Reliability and validity of the Greek translation of the MOS-HIV health survey in HIV-infected individuals

This study was intended to present evidence for the reliability and validity of a Greek translation of the Medical Outcomes Study-HIV Health Survey (MOS-HIV). Design: Sample consisted of 154 HIV-positive men and women, regardless of disease stage, who are being followed at the department of Infectious Diseases of a tertiary hospital of Athens, Greece. The translated Greek version of the MOS-HIV instrument, a brief, comprehensive 35-item health-related quality of life questionnaire, was used to assess ten dimensions of health including overall quality of life, pain, physical functioning, role functioning, social functioning, mental health, energy/fatigue, cognitive function, health distress, and health transition. Additional socio-demographic data and clinical parameters were also collected. Standard guidelines were followed for questionnaire translation to the Greek language. Internal consistency reliability using Cronbach's alpha and the range of measurement of the MOS-HIV subscales were examined. Convergent validity was further examined with the intercorrelations of subscales. ROC analysis was used to estimate the ability of the subscales to discriminate patients according to the characteristics of the disease [i.e. asymptomatic, symptomatic and AIDS, CD4+ lymphocyte count (< 200 cells/mm(3) and > 200 cells/mm(3))] and assess concurrent validity. All the MOS-HIV scales exceeded the minimum reliability standard of 0.70. Physical functioning and health distress had the greatest reliability coefficient, equal to 0.87 and 0.88, respectively. Correlations among MOS-HIV scales were all significant. Physical functioning, pain, and physical health summary scales were significantly lower for AIDS patients compared to asymptomatic HIV+ individuals. All scales except for role functioning and health transition could discriminate well subjects with CD4+ lymphocyte count < 200 cells/mm(3) and > 200 cells/mm(3). The Greek version of the MOS-HIV had good reliability and validity among patients with AIDS. Convergent and concurrent validity were generally confirmed. The MOS-HIV may be useful in assessing health-related quality of life in AIDS patients in Greece. Further research is needed for the evaluation of the Greek version of the MOS-HIV responsiveness to changes over time.