Validation of the Thai version of the World Health Organization’s Quality of Life Scale (WHOQOL-BREF-THAI) among Thai Nursing Students in Northeast Thailand: A multi-canter study

Background: The Thai version of World Health Organization Quality of Life Scale (WHOQOL-BREF-THAI) has been verified among a variety of populations. However, existing research lacks comprehensive psychometric properties, including factor structure, specifically among nursing students. This study examined the WHOQOL-BREF's unique psychometric features for the Thai nursing students in Northeast Thailand.Methods: A cross-sectional study recruited the Thai nursing students using multi-stage simple random sampling from 15 universities located in the Northeast of Thailand. The data was collected via self-assessment questionnaires, and the 3,570 participants were then randomly split into two subsamples (group 1, n=2,000, and group 2, n=1,570). After reducing some items using statistical methods, an exploratory factor analysis (EFA) was carried out on group 1 to explore the factor structure of the WHOQOL-BREF-THAI. Finally, group 2 was used in a confirmatory factor analysis (CFA) to validate the EFA's modified structure along with an assessment of the construct validity of the WHOQOL-BREF-THAI.Results: A total of 3,570 Thai nursing students were enrolled. Principal component analysis in a random subsample supported a four-factors model with 24 items was originally suggested for the factorial construct validity, and contained 24 items, spread across four components as follows: physical (7 items), psychological (6 items), social relationship (3 items) and environmental (8 items). The purpose domain structure showed good fit in CFA in the other subsample. Internal reliability was satisfactory (Cronbach's alpha was greater than 0.70) for both the total scale and subscales. In terms of convergent validity, average variance extracted (AVE) revealed that all WHOQOL-BREF-THAI subscales achieved convergence effect with AVE ranging from 0.50 to 0.69.Conclusion: These results reveal that the WHOQOL-BREF-THAI is a valid and reliable tool for health care providers to utilize to measure QOL among Thai nursing students. QOL is also likely to have an impact on their future clinical success. Therefore, the WHOQOL-BREF can be an essential inventory for researching the factors influencing nursing students'QOL, with implications for nursing education.<br>