Evaluating quality of life outcomes following joint replacement: psychometric evaluation of a short form of the WHOQOL-Bref
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Reducing participant burden is important in health research and clinical assessment. We examined the psychometric properties of the EUROHIS-QOL 8-item index, a short version of the 26-item World Health Organisation Quality of Life questionnaire (WHOQOL-Bref), in a sample of people receiving joint replacement surgery.
Participants (n = 1008) completed the WHOQOL-Bref at either 6, 12, 24 or 60 months after hip or knee replacement. The factor structure, differential item functioning (DIF) and unidimensionality of the EUROHIS-QOL 8-item index were examined using exploratory and confirmatory factor analyses and Rasch analyses. Convergent validity was examined using correlations with the parent measure and other patient-reported outcome measures (Oxford scores, Western Ontario and McMaster Universities Osteoarthritis Index). Discriminant validity was assessed between groups reporting high versus low pain and function, and by joint replaced.
The measure demonstrated high internal consistency (α = 0.86), adequate convergent (r = 0.47–0.82, p < 0.001) and discriminant validity (p < 0.001). Factor and Rasch analyses supported a unidimensional structure. However, there were also indications of multidimensionality, with support for a two-factor model focusing on general health and function, and psychosocial aspects of QOL. There was minimal evidence of DIF, with just one item evaluating energy level showing DIF for age.
The EUROHIS-QOL 8-item index demonstrated adequate properties as a unidimensional scale and as a two-factor scale evaluating general health and function, and psychosocial aspects of quality of life. It is low on clinical and participant burden, showed minimal ceiling effects and showed good concurrent and discriminant validity.
KeywordsQuality of life EUROHIS-QOL 8-item index Total joint replacement WHOQOL-Bref
Thanks to our Research Assistants Lyn Jeffries and Caroline Norris for managing our database.
- 3.Khan, F., Ng, L., Gonzalez, S., Hale, T., & Turner-Stokes, L. (2008). Multidisciplinary rehabilitation programmes following joint replacement at the hip and knee in chronic arthropathy. Cochrane Database of Systematic Reviews(2), Art. No.: CD004957. doi: 10.1002/14651858.CD004957.pub3.
- 9.Ackerman, I., Graves, S., Bennell, K., & Osbourne, R. (2006). Evaluating quality of life in hip and knee replacement: Psychometric properties of the World Health Organization quality of life short version instrument. Arthritis & Rheumatism (Arthritis Care & Research), 55(4), 583–590.CrossRefGoogle Scholar
- 13.Ware, J., Kosinski, M., & Gandek, B. (2000). SF-36 health survey: Manual and interpretation guide. Lincoln, RI: Quality Metric Incorporated.Google Scholar
- 14.Bellamy, N., Buchanan, W., Goldsmith, C., Campbell, J., & Stitt, L. (1988). Validation study of WOMAC: A health status instrument for measuring clinically important patient-relevant outcomes following total hip or knee arthroplasty in osteoarthritis. Journal of Orthopaedic Rheumatology, 1, 95–108.Google Scholar
- 15.Dawson, J., Fitzpatrick, R., & Carr, A. (1996). Questionnaire on the perceptions of patients about total hip replacement. Journal of Bone Joint Surgery, 78B, 185–190.Google Scholar
- 20.Gomez-Olive, F., Thorogood, M., Clark, B., Kahn, K., & Tollman, S. (2010). Assessing health and well-being among older people in rural South Africa. Global Health Action, S2, 23–35.Google Scholar
- 21.Kyobutungi, C., Egondi, T., & Ezeh, A. (2010). The health and well-being of older people in Nairobi’s slums. Global Health Action, S2, 45–53.Google Scholar
- 23.Bellamy, N. (2009). WOMAC Osteoarthritis Index: User guide IX. Brisbane.Google Scholar
- 29.Wright, B., & Masters, G. (1982). Rating scale analysis. Chicago: Mesa Press.Google Scholar
- 34.Fang, J., Power, M., Lin, Y., Zhang, J., Hao, Y., & Chatterji, S. (2011). Development of short versions for the WHOQOL-OLD module. The Gerontologist, 52(1), 6–78. doi: 10.1093/geront/gnr085.
- 36.New Zealand Orthopaedic Association (2013). New Zealand Joint Registry: Fourteen Year Report (January 1999 to December 2012). In A. Rothwell, T. Hobbs, & C. Frampton (Eds.), New Zealand Joint Registry Reports. www.nzoa.org.nz. Accessed 28 May 2014.