Preliminary Validation Study of the WHO Quality of Life (WHOQOL) Scales for People with Spinal Cord Injury in Mainland China

Overview

Journal J Spinal Cord Med

Date 2020 Dec 2

PMID 33263492

Citations 4

Authors

Feng-Shui Chang

Qi Zhang

Hai-Xia Xie

Hui-Fang Wang

Yu-Hui Yang

Ying Gao

Chuan-Wei Fu

Gang Chen

Jun Lu

Affiliations

Soon will be listed here.

Abstract

Objective: To validate the WHOQOL Scales (WHOQOL-BREF and WHOQOL-DIS module) for people with spinal cord injury in Mainland China.

Design: Cross-sectional study.

Setting: Shanghai Sunshine Rehabilitation Center.

Participants: 249 adults with SCI who were admitted to a rehabilitation training program between 2017 and 2019.

Interventions: Not applicable.

Methods: Questionnaires about personal and injury characteristics, the WHOQOL Scales, global QOL, Zung Self-Rating Anxiety/Depression Scale (SAS/SDS), and Community Integration Questionnaire (CIQ) were administrated. Floor and ceiling effects, reliability, and validity analyses were tested.

Results: The 8 domains of the WHOQOL Scales showed no floor or ceiling effects. Cronbach alpha values of the WHOQOL-BREF and the WHOQOL-DIS were 0.93 and 0.78, respectively. Test-retest reliability was good for the WHOQOL Scales. Satisfactory criterion-related validity was shown by the correlation analysis among the WHOQOL Scales, SAS/SDS, CIQ, and global QOL. Good item-domain correlations (>0.50) were found for 38 items of the 39-item WHOQOL Scales, excepting the "impact of disability" (0.48) of the WHOQOL-DIS. Confirmatory Factor Analysis (CFA) supported a construct of the WHOQOL-DIS as made of four domains: autonomy, social inclusion, social activities, and discrimination. CFI and RMSEA values were 0.91 and 0.07, respectively, for the four-domain structure WHOQOL-DIS, with a higher-order factor. WHOQOL-BREF domains and WHOQOL-DIS scores showed the predicted pattern among known groups.

Conclusion: The WHOQOL Scales are valid and reliable, and they can be used to measure QOL in people with SCI in China. We suggest the WHOQOL-DIS be analyzed as one general item constituting a single 12-item domain.

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