Health, social, behavioral, and labor correlates of quality of life in a well population: a contribution to construct validity of the WHOQOL-BREF.

The study aims to assess the hypothetical construct underlying the WHOQOL-BREF scale of quality of life in the working environment, wherein individuals are reasonably healthy. We analyzed cross-sectional data from civil servants at university campuses in Rio de Janeiro, Brazil, which focused on social determinants of health possibly related to quality of life. We simultaneously assessed the association of quality of life domains with physical and mental health, physical activity, eating habits, stress and social support at work, situations of discrimination, and socioeconomic status using structural equation modeling. Most of the 3,574 participants were non-manual workers (57%), woman (56%), with median age of 42 years, and 42% had a university degree. The association of psychological distress stood out from other covariates in all four domains of quality of life, particularly the psychological domain. The direct association between socioeconomic status and the environmental domain, the inverse association of recent morbidity to the physical domain, and the inverse association of discrimination with all domains were also noteworthy. The results strengthened the construct validity from factor analysis of WHOQOL-BREF, with additional evidence from the association with constructs related to quality of life obtained in a study of social determinants of health. There seems to be space to expand the use of WHOQOL-BREF to provide valid inferences on the quality of life of workers, targeting individuals whose very low scores might signal the need for support, and to assess changes in quality of life following interventions in groups of workers.