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Psychometric evaluation, using Rasch analysis, of the WHOQOL-BREF in heroin-dependent people undergoing methadone maintenance treatment: further item validation
BACKGROUND: The brief version of World Health Organization Quality of Life assessment (WHOQOL-BREF), a useful outcome measure for clinical decision making, has been evaluated using classical test theory (CTT) for psychometric properties on heroin-dependent patients. However, CTT has a major disadvan...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4190329/ https://www.ncbi.nlm.nih.gov/pubmed/25277717 http://dx.doi.org/10.1186/s12955-014-0148-6 |
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author | Chang, Kun-Chia Wang, Jung-Der Tang, Hsin-Pei Cheng, Ching-Ming Lin, Chung-Ying |
author_facet | Chang, Kun-Chia Wang, Jung-Der Tang, Hsin-Pei Cheng, Ching-Ming Lin, Chung-Ying |
author_sort | Chang, Kun-Chia |
collection | PubMed |
description | BACKGROUND: The brief version of World Health Organization Quality of Life assessment (WHOQOL-BREF), a useful outcome measure for clinical decision making, has been evaluated using classical test theory (CTT) for psychometric properties on heroin-dependent patients. However, CTT has a major disadvantage of invalid summated score, and using Rasch models can overcome the shortcoming. The purpose of this study was using Rasch models to evaluate the psychometric properties of the WHOQOL-BREF for heroin-dependent patients, and the hypothesis was that each WHOQOL-BREF domain is unidimensional. METHODS: Two hundred thirty six participants (24 females, mean [SD] age = 38.07 [7.44] years, first used heroin age = 26.13 [6.32] years), with a diagnosis of opioid dependence, were recruited from a methadone maintenance treatment program. Each participant filled out the WHOQOL-BREF. Parallel analysis (PA) and Rasch rating scale models were used for statistical analyses. RESULTS: Based on the PA analyses, four domains of the WHOQOL-BREF were unidimensional. The Rasch analyses showed three negatively worded items (2 in Physical and 1 in Psychological) reported as misfits that may not contribute to the Physical and Psychological domains; one positively worded item in the Physical domain may be redundant. All values for the separation indices were above 2 except for the person separation index in the Physical domain (1.93). Category functioning and item independency of four WHOQOL-BREF domains were supported by the Rasch analyses, and there were 5 items showing the differential item function (DIF) for positive versus negative HIV (human immunodeficiency virus) infection. CONCLUSIONS: The WHOQOL-BREF is a valid outcome measure for assessing general quality of life for substance abusers in terms of physical, psychological, social, and environmental factors. It can also be used as a treatment outcome measure to evaluate the effect of treatments for substance abusers. However, the three misfit negatively worded items should be used with caution because the substance abuser may not fully understand their meaning. Future research may apply cognitive interviews to determine the cognitive functioning of substance abusers and their interpretation of negatively worded items. |
format | Online Article Text |
id | pubmed-4190329 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-41903292014-10-10 Psychometric evaluation, using Rasch analysis, of the WHOQOL-BREF in heroin-dependent people undergoing methadone maintenance treatment: further item validation Chang, Kun-Chia Wang, Jung-Der Tang, Hsin-Pei Cheng, Ching-Ming Lin, Chung-Ying Health Qual Life Outcomes Research BACKGROUND: The brief version of World Health Organization Quality of Life assessment (WHOQOL-BREF), a useful outcome measure for clinical decision making, has been evaluated using classical test theory (CTT) for psychometric properties on heroin-dependent patients. However, CTT has a major disadvantage of invalid summated score, and using Rasch models can overcome the shortcoming. The purpose of this study was using Rasch models to evaluate the psychometric properties of the WHOQOL-BREF for heroin-dependent patients, and the hypothesis was that each WHOQOL-BREF domain is unidimensional. METHODS: Two hundred thirty six participants (24 females, mean [SD] age = 38.07 [7.44] years, first used heroin age = 26.13 [6.32] years), with a diagnosis of opioid dependence, were recruited from a methadone maintenance treatment program. Each participant filled out the WHOQOL-BREF. Parallel analysis (PA) and Rasch rating scale models were used for statistical analyses. RESULTS: Based on the PA analyses, four domains of the WHOQOL-BREF were unidimensional. The Rasch analyses showed three negatively worded items (2 in Physical and 1 in Psychological) reported as misfits that may not contribute to the Physical and Psychological domains; one positively worded item in the Physical domain may be redundant. All values for the separation indices were above 2 except for the person separation index in the Physical domain (1.93). Category functioning and item independency of four WHOQOL-BREF domains were supported by the Rasch analyses, and there were 5 items showing the differential item function (DIF) for positive versus negative HIV (human immunodeficiency virus) infection. CONCLUSIONS: The WHOQOL-BREF is a valid outcome measure for assessing general quality of life for substance abusers in terms of physical, psychological, social, and environmental factors. It can also be used as a treatment outcome measure to evaluate the effect of treatments for substance abusers. However, the three misfit negatively worded items should be used with caution because the substance abuser may not fully understand their meaning. Future research may apply cognitive interviews to determine the cognitive functioning of substance abusers and their interpretation of negatively worded items. BioMed Central 2014-10-03 /pmc/articles/PMC4190329/ /pubmed/25277717 http://dx.doi.org/10.1186/s12955-014-0148-6 Text en © Chang et al.; licensee BioMed Central Ltd. 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Chang, Kun-Chia Wang, Jung-Der Tang, Hsin-Pei Cheng, Ching-Ming Lin, Chung-Ying Psychometric evaluation, using Rasch analysis, of the WHOQOL-BREF in heroin-dependent people undergoing methadone maintenance treatment: further item validation |
title | Psychometric evaluation, using Rasch analysis, of the WHOQOL-BREF in heroin-dependent people undergoing methadone maintenance treatment: further item validation |
title_full | Psychometric evaluation, using Rasch analysis, of the WHOQOL-BREF in heroin-dependent people undergoing methadone maintenance treatment: further item validation |
title_fullStr | Psychometric evaluation, using Rasch analysis, of the WHOQOL-BREF in heroin-dependent people undergoing methadone maintenance treatment: further item validation |
title_full_unstemmed | Psychometric evaluation, using Rasch analysis, of the WHOQOL-BREF in heroin-dependent people undergoing methadone maintenance treatment: further item validation |
title_short | Psychometric evaluation, using Rasch analysis, of the WHOQOL-BREF in heroin-dependent people undergoing methadone maintenance treatment: further item validation |
title_sort | psychometric evaluation, using rasch analysis, of the whoqol-bref in heroin-dependent people undergoing methadone maintenance treatment: further item validation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4190329/ https://www.ncbi.nlm.nih.gov/pubmed/25277717 http://dx.doi.org/10.1186/s12955-014-0148-6 |
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