Paper
Saturday, 22 July 2006
This presentation is part of : Developing and Testing Measurement Instruments
Development and Testing of the WHOQOL-OLD
Anita Molzahn, PhD, MN, BScN, School of Nursing, University of Victoria, Victoria, BC, Canada and Mary Kalfoss, DrPH, MA, BSN, Dept. of Research, Diakonova University College, Oslo, Norway.
Learning Objective #1: describe the process for developing and testing the WHOQOL-OLD.
Learning Objective #2: identify how to gain access to the instrument for research or evaluation purposes.
Since the early 1990s, the WHOQOL Group has been working on the development of generic quality of life (QOL) measures that could be used to facilitate cross-cultural comparisons. The WHOQOL-100 and WHOQOL-BREF focus on the assessment of physical, psychological, social and environmental aspects of QOL and have been in use for some time. However, the research group was concerned that the instruments did not capture aspects of QOL specific to older adults. Hence, we engaged in research to develop a module for older adults to augment the original measures. Twenty two national centers participated in the project, funded by the European Commission, 5th Framework Competition. We began by holding four focus groups in each of 22 centres, to identify areas of QOL important to older adults. In each center, two focus groups were held with older adults, one with lay caregivers, and one with health care providers.  Using these qualitative data, aspects of QOL specific to older adults were identified and used to generate new items. We pilot tested the module, and used the findings to make revisions to the instrument. The instrument was then field tested. The final measure includes 24 items, with four questions addressing the following additional facets: sensory abilities, autonomy, past present and future activities, social participation, death and dying, and intimacy. After international pooling, the consistency reliability using Cronbach’s alpha ranged from .72 for the autonomy facet to .91 for the intimacy facet.  Modern psychometric methods including structural equation modeling and item response theory were used to help validate the instrument. Although there is no perfect measure, and ongoing testing of the measure continues, the WHOQOL-OLD offers a useful tool for nurse researchers interested in exploring QOL of older adults, in both healthy and sick populations. Possible clinical applications of the measure will be discussed.

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