Assessing quality of life in severe obesity: development and psychometric properties of the ORWELL-R

Eat Weight Disord. 2016 Jun;21(2):277-88. doi: 10.1007/s40519-015-0222-z. Epub 2015 Oct 1.

Abstract

Purpose: Several health-related quality-of-life (HRQoL) dimensions are affected by obesity. Our goal was to characterize the psychometric properties of the ORWELL-R, a new obesity-related quality-of-life instrument for assessing the "individual experience of overweightness".

Methods: This psychometric assessment included two different samples: one multicenter clinical sample, used for assessing internal consistency, construct validity and temporal reliability; and a community sample (collected through a cross-sectional mailing survey design), used for additional construct validity assessment and model fit confirmation.

Results: Overall, 946 persons participated (188 from the clinical sample; 758 from community sample). An alpha coefficient of 0.925 (clinical sample) and 0.934 (community sample) was found. Three subscales were identified (53.2 % of variance): Body environment experience (alpha = 0.875), Illness perception and distress (alpha = 0.864), Physical symptoms (alpha = 0.674). Adequate test-retest reliability has been confirmed (ICC: 0.78 for the overall score). ORWELL-R scores were worse in the clinical sample. Worst HRQoL, as measured by higher ORWELL-R scores, was associated with BMI increases. ORWELL-R scores were associated with IWQOL-Lite and lower scores in happiness.

Conclusions: ORWELL-R shows good internal consistency and adequate test-retest reliability. Good construct validity was also observed (for convergent and discriminant validity) and confirmed through confirmatory factor analysis (in both clinical and community samples). Presented data sustain ORWELL-R as a reliable and useful instrument to assess obesity-related QoL, in both research and clinical contexts.

Keywords: Health-related quality of life; ORWELL-R; Obesity; Validation.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Health Status
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Obesity, Morbid / psychology*
  • Psychometrics
  • Quality of Life / psychology*
  • Reproducibility of Results
  • Self Concept*
  • Stress, Psychological / psychology
  • Symptom Assessment
  • Young Adult