Uddin Mohammed Nazim, Islam Fakir M Amirul
Department of Statistics, Data Science and Epidemiology; Faculty of Health, Arts and Design; Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
Organisation for Rural Community Development (ORCD), Dariapur, Narail, Bangladesh.
BMC Health Serv Res. 2019 Apr 5;19(1):216. doi: 10.1186/s12913-019-4026-0.
This study aimed to validate the psychometric properties of the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF) questionnaire for use in a rural district of Bangladesh.
This cross-sectional study recruited a multi-stage cluster random sample of 2425 participants from the rural district Narail of Bangladesh in May-July 2017. Rasch analysis was carried out using the sampled participants, as well as multiple validation random sub-samples of 300 participants, to validate four domains of the WHOQOL-BREF questionnaire: physical, psychological, social and environmental.
The original WHOQOL-BREF appeared to be a poor fit for both sampled and sub-sampled group of participants in Narail district in all underlying domains: physical, psychological, social and environmental. Two items (sleep and work capacity) from the physical domain, two items (personal belief and negative feelings) from the psychological domain and three items (home environment, health care and transport) from the environment domain were excluded for goodness of fit of the Rasch model. The social domain exhibited reasonably reliable fitness while fulfilling all the assumptions of the Rasch model. A modified version of the WHOQOL-BREF questionnaire using five-items for the physical ([Formula: see text] = 36.47, p = 0.013, Person Separation Index (PSI) = 0.773), four-items for the psychological ([Formula: see text] = 28.30, p = 0.029, PSI = 0.708) and five-items for the environmental ([Formula: see text] = 36.97, p = 0.011, PSI = 0.804) domain was applied, which showed adequate internal consistency, reliability, unidimensionality, and similar functioning for different age-sex distributions.
The modified WHOQOL-BREF questionnaire translated into Bengali language appeared to be a valid tool for measuring quality of life in a typical rural district in Bangladesh. Despite some limitations of the modified WHOQOL-BREF questionnaire, further application of Rasch analysis using this version or an improved one in other representative rural areas of Bangladesh is recommended to assess the external validity of the outcomes of this study and to determine the efficacy of this tool to measure the quality of life at the national rural level.
本研究旨在验证世界卫生组织生存质量测定量表简表（WHOQOL - BREF）问卷在孟加拉国一个农村地区使用时的心理测量特性。
这项横断面研究于2017年5月至7月从孟加拉国纳赖尔农村地区招募了一个2425名参与者的多阶段整群随机样本。使用抽样参与者以及300名参与者的多个验证随机子样本进行拉施分析，以验证WHOQOL - BREF问卷的四个领域：生理、心理、社会和环境。
在所有潜在领域（生理、心理、社会和环境）中，原始的WHOQOL - BREF问卷对于纳赖尔地区的抽样参与者和子抽样参与者群体而言，拟合度似乎都很差。为使拉施模型拟合良好，从生理领域排除了两个项目（睡眠和工作能力），从心理领域排除了两个项目（个人信念和负面情绪），从环境领域排除了三个项目（家庭环境、医疗保健和交通）。社会领域在满足拉施模型的所有假设时表现出合理可靠的拟合度。应用了一个修改版的WHOQOL - BREF问卷，生理领域使用五个项目（[公式：见原文] = 36.47，p = 0.013，个人分离指数（PSI）= 0.773），心理领域使用四个项目（[公式：见原文] = 28.30，p = 0.029，PSI = 0.708），环境领域使用五个项目（[公式：见原文] = 36.97，p = 0.011，PSI = 0.804），该问卷显示出足够的内部一致性、可靠性、单维性，并且在不同年龄 - 性别分布中功能相似。
翻译成孟加拉语的修改版WHOQOL - BREF问卷似乎是测量孟加拉国一个典型农村地区生活质量的有效工具。尽管修改版WHOQOL - BREF问卷存在一些局限性，但建议在孟加拉国其他有代表性的农村地区使用该版本或改进版本进一步进行拉施分析，以评估本研究结果的外部有效性，并确定该工具在全国农村层面测量生活质量的功效。
