Normative and psychometric properties of the whoqol older adults module (whoqol-old) in the national repository

Abstract

Introduction: The main objectives of this study were to present population norms and the construct validity of the WHOQOL-OLD using classical and modern (Rasch) psychometric analyses.Methods: This study was conducted on the pooled data of 29 studies, 16 of which were representative of the population (n=6951). The psychometric properties of the WHOQOL-OLD were evaluated with classical (confirmatory factor analysis and multivariate regression model) and probabilistic test theory (Rasch and DIF) analyses. Results: The mean age of the Turkish WHOQOL-OLD data pool was 73.2 +/- 6.8. The mean overall scale score was 81.27 +/- 13.57 and the range of the mean dimension scores was between 12.34 (social participation) and 14.59 (intimacy). The elderly (advanced age) and women are more sensitive to the decrease in quality-of-life (QoL) scores. Both Cronbach's alpha values and item analyses indicated good internal consistency for all dimensions. Exploratory factor analyses (EFA) generated five factors instead of a six-factor original scale structure. "Past, present, and future activities" and "social participation" were combined in a single dimension in the EFA. Confirmatory factor analyses resulted in acceptable goodness of fit indices, such as Confirmation Fit Index (CFI)=0.951 and Root Mean Square Error of Approximation (RMSEA)=0.055. Turkish elders perceive the death and dying dimension as culturally closer to the culture of developing countries than developed Western cultures. Conclusion: Turkish older adults' QoL scores were more or less like those of other older adults in developing countries. This study's results confirm that the acceptable psychometric properties of the WHOQOL-OLD-TR with some items (items 9 and 20) need to be worked on further.