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Face Validity of Four Preference-Weighted Quality-of-Life Measures in Residential Aged Care: A Think-Aloud Study

Author

Listed:
  • Lidia Engel

    (Monash University)

  • Leona Kosowicz

    (National Ageing Research Institute)

  • Ekaterina Bogatyreva

    (Monash University
    Deakin University)

  • Frances Batchelor

    (National Ageing Research Institute
    The University of Melbourne)

  • Nancy Devlin

    (The University of Melbourne)

  • Briony Dow

    (National Ageing Research Institute
    The University of Melbourne)

  • Andrew S. Gilbert

    (National Ageing Research Institute
    La Trobe University)

  • Brendan Mulhern

    (University of Technology Sydney)

  • Tessa Peasgood

    (The University of Melbourne)

  • Rosalie Viney

    (University of Technology Sydney)

Abstract

Objective There is an increased use of preference-weighted quality-of-life measures in residential aged care to guide resource allocation decisions or for quality-of-care assessments. However, little is known about their face validity (i.e., how understandable, appropriate and relevant the measures are ‘on their face’ when respondents complete them). The aim of this study was to assess the face validity of four preference-weighted measures (i.e., EQ-5D-5L, EQ-HWB, ASCOT, QOL-ACC) in older people living in residential aged care. Methods Qualitative cognitive think-aloud interviews were conducted using both concurrent and retrospective think-aloud techniques. To reduce burden, each resident completed two measures, with the four measures randomised across participants. Audio recordings were transcribed and framework analysis was used for data analysis, based on an existing framework derived from the Tourangeau four-stage response model. Results In total, 24 interviews were conducted with residents living across three residential aged care facilities in Melbourne, Australia. Response issues were identified across all four measures, often related to comprehension and difficulty selecting a response level due to double-barrelled and ambiguous items that have different meanings in the residential aged care context. We also identified issues related to understanding instructions, non-adherence to the recall period, and noted positive responding that requires attention when interpreting the data. Conclusions Our findings provide further evidence on the appropriateness of existing measures, indicating numerous response issues that require further research to guide the selection process for research and practice.

Suggested Citation

  • Lidia Engel & Leona Kosowicz & Ekaterina Bogatyreva & Frances Batchelor & Nancy Devlin & Briony Dow & Andrew S. Gilbert & Brendan Mulhern & Tessa Peasgood & Rosalie Viney, 2023. "Face Validity of Four Preference-Weighted Quality-of-Life Measures in Residential Aged Care: A Think-Aloud Study," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 16(6), pages 655-666, November.
    • Handle: RePEc:spr:patien:v:16:y:2023:i:6:d:10.1007_s40271-023-00647-6
    DOI: 10.1007/s40271-023-00647-6
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    References listed on IDEAS

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    1. Jenny Cleland & Claire Hutchinson & Jyoti Khadka & Rachel Milte & Julie Ratcliffe, 2019. "A Review of the Development and Application of Generic Preference-Based Instruments with the Older Population," Applied Health Economics and Health Policy, Springer, vol. 17(6), pages 781-801, December.
    2. Catherine Milte & Ruth Walker & Mary Luszcz & Emily Lancsar & Billingsley Kaambwa & Julie Ratcliffe, 2014. "How Important Is Health Status in Defining Quality of Life for Older People? An Exploratory Study of the Views of Older South Australians," Applied Health Economics and Health Policy, Springer, vol. 12(1), pages 73-84, February.
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