Assessing quality of life in middle-aged and older adults with HIV: psychometric testing of the WHOQOL-HIV-Bref
The aim of this study was to test the psychometric properties of the World Health Organization quality of life in HIV infection, abbreviated version (WHOQOL-HIV-Bref) in a sample of human immunodeficiency virus (HIV)-infected patients aged 50 years and older.
The sample consisted of 185 patients, recruited in the main departments of infectious diseases of 10 Portuguese hospitals. In addition to the WHOQOL-HIV-Bref, patients also completed the brief symptom inventory, a self-report questionnaire for measuring psychopathological symptoms.
The European Portuguese version of WHOQOL-HIV-Bref showed acceptable reliability (Cronbach’s alpha range 0.65–0.86 across domains). Confirmatory factor analysis corroborated the original six-domain structure. Convergent validity with depressive and psychopathological symptoms was satisfactory for all domains. Overall quality of life (QoL), physical and independence domains discriminated well subjects considering the HIV stage. None of the domains were significantly different according to CD4+ T cell count subgroups.
These results offer promising support for the use of the WHOQOL-HIV-Bref as a measure of QoL among HIV-infected patients aged 50 years and older. Its briefness and multidimensionality allow a more practical and comprehensive assessment of QoL, both on clinical and research settings.
KeywordsHIV infection Middle-aged and older adults Quality of life Reliability Validity
Brief symptom inventory
Confirmatory factor analysis
Comparative fit index
Human immunodeficiency virus
Quality of life
Root mean square error of approximation
World Health Organization
World Health Organization quality of life in HIV infection, abbreviated version
This study was supported by Coordenação Nacional para a Infecção VIH/sida (Ref. 5-1.8.4/2007) and was developed within the research line “Relationships, Development and Health”, of the R&D Unit of the Institute of Cognitive Psychology, Vocational and Social Development of the University of Coimbra (PEst-OE/PSI/UI0192/2011). Marco Pereira is supported by a Post-doctoral Scholarship from the Portuguese Foundation for Science and Technology (SFRH/BPD/44435/2008)
Conflict of interest
The authors declare no conflict of interest with their funding bodies.
- 4.WHOQOL Group. (1994). Development of the WHOQOL: Rationale and current status. International Journal of Mental Health, 23(3), 24–56.Google Scholar
- 11.Canavarro, M. C., Vaz Serra, A., Simões, M. R., Rijo, D., Pereira, M., Gameiro, S., et al. (2009). Development and general psychometric properties of the Portuguese from Portugal version of the World Health Organization quality of life assessment (WHOQOL-100). International Journal of Behavioral Medicine, 16, 116–124. doi: 10.1007/s12529-008-9024-2.PubMedCrossRefGoogle Scholar
- 12.Chandra, P. S., Gandhi, C., Satishchandra, P., Kamat, A., Desai, A., Ravi, V., et al. (2006). Quality of life in HIV subtype C infection among asymptomatic subjects and its association with CD4 counts and viral loads—a study from South India. Quality of Life Research, 15, 1597–1605. doi: 10.1007/s11136-006-9001-7.PubMedCrossRefGoogle Scholar
- 17.Derogatis, L. R. (1993). BSI: Brief symptom inventory: Administration, scoring and procedures manual. Minneapolis: Natural Computers System.Google Scholar
- 18.National Institute on Aging. (2009). HIV, AIDS and older people. Retrieved April 11, 2014. http://www.niapublications.org/agepages/aids.asp.
- 19.Byrne, B. (2010). Structural equation modeling with AMOS: Basic concepts, applications and programming (2nd ed.). New York: Taylor & Francis Group.Google Scholar
- 20.Streiner, D. L., & Norman, G. N. (1995). Health measurement scales: A practical guide to their development and use (2nd ed.). Oxford: Oxford University Press.Google Scholar
- 21.Terwee, C. B., Bot, S. D., de Boer, M. R., van der Windt, D. A., Knol, D. L., Dekker, J., et al. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology, 60, 34–42. doi: 10.1016/j.jclinepi.2006.03.012.PubMedCrossRefGoogle Scholar
- 24.High, K. P., Brennan-Ing, M., Clifford, D. B., Cohen, M. H., Currier, J., Deeks, S. G., et al. (2012). HIV and aging: State of knowledge and areas of critical need for research. A report to the NIH office of AIDS research by the HIV and aging working group. Journal of Acquired Immune Deficiency Syndromes, 60, S1–S18. doi: 10.1097/QAI.1090b1013e31825a33668.PubMedCrossRefGoogle Scholar
- 25.Hays, R. D., Cunningham, W. E., Sherbourne, C. D., Wilson, I. B., Wu, A. W., Cleary, P. D., et al. (2000). Health-related quality of life in patients with human immunodeficiency virus infection in the United States: Results from the HIV Cost and Services Utilization Study. American Journal of Medicine, 108, 714–722. doi: 10.1016/S0002-9343(00)00387-9.PubMedCrossRefGoogle Scholar