[Published Article] Convergent and Discriminant Validity of the WHOQOLBREF Using a Multitrait-Multimethod Approach

Convergent and Discriminant Validity of the WHOQOLBREF Using a Multitrait-Multimethod Approach

Yu-Yu Hsiao   Chia-Huei Wu   Grace Yao

Social Indicator Research (in press)

Abstract

 

The WHOQOL-BREF is a commonly used questionnaire in quality of life research. Previous research has shown that the four domains of the WHOQOL-BREF (physical health, psychological health, social relationships, and environmental health) are highly related. Whether these high correlations reflected the true relations across the domains or the influence of common method effect; however, is still unknown. This study examines the convergent and discriminant validity of the four domains of the WHOQOLBREF by using the multitrait-multimethod (MTMM) approach to control the method effect. Two different samples, with a total of 186 and 201 adults, respectively, were used in the present study. Each participant filled out the WHOQOL-BREF questionnaires using four different scaling methods (Likert-type scale, visual analogue scale, pie scale, and partner rating). The covariance matrix of the MTMM result was analyzed with confirmatory factor analysis modeling. Two models were applied, including the correlated traits-correlated uniqueness (CTCU) model and the uncorrelated traits-correlated uniqueness (UTCU) model. Results showed that the CTCU model fit the data better than did the UTCU model, suggesting that the variables tapping the four domains of the WHOQOL-BREF have excellent convergent validity; the four domains have moderate correlations, indicating that the four domains are related but not identical.

 

Keywords Multitrait-multimethod matrix, Quality of life, WHOQOL, Confirmatory factor analysis, Validity

Submitted: 03-13-2013
Accepted: 03-19-2013


(註記)
這篇文章從投稿到接受只花了六天，看起來真不可思議，但實際上背後也是歷經了許多波折。一開始這篇文章的target期刊是Quality of Life Research，但審了兩個多月後得到了reject的回應。之後又投了Educaitonal and Psychological Measurement和Journal of Happiness Studies，雖然備受煎熬但我們也從reviewers的建議中修改了文章的架構以及一些論述，同時也修改了實驗設計。最後的成品被SIR火速接受，這段日子的辛苦也算是有了代價。在寫這篇文章的過程中，我和共同作者們之間對於文章的架構以及討論的部分出現了部分分歧，但在討論的過程中讓我學習到如何在分歧中陳述自己的觀點，並嘗試完成對話的過程，這些都是在寫文章投稿之餘無價的收穫。

[Published Article] Is there a disparity in the hospital care received under a universal health insurance program in Taiwan?

Is there a disparity in the hospital care received under a universal health insurance program in Taiwan?

Yu-Yu Hsiao, Shou-Hsia Cheng

International Journal for Quality in Health Care (in press)

Abstract

Objective To analyze the disparity in hospital care among people of various socio-economic status (SES) under a universal health insurance scheme. Design A questionnaire survey mailed to discharged patients in October 2010. Setting This study included 183 large-scale hospitals in Taiwan. Participants A total of 3015 patients/caregivers completed the questionnaires, which yielded a response rate of 58%. Main Outcome Measures Three variables were included. The two access-to-care variables were admission route and accreditation level of the hospital in which the patient stayed. A structured questionnaire, the Patient-Reported Hospital Quality (PRHQ), was included to characterize patient’s experience of hospital stay. Results Patients with lower education were less likely to be admitted to a hospital according to a planned schedule, or to choose an academic medical center hospital. However, SES was not associated with the PRHQ scores. Furthermore, patients with unplanned admission were associated with lower PRHQ scores than those with planned admission to the hospital. Conclusions Under the universal health insurance system in Taiwan, lower education is associated with unplanned admission to a hospital, which might result in poorer perceived quality of care. Reducing unplanned admission is a challenge for health authorities in the future.

Keywords access to care, quality of care, hospital, socioeconomic status, Taiwan

Submitted: 11-22-2011
Revised: 02-20-2012
Accepted: 01-15-2013


(註記)
第一篇發表在英文期刊上，同時也是列為第一作者的文章。投稿到接受中間花了一年多的時間，但其實占了比較多時間的是在resubmitted到accepted的這段時間，長達一年。比較有趣的是，resubmitted之後我們等了半年多都沒等到回應，寫了幾封e-mail之後竟然才收到文章進行審查的e-mail。好在後來的過程還算順遂，沒有甚麼大問題就被接受了。