基于偏好的通用测量方法对非正式照料者是否有效？一项心理测量学调查。

Are generic preference-based measures valid for use in informal carers? A psychometric investigation.

作者信息

Faller Jan, Mihalopoulos Cathrine, Chen Gang, McCaffrey Nikki, Mulhern Brendan, Engel Lidia

机构信息

Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

出版信息

Value Health. 2025 Jul 21. doi: 10.1016/j.jval.2025.07.009.

DOI:10.1016/j.jval.2025.07.009

PMID:40701341

Abstract

OBJECTIVES

Using generic preference-based measures (GPBMs) to capture informal carer health-related quality-of-life outcomes provides consistency across economic evaluations and facilitates combining patient and carer quality-adjusted life years. This study assesses the psychometric performance of the 5-level EQ-5D (EQ-5D-5L) and Assessment of Quality of Life 8-Dimension (AQoL-8D) and how they conceptually relate to carer-related measures among Australian informal carers.

METHODS

This was a secondary analysis of an online survey (n=500 informal carers) containing carer-related measures (Adult Social Care Outcomes Toolkit for Carers [ASCOT-Carer], Care-Related Quality-of-Life [CarerQol], Carer Experience Scale [CES]) and GPBMs (EQ-5D-5L, AQoL-8D). Descriptive analysis, ceiling effects, convergent and known-group validity, and test-retest reliability were assessed. Exploratory factor analysis (EFA) was conducted exploring the conceptual overlap between the GPBMs and carer-related measures.

RESULTS

Completion rates for the GPBMs were above 94%, with no ceiling effects. Test-retest reliability (only available for the EQ-5D-5L) revealed good agreement (ICC=0.825), with moderate (usual activities, pain/discomfort, anxiety/depression) to substantial (mobility, self-care) agreement on domains. Both GPBMs moderately correlated with carer-specific measures and discriminated groups based on hours of care, tasks, number of care recipient diagnoses, number cared for, sharing a household, and duration of care. EFA identified some overlap (predominantly health-related concepts) between carer-related measures and the GPBMs.

CONCLUSION

The EQ-5D-5L and AQoL-8D are acceptable for use in informal carers, with the choice of instrument dependent on the constructs intended to be measured. The inclusion of both GPBMs and carer-related measures during outcome assessment may still be warranted to understand carer wellbeing and burden.

摘要

目的

使用基于偏好的通用测量方法（GPBMs）来获取非正式照料者与健康相关的生活质量结果，可使经济评估具有一致性，并有助于将患者和照料者的质量调整生命年相结合。本研究评估了5级EQ-5D（EQ-5D-5L）和生活质量8维度评估（AQoL-8D）的心理测量性能，以及它们在概念上与澳大利亚非正式照料者中与照料者相关的测量方法之间的关系。

方法

这是一项对在线调查（n = 500名非正式照料者）的二次分析，该调查包含与照料者相关的测量方法（照料者成人社会护理结果工具包[ASCOT-Carer]、与照料相关的生活质量[CarerQol]、照料者体验量表[CES]）和GPBMs（EQ-5D-5L、AQoL-8D）。评估了描述性分析、天花板效应、收敛效度和已知组效度以及重测信度。进行了探索性因素分析（EFA），以探索GPBMs与照料者相关测量方法之间的概念重叠。

结果

GPBMs的完成率高于94%，无天花板效应。重测信度（仅适用于EQ-5D-5L）显示出良好的一致性（ICC = 0.825），在各领域中，中等程度（日常活动、疼痛/不适、焦虑/抑郁）到高度（行动能力、自我护理）的一致性。两种GPBMs均与照料者特定测量方法中度相关，并根据照料时长、任务、受照料者诊断数量、照料人数、是否同住以及照料持续时间区分不同群体。EFA确定了照料者相关测量方法与GPBMs之间存在一些重叠（主要是与健康相关的概念）。