Botes Riaan, Vermeulen Karin M, Gerber Anthonie M, Ranchor Adelita V, Buskens Erik
Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB, The Netherlands.
Department of Basic Medical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, 9300, South Africa.
Patient Prefer Adherence. 2019 May 7;13:721-728. doi: 10.2147/PPA.S193171. eCollection 2019.
Valuing hypothetical health states is a demanding personal process, since it involves the psychological evaluation of hypothetical health states. It seems plausible that elderly individuals will value hypothetical health states differently than the general population. It is, however, important to understand the psychological division that oldest old subgroups construct between acceptable and unacceptable health states. This information can produce important evidence regarding well-being and disability conceptualization. To investigate how Dutch oldest old, conceptualize health-related quality of life health states when compared to well-being health states. In addition, we aim to compare subgroups, based on dependency classification. Ninety-nine elderly living in the Groningen, Hoogeveen and Veendam areas of the Netherlands participated in the study. Respondents were classified into three groups based on dependency levels. The respondents were asked to value hypothetical health states, a generic preference-based HRQoL and a well-being instrument, using a visual analog scale. All three groups ranked the same health states, from both questionnaires, below the average across the health states. The health-related quality of life health states was consistently ranked lower than the current well-being health states. Health state valuations performed by the oldest old indicate that conceptually, respondents view below average health-related and well-being health states as undesirable. The results indicated that the oldest old do view deficits in health-related health states as more important than deficits in well-being health states. Since the oldest old performed the valuations, focused interventions to improve below average health-related outcomes might be the most cost-effective way to increase oldest old well-being outcomes.
评估假设的健康状态是一个要求颇高的个人过程，因为它涉及对假设健康状态的心理评估。老年人对假设健康状态的评估方式可能与普通人群不同，这似乎是合理的。然而，了解最年长者亚组在可接受和不可接受的健康状态之间构建的心理划分很重要。这些信息可以提供有关幸福感和残疾概念化的重要证据。为了研究与幸福感健康状态相比，荷兰最年长者如何概念化与健康相关的生活质量健康状态。此外，我们旨在根据依赖程度分类比较亚组。居住在荷兰格罗宁根、霍赫芬和芬丹地区的99名老年人参与了该研究。根据依赖程度，受访者被分为三组。要求受访者使用视觉模拟量表对假设的健康状态、一种基于偏好的通用健康相关生活质量工具和一种幸福感工具进行评估。所有三组对两份问卷中的相同健康状态的排名均低于所有健康状态的平均水平。与健康相关的生活质量健康状态的排名一直低于当前的幸福感健康状态。最年长者进行的健康状态评估表明，从概念上讲，受访者认为低于平均水平的与健康相关和幸福感健康状态是不理想的。结果表明，最年长者确实认为与健康相关的健康状态缺陷比幸福感健康状态缺陷更重要。由于是最年长者进行评估，因此集中干预措施以改善低于平均水平的与健康相关的结果可能是提高最年长者幸福感结果的最具成本效益的方法。
