Akpa Onoja Matthew, Fowobaje Kayode Raphael
Deparment of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan.
WHO Collaboration centre, Department of Paediatrics, University College Hospital (UCH), Ibadan. Nigeria.
Arch Basic Appl Med. 2018 Feb;6(1):35-44. Epub 2018 May 2.
The World Health Organization's Quality of Life Instrument (WHOQOL-BREF) is widely validated and popularly used in assessing perceived quality of life (QOL) of adolescents and the general population. Though the WHOQOL-BREF has been used in some studies in Nigeria, its theoretical structure has not been comprehensively investigated. This study examined the factor structure of the Adopted WHOQOL-BREF questionnaire and it theoretical structure in a large sample of adolescents in Nigeria.
Data on demographic characteristics and QOL were extracted from 1,963 adolescents who participated in a state-wide study on psychosocial functioning and quality of life of adolescents in Benue State, Nigeria. Descriptive statistics were used to present the distribution of the data while Cronbach's alpha and Polychoric ordinal alpha were used to describe the internal consistency (reliability) of the adapted WHOQOL-BREF and alpha value of 0.700 was considered reliable. Structural analysis was performed to extract the underlying factors while confirmatory factor analyses were used to assess some hypothesized structure of the adapted WHO-QOL BREF. Relative Chi-square test (/) value ≤3.0 was regarded a good fit while multiple fit indexes with values ≥0.90 (for acceptable fit) were used for assessing diverse aspects of the models. All analyses were performed at 5% significance level using IBM SPSS statistics version 20, R package and AMOS version 21.
Participants were mostly male (54.8%) and 14.7±1.4 years old with 51.0% residing in rural areas. The overall internal consistency of the 4-factor model was 0.862 (for Cronbach's Alpha) and 0.989 (for Polychoric Alpha) while the 2-factor model had 0.870 (for Cronbach's Alpha) and 0.990 (for Polychoric Alpha). The Cattelle's Scree plot, Horn's parallel analysis and the confirmatory factor analysis revealed a 2-factor model as the best model for the WHO-QOL BREF. The 23-item 2-factor structure had a relative Chi-square test value / < 3 = 2.98, p < 0.001 with all fit indices within the acceptable range.
The adapted WHO QOL BREF can be safely used to assess quality of life among Adolescents in Nigeria and related settings. Using the two factors extracted in the present study may yield better results in settings similar to the present study location.
世界卫生组织生活质量量表（WHOQOL-BREF）已得到广泛验证，并普遍用于评估青少年及普通人群的生活质量感知。尽管WHOQOL-BREF已在尼日利亚的一些研究中使用，但其理论结构尚未得到全面研究。本研究在尼日利亚的大量青少年样本中，考察了采用的WHOQOL-BREF问卷的因子结构及其理论结构。
从1963名参与尼日利亚贝努埃州青少年心理社会功能和生活质量全州研究的青少年中提取人口统计学特征和生活质量数据。描述性统计用于呈现数据分布，而Cronbach's α系数和多列相关系数用于描述改编后的WHOQOL-BREF的内部一致性（信度），α值0.700被认为是可靠的。进行结构分析以提取潜在因子，同时使用验证性因子分析来评估改编后的WHO-QOL BREF的一些假设结构。相对卡方检验（/）值≤3.0被视为拟合良好，而值≥0.90（可接受拟合）的多个拟合指数用于评估模型的各个方面。所有分析均使用IBM SPSS Statistics 20版、R包和AMOS 21版在5%显著性水平下进行。
参与者大多为男性（54.8%），年龄为14.7±1.4岁，51.0%居住在农村地区。四因子模型的总体内部一致性为0.862（Cronbach's α系数）和0.989（多列相关系数）；二因子模型的内部一致性为0.870（Cronbach's α系数）和0.990（多列相关系数）。卡特尔碎石图、霍恩平行分析和验证性因子分析表明，二因子模型是WHO-QOL BREF的最佳模型。23项二因子结构的相对卡方检验值/ < 3 = 2.98，p < 0.001，所有拟合指数均在可接受范围内。
改编后的WHO QOL BREF可安全用于评估尼日利亚及相关环境中青少年的生活质量。在与本研究地点类似的环境中，使用本研究中提取的两个因子可能会产生更好的结果。
