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Title: Psychometric evaluation of the WHOQOL-BREF, Taiwan version, across five kinds of Taiwanese cancer survivors : Rasch analysis and confirmatory factor analysis
Authors: Lin, CY 
Hwang, JS
Wang, WC
Lai, WW
Su, WC
Wu, TY
Yao, G
Wang, JD
Issue Date: 2019
Source: Journal of the Formosan Medical Association, Jan. 2019, v. 118, no. 1, pt. 2, p. 215-222
Abstract: Background: Quality of life (QoL) is important for clinicians to evaluate how cancer survivors judge their sense of well-being, and WHOQOL-BREF may be a good tool for clinical use. However, at least three issues remain unresolved: (1) the psychometric properties of the WHOQOL-BREF for cancer patients are insufficient; (2) the scoring method used for WHOQOL-BREF needs to be clarify; (3) whether different types of cancer patients interpret the WHOQOL-BREF similarly.
Methods: We recruited 1000 outpatients with head/neck cancer, 1000 with colorectal cancer, 965 with liver cancer, 1438 with lung cancer and 1299 with gynecologic cancers in a medical center. Data analyses included Rasch models, confirmatory factor analysis (CFA), and Pearson correlations.
Results: The mean WHOQOL-BREF domain scores were between 13.34 and 14.77 among all participants. CFA supported construct validity; Rasch models revealed that almost all items were embedded in their expected domains and were interpreted similarly across five types of cancer patients; all correlation coefficients between Rasch scores and original domain scores were above 0.9.
Conclusion: The linear relationship between Rasch scores and domain scores suggested that the current calculations for domain scores were applicable and without serious bias. Clinical practitioners may regularly collect and record the WHOQOL-BREF domain scores into electronic health records.
Keywords: Confirmatory factor analysis
Psychometric properties
Quality of life
Rasch analysis
Publisher: Elsevier
Journal: Journal of the Formosan Medical Association 
ISSN: 0929-6646
EISSN: 1876-0821
DOI: 10.1016/j.jfma.2018.03.018
Rights: Copyright © 2018, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (
The following publication Lin, C. Y., Hwang, J. S., Wang, W. C., Lai, W. W., Su, W. C., Wu, T. Y., . . . Wang, J. D. (2019). Psychometric evaluation of the WHOQOL-BREF, Taiwan version, across five kinds of Taiwanese cancer survivors: Rasch analysis and confirmatory factor analysis. Journal of the Formosan Medical Association, 118(1), 2, 215-222 is available at
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