Hierarchical measurement structure in the Women’s Health Questionnaire: a confirmatory factor analysis

Abstract

Purpose: This study conducted confirmatory factor analysis (CFA) to examine the measurement structure of the Women’s Health Questionnaire (WHQ) and how its components were organized.

Methods: Participants were 448 postmenopausal women, with a mean age of 63.3 years. CFA was conducted to test how well several proposed measurement models fit the data.

Results: The single-factor model performed poorly, indicating the presence of multiple factors. The model with seven correlated factors fit the data well, although the varying degrees of inter-factor correlations suggested grouping of similar factors. The hierarchical measurement structure, with seven first-order factors organized under two second-order factors of physical health and mental health functioning, demonstrated a good fit with the data (χ²(367) = 694.05, p < 0.001; root mean square error of approximation = 0.05; comparative fit index = 0.95) and a meaningful pattern. The Mental Health factor was represented by Depressed Mood, Anxiety/Fear, Memory/Concentration Problems, and Sleep Problems. The Physical Health factor was manifested mainly by Somatic Symptoms, Menstrual Symptoms, and Vasomotor Symptoms, and, to a lesser extent, also by Sleep Problems and Memory/Concentration Problems.

Conclusion: Findings suggested that, in addition to a global index and subscale scores, the WHQ may produce summary scores of physical health and mental health functioning in evaluation of well-being among postmenopausal women.

Chinese abstract

目的：本研究采用验证性因素分析法（CFA）对女性健康问卷（WHQ）的测量结构及其组成进行分析。

方法：研究对象为绝经后448名妇女, 平均年龄63.3岁。进行CFA的目的是测试几种推荐的测量模型与数据的拟合程度。

结果：单因素模型的拟合度不佳, 表明存在多种因素。具有七个相关因子的模型很好地拟合了数据, 尽管不同程度因子间的相关性表明需要对相似因子进行分组。由七个一级因子构成了二个关于生理健康和心理健康功能的二级因子, 由它们组成的分层测量结构与数据（χ²(367）=694.05, P<0.001；近似均方根误差=0.05；比较拟合指数=0.95）具有良好的拟合性和一个有意义的模型。心理健康因素表现为抑郁情绪、焦虑/恐惧、记忆/集中问题和睡眠问题。身体健康因素主要表现为躯体症状、月经症状和血管舒缩症状, 在较小程度上也表现为睡眠问题和记忆/集中问题。

结论：研究结果表明, 除了一个整体指数和子量表评分外, WHQ还可能产生身体健康和心理健康功能的总分用于评价绝经后妇女的健康。

Keywords:

• Health-related quality of life
• measurement structure
• scale validation
• confirmatory factor analysis
• women’s health
• postmenopausal women

Research involving human participants and/or animals

All procedures performed in studies involving human participants 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.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors report no conflicts of interest.

Source of funding

National Institute on Aging, National Institutes of Health (R01AG-024154-01-05, R01AG-024154-06-08, R01AG-024154-S2, and R01-AG059690).