Uy Elenore Judy B, Bautista Dianne Carrol, Xin Xiaohui, Cheung Yin Bun, Thio Szu-Tien, Thumboo Julian
Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Singapore.
Singapore Clinical Research Institute, Singapore, Singapore.
PLoS One. 2018 Feb 8;13(2):e0189687. doi: 10.1371/journal.pone.0189687. eCollection 2018.
Health-related quality of life (HRQOL) instruments are sometimes used without explicit understanding of which HRQOL domains are important to a given population. In this study, we sought to elicit an importance hierarchy among 27 HRQOL domains (derived from the general population) via a best-worst scaling survey of the population in Singapore, and to determine whether these domains were consistently valued across gender, age, ethnicity, and presence of chronic illnesses. We conducted a community-based study that sampled participants with quotas for gender, ethnicity, age, presence of chronic illness, and interview language. For the best-worst scaling exercise, we constructed comparison sets according to a balanced incomplete block design resulting in 13 sets of questions, each with nine choice tasks. Each task involved three HRQOL domains from which participants identified the most and least important domain. We performed a standard analysis of best-worst object scaling design (Case 1) using simple summary statistics; 603 residents participated in the survey. The three most important domains of health were: "the ability to take care of self without help from others" (best-worst score (BWS): 636), "healing and resistance to illness" (BWS: 461), and "having good relationships with family, friends, and others" (BWS: 373). The 10 top-ranked domains included physical, mental, and social health. The three least important domains were: "having a satisfying sex life" (BWS: -803), "having normal physical appearance" (BWS: -461), and "interacting with others (talking, shared activities, etc.)" (BWS: -444). Generally, top-ranked domains were consistently valued across gender, age, ethnicity, and presence of chronic illness. We conclude that the 10 top-ranked domains reflect physical, mental, and social dimensions of well-being suggesting that the sampled population's views on health are consistent with the World Health Organization's definition of health, "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".
与健康相关的生活质量（HRQOL）工具有时在未明确了解哪些HRQOL领域对特定人群重要的情况下就被使用。在本研究中，我们试图通过对新加坡人群进行最佳-最差尺度调查，得出27个HRQOL领域（源自普通人群）的重要性层次结构，并确定这些领域在性别、年龄、种族和慢性病存在情况方面是否得到一致重视。我们开展了一项基于社区的研究，对参与者进行了性别、种族、年龄、慢性病存在情况和访谈语言方面的配额抽样。对于最佳-最差尺度练习，我们根据平衡不完全区组设计构建了比较集，得出13组问题，每组有九个选择任务。每个任务涉及三个HRQOL领域，参与者需从中确定最重要和最不重要的领域。我们使用简单汇总统计数据对最佳-最差对象尺度设计（案例1）进行了标准分析；603名居民参与了调查。健康的三个最重要领域是：“在没有他人帮助的情况下照顾自己的能力”（最佳-最差得分（BWS）：636）、“康复和对疾病的抵抗力”（BWS：461）以及“与家人、朋友和其他人保持良好关系”（BWS：373）。排名前十的领域包括身体、心理和社会健康。三个最不重要的领域是：“拥有满意的性生活”（BWS：-803）、“拥有正常的外表”（BWS：-461）以及“与他人互动（交谈、共同活动等）”（BWS：-444）。一般来说，排名靠前的领域在性别、年龄、种族和慢性病存在情况方面得到了一致重视。我们得出结论，排名前十的领域反映了幸福的身体、心理和社会维度，这表明抽样人群对健康的看法与世界卫生组织对健康的定义一致，即“一种身体、心理和社会的完全健康状态，而不仅仅是没有疾病或虚弱”。
