Graduate Program in Medical Sciences: Psychiatry-UFRGS, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
Value Health. 2012 May;15(3):449-57. doi: 10.1016/j.jval.2011.11.035. Epub 2012 Feb 9.
To test the psychometric properties of the EUROHIS-QOL 8-item index, a shortened version of the World Health Organization Quality of Life Instrument-Abbreviated Version (WHOQOL-BREF).
The sample consisted of 2359 subjects identified from primary care settings, with 1193 having a confirmed diagnosis of depression. Data came from six countries (Australia, Brazil, Israel, Russia, Spain, and the United States) involved in a large international study, the Longitudinal Investigation of Depression Outcomes. The structure of the EUROHIS-QOL 8-item index follows that of the WHOQOL-BREF assessment. Internal consistency was measured by using Cronbach's alpha. Convergent validity was assessed by using correlations with different measures for mental health (Symptom Checklist 90), physical health (self-evaluation), and quality of life (WHOQOL-BREF and short form 36 health survey). Discriminant group validity was assessed between diagnosed depressed and nondepressed patients. Differential item functioning and unidimensionality were analyzed by using Rasch analysis. Factor structure was assessed with structural equation modeling analyses.
Internal consistency was acceptable (ranged between 0.72 and 0.81 across countries), and the index discriminated well between depression (t = 6.31-20.33; P < 0.001) across all countries. Correlations between the EUROHIS-QOL 8-item index and different measures--Symptom Checklist 90 (r = -0.42), physical health (r = -0.42), WHOQOL-BREF domains (r = 0.61-0.77), and short form 36 health survey (r = 0.58)--were all significant (P < 0.001). The index is unidimensional with desired item fit statistics. Two items ("daily living activities" and "enough money to meet your needs") had residuals exceeding 4. Differential item functioning was observed with general quality of life, general health, relationships, and home items for age. A common one-factor structure with acceptable fit was identified in three out of six countries (comparative fit index = 0.85, root mean square error of approximation = 0.11).
The EUROHIS-QOL 8-item index showed acceptable cross-cultural performance and a satisfactory discriminant validity and would be a useful measure to include in studies to assess treatment effectiveness.
测试世界卫生组织生活质量量表简表（WHOQOL-BREF）缩短版 EUROHIS-QOL8 条目指数的心理测量学特性。
样本包括来自初级保健机构的 2359 名受试者，其中 1193 名被确诊患有抑郁症。数据来自六个参与大型国际研究（抑郁结局纵向研究）的国家/地区：澳大利亚、巴西、以色列、俄罗斯、西班牙和美国。EUROHIS-QOL8 条目指数的结构遵循 WHOQOL-BREF 评估的结构。使用 Cronbach's α 评估内部一致性。使用与心理健康（症状清单 90）、身体健康（自我评价）和生活质量（WHOQOL-BREF 和简短 36 健康调查）不同测量方法的相关性评估收敛有效性。在确诊的抑郁和非抑郁患者之间评估判别组有效性。使用 Rasch 分析评估不同项目的功能和单维性。使用结构方程模型分析评估因子结构。
各国家的内部一致性可接受（范围为 0.72-0.81），该指数在所有国家均能很好地区分抑郁（t=6.31-20.33；P<0.001）。EUROHIS-QOL8 条目指数与不同测量方法之间的相关性-症状清单 90（r=-0.42）、身体健康（r=-0.42）、WHOQOL-BREF 领域（r=0.61-0.77）和简短 36 健康调查（r=0.58）-均有显著意义（P<0.001）。该指数具有理想的项目拟合统计量，具有单一维度。两项条目（“日常生活活动”和“有足够的钱满足您的需求”）的残差超过 4。观察到一般生活质量、一般健康、人际关系和家庭项目的年龄存在差异项目功能。在六个国家中的三个国家（比较拟合指数=0.85，近似均方根误差=0.11）中确定了一个具有可接受拟合度的常见单因素结构。
EUROHIS-QOL8 条目指数表现出可接受的跨文化性能和令人满意的判别有效性，将是评估治疗效果的有用指标。
