Validation of the WHOQOL-BREF quality of life questionnaire for use with medical students.

PURPOSE: The purpose of the present study was to validate the use of the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire with medical students. METHODS: A sample of 274 medical students in their fourth and fifth years of study (80% response rate) completed the WHOQOL-BREF instrument. The four-domain factor structure of the questionnaire was tested using confirmatory factor analysis. A variety of other tests of reliability and validity were conducted. RESULTS: Goodness-of-fit indices from the confirmatory factor analysis were acceptable, and the factor structure of the WHOQOL-BREF was confirmed in this sample. Reliability was good, but three of the items showed strong ceiling effects. CONCLUSION: The WHOQOL-BREF is valid to use with medical students to assess health-related quality of life. Some items, such as those inquiring about pain and medication, may not be suitable for medical students or young people in general.

Metaphors for illness in contemporary media.

Essayist Susan Sontag alerted us more than 20 years ago to the way in which clusters of metaphors attach themselves to our discussion of certain diseases, and the influence these metaphors exert on public attitudes to the diseases themselves and to those who experience them. This study of feature articles on five diseases-avian flu, cancer, diabetes, heart disease, and HIV/AIDS-published recently in the New York Times reveals distinct patterns of metaphor usage around each. While the metaphors used in relation to the diseases Sontag studied-cancer and HIV/AIDS-have become less emotive and more positively informative, the sensationalist connotations of the metaphor clusters that have formed around two diseases that were not on the agenda for wide public debate in her time-avian flu and diabetes-are hardly congruent with the serious intent of the articles in which they appeared. By contrast, discussion of heart disease involved very limited use of metaphor. The article ends with a call for journalists and medical professionals to become more aware of the impact of the metaphors they use and to collaborate in developing sets of metaphors that are factually informative and enhance communication between doctors and their patients.