The EUROHIS-QOL 8-item index: psychometric results of a cross-cultural field study

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Abstract
Background: Survey research including multiple health indicators requires brief indices for use in cross-cultural studies, which have, however, rarely been tested in terms of their psychometric quality. Recently, the EUROHIS-QOL 8-item index was developed as an adaptation of the WHOQOL-100 and the WHOQOL-BREF. The aim of the current study was to test the psychometric properties of the EUROHIS-QOL 8-item index. Methods: In a survey on 4849 European adults, the EUROHIS-QOL 8-item index was assessed across 10 countries, with equal samples adjusted for selected sociodemographic data. Participants were also investigated with a chronic condition checklist, measures on general health perception, mental health, health-care utilization and social support. Results: Findings indicated good internal consistencies across a range of countries, showing acceptable convergent validity with physical and mental health measures, and the measure discriminates well between individuals that report having a longstanding condition and healthy individuals across all countries. Differential item functioning was less frequently observed in those countries that were geographically and culturally closer to the UK, but acceptable across all countries. A universal one-factor structure with a good fit in structural equation modelling analyses (SEM) was identified with, however, limitations in model fit for specific countires. Conclusions: The short EUROHIS-QOL 8-item index showed good cross-cultural field study performance and a satisfactory convergent and discriminant validity, and can therefore be recommended for use in public health research. In future studies the measure should also be tested in multinational clinical studies, particularly in order to test its sensitivity.