Abstract:
Background: Quality of life of patients is an important element in the evaluation of outcome of health care, social
services and clinical trials. The WHOQOL instruments were originally developed for measurement of quality of life
across cultures. However, there were concerns raised about the cross-cultural equivalence of the WHOQOL-HIV when
used among people with HIV in Ethiopia. Therefore, this study aimed at adapting the WHOQOL-HIV bref for the Ethiopian setting.
Methods: A step-wise adaptation of the WHOQOL-HIV bref for use in Ethiopia was conducted to produce an
Ethiopian version—WHOQOL-HIV-BREF-Eth. Semantic and item equivalence was tested on 20 people with HIV. One
hundred people with HIV were interviewed to test for measurement equivalence (known group validity and internal
consistency) of the WHOQOL-HIV-BREF-Eth. Confirmatory factor analysis was conducted using data from 348 people
with HIV who were recruited from HIV clinics.
Results: In the process of adaptation, new items of relevance to the context were added while seven items were
deleted because of problems with acceptability and poor psychometric properties. The Cronbach’s α for the final tool
with twenty-seven items WHOQOL-HIV-BREF-Eth was 0.93. All six domains discriminated well between symptomatic
and asymptomatic people with HIV (p < 0.001). Using confirmatory factor analysis, a second order factor structure with six first order indicator factors demonstrated moderate fit to the data ((χ2 = 627.75; DF = 259; p < 0.001),
CFI = 0.82, TLI = 0.77 and RMSEA = 0.064).
Conclusion: The WHOQOL-HIV-BREF-Eth has been shown to be a valid measure of quality of life for use in clinical settings among people with HIV in Ethiopia.
