A qualitative investigation of older adults’ conceptualisation of quality of life and a think-aloud content validation of the EQ-5D-5L, SF-12v2, WEMWBS and ONS-4

PENTON, Hannah, DAYSON, Christopher, HULME, Claire and YOUNG, Tracey (2022). A qualitative investigation of older adults’ conceptualisation of quality of life and a think-aloud content validation of the EQ-5D-5L, SF-12v2, WEMWBS and ONS-4. Value in Health, 25 (12), 2017-2027.

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Link to published version:: https://doi.org/10.1016/j.jval.2022.04.1735
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    Objectives Old age is characterized by declining health, comorbidities, and increasing health and social care service use. Traditionally, patient-reported outcome measures (PROMs) including the EQ-5D-5L and SF-12v2 have focused on health. Nevertheless, aged care often aims to improve broader elements of quality of life (QoL), captured by well-being measures, such as the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) and Office of National Statistics-4 (ONS-4). This study investigates older adults’ conceptualization of QoL and the content validity of the EQ-5D-5L, SF-12v2, WEMWBS, and ONS-4 in measuring their QoL. Methods Qualitative cognitive think-aloud interviews were undertaken with older adults aged 75+, exploring their views on what was important to QoL and, for each measure, the relevance, acceptability, and interpretation of items; suitability of response options; and the comprehensiveness of the measure. Conceptualization of QoL was analyzed thematically and content validity using framework analysis. Results Twenty interviews were undertaken. Older adults’ conceptualization of QoL centered on health, ability to perform usual activities, social contact, and emotional functioning. Possible response shift was observed, as older adults assessed their health relative to lower health expectations at their age or to people in worse states. Participants questioned the relevance of negatively phrased mental items and often preferred the functioning-focused EQ-5D-5L to more subjective ONS-4 and WEMWBS items. Domains suggested to improve comprehensiveness included social contact, coping, security, dignity, and control. Conclusions These findings are useful to researchers developing new PROMs for older adults or for the developers of included PROMs considering permanently adapting or bolting-on domains to improve content validity in older adults.

    Item Type: Article
    Uncontrolled Keywords: 1117 Public Health and Health Services; 1402 Applied Economics; Health Policy & Services
    Identification Number: https://doi.org/10.1016/j.jval.2022.04.1735
    Page Range: 2017-2027
    SWORD Depositor: Symplectic Elements
    Depositing User: Symplectic Elements
    Date Deposited: 12 Jul 2022 09:34
    Last Modified: 15 Nov 2022 11:04
    URI: https://shura.shu.ac.uk/id/eprint/30445

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