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Assessing quality of life in severe obesity: development and psychometric properties of the ORWELL-R

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Abstract

Purpose

Several health-related quality-of-life (HRQoL) dimensions are affected by obesity. Our goal was to characterize the psychometric properties of the ORWELL-R, a new obesity-related quality-of-life instrument for assessing the “individual experience of overweightness”.

Methods

This psychometric assessment included two different samples: one multicenter clinical sample, used for assessing internal consistency, construct validity and temporal reliability; and a community sample (collected through a cross-sectional mailing survey design), used for additional construct validity assessment and model fit confirmation.

Results

Overall, 946 persons participated (188 from the clinical sample; 758 from community sample). An alpha coefficient of 0.925 (clinical sample) and 0.934 (community sample) was found. Three subscales were identified (53.2 % of variance): Body environment experience (alpha = 0.875), Illness perception and distress (alpha = 0.864), Physical symptoms (alpha = 0.674). Adequate test–retest reliability has been confirmed (ICC: 0.78 for the overall score). ORWELL-R scores were worse in the clinical sample. Worst HRQoL, as measured by higher ORWELL-R scores, was associated with BMI increases. ORWELL-R scores were associated with IWQOL-Lite and lower scores in happiness.

Conclusions

ORWELL-R shows good internal consistency and adequate test–retest reliability. Good construct validity was also observed (for convergent and discriminant validity) and confirmed through confirmatory factor analysis (in both clinical and community samples). Presented data sustain ORWELL-R as a reliable and useful instrument to assess obesity-related QoL, in both research and clinical contexts.

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Acknowledgments

The authors are grateful to Ronette Kolotkin, for her authorization of use of the IWQOL-Lite; to Alexandra Dinis, for her insightful advice regarding statistical analysis; to Guy Sermeus, for his valuable contribution in the development of the questionnaire addressing the community sample; to Ann Van Herpe, Nathalie Muanza, Vanessa Schoonjans and Farah Janssens for the development of the community-based sample’s questionnaire layout, its data collection, punching and control; to Dr. João Martins and Dr. Rui Varela for their contribution in clinical sample data punching and control; to Rita Sousa and Cristian Raicu for their valuable revision of the text; and to all patients and citizens who participated in the study. This research received no specific grant from any funding agency of public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Serviço de Endocrinologia, Hospital de Santa Maria, CHLN/Faculdade de Medicina da Universidade de Lisboa, Piso 6, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal

    José Camolas, Mário Mascarenhas & Isabel do Carmo

  2. Espírito Santo Hospital, Evora, Portugal

    André Ferreira & Manuel Carvalho

  3. Diabetes Agency, Careggi Hospital, Florence, Italy

    Edoardo Mannucci

  4. Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal

    Pedro Moreira

  5. Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina da Universidade de Lisboa/DECO PROTESTE, Edf. Egas Moniz, Av. Prof. Egas Moniz, 1649-029, Lisbon, Portugal

    Osvaldo Santos

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  1. José Camolas
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  2. André Ferreira
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Correspondence to José Camolas.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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All procedures involving human participants were in accordance with the ethical standards of the institutions involved and with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Camolas, J., Ferreira, A., Mannucci, E. et al. Assessing quality of life in severe obesity: development and psychometric properties of the ORWELL-R. Eat Weight Disord 21, 277–288 (2016). https://doi.org/10.1007/s40519-015-0222-z

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