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Exploring the Latent Trait and the Measurement Properties of Korean World Health Organization Quality of Life-BREF Measure Applied to Cancer Survivors

  • Bongsam Choi (Department of Physical Therapy, College of Health and Welfare, Woosong University)
  • Received : 2023.04.26
  • Accepted : 2023.04.30
  • Published : 2023.05.20

Abstract

Background: In general, measurement qualities of cross-culturally adapted quality of life (QOL) measures are altered in many aspects, although versions of them are well-validated measures. The latent trait and measurement qualities of the QOL measures for cancer-related samples should be considered when developing cross-culturally adapted measures. Objects: To investigate the latent trait of the translated into Korean World Health Organization Quality of Life-BREF (WHOQOL-BREF) administered to different cancer survivors who had palliative rehabilitation care service (PRCS). Methods: A cross-sectional study with 139 cancer survivors who had an experience of cancer survivorship with PRCS were conducted with a two-step analytic procedure including exploratory factor analysis (EFA) to confirm the latent trait and Rasch rating scale modeling to investigate the measurement qualities of the cross-culturally adapted WHOQOL-BREF measure. Results: While the original WHOQOL-BREF measure constitutes a 4-latent trait, the EFA reveals that 24 items constitute six substantial factors. The item loadings are predominantly spread over factors 1 through 4 in a mixed manner of the latent traits, while the loadings of 'physical health' and 'environmental health' latent traits show similarity to what the original measure intended to assess. The latent trait of the cross-culturally adapted WHOQOL-BREF measure administered to different cancer survivors is likely to reveal more dimensions than the original WHOQOL-BREF measure. Person reliability (i.e., analogous to Cronbach's alpha) and separation are measured with 0.92 and 3.48, respectively. All items except the one item (medical treatment item) fit the Rasch rating model. Conclusion: Findings suggest that the latent trait and the measurement qualities of the cross-culturally adapted WHOQOL-BREF measure should be taken into consideration when applying versions of it to various populations.

Keywords

Acknowledgement

This research is based on the support of 2023 Woosong University Academic Research Funding.

References

  1. World Health Organization (WHO). WHO report on cancer: setting priorities, investing wisely and providing care for all. WHO; 2020.
  2. Hong S, Won YJ, Park YR, Jung KW, Kong HJ, Lee ES; Community of Population-Based Regional Cancer Registries. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2017. Cancer Res Treat 2020;52(2):335-50. https://doi.org/10.4143/crt.2020.206
  3. American Cancer Society. Palliative care. American Cancer Society [Internet]. 2019 May 10 [cited 2023 Apr 16]. Available from: https://www.cancer.org/treatment/treatments-andside-effects/palliative-care/what-is-palliative-care.html
  4. Dy SM, Isenberg SR, Al Hamayel NA. Palliative care for cancer survivors. Med Clin North Am 2017;101(6):1181-96. https://doi.org/10.1016/j.mcna.2017.06.009
  5. Economou D. Palliative care needs of cancer survivors. Semin Oncol Nurs 2014;30(4):262-7. https://doi.org/10.1016/j.soncn.2014.08.008
  6. van Roij J, Fransen H, van de Poll-Franse L, Zijlstra M, Raijmakers N. Measuring health-related quality of life in patients with advanced cancer: a systematic review of self-administered measurement instruments. Qual Life Res 2018;27(8):1937-55. https://doi.org/10.1007/s11136-018-1809-4
  7. Cieza A, Stucki G. Content comparison of health-related quality of life (HRQOL) instruments based on the international classification of functioning, disability and health (ICF). Qual Life Res 2005;14(5):1225-37. https://doi.org/10.1007/s11136-004-4773-0
  8. Efthymiadou O, Mossman J, Kanavos P. Health related quality of life aspects not captured by EQ-5D-5L: results from an international survey of patients. Health Policy 2019;123(2):159-65. https://doi.org/10.1016/j.healthpol.2018.12.003
  9. Development of the World Health Organization WHOQOLBREF quality of life assessment. The WHOQOL Group. Psychol Med 1998;28(3):551-8. https://doi.org/10.1017/S0033291798006667
  10. Choi B. Construct validity of a Korean version of the WHOQOL-BREF and EQ-5D questionnaire applied on various cancer survivors undergoing palliative rehabilitation programs. Phys Ther Korea 2020;27(3):212-9. https://doi.org/10.12674/ptk.2020.27.3.212
  11. Leary MR, Hoyle RH. Handbook of individual differences in social behavior. Guilford Press; 2009;318-29.
  12. Cacioppo JT, Petty RE. The need for cognition. J Pers Soc Psychol 1982;42(1):116-31. https://doi.org/10.1037/0022-3514.42.1.116
  13. McHorney CA. Generic health measurement: past accomplishments and a measurement paradigm for the 21st century. Ann Intern Med 1997;127(8 Pt 2):743-50. https://doi.org/10.7326/0003-4819-127-8_Part_2-199710151-00061
  14. Ashley L, Smith AB, Jones H, Velikova G, Wright P. Traditional and Rasch psychometric analyses of the Quality of Life in Adult Cancer Survivors (QLACS) questionnaire in shorter-term cancer survivors 15 months post-diagnosis. J Psychosom Res 2014;77(4):322-9. https://doi.org/10.1016/j.jpsychores.2014.07.007
  15. Efthymiadou O, Mossman J, Kanavos P. Differentiation of health-related quality of life outcomes between five disease areas: results from an international survey of patients. Int J Technol Assess Health Care 2018;34(5):498-506. https://doi.org/10.1017/S0266462318000557
  16. Yang Y, Longworth L, Brazier J. An assessment of validity and responsiveness of generic measures of health-related quality of life in hearing impairment. Qual Life Res 2013;22(10):2813-28. https://doi.org/10.1007/s11136-013-0417-6
  17. Min SK, Kim KI, Lee CI, Jung YC, Suh SY, Kim DK. Development of the Korean versions of WHO Quality of Life scale and WHOQOL-BREF. Qual Life Res 2002;11(6):593-600. https://doi.org/10.1023/A:1016351406336
  18. Cattell RB. The scree test for the number of factors. Multivariate Behav Res 1966;1(2):245-76. https://doi.org/10.1207/s15327906mbr0102_10
  19. Tavakol M, Wetzel A. Factor analysis: a means for theory and instrument development in support of construct validity. Int J Med Educ 2020;11:245-7. https://doi.org/10.5116/ijme.5f96.0f4a
  20. Bond TG, Fox CM. Applying the Rasch model: fundamental measurement in the human sciences. 2nd ed. Lawrence Erlbaum Associates Publishers; 2007.
  21. Smith AB, Wright P, Selby PJ, Velikova G. A Rasch and factor analysis of the functional assessment of cancer therapygeneral (FACT-G). Health Qual Life Outcomes 2007;5:19.
  22. Embretson SE, Reise SP. Item response theory for psychologists. Lawrence Erlbaum Associates Publishers; 2000.
  23. Titlestad KB, Snibsoer AK, Stromme H, Nortvedt MW, Graverholt B, Espehaug B. Translation, cross-cultural adaption and measurement properties of the evidence-based practice profile. BMC Res Notes 2017;10(1):44.
  24. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976) 2000;25(24):3186-91. https://doi.org/10.1097/00007632-200012150-00014
  25. Ferraz MB. Cross cultural adaptation of questionnaires: what is it and when should it be performed? J Rheumatol 1997;24(11):2066-8.
  26. Guyatt GH. The philosophy of health-related quality of life translation. Qual Life Res 1993;2(6):461-5. https://doi.org/10.1007/BF00422220
  27. Streiner DL. Starting at the beginning: an introduction to coefficient alpha and internal consistency. J Pers Assess 2003;80(1):99-103. https://doi.org/10.1207/S15327752JPA8001_18
  28. Lin CY, Hwang JS, Wang WC, Lai WW, Su WC, Wu TY, et al. Psychometric evaluation of the WHOQOL-BREF, Taiwan version, across five kinds of Taiwanese cancer survivors: Rasch analysis and confirmatory factor analysis. J Formos Med Assoc 2019;118(1 Pt 2):215-22. https://doi.org/10.1016/j.jfma.2018.03.018