Background: Reliable quality of life assessment is critical for identifying health issues, evaluating health interventions, and establishing the best health policies and care packages. The World Health Organization Quality of Life-Old Module is a tool for assessing the subjective quality of life in old age people. It's validated and available in more than 20 languages, except Amharic. Hence, this study was intended to translate it into Amharic language and validate it among old age people in Ethiopia.

Methods: A cross-sectional study was conducted among 180 community-dwelling old age people in Ethiopia, from January 16 to March 13, 2021. Psychometric validation was achieved through Cronbach’s alpha of the internal consistency reliability test, and construct validity from confirmatory factor analysis.

Results: The study participants aged from 60 to 90 years old with a mean age of 69.44. Females made up 61.7% of the population, and 40% of them could not read and write. The results showed a relatively low level of quality of life, with the total transformed score of 58.58 ± 23.15. The Amharic version of the World Health Organization Quality of Life-Old Module showed a Cronbach’s Alpha value of 0.96 and corrected item-total correlations of more than 0.74. Confirmatory factor analysis confirmed the six-factor model with a chi-square (X2) of 341.98 with a p-value less than 0.001. The comparative fit index (CFI) was 0.98, Tucker-Lewis’s index (TCL) was 0.97, and the root mean square error of approximation (RMSEA) was 0.046.

Conclusion: The Amharic version of the World Health Organization Quality of Life-Old Module indicated good internal consistency reliability and construct validity. The tool can be utilized to provide care to Ethiopian community-dwelling old age people.

Study setting

This study was conducted in Ethiopia.

Study design and period

A cross-sectional study design was conducted from January 16 to March 13, 2021.

Study population, sample size and sampling procedures  

This study utilized two groups of the population. The first group was health care experts used for content validation, and the second group was community-dwelling old age people for psychometric validation. The detailed study methods for study population, sample size, and sampling procedures were described in the previous study.

Validation process

This tool validation study was conducted in three stepwise phases. The first phase was to review existing QoL assessment tools for old age people. In the second phase, selection, translation, and review of the tool by experts were conducted. In the last phase, psychometric validation among community-dwelling old age people was performed.

The novel form contains a total of 24 items assembled into six domains, each with four items: autonomy (AUT), past, present, and future activities (PPF), sensory abilities (SAB), social participation (SOP), death and dying (DAD), and intimacy (INT). The module evaluates mostly the two-week duration of testing in self-report form. Although each object is rated on a Likert scale of 1 to 5, they differ in their anchors. Each domain provides an individual score ranging from 4 to 20. The component values can also be converted to a scale of 0 to 100. Furthermore, summing the individual item values yields total scores from 24 to 120, with higher scores indicating better QOL.

Data collection

Data were conducted from two groups: healthcare experts and community-dwelling old age people, in exploratory mixed qualitative and quantitative methods. Each expert evaluated the content validity of the tool through face-to-face contact. The experts' and old age people’s comments were used for words, grammar, clarity, appropriate scoring, and applicability of items. After incorporating the experts’ comments, psychometric validation was conducted among community-dwelling old age people.

Six urban health extension workers and six BSc nurses collected the data after two days of training. The principal investigator and a master’s-degree-trained nutritionist supervised the data collection process. The data were collected through face-to-face interviews using the standardized Amharic version of the questionnaires. Assistance from family members or caregivers was also used.

The international business machines corporation statistical package for the social science (IBM SPSS) can be used to open the data.