Cross-national comparability of the WHOQOL-BREF: A measurement invariance approach

Qual Life Res (2010) 19:219224 DOI 10.1007/s11136-009-9577-9

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Cross-national comparability of the WHOQOL-BREF: A measurement invariance approach

Peter Theuns Joeri Hofmans Mehrdad Mazaheri

Frederik Van Acker Jan L. Bernheim

Accepted: 19 December 2009 / Published online: 20 January 2010 Springer Science+Business Media B.V. 2010

AbstractPurpose To evaluate whether the WHOQOL-BREF measures the QOL construct in the same way across nations. Methods Students from Flanders, Belgium and Iran completed the WHOQOL-BREF as part of a larger Quality of Life questionnaire. Their responses were compared using a multi-group conrmatory factor analysis.

Results In general, the QOL construct appears rather similar in both cultures; however, participants from both

countries seem to respond differently to particular items of the WHOQOL-BREF. Especially for the physical and psychological domain, this is problematic, because none of their indicators works in the same way across samples. Conclusions Notwithstanding some limitations of this study, it must be concluded that the WHOQOL-BREF should only be used with great caution in cross-national comparisons.

Keywords Quality-of-life construct

Measurement invariance Intercultural comparability

Life domains

AbbreviationsQOL Quality of lifeWHOQOL-BREF World health organization quality of life assessment instrumentACSA Anamnestic comparative self assessmentPWI Personal wellbeing indexRMSEA Root mean square error of approximationCFI Comparative t index

Introduction

The sensitivity of Quality of life (QOL) measures to cultural differences is an important problem in cross-national research [14]. It has been found that nancial satisfaction [5, 6], satisfaction with education, material wealth, home life, health [7, 8], satisfaction with esteem needs [1, 5, 7], and number of friends [8] are differentially related to overall life satisfaction in different populations.

P. Theuns (&) F. Van Acker

Vakgroep Experimentele en Toegepaste Psychologie, Faculty of Psychology and Education Sciences, EXTO, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussel, Belgium e-mail: [email protected]

J. Hofmans (&)

Research Group of Quantitative Psychology and Individual Differences, Katholieke Universiteit Leuven, Tiensestraat 102, 3000 Leuven, Belgiume-mail: [email protected]

M. MazaheriDepartment of Psychology, University of Sistan & Baluchestan, Zahedan, Irane-mail: [email protected]

Present Address:F. Van AckerFaculty of Psychology, Open Universiteit Nederland, PO Box 2960, 6401 DL Heerlen, The Netherlands e-mail: [email protected]

J. L. BernheimHuman Ecology, Faculty of Medicine and Pharmacy, MEKO, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussel, Belgiume-mail: [email protected]

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Accordingly, it can be questioned whether different determinants contribute...