Health and Quality of Life Outcomes最新文献

Background: The use of screens, especially mobile devices like tablets and smartphones has increased over the last years and have become an integral to daily life. Adolescents today spend a lot of time using screens both at school and outside school. Identifying possible associations between gaming, social media use and quality of life (QoL) may inform the development of public health guidelines targeting adolescent behaviour. The purpose of this study is to examine the association between gaming, social media use and quality of life (QoL) among adolescents, and whether sex, spending time with friends or psychological distress moderate these associations.

Methods: This study was based on cross-sectional data from the Trøndelag Health study (Young-Hunt4), collected in 2017-2019. The target group comprised 8066 adolescents (13-19 years). QoL was measured with the Norwegian version of the Inventory of Life Quality (ILC). Electronic media use was measured using the two variables social media use and gaming. Multiple linear regression was used to analyse the association between social media use, gaming, and QoL.

Results: Results showed a negative association between gaming (> 3 h per day) after school and quality of life (b = -0.26) and social media use (> 3 h per day) after school and quality of life (b = -0.20). Similar negative associations were observed between more time spent on gaming (> 3 h per day) during weekends and quality of life (b = -0.33) and more time spent on social media (> 3 h per day) during weekends and quality of life (b = -0.16). An interaction effect was observed between sex and social media use (after school), between sex and gaming (after school and during weekends), and between psychological distress and gaming during weekends.

Conclusions: More than three hours spent on gaming or social media per day, both during weekdays and weekends, was negatively associated with QoL. Sex moderated these associations; however, for social media use this was shown only after school. Additional research is needed to further explore these associations.

Background: Resilience is defined as the ability to adapt to adversity, most widely assessed with the self-reported questionnaire Connor-Davidson resilience scale (CD-RISC). While previous studies have demonstrated CD-RISC psychometrically sound, it has not yet been validated in a young Swedish population. Therefore, the aim was to evaluate validity evidence based on test content, response processes and internal structure of the Swedish CD-RISC-25 and the 10-item combination among adolescents and young adults.

Methods: This study is divided into two phases. To ensure validity based on test content eight think-aloud interviews were conducted in phase 1. The results guided refinements prior to phase 2. In phase 2, 1500 16-30-year-old individuals, randomly sampled from the general population to participate by completing an online questionnaire. A Rasch rating scale model analysis was performed.

Results: Think-aloud interviews identified difficult wordings in two items, clarified in the survey before phase 2. The Rasch analysis (n = 325) indicated that the response categories were well-functioning, and local independence was demonstrated among all items. Six items in CD-RISC-25 and one item in CD-RISC (10 items) displayed misfit to the chosen model. The iterative process resulted in shortened 19- and 9-item versions. Person-response validity and unidimensionality were acceptable for the shortened CD-RISC (9 items). No floor or ceiling effects were detected. Person-separation index showed that both versions could differentiate between three different levels of resilience in the sample. Differential item functioning (DIF) was observed in one item related to gender in CD-RISC (9 items). In shortened CD-RISC-25 DIF was found in five items related to gender and in two items related to age.

Conclusions: When used in a young Swedish population, validity evidence based on test content of CD-RISC is lacking due to difficult wordings and may benefit from additional clarification regarding two items. Shortened versions of CD-RISC (19- and 9-item combinations) demonstrated generally acceptable validity evidence based on response processes and internal structure, but only CD-RISC in the 10-item combination exhibited unidimensionality and met set criteria for person-response validity. For assessing resilience in a young Swedish population, CD-RISC in the 10-item combination appears to be more suitable.

Background: Women undergoing pelvic floor procedures (PFPs) to treat their pelvic floor disorder (PFD) may experience pain, affecting their health-related quality of life. Current patient-reported outcome measures (PROMs) assess pain but are not specific to PFD post-surgery. This study was part of developing a new pain-specific PROM for women following PFP, aimed to (1) refine an existing conceptual framework to better understand post- post-PFP in women, (2) draft potential items, and (3) develop a consensus set of items for the new measure to ensure content validity.

Methods: A mixed-methods approach was used to address the aim in three phases: (1) refining an existing conceptual framework for post-PFP pain based on feedback from semi-structured interviews with 16 women, (2) drafting potential items based on the revised framework, and (3) conducting an online two-round Delphi survey with 17 experts ranked to rank, review items, then produce a consensus set.

Results: The interviews conducted identified key attributes of pain that need to be addressed in the new pain instrument for PFP. From the interviews, 114 items were drafted under eight framework domains, and then presented to a panel in the Delphi survey. After two Delphi rounds, 35 items were finalised, with 11 equally merged or deleted, resulting in a final set of 35 items.

Conclusion: This is the first study to develop a set of items for the new pain measure based on the experiences and expertise of women and clinicians. Inclusion of the items can offer valuable insight into pain after PFP.

Background: To investigate the cognitive experiences of completing composite time trade-off (C-TTO) and discrete choice experiment (DCE) tasks for the valuation of the Chinese Short Warwick-Edinburgh Mental Well-being Scale (C-SWEMWBS) in Hong Kong in order to inform an appropriate preference elicitation protocol for this population.

Methods: Eighteen think-aloud interviews employing concurrent and retrospective think-aloud techniques were conducted with Cantonese-speaking adult members of the general population. Each participant completed five C-TTO and five DCE tasks with tailor-made C-SWEMWBS states. Interview transcripts were transcribed verbatim, translated into English, and analysed thematically to identify patterns in participants' thoughts and understanding during task completion.

Results: Participants generally found the C-TTO and DCE tasks manageable. Four themes were identified that reflected participants' experiences: (1) Interview design and structure, bringing attention to potential refinements in presentation and instructions; (2) Representation of items and levels, illustrating participants' comprehension of the different C-SWEMWBS items and levels; (3) Influences on decision-making, identifying personal and external factors that shaped participant's decisions; and (4) Appropriateness of measures, reflecting participant's experiences in imagining and deriving utility values for mental well-being states.

Conclusion: Despite highlighting areas that could be refined to minimise unnecessary cognitive burden, findings indicate that the design of the C-TTO and DCE tasks is both feasible and appropriate for the preference elicitation of C-SWEMWBS states in Hong Kong. This provides the basis for conducting a large-scale study to derive a preference-based value set for the C-SWEMWBS in Hong Kong for economic evaluations of interventions aimed at improving public mental well-being.

Background: To overcome the limitations of existing health-related quality of life (HRQoL) instruments, the HRQoL Instrument with 8 Items (HINT-8) was developed for the Korean population. We aimed to evaluate the validity, interrater reliability, and agreement of the HINT-8 compared to the EQ-5D-5 L among patients with oropharyngeal cancer (OPC).

Methods: A total of 327 patients with OPC aged ≥ 19 years who received treatment at 14 hospitals in South Korea were recruited between August 2023 and February 2024. HRQoL was assessed using the two instruments. The psychometric evaluation included analyses of validity (convergent and known-group validity), agreement (intraclass correlation coefficient and Bland-Altman analysis), and reliability (internal consistency measured by Cronbach's alpha). The ceiling effects and score distributions were also examined.

Results: In total, 299 respondents were included in the final analysis. Both instruments demonstrated high internal consistency (HINT-8: α = 0.872; EQ-5D-5 L: α = 0.845) and good agreement (intraclass correlation coefficient [ICC] = 0.80; 95% confidence interval [CI]: 0.76-0.84). The convergent validity was supported by strong correlations between the HINT-8 index and both the EQ-5D-5 L index (r = 0.805) and EQ VAS (r = 0.715). The ceiling effect of HINT-8 (12.7%) was substantially lower than the EQ-5D-5 L (32.8%).

Conclusions: The HINT-8 is a valid, reliable, and responsive instrument for measuring HRQoL in patients with oropharyngeal cancer. These findings suggest that HINT-8 can serve as a valuable complementary instrument to the EQ-5D-5 L.

Background: Health utility measurement is critical for cost-utility analysis (CUA). However, clinical studies often lack direct utility data, and methods of measuring health utility vary across different periods and regions, resulting in missing utility information. Mapping, a method employed to infer utility when direct utility data is absent, has been widely applied in recent years but still faces challenges. This systematic review evaluates the current landscape, trends, and limitations of mapping studies and provides recommendations for improving study design and reporting standards.

Methods: A literature search was conducted in PubMed, Web of Science, and the HERC Database of Mapping Studies from 2018 to 2024. The study extracted information from the included studies and performed quality assessments based on existing mapping guidelines.

Results: One hundred thirty-one studies were included, 92 focused on Mapping as the primary objective, five were reviews, 13 focused on methodology, and 21 focused on economic evaluation. The source measure, target measure, and models in mapping functions development remain EORTC-QLQ-C30 (n = 13), EQ-5D (n = 79), and OLS (n = 93). Studies now use larger sample sizes and a higher proportion of response Mapping, and model applications have increased in diversity. However, 32 studies still lack conceptual overlap analysis, and only 16 studies with repeated measurements addressed its issue. Additionally, two studies did not report the region of the sample and value set, while 27 had inconsistencies between the two regions.

Conclusions: In the last seven years, mapping studies have improved sample size, model application, and result reporting. However, limitations remain in analysing conceptual overlap, ensuring alignment between the sample and value set regions, and processing repeated measurements. To advance the quality of mapping studies, it is necessary to update mapping guidelines and ensure that all mapping functions are developed in compliance with them.