Validation of the factor structure of the WHOQOL-BREF using meta-analysis of exploration factor analysis and social network analysis.

The brief version of the World Health Organization's Quality of Life Questionnaire, called WHOQOL-BREF, is an internationally applicable measurement for quality of life (QOL) and is widely used in medical and psychological research. Consistent factor structure across countries is essential for the WHOQOL-BREF. However, poor construct validity was found in Lin and Yao's systematic review study. Few studies have investigated this issue. To fill this gap, this study is the first to examine the factor structure of the WHOQOL-BREF using a meta-analysis approach through exploratory factor analysis (EFA) and social network analysis (SNA). Sixteen studies published from 1998 to April 2021 were selected from two well-known academic databases: PsycINFO and MEDLINE. The findings from EFA revealed that four- and five-factor models are acceptable. Because of the weak factor structure of the five-factor model, leading to difficulty in explaining the measurement outcome, the four-factor model was chosen. All 24 items, except Item 8, were loaded on the theoretically designed factors. The theory-based four-factor model proposed by the WHOQOL group was validated. Our results not only provide additional insight into the factor structure of the WHOQOL-BREF but also facilitate its international applicability and comparability. (PsycInfo Database Record (c) 2022 APA, all rights reserved).