Skip to main content

Assessing quality of life in middle-aged and older adults with HIV: psychometric testing of the WHOQOL-HIV-Bref

Quality of Life Research volume 23, pages 2473–2479 (2014)Cite this article

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Abbreviations

BSI:

Brief symptom inventory

CFA:

Confirmatory factor analysis

CFI:

Comparative fit index

HIV:

Human immunodeficiency virus

QoL:

Quality of life

RMSEA:

Root mean square error of approximation

WHO:

World Health Organization

WHOQOL-HIV-Bref:

World Health Organization quality of life in HIV infection, abbreviated version

References

  1. Martin, C. P., Fain, M. J., & Klotz, S. A. (2008). The older HIV-positive adult: A critical review of the medical literature. American Journal of Medicine, 121, 1032–1037. doi:10.1016/j.amjmed.2008.08.009.

    PubMed  Article  Google Scholar 

  2. Balderson, B. H., Lou Grothaus, L., Harrison, R. G., McCoy, K., Mahoney, C., & Catz, S. (2013). Chronic illness burden and quality of life in an aging HIV population. AIDS Care, 25, 451–458. doi:10.1080/09540121.2012.712669.

    PubMed  Article  PubMed Central  Google Scholar 

  3. Sankar, A., Nevedal, A., Neufeld, S., Berry, R., & Luborsky, M. (2011). What do we know about older adults and HIV? A review of social and behavioral literature. AIDS Care, 23, 1187–1207. doi:10.1080/09540121.2011.564115.

    PubMed  Article  PubMed Central  Google Scholar 

  4. WHOQOL Group. (1994). Development of the WHOQOL: Rationale and current status. International Journal of Mental Health, 23(3), 24–56.

    Google Scholar 

  5. WHOQOL-HIV Group. (2003). Initial steps to developing the World Health Organization’s quality of life instrument (WHOQOL) module for international assessment in HIV/AIDS. AIDS Care, 15, 347–357. doi:10.1080/0954012031000105405.

    Article  Google Scholar 

  6. WHOQOL-HIV Group. (2003). Preliminary development of the World Health Organization’s quality of life HIV instrument (WHOQOL-HIV): Analysis of the pilot version. Social Science and Medicine, 57, 1259–1275. doi:10.1016/S0277-9536(02)00506-3.

    Article  Google Scholar 

  7. WHOQOL-HIV Group. (2004). WHOQOL-HIV for quality of life assessment among people living with HIV and AIDS: Results from the field test. AIDS Care, 16, 882–889. doi:10.1080/09540120412331290194.

    Article  Google Scholar 

  8. O’Connell, K., & Skevington, S. (2012). An international quality of life instrument to assess wellbeing in adults who are HIV-positive: A short form of the WHOQOL-HIV (31 items). AIDS and Behavior, 16, 452–460. doi:10.1007/s10461-010-9683-0.

    PubMed  Article  Google Scholar 

  9. Canavarro, M. C., & Pereira, M. (2012). Factor structure and psychometric properties of the European Portuguese version of a questionnaire to assess quality of life in HIV-infected adults: The WHOQOL-HIV-Bref. AIDS Care, 24, 799–807. doi:10.1080/09540121.2011.630362.

    PubMed  Article  Google Scholar 

  10. Canavarro, M. C., Pereira, M., Simões, M. R., & Pintassilgo, A. L. (2011). Quality of life assessment in HIV-infection: Validation of the European Portuguese version of WHOQOL-HIV. AIDS Care, 23, 187–194. doi:10.1080/09540121.2010.498870.

    PubMed  Article  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.

    PubMed  Article  Google 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.

    PubMed  Article  Google Scholar 

  13. Hsiung, P.-C., Fang, C.-T., Wu, C.-H., Sheng, W.-H., Chen, S.-C., Wang, J.-D., et al. (2011). Validation of the WHOQOL-HIV-BREF among HIV-infected patients in Taiwan. AIDS Care, 23, 1035–1042. doi:10.1080/09540121.2010.543881.

    PubMed  Article  Google Scholar 

  14. Tran, B. X. (2012). Quality of life outcomes of antiretroviral treatment for HIV/AIDS patients in Vietnam. PLoS ONE, 7, e41062. doi:10.1371/journal.pone.0041062.

    PubMed  Article  CAS  PubMed Central  Google Scholar 

  15. Saddki, N., Noor, M. M., Norbanee, T. H., Rusli, M. A., Norzila, Z., Zaharah, S., et al. (2009). Validity and reliability of the Malay version of WHOQOL-HIV BREF in patients with HIV infection. AIDS Care, 21, 1271–1278. doi:10.1080/09540120902803216.

    PubMed  Article  CAS  Google Scholar 

  16. Pereira, M., & Canavarro, M. C. (2011). Gender and age differences in quality of life and the impact of psychopathological symptoms among HIV-infected patients. AIDS and Behavior, 15, 1857–1869. doi:10.1007/s10461-011-9928-8.

    PubMed  Article  Google 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.

    PubMed  Article  Google Scholar 

  22. Hyland, M. E. (2003). A brief guide to the selection of quality of life instrument. Health and Quality of Life Outcomes, 1, 24. doi:10.1186/1477-7525-1-24.

    PubMed  Article  PubMed Central  Google Scholar 

  23. Heinonen, H., Aro, A. R., Aalto, A.-M., & Uutela, A. (2004). Is the evaluation of the global quality of life determined by emotional status? Quality of Life Research, 13, 1347–1356. doi:10.1023/B:QURE.0000040788.12947.b9.

    PubMed  Article  CAS  Google 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.

    PubMed  Article  CAS  Google 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.

    PubMed  Article  CAS  Google Scholar 

Download references

Acknowledgments

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.

Author information

Affiliations

  1. Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802, Coimbra, Portugal

    Marco Pereira, Alexandra Martins, Stephanie Alves & Maria Cristina Canavarro

Authors
  1. Marco Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexandra Martins
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephanie Alves
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Maria Cristina Canavarro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marco Pereira.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Pereira, M., Martins, A., Alves, S. et al. Assessing quality of life in middle-aged and older adults with HIV: psychometric testing of the WHOQOL-HIV-Bref. Qual Life Res 23, 2473–2479 (2014). https://doi.org/10.1007/s11136-014-0707-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-014-0707-7

Keywords

  • HIV infection
  • Middle-aged and older adults
  • Quality of life
  • Reliability
  • Validity