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Cross-national comparability of the WHOQOL-BREF: A measurement invariance approach

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Abstract

Purpose

To evaluate whether the WHOQOL-BREF measures the QOL construct in the same way across nations.

Methods

Students from Flanders, Belgium and Iran completed the WHOQOL-BREF as part of a larger Quality of Life questionnaire. Their responses were compared using a multi-group confirmatory factor analysis.

Results

In general, the QOL construct appears rather similar in both cultures; however, participants from both countries seem to respond differently to particular items of the WHOQOL-BREF. Especially for the physical and psychological domain, this is problematic, because none of their indicators works in the same way across samples.

Conclusions

Notwithstanding some limitations of this study, it must be concluded that the WHOQOL-BREF should only be used with great caution in cross-national comparisons.

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Notes

  1. The following constraints were applied in order to identify the model (see [11]): (1) the latent factor means are fixed to 0 in the first group, (2) the intercepts are fixed to 0 in all groups, (3) the scaling factors are fixed to one in the first group, (4) per factor, the factor loading of one item is fixed to 1 (these items are called the reference items), and (5) for each item, an equality constraint was set on the first threshold, and additionally for the reference items, the second threshold was also constrained across groups.

Abbreviations

QOL:

Quality of life

WHOQOL-BREF:

World health organization quality of life assessment instrument

ACSA:

Anamnestic comparative self assessment

PWI:

Personal wellbeing index

RMSEA:

Root mean square error of approximation

CFI:

Comparative fit index

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Author information

Author notes

  1. Frederik Van Acker

    Present address: Faculty of Psychology, Open Universiteit Nederland, PO Box 2960, 6401 DL, Heerlen, The Netherlands

Authors and Affiliations

  1. Vakgroep Experimentele en Toegepaste Psychologie, Faculty of Psychology and Education Sciences, EXTO, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussel, Belgium

    Peter Theuns & Frederik Van Acker

  2. Research Group of Quantitative Psychology and Individual Differences, Katholieke Universiteit Leuven, Tiensestraat 102, 3000, Leuven, Belgium

    Joeri Hofmans

  3. Department of Psychology, University of Sistan & Baluchestan, Zahedan, Iran

    Mehrdad Mazaheri

  4. Human Ecology, Faculty of Medicine and Pharmacy, MEKO, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussel, Belgium

    Jan L. Bernheim

Authors
  1. Peter Theuns
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  2. Joeri Hofmans
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  3. Mehrdad Mazaheri
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  4. Frederik Van Acker
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  5. Jan L. Bernheim
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Correspondence to Peter Theuns or Joeri Hofmans.

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Theuns, P., Hofmans, J., Mazaheri, M. et al. Cross-national comparability of the WHOQOL-BREF: A measurement invariance approach. Qual Life Res 19, 219–224 (2010). https://doi.org/10.1007/s11136-009-9577-9

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