Quality of Life Research

, Volume 19, Issue 7, pp 977–984 | Cite as

Structure of health-related quality of life among people with and without functional limitations

  • Willi Horner-Johnson
  • Rie Suzuki
  • Gloria L. Krahn
  • Elena M. Andresen
  • Charles E. Drum
  • The RRTC Expert Panel on Health Measurement



The objective of this study was to assess the factor structure of nine health-related quality of life (HRQOL) survey items among people with and without disabilities or functional limitations (FL) and determine whether factor loadings were similar for the two groups.


Data were from US states and territories in the 2001 and 2002 Behavioral Risk Factor Surveillance System (BRFSS). Confirmatory factor analyses assessed fit of the data to a previously found factor structure.


A two-factor structure was confirmed, conceptually representing physical and mental health. Although this structure fit data for both people with and without FL, factor loadings were significantly different for the two groups. In all but one instance, factor loadings were higher for people with FL than for people without FL.


Results suggest that people with and without FL conceptualize physical and mental HRQOL similarly. However, the nine items analyzed appear to be a better reflection of the latent constructs of physical and mental HRQOL in the population of people with FL than those without FL.


Health-related quality of life Functional limitation Questionnaires Factor analysis 



Behavioral Risk Factor Surveillance System


Centers for Disease Control and Prevention


Comparative fit index


Functional limitation(s)


Health-related quality of life


Mean and variance-adjusted weighted least squares


Root mean square error of approximation


Tucker–Lewis index



The members of the Rehabilitation Research and Training Center (RRTC) Expert Panel on Health Status Measurement are: Elena Andresen, PhD, University of Florida, Gainesville, Florida; Vincent Campbell, PhD, Centers for Disease Control and Prevention, Atlanta, Georgia; Bradley J. Cardinal, PhD, Oregon State University, Corvallis, Oregon; Charles Drum, JD, PhD, Oregon Health & Science University, Portland, Oregon; Glenn Fujiura, PhD, University of Illinois at Chicago, Chicago, Illinois; Trevor Hall, PsyD, Oregon Health & Science University; Willi Horner-Johnson, PhD, Oregon Health & Science University; Gloria Krahn, PhD, Centers for Disease Control and Prevention; and Margaret Nosek, PhD, Baylor College of Medicine, Houston, Texas. The authors thank Mo Wang for expert consultation and data analysis and Susan Wingenfeld for assistance with references and formatting. The contents of this article were developed under a grant from the Department of Education, NIDRR grant number H133B040034. However, those contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Federal Government.


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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Willi Horner-Johnson
    • 1
  • Rie Suzuki
    • 2
  • Gloria L. Krahn
    • 3
  • Elena M. Andresen
    • 4
  • Charles E. Drum
    • 1
  • The RRTC Expert Panel on Health Measurement
    • 1
  1. 1.Oregon Institute on Disability and Development, RRTC: Health and WellnessOregon Health & Science UniversityPortlandUSA
  2. 2.Department of Health Sciences and AdministrationUniversity of Michigan–FlintFlintUSA
  3. 3.Division of Human Development and Disability, National Center on Birth Defects and Developmental DisabilitiesCenters for Disease Control and PreventionAtlantaUSA
  4. 4.Department of Epidemiology and Biostatistics, College of Public Health and Health ProfessionalsUniversity of FloridaGainesvilleUSA

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