Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Pb 1039 Blindern, 0315, Oslo, Norway.
Division of Health Services, Norwegian Institute of Public Health, Pb 4044 Nydalen, 0403, Oslo, Norway.
BMC Med Res Methodol. 2019 Mar 4;19(1):44. doi: 10.1186/s12874-019-0690-3.
Quality of life (QoL) is an established outcome measure of substance use disorder treatment. The WHOQOL-BREF is the gold standard tool, but its appropriateness for particularly vulnerable patient populations must be further explored. This article examines the scaling qualities of the WHOQOL-BREF in a Norwegian substance use disorder population, and explores relationships with social and health variables.
107 participants in a larger national treatment study provided data during structured interviews. Item responses, responsiveness, and domain scaling qualities are reported. General linear models identified correlates of impaired QoL.
Three out of four domains exhibited acceptable scaling qualities, while the social relationships domain had low internal validity. 59% of the variance in physical health QoL was explained in our model by the negative main or interaction effects of depression, unemployment, social isolation, smoking, residential treatment, and weight dissatisfaction. 52% of the variance in psychological health QoL was explained by depression and being single. Depression also had significant main effects in social relationships QoL (R = .27) and environment QoL (R = .39), and social isolation and exercise had further interaction effects in environment QoL.
After one year in treatment, the impact of low social contact in reducing QoL, rather than specific substance use patterns, was striking. The social relationships domain is the shortest in the WHOQOL-BREF, yet social variables were important in other areas of QoL. Social support could benefit from more attention in treatment, as a lack of social support seems to be a strong risk factor for poor QoL in various domains. The WHOQOL-BREF exhibits otherwise satisfactory measurement characteristics and is an appropriate tool among this population.
生活质量（QoL）是物质使用障碍治疗的既定结果衡量标准。WHOQOL-BREF 是金标准工具，但必须进一步探索其对特别脆弱的患者群体的适用性。本文考察了 WHOQOL-BREF 在挪威物质使用障碍人群中的定标质量，并探讨了与社会和健康变量的关系。
在一项较大的全国治疗研究中，107 名参与者在结构化访谈期间提供了数据。报告了项目反应、响应能力和域定标质量。一般线性模型确定了 QoL 受损的相关因素。
四个域中有三个表现出可接受的定标质量，而社会关系域的内部有效性较低。我们的模型解释了身体健康 QoL 方差的 59%，其由抑郁、失业、社会孤立、吸烟、住院治疗和体重不满的负面主要或交互效应引起。心理健康 QoL 的 52%方差由抑郁和单身解释。抑郁对社会关系 QoL（R=0.27）和环境 QoL（R=0.39）也有显著的主要效应，社会孤立和运动对环境 QoL 有进一步的交互效应。
在治疗一年后，低社交接触对降低 QoL 的影响令人瞩目，而不是特定的物质使用模式。在 WHOQOL-BREF 中，社会关系域最短，但社会变量在其他 QoL 领域也很重要。社会支持可能需要在治疗中得到更多关注，因为缺乏社会支持似乎是各个领域 QoL 较差的一个重要危险因素。WHOQOL-BREF 表现出其他令人满意的测量特征，是该人群的合适工具。
