Centre for Health Economics, Monash Business School, Monash University, Victoria, 3145, Australia.
Department of Community Medicine, UiT-the Arctic University of Norway, 9037, Tromsø, Norway.
Qual Life Res. 2023 Feb;32(2):495-505. doi: 10.1007/s11136-022-03243-7. Epub 2022 Sep 20.
The EQ-5D is the most widely applied preference-based health-related quality of life measure. However, concerns have been raised that the existing dimensional structure lacks sufficient components of mental and social aspects of health. This study empirically explored the performance of a coherent set of four psycho-social bolt-ons: Vitality; Sleep; Personal relationships; and Social isolation.
Cross-sectional surveys were conducted with online panel members from five countries (Australia, Canada, Norway, UK, US) (total N = 4786). Four bolt-ons were described using terms aligned with EQ nomenclature. Latent structures among all nine dimensions are studied using an exploratory factor analysis (EFA). The Shorrocks-Shapely decomposition analyses are conducted to illustrate the relative importance of the nine dimensions in explaining two outcome measures for health (EQ-VAS, satisfaction with health) and two for subjective well-being (the hedonic approach of global life satisfaction and an eudemonic item on meaningfulness). Sub-group analyses are performed on older adults (65 +) and socially disadvantaged groups.
Strength of correlations among four bolt-ons ranges from 0.34 to 0.49. As for their correlations with the EQ-5D dimensions, they are generally much less correlated with four physical health dimensions than with mental health dimensions (ranged from 0.21 to 0.50). The EFA identifies two latent factors. When explaining health, Vitality is the most important. When explaining subjective well-being, Social isolation is second most important, after Anxiety/depression.
We provide evidence that further complementing the current EQ-5D-5L health state classification system with a coherent set of four bolt-on dimensions that will fill its psycho-social gap.
EQ-5D 是应用最广泛的偏好健康相关生活质量衡量标准。然而，人们对现有的维度结构缺乏足够的心理健康和社会健康方面的内容表示担忧。本研究实证探讨了一套连贯的四个心理社会附加组件的表现：活力；睡眠；人际关系；和社会隔离。
对来自五个国家（澳大利亚、加拿大、挪威、英国、美国）的在线小组参与者进行横断面调查（总 N=4786）。使用与 EQ 命名法一致的术语描述四个附加组件。使用探索性因素分析（EFA）研究所有九个维度之间的潜在结构。进行 Shorrocks-Shapely 分解分析，以说明九个维度在解释两个健康结果测量（EQ-VAS，对健康的满意度）和两个主观幸福感结果测量（享乐主义的整体生活满意度和关于有意义的幸福项目）方面的相对重要性。对老年人（65+）和社会弱势群体进行亚组分析。
四个附加组件之间的相关性强度在 0.34 到 0.49 之间。至于它们与 EQ-5D 维度的相关性，它们与四个身体健康维度的相关性通常比与心理健康维度的相关性小得多（范围从 0.21 到 0.50）。EFA 确定了两个潜在因素。在解释健康时，活力是最重要的。在解释主观幸福感时，社交隔离仅次于焦虑/抑郁，是第二重要的。
我们提供了证据，表明用一套连贯的四个附加组件进一步补充当前的 EQ-5D-5L 健康状态分类系统，可以填补其心理社会差距。
