JMIR Publications

ABSTRACT

Background:

Quality of life (QoL) is considered a key treatment outcome in bipolar disorder (BD) across research, clinical, and self-management contexts. Web-based assessment of patient reported outcomes offer numerous pragmatic benefits, but require validation to ensure measurement equivalency. A web-based version of the Quality of Life in Bipolar Disorder (QoL.BD) questionnaire was developed (QoL Tool).

Objective:

To evaluate the psychometric properties of a web-based QoL self-report questionnaire for BD (QoL Tool). Key aims were to: a) characterise the QoL of the online sample; b) evaluate the internal consistency of the online measure; and c) determine whether the factor structure of the original version of the QoL.BD was replicated in the web-based instrument.

Methods:

Community Based Participatory Research methods were used to inform the development of a web-based adaptation of the QoL.BD. Individuals with BD who registered for an online account with the QoL Tool were able to opt-in to sharing their data for research purposes. The distribution of scores and internal consistency estimates, as indicated by Cronbach’s alpha, were inspected. An exploratory factor analysis using maximum likelihood and oblique rotation was conducted. Various methods, including inspection of the scree plot, eigenvalues, and minimum average partial correlation were used to determine the optimal factor structure to extract.

Results:

498 people with BD (70.1% female, mean age 39.64 [SD = 12.54], 36.3% BD-I, 39.2% BD-II) consented to sharing their QoL Tool data for the purpose of the present study. Mean scores across the 14 QoL Tool domains were, in general, significantly lower than the original QoL.BD validation sample. Reliability estimates for the QoL Tool domains were comparable to that observed for the QoL.BD (Cronbach’s alpha = 0.70 – 0.93). Exploratory factor analysis supported the extraction of an 11 factor model, with item loadings consistent with the factor structure suggested by the original study. Findings for the sleep and physical subscales differed from the original study, with the present analysis suggesting one shared latent construct.

Conclusions:

The psychometric properties of the web-based QoL Tool are largely concordant with the original pen-and-paper QoL.BD, although some minor differences in the structure of the Sleep and Physical domains were observed. Despite this small variation from the factor structure identified in the QoL.BD, the latent factor structure of the QoL Tool largely reproduced the original findings and theoretical structure of QoL areas relevant to people with BD. These findings underscore the research and clinical utility of this instrument, but further comparison of the psychometric properties of the QoL Tool relative to the QoL.BD are warranted. Future adaptations of the QoL Tool, including the production of an app-based version of the QoL Tool, are also discussed. Clinical Trial: N/A - Data collection predated the requirement for trial registrations