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The suitability of the WHOQOL–BREF for Canadian and Norwegian older adults

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Abstract

The aim of this study was to examine the validity and reliability of the WHOQOL–BREF, a generic quality of life scale, among older people in Canada and Norway. Very similar data from the Canadian and Norwegian Field Trial data (Canada n = 192; Norway, n = 469) were analyzed and compared. Higher negatively skewed mean scores were found for all WHOQOL–BREF domains in Canada. For both study samples, missing values were highest for the sex item from the social domain. Ceiling effects were found (Canada n = 21; Norway n = 11) primarily among items in the physical and environmental domains. In both study samples, a multitrait multimethod procedure indicated items correlated most strongly with their parent domains; however, equally appreciable correlations were observed between physical, psychological, and environmental items (r = 0.33–0.64; p < 0.01). The social domain had the lowest internal consistency (α = 0.67 Canada, α = 0.55 Norway). Confirmatory factor analyses (CFA) yielded marginal goodness-of-fit between the hypothesized WHOQOL–BREF measurement model and the sample data as well as differing patterns of domain misspecification. Patterns of correlations (p < 0.01) of WHOQOL–BREF domains with WHOQOL–OLD facets, a global QOL item, the SF-12, and the geriatric depression scale provided evidence of convergent and divergent validity. Domain scores also significantly discriminated between health and unhealthy populations and presence of morbidity. Empirical support was found, in part, for the construct validity of the WHOQOL–BREF in older adults. Despite some different patterns found in the CFA, possibly due to cultural or sampling differences, it appears that the instrument is reliable, valid, and facilitates cross-cultural comparisons.

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Acknowledgments

The authors would like to acknowledge the contributions of the WHOQOL-OLD Group in the design of the original study that led to the compilation of the data sets. We acknowledge the work of Liv Halvorsrud and Janice Robinson for data collection in Norway and Canada, respectively. Funding for the original project was obtained from the European Commission fifth Framework Competition, the University of Victoria Internal SSHRC grants, and Diakonova University College funding, Oslo. We are also grateful to EJA’s referees for their valuable suggestions.

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  1. Department of Research, Diakonova University College, Linstowsgate 5, 0166, Oslo, Norway

    Mary H. Kalfoss

  2. Faculty of Nursing, University of Alberta, 3rd Floor Clinical Sciences Building, Edmonton, AB, Canada, T6G 2G3

    Gail Low

  3. School of Nursing, University of Victoria, PO Box 1700, Victoria, BC, Canada, V8W 2Y2

    Anita E. Molzahn

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  1. Mary H. Kalfoss
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Correspondence to Mary H. Kalfoss.

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Kalfoss, M.H., Low, G. & Molzahn, A.E. The suitability of the WHOQOL–BREF for Canadian and Norwegian older adults. Eur J Ageing 5, 77–89 (2008). https://doi.org/10.1007/s10433-008-0070-z

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