"When I saw walking I just kind of took it as wheeling": interpretations of mobility-related items in generic, preference-based health state instruments in the context of spinal cord injury

被引:16
|
作者
Michel, Yvonne Anne [1 ]
Engel, Lidia [2 ,3 ]
Rand-Hendriksen, Kim [1 ,4 ]
Augestad, Liv Ariane [1 ]
Whitehurst, David G. T. [2 ,3 ,5 ]
机构
[1] Univ Oslo, Inst Hlth & Soc, Fac Med, Dept Hlth Management & Hlth Econ, Postboks 1089, N-0318 Oslo, Norway
[2] Simon Fraser Univ, Fac Hlth Sci, Burnaby, BC, Canada
[3] Vancouver Coastal Hlth Res Inst, Ctr Clin Epidemiol & Evaluat, Vancouver, BC, Canada
[4] Akershus Univ Hosp, Hlth Serv Res Ctr, Lorenskog, Norway
[5] Univ British Columbia, Int Collaborat Repair Discoveries, Fac Med, Vancouver, BC, Canada
来源
关键词
Preference-based health state instruments; Validity; HRQoL; Mobility; Spinal cord injury; Reframing; Item interpretation; QUALITY-OF-LIFE; MULTIATTRIBUTE UTILITY INSTRUMENTS; DESCRIPTIVE SYSTEMS; MENTAL-HEALTH; ECONOMIC-EVALUATION; SF-36; VALIDITY; QUESTIONNAIRE; INDIVIDUALS; RELIABILITY;
D O I
10.1186/s12955-016-0565-9
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: In health economic analyses, health states are typically valued using instruments with few items per dimension. Due to the generic (and often reductionist) nature of such instruments, certain groups of respondents may experience challenges in describing their health state. This study is concerned with generic, preference-based health state instruments that provide information for decisions about the allocation of resources in health care. Unlike physical measurement instruments, preference-based health state instruments provide health state values that are dependent on how respondents interpret the items. This study investigates how individuals with spinal cord injury (SCI) interpret mobility-related items contained within six preference-based health state instruments. Methods: Secondary analysis of focus group transcripts originally collected in Vancouver, Canada, explored individuals' perceptions and interpretations of mobility-related items contained within the 15D, Assessment of Quality of Life 8-dimension (AQoL-8D), EQ-5D-5L, Health Utilities Index (HUI), Quality of Well-Being Scale Self-Administered (QWB-SA), and the 36-item Short Form health survey version 2 (SF-36v2). Ritchie and Spencer's 'Framework Approach' was used to perform thematic analysis that focused on participants' comments concerning the mobility-related items only. Results: Fifteen individuals participated in three focus groups (five per focus group). Four themes emerged: wording of mobility (e.g., 'getting around' vs 'walking'), reference to aids and appliances, lack of suitable response options, and reframing of items (e.g., replacing 'walking' with 'wheeling'). These themes reflected item features that respondents perceived as relevant in enabling them to describe their mobility, and response strategies that respondents could use when faced with inaccessible items. Conclusion: Investigating perceptions to mobility-related items within the context of SCI highlights substantial variation in item interpretation across six preference-based health state instruments. Studying respondents' interpretations of items can help to understand discrepancies in the health state descriptions and values obtained from different instruments. This line of research warrants closer attention in the health economics and quality of life literature.
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页数:11
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  • [1] “When I saw walking I just kind of took it as wheeling”: interpretations of mobility-related items in generic, preference-based health state instruments in the context of spinal cord injury
    Yvonne Anne Michel
    Lidia Engel
    Kim Rand-Hendriksen
    Liv Ariane Augestad
    David GT Whitehurst
    Health and Quality of Life Outcomes, 14
  • [2] Health state descriptions, valuations and individuals' capacity to walk: a comparative evaluation of preference-based instruments in the context of spinal cord injury
    Whitehurst, David G. T.
    Mittmann, Nicole
    Noonan, Vanessa K.
    Dvorak, Marcel F.
    Bryan, Stirling
    QUALITY OF LIFE RESEARCH, 2016, 25 (10) : 2481 - 2496
  • [3] Health state descriptions, valuations and individuals’ capacity to walk: a comparative evaluation of preference-based instruments in the context of spinal cord injury
    David G. T. Whitehurst
    Nicole Mittmann
    Vanessa K. Noonan
    Marcel F. Dvorak
    Stirling Bryan
    Quality of Life Research, 2016, 25 : 2481 - 2496