Department of Psychiatry, Section Medical Psychology, Erasmus MC, Rotterdam, The Netherlands.
Health Services Management Department, Guizhou Medical University, Guiyang, China.
J Patient Rep Outcomes. 2024 Aug 5;8(1):83. doi: 10.1186/s41687-024-00767-z.
The EQ Health and Wellbeing (EQ-HWB) is a new questionnaire for measuring quality of life (QoL) from a broad perspective. The items of the EQ-HWB were derived based on a 'qualitative review' of literature, which reported primarily on Western studies. It can be argued that the QoL is a cultural-related concept and therefore people from China have a different understanding of the QoL. This study aimed to explore whether Chinese citizens could understand the EQ-HWB's candidate items and what they thought of those items. In doing so, we wanted to examine the face validity of the candidate items and explore if further cultural adaptation is necessary.
This research was part of the E-QALY project, in which 36 candidate items were selected for the EQ-HWB from a 97-item pool. In China, three interviewers investigated the face validity of these EQ-HWB candidate items in semi-structured qualitative face-to-face interviews. Respondents were invited to report 'problems' with regard to the interpretation of the items and these problems were grouped into themes. We explored to what extent those themes related to specific cultural aspects in China. We also classified the rates of reported problems for each item into three groups: 1) less than 20%, 2) from 20-50%, and 3) over 50%.
For 17 items the rate of reported problems was less than 20%, 15 items fell into the second group (with 20 - 50%) and for 4 items the rate of problems reported was more than 50%. The thematic analysis revealed eight themes: ambiguous problems in the interpretation of 16 items; difficult to understand (11); contained a complex negative expression (10); examples used seemed inappropriate (7); misleading connotation in Chinese (2); long and complex (2); complex response options (1); and use of non-colloquial language (1).
Our research shows that EQ-HWB candidate items require careful examination to make them more comprehensible. Most of the reported problem themes were generic problems related to the items, and only a few face validity issues appeared to relate to specific cultural aspects in China, even though most of the items were based on Western studies. Our findings are reassuring for the instrument's international application, especially in China.
EQ 健康与幸福感（EQ-HWB）是一种新的问卷，用于从广泛的角度衡量生活质量（QoL）。EQ-HWB 的项目是基于对文献的“定性回顾”得出的，这些文献主要报道了西方的研究。可以说，生活质量是一个与文化相关的概念，因此中国人对生活质量有不同的理解。本研究旨在探讨中国公民是否能够理解 EQ-HWB 的候选项目以及他们对这些项目的看法。通过这样做，我们想检查候选项目的表面有效性，并探讨是否需要进一步进行文化适应性调整。
本研究是 E-QALY 项目的一部分，该项目从 97 项 EQ-HWB 中选择了 36 项候选项目。在中国，三位访谈员通过半结构化的定性面对面访谈，调查了这些 EQ-HWB 候选项目的表面有效性。受访者被邀请报告对项目解释的“问题”，并将这些问题分为主题。我们探讨了这些主题与中国特定文化方面的相关程度。我们还将每个项目的报告问题率分为三组：1）少于 20%，2）20-50%，和 3）超过 50%。
对于 17 项，报告问题的比例低于 20%，15 项属于第二类（20-50%），4 项报告问题的比例超过 50%。主题分析揭示了八个主题：16 项解释上存在歧义问题；11 项难以理解；10 项包含复杂的负面表达；7 项使用的例子似乎不恰当；2 项含有误导性的中文内涵；2 项冗长复杂；1 项复杂的应答选项；1 项使用非口语化语言。
我们的研究表明，EQ-HWB 候选项目需要仔细检查，以使其更易于理解。报告的大多数问题主题都是与项目相关的通用问题，只有少数表面有效性问题似乎与中国的特定文化方面有关，尽管大多数项目都是基于西方的研究。我们的发现令人放心，表明该工具可以在国际上应用，特别是在中国。
