Abstract:
Objective: The purpose of this study was to evaluate the psychometric properties of the
World Health Organization's five item well-being index (WHO-5) when administered to
adults living with HIV or epilepsy in a rural setting at the coast of Kenya.
Methods: A case control study design was conducted among 230 adults aged 18-50
years, who comprised 147 cases (63 living with epilepsy and 84 living with HIV) and 83
healthy controls. The participants were administered to a face-to-face interview during
which they completed the Swahili version of WHO-5 well-being index, the Major
Depression Inventory (MDI) and responded to some items on their socio-demographic
characteristics. Analysis to assess internal consistency, construct validity, discriminant
validity, and convergent validity of the Swahili version of WHO-5 well-being index was
conducted. A multivariate regression was carried out to assess the association between
psychological wellbeing (assessed using Swahili version of WHO-5 well-being index)
and having a chronic illness (HIV or epilepsy).
Results: The Swahili version of WHO-5 well-being index demonstrated good internal
consistency with Cronbach alpha ranges of 0.86-0.88 among the three study groups. The
tool had good discriminant validity. A one factor structure of the tool was obtained from
confirmatory factor analysis (overall Comparative Fit Index = 1.00, Tuckler Lewis Index
= 1.01, Root Mean Square of Error Approximation = 0.00). Living with HIV or epilepsy
in comparison to being a healthy control was significantly associated with greater odds of
having sub-optimal psychological wellbeing.
Conclusion: Our findings demonstrate that the Swahili version of WHO-5 well-being
index has good psychometric properties and is appropriate for use to evaluate
psychological well-being among adults living with chronic conditions such as HIV or
epilepsy from a rural low resource setting in Kenya. Given its brevity and ease of use, the
Swahili version of WHO-5 well-being index could potentially be used by lay workers
and other paraprofessional to monitor psychological well-being among chronically ill
adults in resource poor settings.