Development and validation of the WHOQOL-OLD in Taiwan

Objectives: To develop and validate the WHOQOL-OLD-Taiwan version. Methods: This was a cross-sectional study. First, we translated this questionnaire by following standard procedure. After a pilot study, we collected data from 438 seniors over 60 years of age from communities in greater Taipei and Chiayi from June to October, 2012. In addition to filling out the WHOQOL-OLD, the participants also completed the WHOQOL-BREF, Geriatric Depression Scale-15, Barthel Index, and Mini-Mental State Examination as the criterion variables. We examined the following psychometric properties: internal consistency reliability, content validity, construct validity, concurrent validity, predictive validity, and discriminant validity by using correlation analysis, regression analysis, two independent group t-tests, and confirmatory factor analysis. Results: The internal consistency coefficients were between 0.71∼0.86. The correlation coefficients between each item (r=0.62∼0.88) and the facet of belonging were higher than those with other facets. Confirmatory factor analysis generally supported the idea that the WHOQOL-OLD was a second-order factor model, which indicated that six factors were subsumed under an overall "quality of life" factor. Most of the correlation coefficients between the facets of WHOQOL-OLD and several concurrent criteria were statistically significant (p < 0.01), but some correlations were not as high as expected. Except for predicting G1 and G2, the WHOQOL-OLD explained about 40% of the variation in the overall quality of life indices. This study also showed that the WHOQOL-OLD was a good add-on module. Elderly people with better and worse health conditions could be discriminated by the WHOQOL-OLD through independent group t-tests (p < 0.01). Conclusions: The WHOQOL-OLD-Taiwan version has good psychometric properties. The WHOQOL-OLD module appears to be a useful instrument for use with community-dwelling Taiwanese seniors.