Psychometric properties of the WHOQOL-BREF amongst wounded, injured, and ill members of the United States military
| DOI | https://doi.org/10.1108/MHRJ-12-2016-0023 |
| Published date | 12 June 2017 |
| Pages | 124-135 |
| Date | 12 June 2017 |
| Author | Keston Lindsay,Michelle Ferrer,Ronald Davis,David Nichols |
| Subject Matter | Health & social care,Mental health |
Psychometric properties of the
WHOQOL-BREF amongst wounded,
injured, and ill members of the
United States military
Keston Lindsay, Michelle Ferrer, Ronald Davis and David Nichols
Abstract
Purpose –Advances in military medical care have facilitated a reduction of fatalities in the global war on
terror, relative to previous conflicts. The physical and psychological trauma of returning personnel remain a
challenge, and poor physical and psychological health have been shown to affect quality of life (QOL).
The purpose of this paper is to validate the WHOQOL-BREF questionnaire amongst wounded, injured and ill
military personnel, and to determine the characteristics of distinct groups found in this sample.
Design/methodology/approach –In total, 52 male and female military personnel (34.69 + 7.63 years,
n¼51) completed 24 items of the WHOQOL-BREF. Principal component analysis using the direct oblimin
rotation was used to determine the factor structureof the WHOQOL-BREF and k-means cluster analysis was
used to determine QOL characteristics of the separate groups.
Findings –The WHOQOL-BREF is a reliable tool for measuring QOL for American military personnel.
However, the psychometric structure of the WHOQOL-BREF in this sample differed from the original
domains. The first cluster analysis based on the original domains produced two clusters: a group of 12 that
had poor QOL, and a group of 40 that had relatively good QOL except for the physical domain. The second
cluster analysis differed in independence and access/social support only.
Research limitations/implications –Although the sample was small for principal component analysis,
the investigators chose to proceed with this procedure, because objective indicators such as measures of
sampling adequacy and communalities met or exceeded acceptable thresholds.
Originality/value –Rehabilitation programs for military ill, injured and wounded should contain components
that promote independence and self-actualization.
Keywords Quality of life, Military personnel, Post-traumatic stress, Veterans’health, WHOQOL-BREF
Paper type Research paper
Introduction
Health of military personnel
As of 2015, deaths of military personnel who have served in campaigns such as Operations
Freedom’s Sentinel, Inherent Resolve, Iraqi Freedom, New Dawn, and Enduring Freedom have
numberedin the tens of thousands (Fischer,2015). While this is a lower numberthan in any conflict
since the Second World War, there are many wounded, injured and ill personnel returning from
combat. Of these, an estimated 31 percent have experienced post-traumatic stress disorder
(PTSD). A far larger proportion of personnel are surviving their injuries (Gawande, 2004) as
improvements have been made in the care of wounded personnel, even those with severe blast
injuries (Gawande, 2004).
Comorbid physical and mental health diagnoses amongst military personnel are documented
(Gawande, 2004; Friedman, 2005; Seal et al., 2007). They experience high intensity guerrilla
Received 21 December 2016
Revised 21 April 2017
Accepted 3 May 2017
The authors would like to thank
the participants for their time in
participating in this study. All
authors declare that they had no
competing interests. All
procedures performed were in
accordance with the ethical
standards of the institutional and/
or national research committee
and with the 1964 Helsinki
declaration and its later
amendments or comparable
ethical standards.
Keston Lindsay is an Assistant
Professorat the Beth-El College
of Nursing andHealth Sciences,
University of Colorado at
Colorado Springs,Colorado
Springs, Colorado,USA.
Michelle Ferrer is a Professor at
the Department of Kinesiology
and Physical Education,
Eastern Connecticut State
University, Willimantic,
Connecticut, USA.
Ronald Davis and David
Nichols are both based at the
Department of Kinesiology,
Texas Woman’s University,
Denton, Texas, USA.
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VOL. 22 NO. 2 2017, pp. 124-135, © Emerald Publishing Limited, ISSN 1361-9322 DOI 10.1108/MHRJ-12-2016-0023
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