title: Cognitive testing of the WHOQOL-BREF Bangladesh tool in a northern rural Bangladeshi population with lymphatic filariasis.
abstract: OBJECTIVE
  The purpose of this study was to test the cultural suitability of the WHOQOL-BREF Bangladesh for a rural village population in Bangladesh.
  
  
  METHODS
  Participants (n = 35) were purposefully stratified for age, gender, education level and location from the Nilphamari district in northern rural Bangladesh. Cognitive interviews were conducted via an emergent probing method to identify issues with language and constructs within the tool. Data were collected through note taking and recordings of interviews. A coding framework was used to identify key issues with questions, which were analysed using SPSS version 19 and Chi-square analysis using a Fisher's exact test to determine statistically significant variances within the sample.
  
  
  RESULTS
  Twenty-two of the 26 questions in the tool were found to be problematic. The majority of problems with questions related to wording and conceptual difficulties. The majority of participants found the tool to be overly formal. Issues with translation appeared to affect the interpretation of a number of questions, and some concepts in the tool were found to be irrelevant in a village setting. There were statistically significant differences between those of different educational backgrounds and between genders.
  
  
  CONCLUSIONS
  The study found that the WHOQOL-BREF Bangladesh as it currently stands is not culturally or linguistically suitable for use within a rural northern Bangladeshi population.
authors.affiliation: Occupational Therapy, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Douglas, QLD, 4811, Australia, lynne.zeldenryk@jcu.edu.au.
authors.forename: Lynne
authors.initials: L
authors.lastname: Zeldenryk
authors.forename: Susan
authors.initials: S
authors.lastname: Gordon
authors.forename: Marion
authors.initials: M
authors.lastname: Gray
authors.forename: Richard
authors.initials: R
authors.lastname: Speare
authors.forename: Wayne
authors.initials: W
authors.lastname: Melrose
authors.forename: Moazzem
authors.initials: M
authors.lastname: Hossain
authors.forename: Gary
authors.initials: G
authors.lastname: Williams
mesh_terms: D000328:Adult; D001459:Bangladesh; D004605:Elephantiasis, Filarial / Q000208:ethnology / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011581:Psychological Tests / Q000592:standards; D011594:Psychometrics / Q000295:instrumentation*; D011788:Quality of Life / Q000523:psychology*; D012424:Rural Population; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014944:World Health Organization