Validating the Well-Being of Older People (WOOP) Instrument in China

Generic health-related quality of life (HRQoL) measures have been used for estimating utility value, which is then used for calculating quality-adjusted life years (QALYs). HRQoL measures may not capture many of the relevant and important non-health aspects of quality of life. The well-being of older people (WOOP) instrument was first developed in the Netherlands. This study aimed to validate this new instrument among older people in China. WOOP was first translated into simplified Chinese (for use in Mainland China) by two experienced translators. From July to August 2022, a cross-sectional study was conducted on a convenience sample of 500 older people in Southwestern China. Older people who provided consent reported their demographic information and completed the simplified Chinese version of the WOOP instrument using a pencil and paper. The feasibility of WOOP was determined by the percentage of missing responses. Then, using the data without any missing responses, we examined the item response distributions, pairwise Spearman correlations, underlying factors, and known-group validity of WOOP. Among the nine items of WOOP, three had more than 10% missing responses. The response distributions of the nine items were overall good without signs of ceiling and floor effects. The correlations among the WOOP items were low. A two-factor exploratory factor analysis model suggested that the WOOP items can be categorized into either internal or external well-being items. Good known-group validity results were found. Some WOOP items may not be easily understood by a small proportion of rural residents. However, other results have suggested WOOP to be a valid instrument for measuring the well-being of the elderly in China. The availability of WOOP enables the measurement of well-being-related utility.