Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, England, UK.
Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, England, UK; Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
Value Health. 2020 Jun;23(6):782-790. doi: 10.1016/j.jval.2020.01.015. Epub 2020 May 11.
Carer quality-of-life (QoL) effects are recommended for inclusion in economic evaluations, but little is known about the relative performance of different types of QoL measures with carers. This study evaluated the validity and responsiveness of 3 care-related QoL measures (the Carer Experience Scale [CES], CarerQoL-7D, and ASCOT-Carer), 1 health-related QoL measure (the EQ-5D-5L), and 1 generic QoL measure (the ICECAP-A).
Validity and responsiveness were assessed in a UK sample of informal carers of adults with dementia, stroke, mental illness, or rheumatoid arthritis. A questionnaire containing the 5 QoL measures was posted to carers identified through the Family Resources Survey (N = 1004). Hypotheses regarding the anticipated associations between constructs related to the QoL of carers were tested to investigate construct validity and responsiveness.
Each measure exhibited some level of construct validity. In general, larger effect sizes and stronger associations were detected for the ASCOT-Carer and ICECAP-A measures in the pooled sample and across all conditions. The 5 measures did not exhibit clear responsiveness to changes over a 12-month period in care recipient health status or hours of care provided per week.
The results of this study provide initial evidence of the validity of care-related, health-related, and generic QoL (capability) measures in informal carers of adults with 4 highly prevalent conditions. Care-related measures were not always more sensitive to constructs associated with QoL of carers compared with generic measures. The performance of the ICECAP-A was comparable with that of the best-performing care-related measure, the ASCOT-Carer.
建议将照顾者生活质量（QoL）的影响纳入经济评估中，但对于不同类型的照顾者 QoL 测量方法的相对表现知之甚少。本研究评估了 3 种与照顾相关的 QoL 测量方法（照顾者体验量表[CES]、照顾者 QoL-7D 和 ASCOT-Carer）、1 种与健康相关的 QoL 测量方法（EQ-5D-5L）和 1 种通用 QoL 测量方法（ICECAP-A）的有效性和反应能力。
在英国一组患有痴呆症、中风、精神疾病或类风湿关节炎的成年患者的非正式照顾者中评估了有效性和反应能力。通过家庭资源调查（N=1004）确定的照顾者收到了一份包含 5 种 QoL 测量方法的问卷。为了研究结构有效性和反应能力，测试了与照顾者 QoL 相关的结构之间预期关联的假设。
每种方法都表现出一定程度的结构有效性。总体而言，在合并样本和所有条件下，ASCOT-Carer 和 ICECAP-A 方法的效果大小和相关性更强。这 5 种方法在 12 个月的护理对象健康状况或每周护理时间变化期间并未明显表现出反应能力。
这项研究的结果提供了初步证据，证明了与 4 种高度流行疾病的成年患者的非正式照顾者相关的照顾、健康和通用 QoL（能力）测量方法的有效性。与通用措施相比，照顾相关措施并不总是对与照顾者 QoL 相关的结构更敏感。ICECAP-A 的表现与表现最佳的照顾相关措施 ASCOT-Carer 相当。
