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Psychometric evaluation of the WHOQOL-BREF and its shorter versions for general Thai population: confirmatory factor analysis and Rasch analysis

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Abstract

Purpose

Rasch analysis was employed to validate the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and its existing shorter versions in the general Thai population.

Methods

1200 respondents were randomly selected to complete the questionnaire. Confirmatory factor analysis (CFA) was employed to test the structure of the WHOQOL-BREF and its shorter versions with the random sub-sample of 900 respondents, while Rasch analysis was performed with a random sub-sample of 300 respondents.

Results

The CFA confirmed the factor structure of WHOQOL-BREF and its shorter versions. The Rasch analysis revealed that the WHOQOL-BREF, when a four-domain structure was tested using a subtest approach, achieved acceptable model fit to the Rasch model and met the expectations of unidimensionality with high reliability (PSI = 0.87). Individual domain models were also unidimensional, but reliability of the 3-item social domain was inadequate. While the 8-item EUROHIS-QOL-8 and 5-item WHOQOL-5 achieved an overall acceptable fit and met the expectations of unidimensionality, the reliability of the WHOQOL-5 was below the acceptable threshold (PSI = 0.66). Reliability of the EUROHIS-QOL-8 was satisfactory (PSI = 0.79).

Conclusions

The WHOQOL-BREF is a valid instrument for use in the Thai general population, both as a total score as well as individual subscales. Rasch analysis also supports the use of EUROHIS-QOL-8, but the WHOQOL-5 lacks good reliability. While the reliability of the EUROHIS-QOL-8 is sufficiently high for between-group analysis, the Thai WHOQOL-BREF total score can also be used for within-participant analyses. Rasch investigation with a more varied health conditions of general Thai samples or patient groups is encouraged for future studies.

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Data availability

The data analyzed and reported in this manuscript is not available for public sharing because all raw data should be kept it with researcher for privacy in order to comply with the ethical standard.

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Acknowledgements

The author expresses sincere gratitude to the EuroQoL group for their permission to use the EQ-5D-5L questionnaire in this study, and also thanks all local village leaders and participants from the provinces of Nakhon-Srithammarat, Khon-Kaen, Chonburi, Chiang-Mai, and Bangkok in Thailand who facilitated or participated in the data collection process. Special thanks to all interviewers for their assistance with the data collection process

Funding

This work was supported by the Research Grant No. Rx2/2562 from the Burapha University through the National Research Council of Thailand. The results,  interpretation of data, conclusions and opinions have not been endorsed by the grant.

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Authors and Affiliations

  1. Division of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, 169 Long-Hard Bangsaen Rd., Mueang, 20131, Chonburi, Thailand

    Krittaphas Kangwanrattanakul

  2. Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand

    Christian U. Krägeloh

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This study was jointly designed by KK and CK. Only KK was involved in data collection. Data analyses were performed by KK and confirmed by CK. All authors were involved in drafting, revising, and final approval of this manuscript.

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Correspondence to Krittaphas Kangwanrattanakul.

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This work was approved by the Burapha University Institutional Review Board (BUU-IRB): 108/2562 before the study commenced.

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Kangwanrattanakul, K., Krägeloh, C.U. Psychometric evaluation of the WHOQOL-BREF and its shorter versions for general Thai population: confirmatory factor analysis and Rasch analysis. Qual Life Res 33, 335–348 (2024). https://doi.org/10.1007/s11136-023-03521-y

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