Abstract
Background
In order to predict social, mental and health care needs we must measure Quality of life of residents. In Afghanistan there was no assessment to measure quality of life of people. The aim of this study was to culturally adapt the WHOQOL-BREF into Dari language of Afghanistan and present its psychometric properties.
Methods
Cultural adaptation of the WHOQOL-BREF into Dari has consisted of two stages: translation stage, and the cognitive debriefing (pilot) stage following the translation stage. The process of translation of WHOQOL-BREF included recommended methodology, mandating forward translation, backward translation was followed. A total number of 1473 people did participate in this research. Psychometric analyses consisted of item analyses; reliability and validity analyses. Internal consistency analyses were done by Cronbach's alpha value and validity analyses consisted of construct validity (convergent validity by SF-36 and confirmatory factor analyses) and criterion validity (multiple linear regression by overall QoL item (item1)) analyses. Acceptable type 1 error was considered as 0.05 in all analyses. Analyses were done by using Lisrel v8.05 statistical package.
Results
Item domain correlations and -if item deleted- Cronbach alpha values no problematic item in Afghan version of the WHOQOL-BREF. Internal consistency of the scale was in acceptable limits for all domains (alpha values = 0.79–0.80) except for the social relations domain (alpha = 0.41). Using overall QoL item (item q1) as the dependent variable, multiple regression analysis revealed a R2 value of 57% and all of the four domains of the WHOQOL except that of Social relation domain (beta = 0.03) could explain the variance of the q1, the best domain is the environmental domain with a beta value of 0.30. Construct validity is tested by known groups validity; factorial validity and the convergent validity. All of the known categories of the age, gender, education, social class and economic status, having chronic illness were significantly sensitive to the domain scores of the WHOQOL (p < 0.001). Physical and Psychological domains of the WHOQOL-BREF was highly correlated with the related domains of the SF-36 (r = 0.60 and 0.64). Social and environmental domains showed poor correlations with the SF36. Confirmatory factor analyses showed acceptable goodness of fit results. Chi-square = 2174,748 and Degrees of freedom = 246; GFI: 0.88, CFI: 0.83; RMR: 0.066 and RMSEA: 0.073.
Conclusion
Afghan Dari version of the WHOQOL-BREF can confidently be used in clinical setting and in population level to assess the QoL of the people. The results of the social relations domain should be interpreted with caution due to its poor psychometric power. Further studies are needed to address the social aspects of quality of life in Afghan population.