The Suitability of the World Health Organization Quality of Life Instrument-BREF in Cancer Relatives

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Abstract
The quality of life of cancer relatives should influence the justification, selection, and modification of nursing interventions in the cancer patient-family dyad. To justify these interventions, relevant, valid, and reliable quality of life assessments are needed. The purpose of this study was to examine the relevancy, validity, and reliability of the World Health Organization Quality of Life Instrument-BREF in a sample of 435 Norwegian cancer relatives. The World Health Organization Quality of Life Instrument-Short Form is a multidimensional, generic instrument designed for the assessment of quality of life cross-culturally. Cronbach alpha ranged from .59 in the social domain to .86 in the psychological domain. Correlational analysis confirmed the relevancy of the items and domains and lent partial support to the construct validity of the scale. Multivariate analyses showed that all domains were significant explanatory variables for overall quality of life and health satisfaction with the exception of the environmental domain. Subgroups effects were best shown by the physical domain. Factor analysis resulted in a 4-factor solution, with 24 items explaining 57% of the cumulative variance in this sample. Results of a confirmatory factor analyses showed reasonably good fit indices, although several covariates between the residuals had to be added, and the covariates between the factors were high. The World Health Organization Quality of Life Instrument-BREF has been translated into 40 languages. It is hoped that cancer nurses will continue to test the instrument in various groups of relatives so that scale validity and conceptual clarity can be improved and subgroup interactions confirmed.

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