Reliability and validity of the Indonesian version of the World Health Organization quality of life-old (WHOQOL-OLD): a Rasch modeling

Keywords: elderly, quality of life, reliability and validity, WHOQOL-OLD
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BACKGROUND The World Health Organization (WHO) has developed the WHOQOL-OLD instrument, specifically measuring the quality of life (QoL) of the elderly, but the Indonesian version of the WHOQOL-OLD has not been available.

METHODS This study was conducted in 2 steps. First, the instrument was translated and pre-tested to 8 elderly respondents from 2 villages in Lembang, West Java, Indonesia. Second, Rasch modeling was used as implemented by the Winstep version 3.73 software to analyze the reliability, validity, value of separation, Wright map analysis, item-fit order, and differential item functioning in elderly respondents (aged ≥60 years old and did not have dementia) from 6 community health centers in Bangka Regency, Bangka Belitung, Indonesia from July to December 2018.

RESULTS Overall, the Indonesian version of the WHOQOL-OLD demonstrated good reliability and validity tests in 175 respondents. The overall value of the person reliability was 0.73 with the Cronbach’s alpha of 0.75, and the value of the item reliability was 0.97. A misconception and bias occurred in the death and dying facet, especially in the demographic categories of age, gender, and marital status.

CONCLUSIONS The Indonesian version of the WHOQOL-OLD module has good psychometric properties to measure the QoL of the Indonesian older population. However, further studies involving various ethnicities, religious groups, and districts in Indonesia should be carried out before the module can be used throughout the country.


  1. United Nations. World population ageing 2015. New York: United Nations; 2015.

  2. BPS-Statistics Indonesia. [Elderly population statistics 2018]. Jakarta: BPS-Statistics Indonesia; 2018. Indonesian.

  3. World Health Organization. World report on ageing and health 2015. Geneva: World Health Organization; 2015.

  4. Ornstein SM, Nietert PJ, Jenkins RG, Litvin CB. The prevalence of chronic diseases and multimorbidity in primary care practice: a PPRNet report. J Am Board Fam Med. 2013;26(5):518-24.

  5. Zhang R, Lu Y, Shi L, Zhang S, Chang F. Prevalence and patterns of multimorbidity among the elderly in China: a cross-sectional study using national survey data. BMJ Open. 2019;9:e024268.

  6. Pati S, Agrawal S, Swain S, Lee JT, Vellakkal S, Hussain MA, et al. Non communicable disease multimorbidity and associated health care utilization and expenditures in India: cross-sectional study. BMC Health Serv Res. 2014;14:451.

  7. Rosyada A, Trihandini I. [Determination of diabetes mellitus chronic complications on elderly]. J Kesehat Masy Nas. 2013;7(9):395-401. Indonesian.

  8. Pereira DS, Nogueira JAD, da Silva CAB. Quality of life and the health status of elderly persons: a population-based study in the central sertão of Ceará. Rev Bras Geriatr e Gerontol. 2015;18(4):893-908.

  9. Metelko Z, Szabo S, Diseases M, Kumar S, Delhi N, Heck V, et al. The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403-9.

  10. World Health Organization. Programme on mental health: WHOQOL user manual. Geneva: World Health Organization; 1998.

  11. Power M, Quinn K, Schmidt S; WHOQOL-OLD group. Development of the WHOQOL-old module. Qual Life Res. 2005;14(10):2197-214.

  12. González-Celis AL, Gómez-Benito J. Quality of life in the elderly: psychometric properties of the WHOQOL-OLD module in Mexico. Health (Irvine Calif). 2013;05(12A):110-6.

  13. Liu R, Wu S, Hao Y, Gu J, Fang J, Cai N, et al. The Chinese version of the World Health Organization quality of life instrument-older adults module (WHOQOL-OLD): psychometric evaluation. Health Qual Life Outcomes. 2013;11:156.

  14. Gobbens RJJ, van Assen MALM. Psychometric properties of the Dutch WHOQOL-OLD. Health Qual Life Outcomes. 2016;14:103.

  15. Chachamovich E, Fleck MP, Trentini C, Power M. Brazilian WHOQOL-OLD module version: a Rasch analysis of a new instrument. Rev Saúde Publica. 2008;42(2):308-16.

  16. World Health Organization. WHOQOL-OLD manual. World Health Organization. 2006.

  17. Sumintono B, Widhiarso W. [The Rasch model application for social sciences research]. Cimahi: Trim Komunikata Publishing House; 2014. Indonesian.

  18. Saidi SS, Siew NM. Reliability and validity analysis of statistical reasoning test survey instrument using the Rasch measurement model. Int Electron J Math Educ. 2019;14(3):535-46.

  19. Tavakol M, Dennick R. Making sense of Cronbach's alpha. Int J Med Educ. 2011;2:53-5.

  20. Tayeb MA, Al-Zamel E, Fareed MM, Abouellail HA. A "good death": perspectives of Muslim patients and health care providers. Ann Saudi Med. 2010;30(3):215-21.

  21. Muzdalipah, Reza I, Zaharuddin. [The meaning of death in the Muslims elderly]. J Psikol Islam dan Budaya. 2018;1(2):131-42. Indonesian.

  22. Leong M, Olnick S, Akmal T, Copenhaver A, Razzak R. How Islam influences end-of-life care: education for palliative care clinicians. J Pain Symptom Manage. 2016;52(6):771-4.e3.

How to Cite
Gondodiputro S, Wiwaha G, Lionthina M, Sunjaya DK. Reliability and validity of the Indonesian version of the World Health Organization quality of life-old (WHOQOL-OLD): a Rasch modeling. Med J Indones [Internet]. 2021Jun.30 [cited 2021Aug.6];30(2):143-51. Available from:
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