WHOQOL-HIV (validação)

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religion, occupation, marital status, number of
children, HIV positive partner, transmission category,
clinical admission history, CD4 lymphocyte
count and viral load, history of psychiatric and/or
psychological treatment, use of psychoactive drugs,
demand for psychiatric and/or psychological treatment.
WHO case definition for AIDS surveillance. This was
created for AIDS surveillance in adolescents and
adults in various countries, especially those with
limited resources for laboratory diagnosis. According
to clinical criteria, a seropositive patient is classified
as asymptomatic HIV, symptomatic HIV or AIDS
(World Health Organization, 1994). The advantage
of this criterium is the simplicity of its use and its low
cost, as there is no need for serological tests. Its
limitations are low sensitivity, and particularly, low
specificity for tuberculosis, as HIV-negative patients
with tuberculosis may be accounted as AIDS cases
due to similar clinical symptoms (World Health
Organization, 1994).
Brazil economic classification criteria. This instrument
classifies subjects into socio-economic groups by
means of information on schooling and possession
of particular ‘comfort items’, such as TV sets,
refrigerators, radios, automobiles and servants. The
number of entities is considered and scored as
points; the sum of points will place the interviewed
person in class A, B, C, D or E (Brazil Economic
Classification Criteria http://www.anep.org.br/codigosguias/CCEB.pdf
accessed: 1 March, 2000).
World Health Organization Quality of Life-HIV/AIDS
module (WHOQOL-HIV). The WHOQOL-HIV is
composed of six domains (Physical, Psychological,
Level of Independence, Social Relations, Environment,
Spirituality/Religiousness/Personal Beliefs)
and 30 facets. The questionnaire is self-administered
and the patient is asked to focus on his or her
experiences in the past two weeks. Each item is
scored on a Likert-type scale (1 through 5). Additionally,
4 items are dedicated to evaluate general
QOL and general state of health. Standardized
scores (range0-100) may be calculated for each
facet, domain, general QOL and general state of
health. Higher scores indicate better quality of life,
with exceptions in these following facets: pain,
negative feelings, treatment dependency, forgiveness,
spiritual connection/personal spiritual experience,
death/dying, in which the direction of the
scores is inverted (Starace et al., 2002).
Patients required approximately 90 minutes to
respond two QOL instruments (WHOQOL-HIV
and SF-36), BDI and STAI. These instruments
were self-responded.
Quality of life in HIV-positive Brazilians 925
Statistical analysis
The reliability and validity of the construct of the
WHOQOL-HIV domains was evaluated with Cronbach
alpha. The instrument’s structure was examined
evaluating the correlation between each item
and the facet’s total corrected score (the facet’s total
corrected score is obtained by subtracting the score
of the evaluated item from the facet’s total score).
The WHOQOL-HIV’s capacity to discriminate
disease stages (discriminant validity) was examined
by Analysis of Variance (ANOVA), followed by the
Tukey test. The concurrent validity was analysed
between the WHOQOL-HIV domains and the
General Quality of Life facets (originally a facet of
the WHOQOL-100) also using the Pearson correlation
coefficient.
The statistical packets used were SPSS version
10.0, STATA version 7.0 and PEPI version 3.0, with
level of significance a0.05.
Ethics issues
All the individuals invited to participate in the study
completed a letter of consent presenting the objectives
of the study. The Ethics Committee at Hospital
de Clínicas de Porto Alegre (HCPA) approved the
project.
Results
Sample
A total of 308 patients participated in the study, 222
outpatients and 86 hospitalized. Of these, 131
(42.5%) were asymptomatic, 91 (29.5%) symptomatic
and 86 (27.9%) with AIDS. The majority of
the subjects were male (186, 60.4%) and the mean
age was 34.6 years (98.1), 186 people (60.4%) had
at least 8 years of schooling and 40.9% were married
or lived as such. The largest number were in social
class C, 190 (62.1%), which correspond to middle
class (see Table I). Nearly three-quarters of the
sample had engaged in high-risk sexual activity,
Table I. Sample characteristics (n308).
N %
Male Sex 186 60.4
Married/lives as such 126 40.9
]8 years of schooling 186 60.6
Social class
AB 66 21.6
C 190 62.1
DE 50 16.3
Risk behaviour
Sexual Risk 225 73.1
Sharing needles 66 21.6
Transfusion/haemophilia 49 15.9