Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2017-0058
Trends in Psychiatry and Psychotherapy
Original Article

Psychometric properties of the World Health Organization Quality of Life Instrument-Abbreviated version in Portuguese-speaking adults from three different countries

Propriedades psicométricas do Instrumento de Qualidade de Vida da Organização Mundial de Saúde - Versão Abreviada em adultos falantes de língua portuguesa de três países diferentes

Wanderson Roberto da Silva; Fernanda Salloume Sampaio Bonafé; João Marôco; Benvindo Felismino Samuel Maloa; Juliana Alvares Duarte Bonini Campos

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Abstract

Abstract Objective: To evaluate the validity, reliability and invariance of the World Health Organization Quality of Life Instrument-Abbreviated version (WHOQOL-Bref) in Portuguese-speaking adults from three different countries. Methods: A total of 4,020 Brazilian, Portuguese, and Mozambican individuals participated in the study. The total sample was divided into four samples: Brazilian patients (n = 1,120), Brazilian students (n = 1,398), Portuguese students (n = 1,165) and Mozambican students (n = 337). Factorial validity of the WHOQOL-Bref was assessed by confirmatory factor analysis. The convergent and discriminant validities of the instrument were assessed using the average variance extracted (AVE) and the square of Pearson's correlational coefficient (r2), respectively. Composite reliability and ordinal alpha were used as measures of reliability. The metric, scalar, and strict invariance of WHOQOL-Bref was evaluated by multi-group analysis in independent subsamples (within each sample) and only between Brazil and Portugal (transnational invariance), because the configural model of Mozambique was different. Results: The original model of the WHOQOL-Bref did not show a good fit for the samples. Different items were excluded to fit the instrument in each sample (different models for WHOQOL-Bref among Brazilian, Portuguese, and Mozambican samples). AVE and r2 were not adequate; however, the reliability of the WHOQOL-Bref was good, except in the Mozambican sample. Invariance was observed only in independent subsamples. Conclusion: The WHOQOL-Bref fitted models showed adequate factorial validity and invariance in independent subsamples. The transnational non-invariance of the WHOQOL-Bref shows the influence of culture on the operationalization of the quality of life construct.

Keywords

Quality of life, validity, reliability, students, patients

Resumo

Resumo Objetivo: Avaliar a validade, a confiabilidade e a invariância do World Health Organization Quality of Life instrument-Abbreviated version (WHOQOL-Bref) em adultos de três diferentes países de língua portuguesa. Métodos: Um total de 4.020 indivíduos brasileiros, portugueses e moçambicanos participaram do estudo. A amostra total foi dividida em quatro amostras: pacientes brasileiros (n = 1.120), estudantes brasileiros (n = 1.398), estudantes portugueses (n = 1.165) e estudantes moçambicanos (n = 337). A validade fatorial do WHOQOL-Bref foi avaliada por meio de análise fatorial confirmatória. As validades convergente e discriminante do instrumento foram avaliadas utilizando a variância média extraída (VEM) e o quadrado do coeficiente de correlação de Pearson (r2), respectivamente. A confiabilidade composta e o coeficiente alfa ordinal foram utilizados como medidas de confiabilidade. As invariâncias métrica, escalar e estrita do WHOQOL-Bref foram avaliadas por análise multi-grupos em subamostras independentes (dentro de cada amostra) e somente entre Brasil e Portugal (transnacional), porque o modelo configuracional de Moçambique era diferente. Resultados: O modelo original do WHOQOL-Bref não apresentou bom ajustamento para as amostras. Diferentes itens foram excluídos para ajustar o instrumento em cada amostra (modelos diferentes para o WHOQOL-Bref entre amostras brasileiras, portuguesas e moçambicanas). A VEM e o r2 não foram adequados; entretanto, a confiabilidade do WHOQOL-Bref foi boa, exceto na amostra moçambicana. A invariância foi encontrada apenas em subamostras independentes. Conclusão: Os modelos ajustados do WHOQOL-Bref apresentaram adequada validade fatorial e invariância em subamostras independentes. A não invariância transnacional do WHOQOL-Bref revela a influência da cultura na operacionalização do construto qualidade de vida.

Palavras-chave

Qualidade de vida, validade, confiabilidade, estudantes, pacientes

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