Yang Fan, Jiang Shan, He Xiao-Ning, Li Hong-Chao, Wu Hong-Yan, Zhang Tian-Tian, Wu Jing
Centre for Health Economics, University of York, York, UK.
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Pharmacoecon Open. 2021 Mar;5(1):101-109. doi: 10.1007/s41669-020-00212-z.
The 5-level EQ-5D (EQ-5D-5L) has been increasingly used in China to measure the health status of the general population and patients. However, its content validity among rural residents in China has not been formally evaluated. This qualitative study aims to assess the content validity of EQ-5D-5L among rural Chinese.
Participants were recruited from four regions (North, South, East and West) across China. Eligible participants were those living in the rural area in last three years and making a living by agricultural operations. Semi-structured interviews were conducted. Interview transcripts were analysed to assess the comprehensibility, relevance, clarity and comprehensiveness.
Sixty-two participants were included, comparable to the national figures regarding age, sex and education. For comprehensibility, participants could understand the 'mobility', 'self-care' and 'usual activities' domains well, but some reported confusions in 'pain/discomfort' (n = 42) and 'anxiety/depression' (n = 35). Some also reported difficulties in understanding anxiety (n = 6) and depression (n = 9), possibly due to the formal wording used. For relevance, all domains were reported as health-related and participants' responses were based on their own health. For clarity, all could distinguish the five levels, but suggestions on reducing response levels and alternative wording for 'slight' were raised. For comprehensiveness, two aspects (fatigue/energy and appetite) were raised beyond the EQ-5D-5L domains. The 'mobility' domain was selected as the most important and 'anxiety/depression' as the least important.
Rural Chinese reported problems on the content validity of Chinese EQ-5D-5L. It might be sensible to consider some revisions to make it more understandable for rural residents.
5维度EQ-5D（EQ-5D-5L）在中国越来越多地用于测量普通人群和患者的健康状况。然而，其在中国农村居民中的内容效度尚未得到正式评估。本定性研究旨在评估EQ-5D-5L在中国农村居民中的内容效度。
从中国四个地区（北部、南部、东部和西部）招募参与者。符合条件的参与者是过去三年居住在农村地区且以农业生产为生的人。进行了半结构化访谈。对访谈记录进行分析，以评估其可理解性、相关性、清晰度和全面性。
纳入了62名参与者，其年龄、性别和教育程度与全国数据相当。在可理解性方面，参与者能够很好地理解“行动能力”“自我照顾”和“日常活动”领域，但一些人表示在“疼痛/不适”（n = 42）和“焦虑/抑郁”（n = 35）方面存在困惑。一些人还报告在理解焦虑（n = 6）和抑郁（n = 9）方面有困难，可能是由于使用的正式措辞。在相关性方面，所有领域都被报告与健康相关，参与者的回答基于他们自己的健康状况。在清晰度方面，所有人都能区分五个级别，但有人提出了减少回答级别以及对“轻度”采用替代措辞的建议。在全面性方面，有人提出了超出EQ-5D-5L领域的两个方面（疲劳/精力和食欲）。“行动能力”领域被选为最重要的领域，“焦虑/抑郁”被选为最不重要的领域。
中国农村居民报告了中文版EQ-5D-5L在内容效度方面存在问题。考虑进行一些修订以使农村居民更容易理解可能是明智的。
