Colbourn Tim, Masache Gibson, Skordis-Worrall Jolene
Parent and Child Health Initiative (PACHI), Amina House (top floor, Entrance 3), Paul Kagame Road roundabout, P.O. Box 31686, Lilongwe 3, Malawi.
BMC Res Notes. 2012 Jul 3;5:346. doi: 10.1186/1756-0500-5-346.
Quality of life measurement is a useful addition to measurement of health outcomes in evaluation of the benefits of many health and welfare interventions. The WHOQOL-BREF measures quality of life from a broad multi-dimensional perspective but was not used in Malawi. The objective of this study was to translate the WHOQOL-BREF questionnaire into the main local language of Malawi: Chichewa; and to validate it quantitatively with respect to internal consistency, domain structure, and discriminant validity for this context.
WHO-mandated guidelines were followed for translation, adaptation, pre-testing (focus groups), piloting (patient interviews) and data coding. Analyses using descriptive statistics, correlation and regression were undertaken to investigate the validity of the WHOQOL-BREF in the ways described above. Additional regression analyses examined the impact of socio-demographic variables on the domain scores.
309 respondents completed the questionnaire (with >98% response rates for all questions except Q21 (sex life)). 259 were sick with a variety of health problems, and 50 were considered healthy. All domains showed adequate internal consistency (Cronbach's alpha > =0.7) with all item scores also most highly correlated with the scores of their assigned domain. All domain scores varied by health problem, and more depressed respondents had significantly lower scores in all domains than those less depressed. Domain scores and their associations with socio-demographic variables are presented and discussed.
This study demonstrates that the new Chichewa WHOQOL-BREF questionnaire is acceptable and comprehensible to respondents in Malawi. The questionnaire also passed a number of tests of the validity of its psychometric properties. In the pilot population we found that older age was associated with lower Physical domain scores. Conversely, higher levels of educational attainment were found to be associated with higher quality of life in all domains except for Social Relationships. Respondents living as married or single were found to have higher quality of life in the Physical, Psychological and Social domains, and those who were widowed lower Physical quality of life.
在评估许多健康和福利干预措施的益处时，生活质量测量是对健康结果测量的有益补充。世界卫生组织生活质量简表（WHOQOL-BREF）从广泛的多维度视角测量生活质量，但在马拉维未被使用。本研究的目的是将WHOQOL-BREF问卷翻译成马拉维的主要当地语言：奇切瓦语；并针对该背景下的内部一致性、领域结构和区分效度对其进行定量验证。
遵循世界卫生组织规定的指南进行翻译、改编、预测试（焦点小组）、试点测试（患者访谈）和数据编码。使用描述性统计、相关性和回归分析以上述方式调查WHOQOL-BREF的效度。额外的回归分析研究了社会人口统计学变量对领域得分的影响。
309名受访者完成了问卷（除问题21（性生活）外，所有问题的回答率均>98%）。259人患有各种健康问题，50人被认为健康。所有领域均显示出足够的内部一致性（克朗巴哈系数α≥0.7），所有项目得分也与其所属领域的得分高度相关。所有领域得分因健康问题而异，抑郁程度较高的受访者在所有领域的得分均显著低于抑郁程度较低的受访者。呈现并讨论了领域得分及其与社会人口统计学变量的关联。
本研究表明，新的奇切瓦语WHOQOL-BREF问卷在马拉维的受访者中是可接受且易于理解的。该问卷还通过了多项心理测量特性效度测试。在试点人群中，我们发现年龄较大与身体领域得分较低相关。相反，除社会关系领域外，较高的教育程度与所有领域较高的生活质量相关。已婚或单身的受访者在身体、心理和社会领域的生活质量较高，而丧偶者的身体生活质量较低。
