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Measurement invariance of the kidney disease and quality of life instrument (KDQOL-SF) across Veterans and non-Veterans

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Title: Measurement invariance of the kidney disease and quality of life instrument (KDQOL-SF) across Veterans and non-Veterans
Author(s): Saban, Karen L.; Bryant, Fred B.; Reda, Domenic J.; Stroupe, Kevin T.; Hynes, Denise M.
Subject(s): veterans kidney disease
Abstract: Background: Studies have demonstrated that perceived health-related quality of life (HRQOL) of patients receiving hemodialysis is significantly impaired. Since HRQOL outcome data are often used to compare groups to determine health care effectiveness it is imperative that measures of HRQOL are valid. However, valid HRQOL comparisons between groups can only be made if instrument invariance is demonstrated. The Kidney Disease Quality of Life Short Form (KDQOL-SF) is a widely used HRQOL measure for patients with chronic kidney disease (CKD) however, it has not been validated in the Veteran population. Therefore, the purpose of this study was to examine the measurement invariance of the KDQOL-SF across Veterans and non-Veterans with CKD. Methods: Data for this study were from two large prospective observational studies of patients receiving hemodialysis: 1) Veteran End-Stage Renal Disease Study (VETERAN) (N = 314) and 2) Dialysis Outcomes and Practice Patterns Study (DOPPS) (N = 3,300). Health-related quality of life was measured with the KDQOL-SF, which consists of the SF-36 and the Kidney Disease Component Summary (KDCS). Single-group confirmatory factor analysis was used to evaluate the goodness-of-fit of the hypothesized measurement model for responses to the subscales of the KDCS and SF-36 instruments when analyzed together; and given acceptable goodness-of-fit in each group, multigroup CFA was used to compare the structure of this factor model in the two samples. Pattern of factor loadings (configural invariance), the magnitude of factor loadings (metric invariance), and the magnitude of item intercepts (scalar invariance) were assessed as well as the degree to which factors have the same variances, covariances, and means across groups (structural invariance). Results: CFA demonstrated that the hypothesized two-factor model (KDCS and SF-36) fit the data of both the Veteran and DOPPS samples well, supporting configural invariance. Multigroup CFA results concerning metric and scalar invariance suggested partial strict invariance for the SF-36, but only weak invariance for the KDCS. Structural invariance was not supported. Conclusions: Results suggest that Veterans may interpret the KDQOL-SF differently than non-Veterans. Further evaluation of measurement invariance of the KDQOL-SF between Veterans and non-Veterans is needed using large, randomly selected samples before comparisons between these two groups using the KDQOL-SF can be done reliably.
Issue Date: 2010-10-25
Publisher: BioMed Central
Citation Info: Saban, K. L., Bryant, F. B., Reda, D. J., Stroupe, K. T., & Hynes, D. M. 2010. Measurement invariance of the kidney disease and quality of life instrument (KDQOL-SF) across Veterans and non-Veterans. Health and Quality of Life Outcomes, 8. DOI: 10.1186/1477-7525-8-120.
Type: Article
Description: The original source for this publication is at BioMed Central; DOI: 10.1186/1477-7525-8-120. © 2010 Saban et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
URI: http://hdl.handle.net/10027/7704
ISSN: 1477-7525
Sponsor: This research was supported by the U.S. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service - "Cost and Effectiveness of End-Stage Renal Disease Care" (D. Hynes, Principal Investigator) (ECI 20 016). Dr. Hynes is supported by a five-year Veterans Affairs Health Services Research and Development Service Research Career Scientist Award. Dr. Saban is supported by a three-year Veterans Affairs Health Services Research and Development Service Postdoctoral Fellowship (TPN 42-001). DOPPS data were provided by Arbor Research Collaborative for Health which administers and coordinates the Dialysis Outcomes and Practice Study. DOPPS is supported by scientific research from Amgen (since 1996), Kyowa Hakko Kirin (since 1999, in Japan), Genzyme (since 2009), and Abbott (since 2009), without restrictions on publications.
Date Available in INDIGO: 2011-05-27
 

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