BACKGROUND Quality of life (QoL) is important to assess in patient care. Researchers have previously claimed validity of the Quality of Life Scale (QOLS) across multiple samples of individuals, but close inspection of results suggest further psychometric investigation of the instrument is warranted. Therefore, the purposes of this study were to: 1) evaluate the proposed five-factor, 15-item and three-factor, 16-item QOLS; 2) if the factor structure could not be confirmed, re-assess the QOLS using exploratory factor analysis (EFA) and covariance modeling to identify a parsimonious refinement of the QOLS structure for future investigation. METHODS Participants varying in age, physical activity level, and identified medical condition(s) were recruited from clinical sites and ResearchMatch. Confirmatory factor analyses (CFA) were performed on the full sample (n = 1036) based on proposed 15- and 16-item QOLS versions. Subsequent EFA and covariance modeling was performed on a random subset of the data (n1 = 518) to identify a more parsimonious version of the QOLS. The psychometric properties of the newly proposed model were confirmed in the remaining half of participants (n2 = 518). Further examination of the scale psychometric properties was completed using invariance testing procedures across sex and health status sub-categories. RESULTS Neither the 15- nor 16-item QOLS CFA met model fit recommendations. Subsequent EFA and covariance modeling analyses revealed a one-factor, five-item scale that satisfied contemporary statistical and model fit standards. Follow-up CFA confirmed the revised model structure; however, invariance testing requirements across sex and injury status subgroups were not met. CONCLUSIONS Neither the 15- nor 16-item QOLS exhibited psychometric attributes that support construct validity. Our analyses indicate a new, short-form model, might offer a more appropriate and parsimonious scale from some of the original QOLS items; however, invariance testing across sex and injury status suggested the psychometric properties still vary between sub-groups. Given the scale design concerns and the results of this study, developing a new instrument, or identifying a different, better validated instrument to assess QoL in research and practice is recommended.

中文翻译：

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检查生活质量量表的阶乘有效性。

背景技术生活质量（QoL）对于评估患者护理至关重要。研究人员此前曾声称，在多个个体样本中生活质量量表（QOLS）的有效性，但对结果的仔细检查表明，有必要对该仪器进行进一步的心理测量研究。因此，本研究的目的是：1）评价拟议的五因素15项目和三因素16项目QOLS；2）如果无法确定因素结构，则使用探索性因素分析（EFA）和协方差模型重新评估QOLS，以识别QOLS结构的简化方案，以供将来研究。方法从临床地点和ResearchMatch招募年龄，体力活动水平和确定的医疗状况不同的参与者。基于建议的15和16项QOLS版本，对全部样本（n = 1036）进行了验证性因子分析（CFA）。随后对数据的随机子集（n1 = 518）进行了EFA和协方差建模，以识别更简化的QOLS版本。其余一半的参与者（n2 = 518）证实了新提出的模型的心理测量特性。使用跨性别和健康状况子类别的不变性测试程序，完成了对量表心理计量学特性的进一步检查。结果15项和16项QOLS CFA均未达到模型拟合建议。随后的EFA和协方差建模分析揭示了满足现代统计和模型拟合标准的一因素五项量表。后续的终审法院确认了修订后的模型结构；然而，未满足跨性别和伤害状态亚组的不变性测试要求。结论15项和16项QOLS均未显示支持建构效度的心理计量学属性。我们的分析表明，新的，简短的模型可能会从一些原始的QOLS项目中提供更合适和更简洁的规模。但是，跨性别和伤害状态的不变性测试表明，心理特征在各亚组之间仍存在差异。考虑到规模设计的关注和这项研究的结果，建议开发一种新的仪器，或者确定一种其他的，经过更好验证的仪器来评估研究和实践中的QoL。我们的分析表明，新的，简短的模型可能会从一些原始的QOLS项目中提供更合适和更简洁的规模。但是，跨性别和伤害状态的不变性测试表明，心理特征在各亚组之间仍存在差异。考虑到规模设计的关注和这项研究的结果，建议开发一种新的仪器，或者确定一种其他的，经过更好验证的仪器来评估研究和实践中的QoL。我们的分析表明，新的，简短的模型可能会从一些原始的QOLS项目中提供更合适和更简洁的规模。但是，跨性别和伤害状态的不变性测试表明，心理特征在各亚组之间仍存在差异。考虑到规模设计的关注和这项研究的结果，建议开发一种新的仪器，或者确定一种其他的，经过更好验证的仪器来评估研究和实践中的QoL。