Validity of the Health-Related Quality of Life Instrument with 8 Items (HINT-8) in the Korean Elderly: A Cross-Sectional Study

Abstract

Purpose: This study evaluated the validity of the 8-item Health-Related Quality of Life (HINT-8) instrument for older adults in Korea. Methods: This study used data from the 2019 Korean National Health and Nutrition Examination Survey. Health-related quality of life distribution and the ceiling effect were investigated using the HINT-8 and EuroQol-five-dimensions three-level version (EQ-5D-3L) for 1,519 people aged 65 or older in Korea. To examine the known-group validity, the difference between the HINT-8 and EQ-5D-3L utility indexes according to general and disease-related characteristics was analyzed. To examine the convergence validity, the correlations between each domain and the HINT-8 and EQ-5D-3L indexes were evaluated. Results: The HINT-8 (3.6%) and EQ-5D-3L (51.3%) answered that there were no problems across all items. The HINT-8’s ceiling effect was much lower than that of the EQ-5D-3L. The utility index of quality of life in older adults was .76 in the HINT-8 and .88 in the EQ-5D-3L. For each variable category, both the HINT-8 and EQ-5D-3L indexes showed a statistically significant difference. In other words, the quality-of-life index was lower for women, those of higher age, a lower education level, lower income level, hospitalization or outpatient visits, or high stress level. The correlation between the similar domains of the HINT-8 and EQ-5D-3L was higher than that of the other domains. The correlation coefficient between the HINT-8 and EQ-5D-3L indexes was .60 (p<.001). Conclusion: The HINT-8 showed adequate validity to measure health-related quality of life for Korean older adults.