4]Blane D, Higgs P, Hyde M, Wiggins R: Life course influences on quality of life in early old age. Soc Sci Med 2004, 58:2171-2179.
• [5]Baltes PB, Smith J: New frontiers in the future of aging: from successful aging of the young old to the dilemma of the fourth age. Gerontology 2003, 49:123-136.
• [6]Haywood KL, Garratt AM, Schmidt LJ, Mackintosh A, Fitzpatrick R: Health status and quality of life of life in older people: a review. National Centre for Health Outcomes Development, Oxford; 2004.
• [7]Bowling A: Measuring health. Open University Press, Buckingham; 1997.
• [8]Power M, Quinn K, Schmidt S: Development of the WHOQOL-Old Module. Qual Life Res 2005, 14:2197-2214.
• [9]Sarvimäki A, Stenbock-Hult B: Quality of life in old age described as a sence of well-being, meaning and value. J Adv Nurs 2000, 32:1025-1033.
• [10]Higgs P, Hyde M, Wiggins R, Blane D: Researching quality of life in early old age: the importance of the sociological dimension. Soc Policy Adm 2003, 37:239-252.
• [11]Hunt S: The problem of quality of life. Qual Life Res 1997, 6:205-212.
• [12]Study protocol for the World Health Organisation project to develop a quality of life assessment instrument (WHOQOL) Qual Life Res 1993, 2:153-159.
• [13]Kuyken W, Orley J (Eds): The development of the World Health Organization quality of life assessment instrument: The WHOQOL In Quality of Life Assessment: International Perspectives. Springer, Berlin; 1994:41-57.
• [14]Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment Psychol Med 1998, 28:551-558.
• [15]The World Health Organization Quality of Life Assessment (WHOQOL): Development and General Psychometric Properties Soc Sci Med 1998, 46:1569-1585.
• [16]Power M, Bullinger M, Harper A: The World Health Organization WHOQOL-100: Tests of the Universality of Quality of Life in 15 Different Cultural Groups Worldwide. Health Psychol 1999, 18:495-505.
• [17]Skevington S: Advancing cross-cultural research on quality of life: observations drawn from the WHOQOL development. Qual Life Res 2002, 11:135-144.
• [18]Saxena S, Carlson D, Billington R, Orley J: The WHO quality of life assessment instrument (WHOQOL-BREF): The importance of its items for cross-cultural research. Qual Life Res 2001, 10:711-721.
• [19]Angermeyer M, Kilian R, Matschinger H: WHOQOL-100 und WHOQOL-BREF. Handbuch für die deutschsprachige Version der WHO Instrumente zur Erfassung von Lebensqualität. Hogrefe, Göttingen; 2000.
• [20]Winkler I, Buyantugs L, Petscheleit A, Kilian R, Angermeyer M: Die interkulturelle Erfassung der Lebensqualität im Alter: Das WHOQOL-OLD-Projekt. Z f Gerontopsychologie und -psychiatrie 2003, 16:177-192.
• [21]Liu R, Wu S, Hao Y, Gu J, Fang J, Cai N, Zhang J: The Chinese version of the world health organization quality of life instrument-older adults module (WHOQOL-OLD): psychometric evaluation. Health Qual Life Outcomes 2013, 11:156. BioMed Central Full Text
• [22]Kalbe E, Kessler J, Calabrese P, Smith R, Passmore AP, Brand M, Bullock R: DemTect: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia. Int J Geriatr Psychiatry 2004, 19:136-143.
• [23]Winkler I, Matschinger H, Angermeyer M: The WHOQOL-OLD ¿ A questionnaire for the intercultural measuring of quality of life in the elderly. Psychother Psychosom Med Psychol 2006, 56:63-69.
• [24][http://www.rki.de] webcite Robert Koch Institut: Bundes-Gesundheitssurvey. 1998, Internet: ; Stand: 09.08.2012.
• [25]Kovar MG, Lawton MP: Functional disability: activities and instrumental activities of daily living. In Focus on assessment techniques. Volume 14. Edited by Lawton MP, Teresi JA. Springer, New York; 1994:57-75.
• [26]Lawton MP, Brody EM: Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969, 9:179-186.
• [27]Edelen MO, Reeve BB: Applying item response theory (IRT) modeling to questionnaire development, evaluation, and refinement. Qual Life Res 2007, 16:5-18.
• [28]Reeve BB, Hays RD, Chih-Hung C, Perfetto EM: Applying item response theory to enhance health outcomes assessment. Qual Life Res 2007, 16:1-3.
• [29]Cook KF, Teal CR, Bjorner JB, Cella D, Chih-Hung C, Crane PK, Gibbons LE, Hays RD, McHorney CA, Ocepek-Welikson K, Raczek AE, Teresi JA, Reeve BB: IRT health outcomes data analysis project: an overview and summary. Qual Life Res 2007, 16:121-132.
• [30]Dorans NJ: Linking scores from multiple health outcome instruments. Qual Life Res 2007, 16:85-94.
• [31]Masters GN: A Rasch model for partial credit scoring. Psychometrika 1982, 47:149-174.
• [32]Masters GN: The analysis of partial credit scoring. Appl Meas Educ 1988, 1:279-297.
• [33]Wright BD, Masters GN: Rating scale analysis. MESA Press, Chicago; 1982.
• [34]Rasch G: Probabilistic Models for Some Intelligence and Attainment Tests. The University of Chicago (Originally published 1960), Chicago; 1980.
• [35]Rost J: Measuring attitudes with a threshold model drawing on a traditional scaling concept. Appl Psychol Meas 1988, 12:397-409.
• [36]Masters GN, Wright BD: The essential process in a family of measurement models. Psychometrika 1984, 49:529-544.
• [37]Verhelst ND, Verstralen HHFM: Some considerations on the partial credit model. Psicologica 2008, 29:229-254.
• [38]Wright BD, Masters GN: Computation of OUTFIT and INFIT statistics. Rasch Meas Trans 1990, 3(4):84-85.
• [39]Bond TG, Fox CM: Applying the Rasch model. L. Erlbaum Mahwah, NJ; 2007.
• [40]Smith RM: Fit analysis in latent trait measurement models. J Appl Meas 2000, 1:199-218.
• [41]Smith RM: Polytomous mean-square fit statistics. Rasch Meas Trans 1996, 10:516-517.
• [42]Linacre JM, Wright BD: Reasonable mean square fit values. Rasch MeasTrans 1994, 83:370.
• [43]Rost J, von Davier M: A conditional item-fit index for Rasch models. Appl Psychol Meas 1994, 18:171-182.
• [44]Andrich D: Rasch Models for Measurement. SAGE Publications, Newbury Park; 1988.
• [45]von Davier M: WINMIRA; a program system for analysis with the Rasch Model, with the Latent Class Analysis and with the Mixed Rasch Model. IPN, Kiel; 2001.
• [46]Jöreskog KG: Statistical analysis of sets of congeneric tests. Psychometrika 1971, 36:109-133.
• [47]Muthén LK, Muthén BO: Mplus user¿s guide. Muthén & Muthén, Los Angeles; 2012.
• [48]Mair P, Hatzinger R: Extended Rasch modeling: the eRm package for the application of IRT models in R. J Stat Softw 2007, 20:1-20.
• [49]Rizopoulos D: An R package for latent variable modeling and item response theory analyses. J Stat Softw 2006, 17:1-25.
• [50]Stata Statistical Software: Release 13. StataCorp LP, TX; 2013.
• [51]Power M, Quinn K, Schmidt S: Development of the WHOQOL-OLD module. Qual Life Res 2005, 14:2197-2214.
• [52]Halvorsrud L, Kalfoss M, Diseth A: Reliability and validity of the Norwegian WHOQOL-OLD module. Scand J Caring Sci 2008, 22:292-305.
• [53]Chachamovich E, Fleck MP, Trentini C, Power M: Brazilian WHOQOL-OLD Module version: a Rasch analysis of a new instrument. Rev Saude Publica 2008, 42:308-316.
• [54]Fleck MP, Chachamovich E, Trentini CM: WHOQOL-OLD Project: method and focus group results in Brazil. Rev Saude Publica 2003, 37:793-799.
• [55]Leplege A, Perret-Guillaume C, Ecosse E, Hervy MP, Ankri J, von SN: A new instrument to measure quality of life in older people: the French version of the WHOQOL-OLD. Rev Med Interne 2013, 34:78-84.
• [56]Eser S, Saatli G, Eser E, Baydur H, Fidaner C: The reliability and validity of the Turkish Version of the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-Old). Turk Psikiyatri Derg 2010, 21:37-48.
• [57]Fang J, Power M, Lin Y, Zhang J, Hao Y, Chatterji S: Development of short versions for the WHOQOL-OLD module. Gerontologist 2012, 52:66-78.
• [58]Lucas-Carrasco R, Laidlaw K, Power MJ: Suitability of the WHOQOL-BREF and WHOQOL-OLD for Spanish older adults. Aging Ment Health 2011, 15:595-604.
• [59]Halvorsrud L, Kirkevold M, Diseth A, Kalfoss M: Quality of life model: predictors of quality of life among sick older adults. Res Theory Nurs Pract 2010, 24:241-259.
• [60]Chachamovich E, Fleck M, Laidlaw K, Power M: Impact of major depression and subsyndromal symptoms on quality of life and attitudes toward aging in an international sample of older adults. Gerontologist 2008, 48:593-602.
• [61]Molzahn AE, Kalfoss M, Schick MK, Skevington SM: Comparing the importance of different aspects of quality of life to older adults across diverse cultures. Age Ageing 2011, 40:192-199.
• [62]Dragomirecka E, Bartonova J, Eisemann M, Kalfoss M, Kilian R, Martiny K, von Steinbuechel N, Schmidt S: Demographic and psychosocial correlates of quality of life in the elderly from a cross-cultural perspective. Clin Psychol Psychother 2008, 15:193-204.