A battery of instruments to assess Quality of Life (BASIQ): validation of the italian adaptation of the Quality of Life Instrument Package (QoL-IP)

La batteria di strumenti per l'indagine della Qualità di Vita (BASIQ): validazione dell'adattamento italiano del Quality of Life Instrument Package (QoL-IP)

M. Bertelli1 3, M.P. Merli1-3, A. Bianco1 3, S. Lassi4, G. La Malfa2, G.F. Placidi2, I. Brown5

1 CREA (Centro di Ricerca ed Evoluzione AMG), Firenze; 2 Dipartimento di Scienze Neurologiche e Psichiatriche, Università di Firenze; 3 Gruppo di studio sulla Qualità di Vita della Cooperativa Sociale WORK 2000, Castiglion Fiorentino (Arezzo); 4 ODA (Opera Diocesana d'Assistenza), Diacceto di Firenze, Firenze; 5 Università di Toronto, Toronto, Canada

Objectives

Generic (G) Quality of Life (QoL) has broader implications and potentialities than Health-Related (HR) QoL. Italian tools for the assessment of G-QoL are few and present considerable limitations. The aim of the present work was to assess psychometric characteristics of the BASIQ (BAtteria di Strumenti per l’Indagine della Qualità di Vita), the Italian translation and adaptation of the Quality of Life Instrument Package (QoL-IP) of the Centre for Health Promotion, University of Toronto. The package is based on an interpretative model of QoL that integrates qualitative and quantitative, as well as subjective and objective data, but the core quality of life measure is the perception of satisfaction weighted by ratings of importance. The BASIQ is comprised of three instruments: a direct interview with the person that is scored like a questionnaire but provides considerable qualitative data, a questionnaire for proxies who know the person well (caregiver, front line healthcare operators, etc.), and a questionnaire for external assessors (general practitioner, specialist, lawyer, etc.).

Methods

The BASIQ was used to assess QoL of a sample of 280 participants with psychiatric disorders or Intellectual Disability (ID) or dual diagnosis (ID + psychiatric disorder); control participants were considered to be healthy. All participants were recruited randomly or consecutively among those attending the psychiatric clinic of the University of Florence or residential and rehabilitative facilities for ID in Tuscany and Veneto (Italy). Healthy participants were randomly recruited among students or trainees of the Schools of Medicine and Psychology of the University of Florence and from occasional users of outpatient centres of the Quartiere 2 of Florence. The absence of psychic and physical disorders was certified through their scores on the General Health Questionnaire. Five psychologists, three psychiatrists, two speech therapists and one educator administered the interview and the proxy questionnaire to a random number of consecutive participants. Three general practitioners and one psychiatrist completed the external assessor questionnaire. The inter-rater reliability was assessed through a special session in which different professionals independently attributed scores to the same case, after having been provided information by the referring psychiatrist.

Results

The reliability of the instrument was very good. Reliability and internal consistency analysis resulted in a Cronbach’s alfa of 0.990 and in significant Spearman’s and Pearson’s coefficients for all the computable correlations between subareas in all the subgroups of the sample (Tables I-III). The only 3 non-significant correlation coefficients were among those made by the external assessor. Inter-rater reliability, calculated through Cohen’s K, was higher than 0.7.

Conclusions

As an integrated auto and hetero compiled assessment battery of G-QoL, the BASIQ shows good psychometric characteristics. This instrument appears to be valid for use with all adult individuals, independently from the presence and the type of psychic disorder or intellectual disability. The BASIQ also appears to be appropriate for use by various types of professionals and service providers, both in the role of rater and informant. Thus, it can represent a valuable support in the application of QoL to research and to all practical articulations of new mental health policies.

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