# Validation of the Thai version of the World Health Organization’s Quality of Life Scale (WHOQOL-BREF-THAI) among Thai nursing students in northeast Thailand: A multi-centre study

## TL;DR

This study validated the Thai version of a quality of life scale among nursing students in northeast Thailand, confirming its reliability and usefulness.

## Contribution

The study provides new psychometric validation of the WHOQOL-BREF-THAI specifically for Thai nursing students.

## Key findings

- The WHOQOL-BREF-THAI showed a good four-factor structure with 24 items confirmed through factor analysis.
- Internal reliability was strong, with Cronbach’s alpha above 0.70 for the total scale and subscales.
- Convergent validity was supported, with average variance extracted values ranging from 0.50 to 0.69.

## Abstract

The Thai version of the World Health Organization Quality of Life Scale (WHOQOL-BREF-THAI) has been verified among a variety of populations. However, there is a lack of existing research on its comprehensive psychometric properties, specifically when used with nursing students. This study examined the WHOQOL-BREF’s unique psychometric features with Thai nursing students in northeast Thailand.

In this cross-sectional study, Thai nursing students were recruited using multi-stage simple random sampling from universities located in the northeast of Thailand. The data was collected via self-assessment questionnaires, and the 3,570 participants were then randomly split into two subsamples (group 1, n=2,000, and group 2, n=1,570). After reducing the number of items using statistical methods, an exploratory factor analysis (EFA) was carried out on group 1 to explore the factor structure of the WHOQOL-BREF-THAI. Finally, group 2 was used in a confirmatory factor analysis (CFA) to validate the EFA’s modified structure along with an assessment of the construct validity of the WHOQOL-BREF-THAI.

Principal component analysis on a random subsample supported a four-factor model with 24 items, originally suggested for factorial construct validity; these 24 items were distributed across the original four domain. The domain structure for the purpose showed a good fit in the CFA on the other subsample. Internal reliability was satisfactory (Cronbach’s alpha was greater than 0.70) for both the total scale and subscales. In terms of convergent validity, average variance extracted (AVE) revealed that all WHOQOL-BREF-THAI subscales achieved convergence, with AVE values ranging from 0.50 to 0.69.

These results reveal that the WHOQOL-BREF-THAI is a valid and reliable tool which health care providers can utilize to measure QOL among Thai nursing students. Therefore, the WHOQOL-BREF can serve as an essential tool for researching the factors influencing nursing students’ QOL, with implications for nursing education.