Health and Quality of Life Outcomes最新文献

{"title":"Qualitative testing of potential modifications to the EQ-HWB EMV2.1 in adults with mobility problems in the United Kingdom.","authors":"Aisha Moolla, Jill Carlton, Tessa Peasgood","doi":"10.1186/s12955-026-02577-x","DOIUrl":"10.1186/s12955-026-02577-x","url":null,"abstract":"<p><strong>Background: </strong>The EQ-Health and Wellbeing (EQ-HWB) is a generic measure assessing the impact of health, social care, and informal caregiving on quality of life. The 9-item short form, the EQ-HWB-9 v1.1 (experimental, 2022), underwent international validation, with subsequent modifications to item wording, response options, layout, and item order resulting in the EQ-HWB EMV2.1 (experimental modified, 2025). This study aimed to assess the content validity of this version in individuals with mobility problems.</p><p><strong>Methods: </strong>Twelve adults in the UK with self-reported health conditions and mobility problems participated in semi-structured interviews. Participants described their health experiences, reviewed each EQ-HWB EMV2.1 item, and compared potential further modifications to the 'mobility' item wording and 'cognition' response options. Comprehension, relevance, comprehensiveness and preferences were explored using verbal probing. Interviews were transcribed and analysed using framework analysis, guided by content validity domains, with double-coding for 25% of transcripts to ensure alignment.</p><p><strong>Results: </strong>Participants (age 35-79 years) reported 35 health conditions. Eight items were understood as intended by all participants. The 'mobility' item presented varied interpretations (home-based limitations, daily activities, or aid use, n = 4), highlighting the need for an illustrative example, though no single wording was universally preferred. For 'cognition', participants understood both frequency and difficulty response scales; preferences were split, indicating no required modifications. Some overlap between items was noted ('mobility'-'activities', 'cognition'-'exhaustion'/'anxiety'/'pain'), but participants did not perceive redundancy and valued separate items for nuanced measurement. Most items were considered relevant, and participants suggested additional content on medical management, support, mental health impact, and free-text contextualisation. The seven-day recall period and instructions were generally well understood.</p><p><strong>Conclusion: </strong>The EQ-HWB EMV2.1 demonstrates good content validity in a sample of patients with mobility problems, with most items comprehensible and relevant. The 'mobility' item would benefit from an example to reduce interpretive variability, while 'cognition' response options are appropriate. Some item overlap is expected in complex health populations, yet distinctions between items are meaningful. Participants highlighted the importance of healthcare experiences in quality-of-life assessment. These results inform instrument refinement, but final changes should integrate broader evidence from global validation studies across other populations and languages.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Content validity of the modified EQ-HWB-9 in a sample of Argentinean patients, informal caregivers, and members of the general public.","authors":"Maria Belizan, Natalí Ini, Fernando Argento, Michael Herdman, Clara Mukuria, Federico Augustovski","doi":"10.1186/s12955-026-02581-1","DOIUrl":"https://doi.org/10.1186/s12955-026-02581-1","url":null,"abstract":"<p><strong>Background: </strong>In response to the challenge of measuring the impact of health, social care, and informal caregiving on quality of life, the EuroQol Group developed the Experimental EuroQol Health and Wellbeing (EQ-HWB-9). Evidence from preliminary testing informed a series of revisions to improve the instrument's performance. This study aimed to assess the content validity of the Argentina (Spanish) EQ-HWB-9 Experimental Modified Paper Self-Complete v1.2 (modified EQ-HWB-9), to explore whether its modifications represented an improvement over the earlier experimental version, and to examine how participants ranked the frequency scale response options.</p><p><strong>Methods: </strong>Qualitative cognitive interviews were conducted using a semi-structured guide with open-ended questions and targeted probes to assess comprehensibility, relevance, and comprehensiveness of the modified EQ-HWB-9. Participants were recruited through purposive sampling via patient associations, retirement centers, and social media. Thematic content analysis was guided by an a priori framework. Participants also completed a response option ordering exercise to compare their rankings with the instrument's frequency scale.</p><p><strong>Results: </strong>Twenty participants were included: patients (n = 12), informal carers (n = 4), and members of the general public (n = 4); nine were also social care users. The median age was 64.5 years (range 25-88) and 12 were women. All participants found the questionnaire easy to understand, items were deemed relevant, and response options appropriate. Some participants noted missing content related to leisure, social relationships, financial situation, and environment, and suggested minor wording revisions. The modified EQ-HWB-9 was generally preferred over the earlier version, supporting better comprehension and alignment with local language and context. In the frequency scale task, \"none of the time\" and \"most or all of the time\" were consistently placed at the expected extremes (90% and 85%, respectively), while intermediate labels showed greater variability, with overall ordering showing good alignment with the instrument's scale.</p><p><strong>Conclusion: </strong>This study, conducted as part of an international multi-language effort, represents the first content validity assessment of the modified EQ-HWB-9 in Spanish and Latin America. Findings support the instrument's utility, though further refinements to item wording are recommended. Ongoing iterative testing will help ensure the tool reliably measures health and wellbeing to inform policy and practice.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pre-illness reference reminder alters cross-sectional patient-reported outcome responses: evidence from EQ-5D-5L and EQ-HWB-9.","authors":"Xun Ran, Qimeng Mu, Qiaomei Wang, Zhihao Yang","doi":"10.1186/s12955-026-02580-2","DOIUrl":"https://doi.org/10.1186/s12955-026-02580-2","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate whether a brief pre-survey reminder prompting patients to reflect on their pre-illness health was associated with altered response patterns in cross-sectional patient-reported outcome measures (PROMs).</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 244 inpatients in a hepatobiliary surgery department. Participants were assigned to a control group (standard recall instructions for the EQ-5D-5L and EQ-HWB-9) or a reminder group (identical instructions, preceded by the reminder). Response distributions were compared descriptively, and adjusted ordered logistic regression models were used to assess the association between the reminder and reported problem severity.</p><p><strong>Results: </strong>A total of 244 inpatients participated, with 123 in the control group and 121 receiving the pre-illness reminder. There were no missing data for the EQ-5D-5L or EQ-HWB-9 items, and EQ VAS data were missing for three participants only. The reminder group reported lower ceiling effects and higher problem severity across both instruments. In adjusted analyses, the reminder was associated with higher odds of reporting more severe problems across all EQ-5D-5L dimensions, with odds ratios ranging from 1.90 to 3.13, and across seven of the nine EQ-HWB-9 items, with odds ratios ranging from 1.94 to 5.43. The reminder group also reported a lower mean EQ VAS score than the control group: 78.23 versus 82.03, p = 0.002.</p><p><strong>Conclusions: </strong>The brief reminder was associated with more severe and differentiated PROM responses. These findings suggest that a pre-illness reference reminder may influence respondents' appraisal of current health in cross-sectional PROM assessment. However, without an objective benchmark for true health status, the findings should be interpreted as consistent with, but not definitive evidence of, a recalibration-related response process.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative exploration of EQ-5D-5L bolt-on variants for fatigue, sleep, and vision in a general population sample.","authors":"Richard Huan Xu, Yixuan Ma, Chenxi Yang, Fanni Rencz","doi":"10.1186/s12955-026-02582-0","DOIUrl":"https://doi.org/10.1186/s12955-026-02582-0","url":null,"abstract":"<p><strong>Objective: </strong>Fatigue, sleep, and vision are among the most commonly used EQ-5D-5 L bolt-ons, with multiple alternative wordings. This study aimed to evaluate and compare the psychometric performance of the following bolt-on variants: (1) fatigue (FA) vs. tiredness (TI); (2) vision (VI) vs. VI with reference to vision aids (VI-A); and (3) sleep (SL) vs. sleep with examples in the dimension title (SL-E).</p><p><strong>Methods: </strong>A representative sample of 1,262 adults in Hong Kong completed an online survey including the EQ-5D-5 L and bolt-ons. The following psychometric properties were assessed: ceiling/floor, informativity (Shannon's indices), convergent validity (correlations with conceptually related items of PROMIS-29 + 2), agreement (Kendall's tau), explanatory power (regression on EQ VAS and PROMIS-29 + 2 Level Sum Scores), and known-group validity (effect sizes).</p><p><strong>Results: </strong>Bolt-ons reduced EQ-5D-5 L's ceiling from 35% to 20-24% and improved relative informativity from 0.33 to 0.35-0.36. FA, TI, SL and SL-E demonstrated moderate-to-strong convergent validity (r = 0.55-0.67) with PROMIS-29 + 2 items. All bolt-ons with the exception of VI-A enhanced explanatory power for both EQ VAS and PROMIS-29 + 2. Agreements between TI and FA (0.71), SL and SL-E (0.74), and VI and VI-A (0.78) were strong. For each of the three bolt-on pairs, differences in reducing the EQ-5D-5 L's ceiling, relative informativity and convergent validity were generally small. In known-group comparisons, FA and SL-E outperformed their counterparts, whereas the difference between VI and VI-A was minimal.</p><p><strong>Conclusion: </strong>All six bolt-on items showed good validity in a general population sample, with minimal differences between items belonging to the same bolt-on pair. These findings inform item development for the experimental EQ-5D Bolt-on Toolbox.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the EQ-HWB-9 in a mental health sample and an investigation of modifications to items.","authors":"Cate Bailey, Karen Trapani, Jonathan N Davies, Nicholas T Van Dam, Julieta Galante, Tessa Peasgood","doi":"10.1186/s12955-026-02579-9","DOIUrl":"https://doi.org/10.1186/s12955-026-02579-9","url":null,"abstract":"<p><strong>Background: </strong>The EQ Health and Wellbeing (EQ-HWB) is a new, generic instrument designed to evaluate quality-of-life across health, public health, and social care settings. The short form comprises nine items (EQ-HWB-9) and validation across diverse populations and contexts is required. We aimed to investigate the validity of the EQ-HWB-9 in an international sample of adults experiencing poor mental health who downloaded a meditation app. We further examined the impact of four item-level modifications on psychometric performance, including investigating a potential ordering effect for the 'activities' item (hypothesised in prior studies) and three minor changes to response options.</p><p><strong>Methods: </strong>The current study was embedded in a larger trial examining engagement with meditation via a free, downloadable app. Participants were randomised to complete the original (2022) and modified (2024) experimental version of the EQ-HWB-9. Psychometric evaluation included analyses of item distribution, known group and convergent validity, and responsiveness to change.</p><p><strong>Results: </strong>There were no differences in demographic characteristics between the EQ-HWB original and modified versions at baseline (n = 865) or follow-up (n = 130). All psychometric tests supported the validity of the EQ-HWB-9 in this population. We found an ordering effect for the activities item, where the activities item showed a greater level of difficulty and a wider distribution over response options when asked before the mobility item, rather than after. There were no observable differences between versions for the other modifications.</p><p><strong>Conclusions: </strong>These findings add to growing literature supporting the EQ-HWB-9 as a suitable instrument for measuring quality-of-life across a range of settings. When the 'activities' item was presented first, as in the modified version, participants appeared to interpret the item more broadly, in line with the developers' intentions. Accordingly, our results support changing the item order of the first two items. Other modifications had little impact on outcomes, suggesting that further qualitative research will be required to inform decisions about their inclusion. Results from this study provide support towards finalisation of the instrument. The development of country-specific value-sets is now critical to support its application in economic evaluation.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomised equivalence study of the EQ-5D-5L Shona versions: evaluation of measurement equivalence between digital and paper formats.","authors":"Jermaine M Dambi, Fredrick D Purba, Beatrice K Shava, Anotida R Hove, Shalom R Doyce, Tariro Tunduwani, Ben Domingue, Dixon Chibanda, A Simon Pickard","doi":"10.1186/s12955-026-02575-z","DOIUrl":"https://doi.org/10.1186/s12955-026-02575-z","url":null,"abstract":"<p><strong>Introduction: </strong>Routine assessment of health-related quality of life (HRQoL) of people living with HIV (PLHIV) is essential. We evaluated measurement equivalence between the digital and paper versions of the Shona EQ-5D-5L and examined known-groups validity.</p><p><strong>Methods and materials: </strong>We conducted a parallel randomised study in Zimbabwe with 700 participants allocated equally to the digital and paper groups.</p><p><strong>Results: </strong>The study included 611 participants with a mean age of 37.5 years (SD 12.2). Most were female (70.7%), had secondary education (67.9%), and reported financial inadequacy (68.7%). The digital and paper versions of the EQ-5D-5L Shona demonstrated measurement equivalence. Older age (AOR = 0.60; 95% CI 0.41-0.88; p = 0.008), food insecurity (AOR = 1.80; 95% CI 1.20-2.80; p = 0.01), financial insecurity (AOR = 1.72; 95% CI 1.10-2.69; p = 0.017), and elevated CMD symptoms (AOR = 0.45; 95% CI 0.29-0.68; p < 0.001) were associated with lower HRQoL.</p><p><strong>Conclusion: </strong>This study demonstrated measurement equivalence between the digital and paper versions of the EQ-5D-5L Shona. Both versions can therefore be used confidently in routine clinical care and research. The findings also highlight the need for tailored interventions to improve HRQoL among PLHIV.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood visual impairment and health-related quality of life in Ghana: evidence from a cross-sectional study.","authors":"Nana Akwasi Owusu Mensah, Josephine Ampomah Boateng, Isaiah Osei Duah Junior, Albert Kwadjo Amoah Andoh, Godsway Commanda Osei, Sylvester Kyeremeh, Sylvia Agyekum, Gabriel Kwaku Agbeshie, Werner Eisenbarth, Kwadwo Owusu Akuffo","doi":"10.1186/s12955-026-02565-1","DOIUrl":"10.1186/s12955-026-02565-1","url":null,"abstract":"<p><strong>Background: </strong>Although visual impairment (VI) is known to affect children's development, there is limited evidence on how VI influences health-related quality of life (HRQoL) among children in Ghana. This study aimed to assess the relationship between childhood VI and HRQoL.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among children aged 2 to 18 years in selected districts of the Ashanti Region, Ghana. Comprehensive ocular assessments including visual acuity (VA), refraction, and anterior and posterior segment evaluations were performed. Health-related quality of life was measured using the PedsQL 4.0 across physical, emotional, social, and school functioning domains. Data were analyzed using descriptive statistics, independent-sample t-tests, and linear regression.</p><p><strong>Results: </strong>A total of 581 children participated (mean ± SD age: 8.64 ± 4.00 years), with females representing 53.0% of the sample. Both child-reported and parent-reported scores showed significantly reduced HRQoL among children with VI across all PedsQL domains compared with children without VI, with school (p < 0.001) and emotional (p = 0.005) functions of child-reported showing statistical significance. Presenting VI was a significant predictor of poor overall HRQoL in both simple (β= -10.351, p < 0.001) and multiple linear regression models (β= -5.650, p = 0.016). No significant associations (p > 0.05) were found between HRQoL and sociodemographic variables, including sex, age, ethnicity, work status, and health insurance.</p><p><strong>Conclusions: </strong>Childhood VI is associated with substantial reductions in multiple dimensions of HRQoL. These findings underscore the need to strengthen early detection, clinical management, and school-based vision support services to improve pediatric eye care in Ghana.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multicenter longitudinal study on development and validation of the quality of life scale QLICD-DM (V2.0) for diabetes mellitus based on classical test theory and generalizability theory.","authors":"Yuxi Liu, Chen Zhou, Runmin Guo, Xiaoqing Zhang, Qingqing Zhang, Chonghua Wan, Riling Chen","doi":"10.1186/s12955-026-02573-1","DOIUrl":"https://doi.org/10.1186/s12955-026-02573-1","url":null,"abstract":"<p><strong>Purpose: </strong>Quality of life (QOL) research in diabetes has long been a concern with many specific instruments being developed, but no scale for diabetes has been developed based on the modular approach. This study aimed to develop and validate the Diabetes Mellitus Scale of the System of Quality of Life Instruments for Chronic Diseases QLICD-DM (V2.0) by a modular approach and mixed methods.</p><p><strong>Methods: </strong>The Scale was developed based on procedural decision-making methods and by combining the general module and the specific module. The instrument was used to assess the quality of life of 242 diabetic patients both before and after treatments. Under Classical Test Theory (CTT), the psychometric properties of the scale were assessed with regard to validity, reliability and responsiveness by correlation analyses, structural equation modeling, as well as t-tests. In addition, G-study and D-study in Generalizability Theory (GT) were used to validate the scale further.</p><p><strong>Results: </strong>The QLICD-DM (V2.0) was developed with a 14-item specific module and a 28-item general module in the final scale. For all domains, Cronbach's α values were greater than 0.70 with the exception of physical function (0.68), the test-retest reliability correlations r and ICCs were greater than 0.80 with the exception of physical and social function (0.65,0.64). The theoretical construct was supported by correlation analyses and confirmatory factor analysis using structural equation modeling, which demonstrated good construct validity. There were significant differences (P < 0.05) in the domains of physical function, specific module and the total scale before and after treatments. The standardized response means (SRMs) of the physical, psychological, social, and the specific module were 0.36, 0.14, 0.11 and 0.28 respectively. All G-coefficients were all greater than 0.70 with the exception of the physical domain (0.683), further confirming the reliability of the scale further. The overall error was found to be small in the G-study and in the D-study, indicating a high level of accuracy.</p><p><strong>Conclusion: </strong>The QLICD-DM (V2.0) not only integrated characteristics of generic and disease-specific instruments but also demonstrated good reliability, validity, and moderate responsiveness, and it could serve as a quality of life assessment tool for diabetes patients.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the impact of chronic graft‑versus‑host disease on patient health‑related quality of life: perspectives from patients and carers.","authors":"Katharina Ecsy, Luke Skinner, Martin Furze, Dawn Hart, Charlotte Sugden Heron, Amy Page, Larissa Dempsey, Adlene Adnan, Arunesh Sil, Richard D A Hudson, Matthew Bradberry","doi":"10.1186/s12955-026-02571-3","DOIUrl":"https://doi.org/10.1186/s12955-026-02571-3","url":null,"abstract":"<p><strong>Background: </strong>Chronic graft-versus-host disease (cGvHD) is a common complication that can occur following hematopoietic stem cell transplantation. This complex, multisystemic condition often requires multiple lines of therapy to treat both the symptoms of cGvHD and the side effects associated with these treatments. Comprehensive data on the impact of cGvHD on health-related quality of life (HRQoL) of patients who have undergone multiple lines of therapy, remain limited. Greater awareness of these challenges could lead to more personalized treatment plans and inform future research.</p><p><strong>Methods: </strong>We performed a two-part study to gather qualitative and quantitative data on the experiences and HRQoL of adult patients with cGvHD who had received more than two lines of therapy. Participants took part in a virtual, in-depth interview moderated by a facilitator (qualitative interviews) and/or an online survey (quantitative survey). The qualitative interviews were conducted using a discussion guide, while the quantitative survey designed based on the responses to the qualitative interview also included the European Quality of Life 5 Dimensions 5 Level Version questionnaire.</p><p><strong>Results: </strong>The qualitative interview included 10 participants, while the quantitative survey enrolled 27. patients reported that cGvHD has a profound impact on numerous aspects of HRQoL. Treatment side effects, treatment burden, frequency of medical appointments, and the impact on daily life, finances, education, and mental health were all contributors to diminished HRQoL. Patients reported feeling unprepared for the severity and longevity of cGvHD symptoms and highlighted the need for improved communication between healthcare professionals (HCPs) treating the same patient.</p><p><strong>Conclusions: </strong>cGvHD significantly impacts the HRQoL of patients, with physical, emotional, and financial burdens. Improved education and disease awareness, personalized treatment plans, and better communication between HCPs treating the same patient are crucial to address these challenges in current care practices. Enhanced support services could alleviate the emotional and financial impact on patients, ultimately improving their overall quality of life (QoL).</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148328977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse childhood experiences and well-being in middle-aged men in South Korea: mediating role of andropause symptoms.","authors":"Jeongok Park, Youngkyung Kim, Hyunju Lee","doi":"10.1186/s12955-026-02569-x","DOIUrl":"https://doi.org/10.1186/s12955-026-02569-x","url":null,"abstract":"<p><strong>Background: </strong>Middle-aged men in South Korea are in a critical period marked by significant physical and psychosocial transitions. While adverse childhood experiences negatively affect lifelong health, the specific mechanisms affecting well-being during midlife remain underexplored. This study aimed to examine the mediating role of andropause symptoms in the relationship between adverse childhood experiences (ACEs) and well-being.</p><p><strong>Methods: </strong>A cross-sectional survey involving 444 community-dwelling Korean men aged 40-64 years was conducted from June to August 2024. Data were collected via an online questionnaire to assess ACEs, andropause symptoms, and well-being. The SAS 9.4 and PROCESS macro were used for data analysis.</p><p><strong>Results: </strong>The participants had a mean age of 50.8 years. High levels of well-being were significantly associated with being married, higher educational attainment, and higher income. Participants reporting high ACEs had significantly lower levels of well-being than those reporting no ACEs. In the mediating analysis, the indirect effect of andropause symptoms on the relationships between ACEs and well-being was statistically significant (β = -0.08, 95% CI = -0.109 to -0.053). This finding suggests that andropause symptoms partially mediate the relationship between ACEs and well-being in middle-aged men.</p><p><strong>Conclusions: </strong>Andropause symptoms appeared to partially mediated the relationship between ACEs and well-being in middle-aged Korean men. Although both ACEs and andropause symptoms are associated with midlife well-being, they have rarely been addressed together. Community-based programs combining trauma-informed counseling and andropause management are needed to improve well-being in middle-aged men.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}