Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Health Qual Life Outcomes. 2021 Oct 12;19(1):239. doi: 10.1186/s12955-021-01872-z.
Women with severe preeclampsia often present with more health complaints compared to those with uncomplicated pregnancies. Estimating the quality of life of women affected with severe preeclampsia could provide direction for further interventions. However, the current measurement of the quality of life has not been culturally adapted and validated for this population. This study aimed to translate, culturally adapt, and test the reliability and validity of the World Health Organization Quality-of-Life-Bref Scale (WHOQOL-BREF) in southern Ethiopia among women with severe preeclampsia.
An institutional-based cross-sectional study was conducted in southern Ethiopia in selected hospitals with randomly recruited women with severe preeclampsia. Cultural adaptation and validation techniques were used to translate and adapt the WHOQOL-BREF scale. Face, content validity, forward and backward translations, and synthesis were computed using an expert panel. The scale was pretested and adjusted accordingly. Internal consistency (Cronbach's alpha) and test-retest reliability (Intraclass Correlation Coefficient = ICC) were examined. Confirmatory factor analysis (CFA) was computed to test the fit of the structure to the local setting before conducting exploratory factor analysis (EFA). Multiple methods for determining the number of factors extracted (scree test, eigenvalues) were used. We compared the original English structure with the new structure in the study setting and extracted a new structure using EFA.
The internal consistency reliabilities ranged from 0.8045 to 0.9123 indicating good-to-excellent reliability. The item‑level content validity ranged from 0.86 to 1.00; the scale‑level content validity index was 0.97. In CFA, the model fit indices were unacceptable (Comparative Fit Index (CFI = 0.87), Root Mean Square Error of Approximation (RMSEA = 0.23), Standardized Root Mean Square Residual (SRMR = 0.38), Tucker Lewis Index (TLI = 0.85) and (PCLOSE = 0.00). Three new factor structures were extracted using EFA for current research with a total variance was 91%.
The failure of the original scale in this study population highlights the importance of culturally adapting tool to local settings. EFA confirmed a three-factor structure, inconsistent with the original English structure.
与无并发症妊娠相比，患有严重先兆子痫的女性通常会出现更多的健康问题。评估受严重先兆子痫影响的女性的生活质量可以为进一步干预提供方向。然而，目前的生活质量测量方法尚未针对该人群进行文化适应性调整和验证。本研究旨在翻译、文化适应，并测试世界卫生组织生活质量简表（WHOQOL-BREF）在埃塞俄比亚南部严重先兆子痫女性中的信度和效度。
在选定的医院进行了一项基于机构的横断面研究，随机招募了患有严重先兆子痫的女性。使用专家小组计算了面部、内容有效性、正向和反向翻译以及综合翻译。该量表进行了预测试并进行了相应调整。检查了内部一致性（Cronbach's alpha）和测试-重测信度（Intraclass Correlation Coefficient = ICC）。在进行探索性因素分析（EFA）之前，计算了验证性因素分析（CFA）以检验结构与当地环境的拟合度。使用了多种方法来确定提取的因素数量（陡度测试、特征值）。我们比较了原始英语结构与研究环境中的新结构，并使用 EFA 提取了新结构。
内部一致性信度范围为 0.8045 至 0.9123，表明信度良好至优秀。项目层面的内容有效性范围为 0.86 至 1.00；量表层面的内容有效性指数为 0.97。在 CFA 中，模型拟合指数不可接受（比较拟合指数（CFI = 0.87），近似均方根误差（RMSEA = 0.23），标准化均方根残差（SRMR = 0.38），Tucker Lewis 指数（TLI = 0.85）和（PCLOSE = 0.00）。使用 EFA 为当前研究提取了三个新的因素结构，总方差为 91%。
原始量表在该研究人群中的失败突出表明，文化适应工具对当地环境的重要性。EFA 证实了一个三因素结构，与原始英语结构不一致。
