Health and Quality of Life Outcomes最新文献

Background: The Carer Experience Scale (CES) measures the caring experience, focusing on caregiver-related quality of life (QoL) rather than health-related QoL. We aimed to validate the Danish language version of CES in family caregivers of people with dementia in Denmark by assessing CES discriminative and convergent validity. Further, we aimed to establish the internal consistency and test-retest reliability of CES.

Methods: A baseline questionnaire from the Danish DemTool intervention trial, including CES and five other measures of QoL and wellbeing was completed by 375 family caregivers of people with dementia. Discriminative validity was assessed by the ability of CES to discriminate between different caring contexts and levels of caregiver strain, as determined by Mann-Whitney U and Kruskal-Wallis H tests. Convergent validity was assessed by analyzing correlations using Spearman's rank correlation coefficients between the CES index and domain scores, and the 5-level EQ-5D version (EQ-5D-5L), European Quality of life visual analog scale (EQ VAS), Neuropsychiatric Inventory Caregiver Distress Scale (NPI-D), World Health Organization Wellbeing Index (WHO-5), and the University of California, Los Angeles Three-Item Loneliness Scale (UCLA 3-item). Internal consistency was assessed using Cronbach's α and test-retest reliability was assessed using intraclass correlation coefficient (ICC) between two different time points.

Results: The CES effectively distinguished between different levels of caregiver strain. Further, the CES was not affected by different caregiver and care recipient characteristics. Supporting convergent validity, the CES index was moderately correlated with NPI-D (ρ=-0.42), WHO-5 (ρ = 0.44), and UCLA 3-item (ρ=-0.40). The CES index was weakly correlated with EQ-5D-5L (ρ = 0.27), and EQ-VAS (ρ = 0.26). The CES showed low internal consistency (α = 0.53), but high test-retest reliability (ICC = 0.76).

Conclusion: The Danish version of CES demonstrated discriminative validity and acceptable psychometric properties, providing further evidence for its use in family caregivers of people with dementia.

Background: To estimate health utility decrements associated with correctable and uncorrectable vision impairment (VI) in community-dwelling older adults in Hong Kong using the EQ-5D-5 L and time trade-off (TTO), and to compare the sensitivity of these utility instruments in detecting VI's quality-of-life impacts.

Methods: A random sample of 999 older adults, previously screened in a community-based eye care programme between 2015 and 2017 and not referred for eye specialist care, completed follow-up eye examinations and questionnaire surveys between 2022 and 2024. Distance VI was defined as presenting visual acuity worse than 6/12 in the better-seeing eye, and categorized as correctable (due to uncorrected refractive error, URE) or uncorrectable (due to pathology), based on best-corrected visual acuity. Health utility was measured using the EQ-5D-5 L questionnaire and the TTO method. Associations between VI type and utility scores were analyzed using multivariable linear regression.

Results: The prevalence of VI was 19.1%, with 15.4% correctable and 3.7% uncorrectable. Mean EQ-5D-5L utility scores were 0.91 (standard deviation [SD] = 0.15) for those without VI, 0.90 (SD = 0.12) for correctable VI, and 0.85 (SD = 0.22) for uncorrectable VI (p < 0.05). Mean TTO scores followed a similar pattern: 0.95 (SD = 0.14), 0.94 (SD = 0.15), and 0.89 (SD = 0.22), respectively. In adjusted models, uncorrectable VI was significantly associated with a 0.052 decrease in TTO utility (95% confidence interval: -0.103 to -0.002; p < 0.05), while correctable VI showed no significant utility loss in either measure.

Conclusions: There were generally lower utility values for community dwelling elders with VI compared to no VI, with significant reductions of uncorrectable VI due to eye diseases in health utility among older adults living in the community. In contrast, correctable VI due to URE did not significantly affect utility values, suggesting that generic instruments like EQ-5D-5 L and TTO may lack sensitivity to detect the burden of milder, reversible vision loss. These findings provide essential data for evaluating the cost-effectiveness of community eye care programs and highlight the need for more targeted quality-of-life measures in vision research.