Reliability and validity of two HIV/AIDS-specific quality of life instruments adapted for use in HIV-positive Zimbabweans

Abstract

We sought to assess the reliability and construct validity of the HIV/AIDS-Targeted Quality of Life instrument (HAT-QoL) and the Medical Outcomes Study HIV Health Survey (MOS-HIV) adapted for use in Shona-speaking rural Zimbabwe. HAT-QoL and MOS-HIV were translated and culturally adapted into Shona, and administered to a convenience-sample of 400 patients with HIV-related opportunistic infections. HIV disease severity and bereavement history were assessed. Factor analysis of the HAT-QoL items produced seven factors that were nearly identical to the factor structure reported for an American sample that was the basis for the current HAT-QoL scales. Factor analysis of the MOS-HIV scales resulted in a single factor, not the expected two-factor structure (physical and mental). Convergent and discriminant validity assessments confirmed, in general, that similar Shona HAT-QoL and MOS-HIV dimensions were correlated and dissimilar ones not correlated. Construct validity assessments indicated that, on the whole, most Shona HAT-QoL and MOS-HIV dimensions were capturing anticipated subgroup differences. The exceptions were the Shona MOS-HIV dimensions of general health perceptions, cognitive function, and the quality of life (QoL) item. The reliability and validity of most Shona-adapted HAT-QoL and MOS-HIV dimensions suggest that both instruments are likely useful in measuring the QoL of rural, Shona-speaking populations in Zimbabwe, Mozambique, Zambia, and Botswana.

Keywords:

• HIV/AIDS
• quality of life
• translation
• Zimbabwe

Acknowledgements

This research was supported by grants from the National Institute of Mental Health (1-R03-MH62250-01) and the Social Science Research Council to Dr. Taylor (P.I.). The University of Pennsylvania, the Zimbabwe National Traditional Healers Association, and the Zimbabwean Medical Research Council provided institutional support for this research. Drs. Taylor, Dolezal and Tross are currently supported by grants from the National Institute of Mental Health (T32 MH19139 and P30-MH43520 to the HIV Center for Clinical and Behavioral Studies (Anke A. Ehrhardt, Ph.D. (P.I.). Dr. Holmes’ involvement was supported by a Veterans Affairs Health Services Research & Development Research Career Development Award (grant #RCD 03-029).