Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Singapore.
Office of Clinical, Academic & Faculty Affairs, Duke-NUS Medical School, Singapore, Singapore.
PLoS One. 2018 Jun 28;13(6):e0199881. doi: 10.1371/journal.pone.0199881. eCollection 2018.
The increasing focus of healthcare systems worldwide on long-term care highlights the need for culturally sensitive Health-Related Quality of Life instruments to accurately capture perceived health of various populations. Such instruments require a contextualized conceptual framework of health domains, which is lacking in some socio-cultural contexts. We developed a comprehensive and culturally sensitive conceptual framework of health domains relevant to the Singaporean population. We recruited Singaporeans/ permanent residents, English/ Chinese-speaking, with/ without chronic illnesses to participate in focus group discussions (FGDs) and in-depth interviews (IDIs). We elicited health areas participants perceived to be important for them to be happy and satisfied with life. To encourage spontaneous emergence of themes, we did not specify any aspect beyond the broad domains of Physical, Mental, and Social health so as not to limit the emergence of new themes. Themes from the transcripts were distilled through open coding (two independent coders), then classified into more abstract domains (each transcript coded independently by two coders from a pool of six coders). From October 2013 to August 2014, 121 members of the general public participated in 18 FGDs and 13 IDIs (44.6% males, mean age: 53.3 years 77% Chinese, 9% Malay, 12% Indian, 63% with chronic illness) while 13 healthcare workers participated as patient-proxies in three FGDs. Thematic analysis identified 27 domains. The 15 physical domains included physical appearance, energy, physical fitness, and health and resistance to illness. The nine mental domains included emotions, self-esteem, and personal freedom. The three social domains were social contact, social relationships, and social roles. This conceptual framework reflected physical, mental, and social dimensions of well-being, suggesting that the Singapore population's views on health support the World Health Organization's definition of health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".
全球医疗保健系统越来越关注长期护理，这凸显出需要使用文化敏感的健康相关生活质量工具来准确捕捉各种人群的健康感知。此类工具需要具有健康领域的语境化概念框架，但在某些社会文化背景下却缺乏这种框架。我们开发了一个与新加坡人口相关的全面且文化敏感的健康领域概念框架。我们招募了讲英语/中文、有/没有慢性病的新加坡公民/永久居民参与焦点小组讨论（FGD）和深入访谈（IDI）。我们引出了参与者认为对他们的生活感到幸福和满意至关重要的健康领域。为了鼓励主题的自发出现，我们没有指定除身体、心理和社会健康等广泛领域之外的任何方面，以免限制新主题的出现。通过开放编码（两名独立编码员）从记录中提取主题，然后将其分类为更抽象的领域（每个记录由六名编码员中的两名独立编码员从编码员库中进行编码）。2013 年 10 月至 2014 年 8 月，共有 121 名普通民众参加了 18 次 FGD 和 13 次 IDI（44.6%为男性，平均年龄 53.3 岁，77%为华人，9%为马来人，12%为印度人，63%患有慢性病），而 13 名医护人员作为患者代理人参加了 3 次 FGD。主题分析确定了 27 个领域。15 个身体领域包括身体外貌、能量、身体健康和对疾病的抵抗力。9 个心理领域包括情绪、自尊和个人自由。3 个社会领域是社会联系、社会关系和社会角色。这个概念框架反映了幸福的身体、心理和社会维度，表明新加坡人口对健康的看法支持世界卫生组织将健康定义为“一种完全的身体、心理和社会福祉的状态，而不仅仅是没有疾病或虚弱”。
