Confirmatory factor analytical study of the WHOQOL-brief:Experience with Egyptian general population and psychiatric samples.

Rationale: Previous reports on the 4- and 6-domain models of the WHOQOL-bref, did not investigate the possibility that alternative factor models may provide a better explanation of the data. Objectives: to assess the factor structure of the WHOQOL- bref in a Egyptian general population sample; and use confirmatory factor analysis (CFA) and path analysis (PA) to see how well the model thus generated fits into the WHOQOL-bref data of Egyptian psychiatric patients and their family caregivers; and compares with WHO models. Method:  In factor analysis (FA), data from 620 general population subjects were used to generate 5-domain model; in CFA and PA the model was tested on the data of 300 psychiatric outpatients and their caregivers, using four goodness of fit (GOF) indices in AMOS. Results: Two factors ("Personal relation" and "environment") from our FA were similar to the WHO's. In CFA, the GOF criteria were met by our model, and WHO's 4-domain model on the psychiatric data. In PA, the two models met the GOF criteria on the general population data.
Conclusion:  The findings support the credentials of WHO's 4-domain model as a universal QOL construct; and favor the impression that analysis of WHOQOL-bref could benefit from including all the items in FA and using overall QOL as a dependent variable.