Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Department of Psychology, Queen's University Belfast, Belfast, UK.
Health Qual Life Outcomes. 2020 Jun 3;18(1):165. doi: 10.1186/s12955-020-01414-z.
With an increasing awareness of people's satisfaction and feeling, health-related quality of life (HRQoL) has become an essential aspect of measuring health. HRQoL is fundamentally a foreign concept introduced to China from the West. While a growing number of studies applied western HRQoL measures, few content validity tests examined the legitimacy of applying Western developed HRQoL measures in a Chinese cultural setting. If there are distinct differences in health conceptualisation between China and the West, it can be argued that those western measures may fail to ask the most appropriate and important questions among a Chinese population in assessing health. As a limited number of studies have investigated Chinese people's understandings of health, this study aimed to explore how health is defined and described in China.
A Q-methodological study was conducted to explore subjective constructions of health among Chinese participants. A scoping review of Chinese generic HRQoL measures, supplemented by a series of qualitative interviews conducted in China, produced a list of 42 statements representing aspects of health considered as being important in a Chinese cultural setting. Chinese participants in face-to-face interviews ranked and sorted these statements. Data were analysed to identify clusters of participants who shared a similar perspective, using a by-person factor analysis procedure.
110 Chinese participants with various demographics characteristics completed sorting interviews. Five independent factors emerged: (I) "Physical independence and social interaction skills"; (II) "Physical health"; (III) "Sensations and feelings"; (IV) "Lifestyles"; (V) "Learning and working abilities".
The Q-study showed that many health statements were rated highly as most important by a diverse range of Chinese participants but were not covered in the commonly used Western HRQoL measure EQ-5D. It then suggests that the EQ-5D descriptive system might need modification to improve its capacity to measure health status in China. The study thus raises a general question as to how appropriate the Western-developed HRQoL measures are when used to assess health in a significantly different cultural setting.
随着人们对满意度和感受的认识不断提高，健康相关生活质量（HRQoL）已成为衡量健康的重要方面。HRQoL 本质上是从西方引入中国的一个外来概念。虽然越来越多的研究应用西方 HRQoL 衡量标准，但很少有内容效度测试检验将西方开发的 HRQoL 衡量标准应用于中国文化背景的合理性。如果中西方在健康概念化方面存在明显差异，可以认为那些西方衡量标准可能无法在中国人群中评估健康时提出最合适和最重要的问题。由于为数不多的研究调查了中国人对健康的理解，因此本研究旨在探讨中国如何定义和描述健康。
采用 Q 方法学研究来探索中国参与者对健康的主观建构。通过对中国通用 HRQoL 衡量标准进行范围综述，并在中国进行一系列定性访谈，得出了 42 个陈述，这些陈述代表了在中国文化背景下被认为重要的健康方面。中国参与者在面对面访谈中对这些陈述进行了排序和分类。通过个人因素分析程序，对数据进行分析，以识别具有相似观点的参与者群体。
共有 110 名具有各种人口统计学特征的中国参与者完成了分类访谈。出现了五个独立因素：（I）“身体独立性和社交技能”；（II）“身体健康”；（III）“感觉和感受”；（IV）“生活方式”；（V）“学习和工作能力”。
Q 研究表明，许多健康陈述被广泛的中国参与者评为最重要的陈述，但没有被常用的西方 HRQoL 衡量 EQ-5D 涵盖。这表明 EQ-5D 描述性系统可能需要修改，以提高其在中国衡量健康状况的能力。因此，该研究提出了一个一般性问题，即当在文化背景显著不同的情况下使用时，西方开发的 HRQoL 衡量标准是否合适。
