Limited attention is devoted to the improvement of the quality of life of patients suffering from the negative consequences of Sickle cell disease (SCD). Our study focuses on the evaluation of the performance of the WHOQOL-BREF as a tool to measure the quality of life of SCD Patients in Bahrain. We conducted a cross-sectional study that enrolled 273 SCD patients selected using a simple random sampling technique from primary health-care centers in Bahrain in 2019. A designed questionnaire including the WHOQOL-BREF was filled by the patients in the health centers. The reliability of the WHOQOL-BREF was assessed by standardized Cronbach’s alpha coefficient, and the validity was measured by convergent validity, principal component analysis and confirmatory factor analysis. The WHOQOL-BREF had good internal consistency as Cronbach’s alpha coefficient for the overall scale was 0.91. The convergent validity results indicated that the correlation coefficients values for all scale domains are significantly correlated at α < 0.01. Confirmatory factor analysis found that the four-domain structure produced a robust fit to the data. The WHOQOL-BREF tool has high internal consistency and validity in assessing the quality of life of Sickle Disease patients in Bahrain. Volume 14 - 2023 | https://doi.org/10.3389/fpsyg.2023.1219576 Background: Limited attention is devoted to the improvement of the quality of life of patients suffering from the negative consequences of Sickle cell disease (SCD) Our study focuses on the evaluation of the performance of the WHOQOL-BREF as a tool to measure the quality of life of SCD Patients in Bahrain Methods: We conducted a cross-sectional study that enrolled 273 SCD patients selected using a simple random sampling technique from primary health-care centers in Bahrain in 2019 A designed questionnaire including the WHOQOL-BREF was filled by the patients in the health centers The reliability of the WHOQOL-BREF was assessed by standardized Cronbach’s alpha coefficient and the validity was measured by convergent validity principal component analysis and confirmatory factor analysis Results: The WHOQOL-BREF had good internal consistency as Cronbach’s alpha coefficient for the overall scale was 0.91 The convergent validity results indicated that the correlation coefficients values for all scale domains are significantly correlated at α < 0.01 Confirmatory factor analysis found that the four-domain structure produced a robust fit to the data Conclusion: The WHOQOL-BREF tool has high internal consistency and validity in assessing the quality of life of Sickle Disease patients in Bahrain only few studies addressed the performance of WHOQOL-BREF on SCD patients and this research has never been conducted on patients suffering from this condition in the gulf region including Bahrain where SCD is believed to account for a heavy psychological burden by family doctors we aimed in this study to assess the Validity and Reliability of the WHOQOL-BREF as a tool for the evaluation of the quality of life of life of Sickle Disease Patients in Bahrain this user-friendly tool might become a recommended asset to monitor the QoL of these patients and respond timely to their needs A cross-sectional study conducted by our group and detailed elsewhere (AlSaleh et al., 2021) provided the required information for this study it enrolled (273 out 288 required according to the formula below) representative Sickle cell disease patients (above 21 years) from all primary health-care centers (PHC) in Bahrain between July and August 2019 who voluntarily accepted to fill the WHOQOL-BREF in the PHCs The sample size was calculated using the following formula: n = (Z2 PQ)/d2 where z = 1.96 p = 0.25 and Q = 0.75 The study population was described elsewhere (AlSaleh et al., 2021) The WHOQOL-BREF questionnaire was administered for eligible volunteers at the PHCs in Bahrain during the month of July and August 2019 They represent a sample selected using systematic random sampling from the database of SCD patients available in the PHC direction The list of the patients available in the medical health records was used as a sampling frame from which the enrolled patients were selected using a random number list generated by computer Patients were excluded if they have been diagnosed with any other health condition associated with chronic pain such as arthritis and/or psychiatric chronic diseases such as epilepsy Vulnerable patients such as patients during the episode of pain crisis or patients who refused or were unable to provide a valid informed consent were also excluded Two other questions are asked separately and refer to an individual’s overall perception of quality of life and an individual’s overall perception of general health Reliability analyses were carried out using Cronbach’s alpha coefficient to assess internal consistency reliability All statistical analyses were conducted using the Statistical Package for the Social Sciences (SPSS) version 27 and the Analysis of Moment Structures (AMOS) software version 23 A value of p <0.05 was considered as statistically significant This study was approved by the Ethical Committee in the College of Medicine and Medical Sciences Arabian Gulf University (approval number: E002-pi-4/19) and the ethical committee of the ministry of health in the kingdom of Bahrain (approval number: AURS/325/2019) All participants provided informed written consent before participation The disease was mild among 54.6% of patients and did not require medication However in 26.4 and 24.9% of cases non-steroidal anti-inflammatory drugs and opioids were prescribed The Reliability of the WHO quality of life as measured (Table 1) by Cronbach’s alpha coefficient (value = 0.91) was satisfactory considering all score items and “environmental domains” (0.83 Analysis indicated that the correlation between the different QoL domains is statistically significant and varied from 0.394 to 0.612 (value of p <0.001). Table 2 shows good convergent validity for the WHO quality of life domains as shown by the significant Pearson’s correlations coefficients between the WHOQOL-BREF domains and perceptions of “Overall Quality of Life,” and “Overall General Health” Factor 1 included all the (7) items of the physical domain and 3 items: one item (negative feeling) and two items of the environment domain (Leisure activity and it explained 15.08% of the rotated variance Four items of the original psychological domain and 3 items: one item (Energy of life) of the original physical health domain and Leisure activity) of the original environment domain and it explained 14.75% of the rotated variance Factor 3 included all the (3) items of social relationships domain and an item (satisfaction with self) of the original psychological domain and it explained 11.83% of the rotated variance Six items of the original environment domain and an item (sexual activity) of the original social relationship’s domain and it explained 10.34% of the rotated variance which provided statistically significant model The structure of the WHOQOL-BREF based on confirmatory factor analysis These different patterns could be explained by the nature and specificities of the related health problems such as patients on wheelchairs with heavy handicaps caused by muscular skeletal dystrophies or elderly with hemiplegia This is the first study to measure the psychometric properties of the WHOQOL-BREF for SCD patients in Bahrain and this area has never been addressed previously although SCD is highly prevalent The study was limited by the retrospective character of the cross-sectional design which might lead to a recall bias Young patients and the most severe ones were not included in the present study for ethical and feasibility reasons which might compromise the generalizability of findings Future prospective studies using larger samples and enrolling patients from secondary care are required to have a more valid and representative evaluation of the tool This study confirmed the usefulness of the WHOQOL-BREF in the measurement of the quality of life of SCD patients using a representative sample from Bahrain It revealed good psychometric properties (Reliability & Validity) and should be recommended for future use in this health condition impact assessment on patients more studies are required to improve the reliability results particularly in the “social relationship” domain where the number of items is relatively reduced This gap might be addressed using a qualitative study design approach which is favored because of its inductive nature in generating items within constructs Quantitative prospective studies on larger samples of patients including the whole severity spectrum of SCD are required we recommend the integration of WHOQOL-BREF in the practice as a rapid tool to evaluate the quality of life for SCD patients at the point of care and timely address their needs The original contributions presented in the study are included in the article/supplementary material further inquiries can be directed to the corresponding author AA and ABS conceived and designed the study and MO performed the research process and collected the data and MA wrote the original draft of the manuscript All authors contributed to the article and approved the submitted version The authors would like to thank the Sickle Disease Patient in Bahrain for their participation in this study The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher Health-related quality of life in adults with sickle cell disease in the Kingdom of Bahrain (FPRP) Determinants of the quality of life of patients with sickle cell disease in Bahrain: implications for a patient-centered management approach at the primary health care Barros da Silva Lima Psychometric properties of the World Health Organization quality of life instrument (WHOQoL-BREF) in alcoholic males: a pilot study Quality of life as an evaluative measure in assessing the impact of community care on people with long-term psychiatric disorders Reliability and validity of the WHOQOL BREF in a sample of Brazilian outpatients with major depression Sickle cell disease: a natural model of acute and chronic pain CrossRef Full Text | Google Scholar A systematic review of instruments for measuring outcomes in economic evaluation within aged care CrossRef Full Text | Google Scholar Psychometric testing of the short version of the world health organization quality of life (WHOQOL-BREF) questionnaire among pulmonary tuberculosis patients in Taiwan Changes in quality of life in chronic psychiatric patients: a comparison between euro Qol (EQ-5D) and WHOQoL Sickle cell disease in Middle East Arab countries Psychometric properties of the World Health Organization quality of life assessment–brief in methadone patients: a validation study in northern Taiwan Psychometric properties of the WHOQOL-BREF (PT) in a sample of elderly citizens Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO study health service use and treatment of people with depressive symptoms Suitability of the WHOQOL-BREF for community-dwelling older people in Taiwan Ilić Šipetić-Grujičić Živanović Mačužić Psychometric properties of the world health organization’s quality of life (WHOQOL-BREF) questionnaire in medical students Quality of life in polish respondents: psychometric properties of the polish WHOQOL–Bref Validation of the WHOQOL-Bref: psychometric properties and normative data for the Norwegian general population How useful is the concept of quality of life in psychiatry PubMed Abstract | CrossRef Full Text | Google Scholar Reliability and validity of the Korean World Health Organization quality of life (WHOQOL)-BREF in people with physical impairments Krägeloh Validation of the WHOQOL-BREF quality of life questionnaire for use with medical students Google Scholar Assessment and reliability of the World Health Organisation quality of life (WHO QOL-BREF) questionnaire in total hip replacement patients Psychometric properties of the Urdu version of the World Health Organization's quality of life questionnaire (WHOQOL-BREF) Quality of life (QoL) among medical students in Saudi Arabia: a study using the WHOQOL-BREF instrument Google Scholar An evaluation of psychometric properties of the Templer’s Death Anxiety Scale-Extended among a sample of Iranian chemical warfare veterans Google Scholar The reliability and validity of the short version of the WHO quality of life instrument in an Arab general population Quality of life and mental illness: reflections from the perspective of the WHOQOL attitudes and practices questionnaire on COVID-19 (KAP COVID-19) The World Health Organization WHOQOL-100: tests of the universality of quality of life in 15 different cultural groups worldwide Statistics for the behavioral sciences Sage publications Google Scholar Validity and reliability of the Amharic version of the World Health Organization’s quality of life questionnaire (WHOQOL-BREF) in patients with diagnosed type 2 diabetes in Felege Hiwot referral hospital Cross-linguistic equivalence of WHOQOL-100: a study from North India The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial Validation of WHOQOL-BREF in Malayalam and determinants of quality of life among people with type 2 diabetes in Kerala The WHOQOL Group (1998) Development of the World Health Organization WHOQOL-BREF quality of life assessment PubMed Abstract | CrossRef Full Text | Google Scholar World sickle cell day 2016: a time for appraisal PubMed Abstract | CrossRef Full Text | Google Scholar Trompenaars and reliability of the WHOQOL-Bref in a population of Dutch adult psychiatric outpatients World Health Organization quality-of-life scale (WHOQOL-BREF): analyses of their item response theory properties based on the graded responses model PubMed Abstract | Google Scholar Sickle cell disease—a history of progress and peril PubMed Abstract | CrossRef Full Text | Google Scholar Modern statistics for the social and behavioral sciences: a practical introduction CRC Press Google Scholar World Health Organization scoring and generic version of the assessment: field trial version Google Scholar Quality of life of medical students in China: a study using the WHOQOL-BREF Fuad N and Chlif S (2023) Validity and reliability of the WHOQOL-BREF in the measurement of the quality of life of Sickle disease patients in Bahrain Received: 10 May 2023; Accepted: 21 August 2023; Published: 01 September 2023 Copyright © 2023 Almarabheh, Salah, Alghamdi, Al Saleh, Elbarbary, Al Qashar, Alserdieh, Alahmed, Alhaddar, Alsada, Yosri, Omran, Khudhair, Salih, Fuad and Chlif. 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