Med Decis Making - Cross-cultural evaluation of the WHOQOL-BREF domains in primary care depressed patients using Rasch analysis.


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CKGROUND: The Rasch model prescribes procedures to ensure that a scale constructed from multiple items conforms to fundamental requirements of interval scales of measurement.OBJECTIVE: To test the Rasch properties of the domains of the World Health Organization Quality of Life Instrument-abbreviated version (WHOQOL-BREF) in depressed patients from primary care settings.DESIGN: Cross-sectional, cross-national study.SETTING: Primary care.PATIENTS: The sample consisted of 1193 patients having a confirmed diagnosis of depression from 6 countries (Australia, Brazil, Israel, Russia, Spain, and the United States) involved in the Longitudinal Investigation of Depression Outcomes (LIDO) study.MEASUREMENTS: The Composite International Diagnostic Interview (CIDI) diagnosed depression, whereas the Center for Epidemiological Studies Depression Scale (CES-D) assessed severity of depression. The WHOQOL-BREF measured generic quality of life (QOL).RESULTS: Three of the 4 WHOQOL-BREF domains (physical, psychological, and environment) conform to the Rasch model expectations, following adjustments required mainly because of individual item misfit or differential item functioning (DIF) due to age or country. The social domain showed relatively poor psychometric properties, as observed in previous studies.CONCLUSIONS: The Rasch analysis demonstrated that, with some modifications, all domains of the WHOQOL-BREF, except for the social domain, provide an interval scale measure of generic subjective QOL in the context of depressed primary care patients in 6 countries worldwide.

Resumo Limpo

ckground rasch model prescrib procedur ensur scale construct multipl item conform fundament requir interv scale measurementobject test rasch properti domain world health organ qualiti life instrumentabbrevi version whoqolbref depress patient primari care settingsdesign crosssect crossnat studyset primari carepati sampl consist patient confirm diagnosi depress countri australia brazil israel russia spain unit state involv longitudin investig depress outcom lido studymeasur composit intern diagnost interview cidi diagnos depress wherea center epidemiolog studi depress scale cesd assess sever depress whoqolbref measur generic qualiti life qolresult three whoqolbref domain physic psycholog environ conform rasch model expect follow adjust requir main individu item misfit differenti item function dif due age countri social domain show relat poor psychometr properti observ previous studiesconclus rasch analysi demonstr modif domain whoqolbref except social domain provid interv scale measur generic subject qol context depress primari care patient countri worldwid

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