de Vries Marieke, Emons Wilco H M, Plantinga Arnoud, Pietersma Suzanne, van den Hout Wilbert B, Stiggelbout Anne M, van den Akker-van Marle M Elske
Department of Social Psychology, Tilburg Institute for Behavioral Economics Research, Tilburg University, Tilburg, The Netherlands; Radboud University, Institute for Computing and Information Sciences (iCIS), Data Science Department, Nijmegen, The Netherlands.
Faculty of Social and Behavioural Sciences, Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands.
Value Health. 2016 Mar-Apr;19(2):167-75. doi: 10.1016/j.jval.2015.11.010. Epub 2016 Jan 28.
Allocation of inevitably limited financial resources for health care requires assessment of an intervention's effectiveness. Interventions likely affect quality of life (QOL) more broadly than is measurable with commonly used health-related QOL utility scales. In line with the World Health Organization's definition of health, a recent Delphi procedure showed that assessment needs to put more emphasis on mental and social dimensions.
To identify the core dimensions of health-related subjective well-being (HR-SWB) for a new, more comprehensive outcome measure.
We formulated items for each domain of an initial Delphi-based set of 21 domains of HR-SWB. We tested these items in a large sample (N = 1143) and used dimensionality analyses to find a smaller number of latent factors.
Exploratory factor analysis suggested a five-factor model, which explained 65% of the total variance. Factors related to physical independence, positive affect, negative affect, autonomy, and personal growth. Correlations between the factors ranged from 0.19 to 0.59. A closer inspection of the factors revealed an overlap between the newly identified core dimensions of HR-SWB and the validation scales, but the dimensions of HR-SWB also seemed to reflect additional aspects. This shows that the dimensions of HR-SWB we identified go beyond the existing health-related QOL instruments.
We identified a set of five key dimensions to be included in a new, comprehensive measure of HR-SWB that reliably captures these dimensions and fills in the gaps of the existent measures used in economic evaluations.
为医疗保健分配必然有限的财政资源需要评估一项干预措施的有效性。干预措施对生活质量（QOL）的影响可能比常用的与健康相关的QOL效用量表所能衡量的更为广泛。根据世界卫生组织对健康的定义，最近的德尔菲程序表明，评估需要更加重视心理和社会层面。
为一种新的、更全面的结果测量方法确定与健康相关的主观幸福感（HR-SWB）的核心维度。
我们为基于德尔菲法的最初一组21个HR-SWB领域中的每个领域制定了项目。我们在一个大样本（N = 1143）中测试了这些项目，并使用维度分析来找出数量较少的潜在因素。
探索性因素分析提出了一个五因素模型，该模型解释了总方差的65%。这些因素与身体独立性、积极情绪、消极情绪、自主性和个人成长有关。各因素之间的相关性在0.19至0.59之间。对这些因素的进一步检查发现，新确定的HR-SWB核心维度与验证量表之间存在重叠，但HR-SWB维度似乎也反映了其他方面。这表明我们确定的HR-SWB维度超出了现有的与健康相关的QOL工具。
我们确定了一组五个关键维度，将纳入一种新的、全面的HR-SWB测量方法中，该方法能够可靠地捕捉这些维度，并填补经济评估中现有测量方法的空白。
