Resolving Dimensionality Problems With WHOQOL-BREF Item Responses

Area of Science:

• Psychometrics
• Health Psychology
• Sociology

Background:

• The World Health Organization Quality of Life Scale (WHOQOL-BREF) is widely used but its underlying latent structure remains debated.
• Understanding the psychometric properties of the WHOQOL-BREF is crucial for accurate quality of life (QOL) measurement.

Purpose of the Study:

• To investigate the latent structure of the WHOQOL-BREF.
• To examine the factorial invariance of the WHOQOL-BREF across gender.
• To explore age and gender interactions in relation to QOL dimensions.

Main Methods:

• A bifactor exploratory structural equation modeling (ESEM) approach was employed.
• Data from a general population sample were analyzed.
• Factorial invariance and latent mean differences were tested across gender and age groups.

Main Results:

• A bifactor ESEM model provided a robust representation of the WHOQOL-BREF data, accounting for general and specific QOL factors.
• The measurement and structural properties of the WHOQOL-BREF were found to be invariant across gender.
• A curvilinear relationship between age and QOL was identified, with a nadir observed during midlife.

Conclusions:

• The findings provide strong validation for the WHOQOL-BREF, supporting its bifactor structure.
• The WHOQOL-BREF demonstrates reliable measurement across genders.
• The study highlights a significant midlife decline in QOL, offering valuable insights for targeted interventions.