Research Article: Psychometric evaluation of the Korean version of the Hepatitis B Quality of Life Questionnaire

Date Published: February 27, 2019

Publisher: Public Library of Science

Author(s): Yeonsoo Jang, Sang Hoon Ahn, Kyunghwa Lee, Jiyeon Lee, Jeong Hyun Kim, David L. Streiner.


The purpose of this study was to conduct a psychometric evaluation of the Korean version of the Hepatitis B Quality of Life Questionnaire (K-HBQOL), which is designed to assess the quality of life of patients with the hepatitis B virus (HBV).

The K-HBQOL was developed by converting the original English version to Korean using a back-and-forth translation method. The translated questionnaire was distributed to 168 adults with HBV. Descriptive statistics were used to summarize the demographic characteristics of these participants. Confirmatory factor analysis and exploratory principal components analysis (CFA and PCA) were performed, applying varimax rotation and using Kaiser’s eigenvalue-greater-than-one rule to examine the factor structure. The minimum average partial rule was also used to identify the number of components.

The original factor model was not confirmed by CFA in this sample. Six components (Psychological Well-being, Stigmatization, Anticipation Anxiety, Weakness, Vitality, and Vulnerability) were extracted by PCA, with 69.11% of the total variance explained. In this process, one component present in the original factor model (Transmission) was not found, while another component (Weakness) was extracted.

This study revealed the psychometric characteristics of the Korean version of the HBQOL for patients with hepatitis B. We suggest a study with a larger sample is needed to evaluate validity and reliability of the K-HBQOL for other Korean populations.

Partial Text

Hepatitis B is one of the most common diseases in the world, and it is a major cause of cirrhosis, liver failure, and liver cancer. According to a 2017 report from the World Health Organization (WHO), approximately 250 million people worldwide are infected with the hepatitis B virus (HBV), while over 800,000 people die annually from complications related to the virus [1]. Over the last 10 years, the prevalence of the hepatitis B surface antigen (HBsAg) in Korea has declined significantly, mainly as a result of a nationwide vaccination project; however, over four percent of Korean adults in their 30s and over remain positive for HBV. In particular, Korean men aged from their 30s to their 50s have a higher sero-prevalence than Korean women [2]. HBV can also have several indirect effects, as the socio-economic burden of patients who are members of the working population may be increased [3, 4], and these socio-economic problems, along with the physical and psychological issues associated with HBV, might confer negative effects on sufferers’ quality of life (QOL).

This is the first study to conduct a psychometric evaluation of a Korean version of the HBQOL in patients with HBV. The results of CFA suggested that the original factor structure of the HBQOL was not a good fit to the current data; accordingly, a factor structure appropriate for the current data was obtained using PCA. Our findings are similar to those of previous studies that did not confirm the original factor models using CFA in validity tests of the translated instruments [19, 20]. When an instrument is translated from the original language to another language, CFA does not always confirm the appropriateness of the original factor model. For this reason, when an instrument is applied in different cultures and languages, the participants’ particular situation and cultural considerations are important [23].

This study revealed the psychometric characteristics of the Korean version of the HBQOL for patients with hepatitis B. The study findings demonstrate that psychometric properties of the K-HBQOL need additional validation. We suggest that further, larger validation research studies should be conducted among diverse Korean populations with HBV in order to confirm and expand upon the current findings.




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