Validation of the Good Spirit, Good Life quality-of-life tool for older Aboriginal Australians

Abstract

Objective: Improving the quality of life (QoL) of older people is a key priority for governments, clinicians, researchers and service providers worldwide. However, the lack of culturally appropriate QoL tools for First Nations people is a major barrier to such efforts. The purpose of this study was to evaluate the psychometric properties of the Good Spirit, Good Life (GSGL) QoL tool for older Aboriginal Australians.

Methods: One hundred and twenty older Aboriginal people living in Perth and Melbourne, Australia, were administered the GSGL tool, along with several other instruments assessing cognition (KICA-Cog), depression (KICA-Dep), anxiety (GAI-SF), health and well-being (EQ-5D-5L and ICECAP-O) and resilience (ARRQ-25). Associations between these instruments and the GSGL tool were explored to determine concurrent and known-groups validity. Internal consistency was assessed with split-half reliability and Cronbach's alpha. Exploratory factor analysis was performed to investigate construct validity.

Results: GSGL scores were positively correlated with ICECAP-O and ARRQ-25 scores, and negatively correlated with EQ-5D-5L score. GSGL scores differed significantly between participants with a probable anxiety disorder or depression, but not those with cognitive impairment. The Spearman-Brown prophecy estimate was 0.83 and Cronbach's alpha was 0.75. Principal component analysis identified two factors, which were labelled foundation and external.

Conclusions: The GSGL tool is a valid tool to assess quality of life in older Aboriginal Australians. The tool demonstrates acceptable convergent, concurrent and known-groups validity. It was co-designed at all stages with older Aboriginal people contributing to its strong face and content validity.

Keywords: Aboriginal; Indigenous; quality of life; validity; well-being.

FIGURE 1

Scores for individual items of the Good Spirit, Good Life tool.

FIGURE 2

Scree plots comparing actual and random data by parallel analysis. Vertical line denotes the number of factors retained.

FIGURE 3

Correlations between Good Spirit, Good Life tool and other instruments. Shaded region indicates 95% confidence interval. EQ‐5D‐5L, EuroQoL‐5 Dimension‐5 Level; GSGL, Good Spirit, Good Life; ICECAP‐O, ICEpop capability measure for older people.