Spanish Interdisciplinary AIDS Society (Sociedad Española Interdisciplinaria del Sida SEISIDA), C/ Doctor Fleming 3, 28036, Madrid, Spain.
Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), Calle Juan del Rosal, 10, ES-28040, Madrid, Spain.
Health Qual Life Outcomes. 2019 Aug 19;17(1):144. doi: 10.1186/s12955-019-1208-8.
The assessment of health-related quality of life (HRQoL) in people living with HIV (PLHIV) has become crucial to evidence-based practice. The goals of this study are to analyze the psychometric properties and evidence of the validity of the Spanish version of WHOQOL-HIV-BREF in a sample of PLHIV in Spain and to examine the more impaired HRQoL facets and dimensions and identify the PLHIV who show the most vulnerable profile.
A total of 1462 PLHIV participated in an observational cross-sectional ex-post-facto study. Data were collected at 33 Spanish sites through an online survey. In addition to measuring HRQoL, the study used other tools to measure treatment adherence (CEAT-VIH 2.0 version), psychological well-being (GHQ-12) and HIV-related stigma (HSSS). Cronbach's alpha, first- and second-order confirmatory factor analysis (CFA), the Pearson coefficient and one-way ANOVA were used to evaluate reliability, construct validity and concurrent and known-group validity, respectively. Differences according to the socio-demographic and epidemiological profiles of participants were analyzed.
First- and second-order CFAs confirmed a six-domain first-order structure of the Spanish version of WHOQOL-HIV-BREF and one second-order factor related to overall HRQoL with an acceptable fit to the data, although some minor changes would improve it. The six-domain structure showed an acceptable internal consistency (Cronbach's alpha ranged from .61 to .81). Significant moderate to large correlations between domains and overall HRQoL, adherence, psychological well-being and negative self-image were found. Significant differences were found according to participants' self-reported CD4+ cell count in several HRQoL facets and domains. Being female, heterosexual, having low socio-economic and educational statuses, having acquired HIV through an unsafe injection and living more years with HIV were related to poorer HRQoL. PLHIV older than 50 presented lower scores in 19 HRQoL facets.
This study demonstrates that the Spanish version of the WHOQOL-HIV-BREF is a valid instrument. It also presents the most recent data about HRQoL in PLHIV in Spain with the largest sample to date.
对艾滋病毒感染者（PLHIV）的健康相关生活质量（HRQoL）进行评估已成为循证实践的关键。本研究的目的是分析西班牙版 WHOQOL-HIV-BREF 在西班牙 PLHIV 样本中的心理测量特性和效度证据，并检查更受损的 HRQoL 方面和维度，并确定表现出最脆弱特征的 PLHIV。
共有 1462 名 PLHIV 参加了一项观察性横断面事后事实研究。通过在线调查在西班牙的 33 个地点收集数据。除了测量 HRQoL 外，该研究还使用其他工具来衡量治疗依从性（CEAT-VIH 2.0 版本），心理健康（GHQ-12）和与 HIV 相关的耻辱感（HSSS）。使用 Cronbach 的 alpha、一阶和二阶验证性因素分析（CFA）、皮尔逊系数和单向方差分析分别评估可靠性、结构效度和同时和已知组有效性。根据参与者的社会人口统计学和流行病学特征分析差异。
一阶和二阶 CFA 证实了西班牙版 WHOQOL-HIV-BREF 的六域一阶结构和一个与整体 HRQoL 相关的二阶因子，该结构与数据具有可接受的拟合度，尽管一些较小的变化可以改善它。六域结构表现出可接受的内部一致性（Cronbach 的 alpha 范围为.61 至.81）。在各域和整体 HRQoL、依从性、心理健康和消极的自我形象之间发现了显著的中度至高强度相关性。根据参与者报告的 CD4+细胞计数，在几个 HRQoL 方面和维度上发现了显著差异。女性、异性恋、社会经济和教育地位较低、通过不安全注射感染 HIV 以及感染 HIV 时间较长与较差的 HRQoL 有关。年龄大于 50 岁的 PLHIV 在 19 个 HRQoL 方面的得分较低。
本研究表明，西班牙版 WHOQOL-HIV-BREF 是一种有效的工具。它还提供了西班牙 PLHIV 最新的 HRQoL 数据，这是迄今为止最大的样本。
