Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Health Qual Life Outcomes. 2022 Jun 24;20(1):99. doi: 10.1186/s12955-022-02009-6.
Some capability dimensions may be more important than others in determining someone's well-being, and these preferences might be dependent on ill-health experience. This study aimed to explore the relative preference weights of the 16 items of the German language version of the OxCAP-MH (Oxford Capability questionnaire-Mental Health) capability instrument and their differences across cohorts with alternative levels of mental ill-health experience.
A Best-Worst-Scaling (BWS) survey was conducted in Austria among 1) psychiatric patients (direct mental ill-health experience), 2) (mental) healthcare experts (indirect mental ill-health experience), and 3) primary care patients with no mental ill-health experience. Relative importance scores for each item of the German OxCAP-MH instrument were calculated using Hierarchical Bayes estimation. Rank analysis and multivariable linear regression analysis with robust standard errors were used to explore the relative importance of the OxCAP-MH items across the three cohorts.
The study included 158 participants with complete cases and acceptable fit statistic. The relative importance scores for the full cohort ranged from 0.76 to 15.72. Findings of the BWS experiment indicated that the items Self-determination and Limitation in daily activities were regarded as the most important for all three cohorts. Freedom of expression was rated significantly less important by psychiatric patients than by the other two cohorts, while Having suitable accommodation appeared significantly less important by the expert cohort. There were no further significant differences in the relative preference weights of OxCAP-MH items between the cohorts or according to gender.
Our study indicates significant between-item but limited mental ill-health related heterogeneity in the relative preference weights of the different capability items within the OxCAP-MH. The findings support the future development of preference-based value sets elicited from the general population for comparative economic evaluation purposes.
在确定一个人的幸福感方面，某些能力维度可能比其他维度更为重要，而这些偏好可能取决于不健康的经验。本研究旨在探索德语版 OxCAP-MH（牛津能力问卷-心理健康）能力量表的 16 个项目的相对偏好权重，并比较不同心理健康体验水平的队列之间的差异。
在奥地利，对 1）精神科患者（直接心理健康经验）、2）（精神）医疗保健专家（间接心理健康经验）和 3）无心理健康经验的初级保健患者进行了最佳最差评分（BWS）调查。使用分层贝叶斯估计计算了德语 OxCAP-MH 仪器的每个项目的相对重要性得分。秩分析和稳健标准误的多变量线性回归分析用于探索三个队列中 OxCAP-MH 项目的相对重要性。
研究纳入了 158 名具有完整病例和可接受拟合统计量的参与者。全队列的相对重要性评分范围为 0.76 至 15.72。BWS 实验的结果表明，对于所有三个队列，自主和日常活动受限这两个项目被认为是最重要的。与其他两个队列相比，精神科患者认为表达自由的重要性显著降低，而专家队列认为有合适的住所的重要性显著降低。队列之间或根据性别，OxCAP-MH 项目的相对偏好权重没有进一步的显著差异。
我们的研究表明，在 OxCAP-MH 的不同能力项目的相对偏好权重中，存在显著的项目间差异，但与心理健康相关的异质性有限。这些发现支持未来从一般人群中得出偏好为基础的价值集，用于比较经济评估目的。
