Quality of life, psychological distress and violence among women in close relationships: a population-based study in Finland.

BACKGROUND: The aim of this study was to examine associations between exposure to violence, quality of life, and psychological distress. Women aged 19-54 years who had been exposed to violence by someone in a close relationship were compared with women unexposed to violence in Finland. We also aimed to investigate associations between different forms of violence (physical, sexual, emotional, or any combination of these) with quality of life and psychological distress. METHODS: We selected a sample of 22,398 women who had returned self-completed questionnaires from a Finnish population-based health survey between 2013 and 2016. Exposure to violence during the past year was assessed through specific questions from the survey. The EUROHIS-QOL 8-item index was used to measure quality of life, and ordinary least square regressions were fitted. The mental health inventory (MHI-5) was used to measure psychological distress. We investigated associations with multivariate logistic regression analysis. RESULTS: Among women in Finland, the prevalence of exposure to violence in any type of close relationship during the past year was 7.6%. Women who had been exposed to violence had significantly worse scores of the EUROHIS-QOL 8-item index, and psychological distress was significantly worse (p < 0.001), compared with unexposed women. Strong associations were found between combinations of violence and both quality of life (coefficient - 0.51, p < 0.001) and mental health (odds ratio 4.16, 95% confidence interval 3.44-5.03). Compared with women who had been exposed to violence by a stranger, women who had been exposed to violence by someone in a close relationship had significantly lower quality-of-life scores (p < 0.001). CONCLUSIONS: This study found that experience of close relationship violence had a negative influence on both quality of life and psychological distress among women in the general Finnish population. Comparison with victims of violence by strangers shows that some of the lower quality-of-life scores among victims are driven by the perpetrator and victim being in a close relationship. Preventive policies in primary care settings aimed at screening and educating young people should be considered as an early form of intervention to reduce the negative mental health consequences of violence.

Psychometric properties of the EUROHIS-QOL 8-item index (WHOQOL-8) in a Brazilian sample

Objective: To test the psychometric properties of the EUROHIS-QOL 8-item index in a Brazilian sample. Methods: The sample consisted of 151 patients and 174 healthy controls (n=325). Several psychometric properties were tested. Results: Reliability showed good internal consistency (Cronbach's alpha = 0.81). The measure showed good discriminant validity between patients and healthy controls (mean1 = 3.32, SD1 = 0.70; mean2 = 3.77, SD2 = 0.63, t = 6.12, p < 0.001). Convergent validity showed significant correlations (p < 0.001) between the EUROHIS-QOL 8-item index and all domains of the WHOQOL-Bref (overall r = 0.47; general health r = 0.54; physical r = 0.69; psychological r = 0.62; social relationship r = 0.55; environment r = 0.55) and between the EUROHIS-QOL 8-item index and the domains of the SF-36, except for the social domain (p = 0.38). On Rasch analysis of unidimensionality, general fit measures showed adequate performance. The EUROHIS-QOL 8-item index also showed good fit on confirmatory factor analysis (CFA) (chi-square = 18.46, degrees of freedom [df] = 15; comparative fit index [CFI] = 0.99; root mean square error of approximation [RMSEA] = 0.03; goodness of fit index [gfi] = 0.99; root mean square residual [RMR] = 0.03; p = 24). Conclusion: The EUROHIS-QOL 8-item index showed good psychometric properties. It is a reliable quality of life measure that can be used in Brazilian populations.

Evaluating quality of life outcomes following joint replacement: psychometric evaluation of a short form of the WHOQOL-Bref.

PURPOSE: Reducing participant burden is important in health research and clinical assessment. We examined the psychometric properties of the EUROHIS-QOL 8-item index, a short version of the 26-item World Health Organisation Quality of Life questionnaire (WHOQOL-Bref), in a sample of people receiving joint replacement surgery. METHODS: Participants (n = 1008) completed the WHOQOL-Bref at either 6, 12, 24 or 60 months after hip or knee replacement. The factor structure, differential item functioning (DIF) and unidimensionality of the EUROHIS-QOL 8-item index were examined using exploratory and confirmatory factor analyses and Rasch analyses. Convergent validity was examined using correlations with the parent measure and other patient-reported outcome measures (Oxford scores, Western Ontario and McMaster Universities Osteoarthritis Index). Discriminant validity was assessed between groups reporting high versus low pain and function, and by joint replaced. RESULTS: The measure demonstrated high internal consistency (α = 0.86), adequate convergent (r = 0.47-0.82, p < 0.001) and discriminant validity (p < 0.001). Factor and Rasch analyses supported a unidimensional structure. However, there were also indications of multidimensionality, with support for a two-factor model focusing on general health and function, and psychosocial aspects of QOL. There was minimal evidence of DIF, with just one item evaluating energy level showing DIF for age. CONCLUSIONS: The EUROHIS-QOL 8-item index demonstrated adequate properties as a unidimensional scale and as a two-factor scale evaluating general health and function, and psychosocial aspects of quality of life. It is low on clinical and participant burden, showed minimal ceiling effects and showed good concurrent and discriminant validity.