Health and Quality of Life Outcomes最新文献

{"title":"Patient and carer treatment preferences for oral medication in chronic kidney disease: a discrete choice experiment across eight countries.","authors":"Simon Fifer, Ciro Esposito, Ricardo Correa-Rotter, Mai-Szu Wu, Helmut Reichel, Hesham M Elsayed, Juan Jose Garcia Sanchez, Surendra Pentakota, Thames Kularatne, Richard Hull, Steven Chadban","doi":"10.1186/s12955-026-02559-z","DOIUrl":"https://doi.org/10.1186/s12955-026-02559-z","url":null,"abstract":"<p><strong>Background: </strong>Chronic Kidney Disease (CKD) affects over 674 million people globally and can lead to kidney failure, which significantly impairs quality and duration of life. While various oral pharmacological treatment options are available, limited research exists on how patients and carers prioritise treatment attributes. This study explored preferences for oral CKD medication across eight countries, involving 2,324 participants (1,511 patients and 813 carers).</p><p><strong>Methods: </strong>A Discrete Choice Experiment (DCE) was conducted in which participants completed seven hypothetical scenarios, each with two unlabelled treatment options and a \"neither\" (or \"stay on current treatment\") option. Five attributes were assessed: delay in dialysis or transplant, life extension, reduced risk of heart failure hospitalisation, risk of side effects, and out-of-pocket costs. Data were analysed using Mixed Multinomial Logit models, generating separate patient and carer models for each country (16 models), enabling cross-country comparisons.</p><p><strong>Results: </strong>Participants across countries placed the highest importance on delaying dialysis or transplant, followed by life extension, with minimising treatment side effects ranked next. They preferred longer delays for dialysis or transplant, with the seven-year delay being most preferred. Regional and patient-carer variations were observed in attribute importance. Model parameters were used to calculate utility for treatment profiles and simulate preference shares, enabling country-level comparisons.</p><p><strong>Conclusion: </strong>Patients and carers consistently prioritised oral medications that delay the need for dialysis or transplant and extend life, although the relative importance of these attributes differed by country and respondent group. The choice of oral medication in CKD is preference-sensitive, and these results have direct implications for shared decision-making in clinical practice. To support application of these findings, we have developed an interactive dashboard that simulates the impact of medication attributes on predicted uptake across all eight countries: https://cappre.shinyapps.io/CKD_Dapa_DCE/.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294668","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":"Population-based changes in oral health-related quality of life in Australia.","authors":"Xiangqun Ju, Liana Luzzi, Lisa M Jamieson","doi":"10.1186/s12955-026-02570-4","DOIUrl":"10.1186/s12955-026-02570-4","url":null,"abstract":"<p><strong>Background: </strong>Good oral health is crucial for overall well-being; yet many people experience pain, discomfort, or social difficulties due to oral problems. Understanding how Australians' oral health and quality of life have changed over time helps identify whether national dental policies and access to care have improved. The study aimed to assess temporal changes in oral health-related quality of life (OHRQoL) and identify associated risk indicators using the short Oral Health Impact Profile (OHIP-14) instrument among Australian adults.</p><p><strong>Methods: </strong>Data were sourced from the two most recent nationally representative surveys in Australia: National Survey of Adult Oral Health, NSAOH-1 (2004-06) and NSAOH-2 (2017-18). Both are population-based cross-sectional studies conducted in Australia, targeting adults aged 15 years and older. The outcome of interest was oral health-related quality of life (OHRQoL), measured using the validated short-form Oral Health Impact Profile (OHIP-14). Survey-weighted negative binomial regression models were employed to estimate both unadjusted and adjusted mean ratios (MRs) and their 95% confidence intervals (CIs) for OHIP-14 scores. Blinder-Oaxaca decomposition analysis was used to assess the contribution of changes in measured population characteristics to differences in mean OHIP-14 scores between two surveys.</p><p><strong>Results: </strong>In total, 4,170 participants completed the OHIP-14 questionnaire in 2004-06, and 2,836 did so in 2017-18. Between the two survey waves, the mean OHIP-14 score decreased from 7.3 to 5.5. After adjusting for all covariates, participants in NSAOH-1 had a 61% higher mean OHIP-14 score compared to those in NSAOH-2 (MR = 1.61; 95% CI: 1.53-1.70). Higher OHIP-14 scores were found among older adults, lower-educated, lower-income individuals, those with poorer health, smokers, frequent toothache sufferers, and people whose last dental visit was for a problem. The decomposition analysis showed that 41% of the difference in mean OHIP-14 scores was explained by measured population characteristics, Household income, and usual reason for dental visiting made the largest contributions to the explained component (80%), followed by smoking status (15%) and education level (9%).</p><p><strong>Conclusion: </strong>OHRQoL among Australian adults improved over 14 years, reflected by lower mean OHIP-14 scores in NSAOH-2 than NSAOH-1. However, poorer OHRQoL remained associated with older age, female sex, socioeconomic disadvantage, poorer self-rated health and oral health, smoking, toothache, and problem-oriented dental visiting. Decomposition analysis suggested that changes in income and dental visiting patterns partly explained this improvement.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283587","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":"Exploring perceptions of digital patient reported outcome measures: a multi-site qualitative case study in four European oncology outpatient clinics.","authors":"Kathrin Cresswell, An Jacobs, Anne-Lore Scherrens, Lise Rosquin, Julien Antonio Luyten, Elias David Lundereng, Victoria Freitas-Durks, Lorraine Warrington, Tonje Lundeby, Marianne Jensen Hjermstad, Robin Williams, Kim Beernaert, Nicoleta Mitrea, Geana Paula Kurita, Marie Fallon, Stein Kaasa","doi":"10.1186/s12955-026-02574-0","DOIUrl":"10.1186/s12955-026-02574-0","url":null,"abstract":"<p><strong>Background: </strong>Digital Patient Reported Outcome Measures (PROMs) can help to promote patient-centred care (PCC). However, they are currently not routinely used, potentially compromising patient outcomes. In this work we sought to (i) explore existing processes, patient and healthcare professionals' (HCP) perceptions of current gaps in PCC and (ii) their views on how a PROMs-based digital system could help to address these gaps in four European oncology outpatient clinics.</p><p><strong>Methods: </strong>We conducted a qualitative multi-site case study including healthcare staff (organisational leaders, managers and HCPs), patients being treated for cancer and caregivers in four outpatient clinics in Brussels (Belgium), Edinburgh (United Kingdom), Oslo (Norway), and Valencia (Spain). Data were collected through a series of semi-structured interviews to explore existing work practices, needs and attitudes. We also conducted non-participant observations of staff meetings and clinic activities to explore existing processes. Data were analysed through a mixture of inductive and deductive approaches drawing on the Technology, People, Organizations, and Macroenvironmental (TPOM) factors framework.</p><p><strong>Results: </strong>We conducted 99 interviews with HCPs, patients and caregivers and 30 observations across the four sites. PCC was regarded as important across all sites. We observed limited existing efforts on systematically recording psychosocial needs of patients. Participants reported concerns that a new digital system to record PROMs may result in increased workloads for clinical staff and adversely impact patient-clinician relationships. Attitudes were influenced by previous experience with digital systems. Organisational leadership and support were viewed as crucial in facilitating adoption, including efforts to train and engage clinical and patient users, making available sufficient resources, and including end-users in system design.</p><p><strong>Conclusions: </strong>While digital PROMs have the potential to enhance PCC in cancer, their routine use is often hindered by sociotechnical challenges. This issue persists across different countries. Success in developing and implementing digital PROMs will require tailored system design and implementation strategies being cognisant of various stakeholder needs. This may include supplementing technological aspects of interventions with educational strategies, supporting local adaptations of designs, and aligning with clinician and organisational drivers for implementation.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283640","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":"Translation, cultural adaptation, and psychometric validation of the simplified Chinese EORTC QLQ-SH22 among cancer patients.","authors":"Yi-Mei Du, Ji Lu, Hong Zhang, Qin Huang, Bing-Hua Wang, Li Liu","doi":"10.1186/s12955-026-02567-z","DOIUrl":"10.1186/s12955-026-02567-z","url":null,"abstract":"<p><strong>Background: </strong>Sexual health is a critical aspect of quality of life in cancer patients. The EORTC QLQ-SH22 (SH22) assesses sexual health-related quality of life (SH-QoL), but no Simplified Chinese version has been validated. This study aimed to translate and culturally adapt the SH22 into Simplified Chinese (SH22-C) and to evaluate its psychometric properties in mainland Chinese cancer patients.</p><p><strong>Methods: </strong>This study comprised two phases. Phase I involved translation and cultural adaptation of the SH22, following the standardized EORTC translation procedure to ensure clarity and cultural relevance. Phase II was a cross-sectional survey in outpatient oncology clinics of a tertiary hospital in mainland China, with 270 adults completing the SH22-C and 30 participants completing a retest after 2 weeks. Psychometric properties assessed included internal consistency, test-retest reliability, structural validity, and convergent/discriminant validity.</p><p><strong>Results: </strong>Cognitive interviews led to revisions of ambiguous sexual activity terms, with no further changes in the second round. Phase II demonstrated excellent internal consistency (Sexual Satisfaction α = 0.93; Sexual Pain α = 0.81) and good test-retest reliability (intraclass correlation coefficients = 0.86 and 0.84, respectively; single-item r = 0.73-0.88). Confirmatory factor analysis confirmed a two-factor structure with acceptable fit and factor loadings of 0.62-0.92. Strong convergent validity and low inter-factor correlation (r = - 0.26) supported discriminant validity.</p><p><strong>Conclusions: </strong>The SH22-C showed good cultural equivalence, reliability, and validity in mainland Chinese cancer patients and provides a valid and practical tool for assessing SH-QoL.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277319","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":"Preference-based measures in people with dementia: a systematic review of psychometric properties.","authors":"Anouk Lamé, Jan Heijdra Suasnabar, Esmee Adam, Ron Handels, Hanneke J A Smaling, Miriam L Haaksma, M Elske van den Akker-van Marle","doi":"10.1186/s12955-026-02563-3","DOIUrl":"10.1186/s12955-026-02563-3","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate measurement of health and well-being outcomes is essential for economic evaluations of dementia care interventions. However, the suitability of existing preference-based measures (PBMs) for people with dementia remains uncertain. This review aims to provide guidance in measurement choice by assessing the psychometric properties of PBMs in people with dementia.</p><p><strong>Methods: </strong>A systematic review was conducted of studies indexed in PubMed, Embase, PsycINFO and Web of Science up to July 2025. Studies were eligible if they evaluated psychometric properties of PBMs in people with dementia. Title and abstract screening were performed using a validated AI-powered tool, ASReview. The quality of the included studies and psychometric properties of the PBMs were assessed using the COSMIN methodology.</p><p><strong>Results: </strong>A total of 21,347 records were identified, of which 32 studies covering fourteen different PBMs were included. The EQ-5D-3L was used in most studies, and studies focused mainly on construct validity and reliability. Study quality was predominantly high, while most psychometric evidence was inconsistent or insufficient. The ICECAP-O and HUI2 demonstrated the most appropriate psychometric evidence.</p><p><strong>Conclusion: </strong>Evidence of psychometric properties of PBMs is insufficient for some measures and limited for other measures. Therefore, none can yet be recommended as fully appropriate for use in people with dementia. This underscores the need for further validation studies to improve preference-based outcome measurement, and to strengthen economic evaluations of dementia care interventions.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271326","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":"Measuring health-related quality of life and well-being in adults with fecal incontinence: a comparative psychometric evaluation.","authors":"Sylvester R Groen, Daniel Keszthelyi, Zsa Zsa R M Weerts, Sadé L Assmann, Stéphanie O Breukink, Brigitte A B Essers","doi":"10.1186/s12955-026-02566-0","DOIUrl":"10.1186/s12955-026-02566-0","url":null,"abstract":"<p><strong>Background: </strong>While traditional disease-management regarding fecal incontinence (FI) primarily focuses on symptom-control and health-related quality of life (HrQoL) outcomes, patients often prioritize broader aspects of health, like well-being. This study evaluates the psychometric performance of ICEpop CAPability measure for Adults (ICECAP-A), a capability-based well-being instrument, alongside two established HrQoL-instruments, EQ-5D-5L and the FI quality of life (FIQL) questionnaire, in an outpatient-population with FI.</p><p><strong>Methods: </strong>Data were obtained from patients with FI recruited from a randomized-controlled trial evaluating the efficacy of anal plugs for FI ((The CONFIDEnCE trial, NCT04657588). Psychometric evaluation of ICECAP-A involved the assessment of the convergent validity, known-group validity (examined across predefined subgroups), acceptability, and floor and ceiling effects.</p><p><strong>Results: </strong>Among 72 participants (mean age 67.3years; 83.3% female), the mean ICECAP-A capability score (0.86, scale 0-1) exceeded the mean EQ-5D-5L utility (0.71, scale - 0.446-1) and the FIQL score (2.34, scale 1-5). ICECAP-A showed good convergent validity (76.6% predefined hypotheses confirmed). Known-group validity was comparable across instruments; ICECAP-A demonstrating significant differences by EQ-VAS, anxiety, and education level, but not outperforming EQ-5D-5L or FIQL. EQ-5D-5L showed stronger effect sizes for anxiety (p < 0.001), depression and symptom severity (non-significant), while FIQL was stronger for education level (p = 0.002). Questionnaire completion was 84.7% overall, reflecting trial dropout only (100% among completers) with no substantial floor or ceiling effects.</p><p><strong>Conclusions: </strong>In patients with FI, ICECAP-A showed psychometric performance comparable to EQ-5D-5L and FIQL, despite its broader conceptual scope. Well-being appeared less influenced by symptom severity, possibly reflecting coping or adaptation. Further research is warranted evaluating ICECAP-A's psychometric advantage over traditional HrQoL-instruments in this clinical context.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264299","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":"How health literacy and eHealth literacy influence quality of life in older adults with chronic diseases: a network and path analysis.","authors":"Hao Zou, Shenglan Zhou, Li Jin, Lijun Xie, Yuchen Wang, Haoyang Shi, Linlin Zhang, Hong Li","doi":"10.1186/s12955-026-02562-4","DOIUrl":"10.1186/s12955-026-02562-4","url":null,"abstract":"<p><strong>Background: </strong>Despite existing research on factors influencing quality of life (QOL) in older adults with chronic diseases, the underlying mechanisms by which health literacy (HL) and e-health literacy (eHL) contribute to QOL improvement remain underexplored. This study aimed to elucidate the complex relationships among HL, eHL, health behaviors, psychosocial factors, and QOL, and to identify the driving pathways of HL and eHL in enhancing QOL.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between March and June 2025 at a tertiary hospital in Xi'an, China. A total of 304 older adults with chronic diseases participated in the study. Participants completed assessments for HL, eHL, cognitive function, frailty, nutrition, physical activity, sleep quality, family function, depression, and QOL (including Physical and Mental Component Summaries, PCS and MCS). Grip strength was also measured. Multiple linear regression, network analysis, and path analysis were employed to determine influencing factors and structural relationships.</p><p><strong>Results: </strong>Higher HL and eHL levels were associated with younger age, higher socioeconomic status, longer daily smartphone usage, and having personal interests; HL was additionally linked to better family function. Network and path analyses revealed that depression, frailty, physical activity, grip strength, and family function were primary direct predictors of QOL, PCS and MCS. Depression and frailty were identified as key risk factors, while sleep quality and nutritional status served as significant mediators. Although HL and eHL did not directly influence QOL, they functioned as upstream variables that indirectly improved QOL by positively influencing these intermediary health behaviors and psychosocial factors.</p><p><strong>Conclusions: </strong>HL and eHL indirectly enhance QOL in older adults with chronic diseases by driving improvements in health behaviors and psychological status. Interventions should target depression, frailty, sleep quality, and nutrition as critical modifiable factors. Future programs aiming to improve HL and eHL should prioritize older individuals with low socioeconomic status and limited digital experience, incorporating age-friendly designs, social interaction, and family involvement.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258009","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":"Predicting poor health-related quality of life among Chinese adolescents using explainable machine learning: the role of school adjustment, family context, and lifestyle factors.","authors":"Liangyu Zhao, Yan Gao, Chenchen Liu, Zeqi Zhang, Yuke Yang, Yining Hu, Wenze Sui, Sen Ma, Shuoqin Zhang, Xinxin Lai, Zhiying Wang, Zhiwen Yang, Xiangren Yi","doi":"10.1186/s12955-026-02568-y","DOIUrl":"10.1186/s12955-026-02568-y","url":null,"abstract":"<p><strong>Background: </strong>Adolescents' health-related quality of life (HRQoL) is influenced by multiple domains, including school, family, and individual lifestyle. However, evidence remains limited on accurately predicting adolescent HRQoL and identifying modifiable determinants. This study aimed to develop a machine-learning prediction model for adolescent HRQoL and to determine key contextual factors associated with low quality of life.</p><p><strong>Methods: </strong>This cross-sectional study included 20,236 adolescents (51.71% female; mean age 15.97 years). HRQoL was assessed using the validated Quality of Life Scale for Children and Adolescents (QLSCA). Twenty predictors covering school adjustment, family characteristics, and health behaviours were entered into 9 machine-learning classifiers and logistic regression. Feature contributions were examined using permutation importance, partial dependence plots (PDPs), and SHapley Additive exPlanations (SHAP). Stratified analyses by sex and school stage were conducted to identify group-specific determinants.</p><p><strong>Results: </strong>School adjustment was the primary predictor of HRQoL, with self-management and peer relations contributing most. Family factors ranked next, particularly more frequent exercise with parents, which was associated with higher HRQoL. Among lifestyle behaviours, higher physical activity and healthier dietary patterns were associated with better HRQoL, whereas excessive screen time was associated with poorer HRQoL. In stratified analyses, peer relations and physical activity were more influential among boys, while self-management, exercising with parents, and adequate sleep contributed more among girls. Middle school students showed more adverse associations with disruptive/antisocial behaviours and screen time, whereas high school students derived greater benefits from family interaction and health behaviours.</p><p><strong>Conclusions: </strong>Explainable machine-learning analyses highlight school adjustment as a central correlate of adolescent HRQoL, alongside family characteristics and health behaviours. These findings provide multidimensional evidence to support targeted interventions in educational, family, and public health settings to improve adolescents' HRQoL.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217695","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":"Exploring spiritual health among South Korean older adults using the ICECAP-O measure: a cross-sectional study.","authors":"Yifei Chen, Ishtiaq Ahmad, Yoshihisa Shirayama, Miyoko Okamoto, Eun Woo Nam, Motoyuki Yuasa","doi":"10.1186/s12955-026-02557-1","DOIUrl":"10.1186/s12955-026-02557-1","url":null,"abstract":"<p><strong>Background: </strong>Spiritual Health (SH) is regarded as a factor that influences an individual's overall well-being. SH is about finding meaning, having a sense of purpose, and feeling inner peace. At the same time, the holistic health viewpoints stress their proximity to human capability and the entirety of life's quality.</p><p><strong>Objective: </strong>The present study sought to determine the relationship between capabilities and subjective well-being in older adults using the ICECAP-O (ICEpop CAPability measure for older people) instrument and also examined the role of the SH measured by PIL (Purpose in Life) as a moderator of the ICECAP-O capability outcomes.</p><p><strong>Methods: </strong>This cross-sectional study was a paper-based questionnaire survey targeting 300 older adults aged 65 and over from Wonju and Yeoju, South Korea. The demographic characteristics, health perception, ICECAP-O result and PIL score were collected. Exploratory Factor Analysis (EFA) identified latent dimensions such as HP, IL and ELS. OLS and Pearson correlation were performed on the ICECAP-O tariff, EFA factors, and PIL scores. Stata 18 was used, with a significance level set at p < 0.05.</p><p><strong>Results: </strong>The mean PIL score was 98.5 ± 15.6, which represents moderate well-being. Regression analyses revealed significant effects of the 3 from 5 EFA factors, including HP (β = -0.09, p < 0.001), IL (β = 0.03, p < 0.05), and ELS (β = -0.03, p < 0.05) on the ICECAP-O tariff. PIL scores significantly and positively correlated with ICECAP-O tariff (r = 0.44, p < 0.001), with HP showing a noteworthy moderating effect (β = 0.05, p < 0.01).</p><p><strong>Conclusion: </strong>The PIL score is a positive predictor of ICECAP-O among South Korea older adults, suggesting that a better sense of purpose improves capability and quality of life. Further research is needed to examine the applicability of this capability instrument across different countries and cultural contexts for spiritual health.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211176","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":"Qualitative assessment of content validity of the modified EQ-HWB-9 by patients, caregivers, and social care users in the United States.","authors":"Jonathan L Nazari, A Simon Pickard, Justin Yu, Maja Kuharic","doi":"10.1186/s12955-026-02561-5","DOIUrl":"10.1186/s12955-026-02561-5","url":null,"abstract":"<p><strong>Background: </strong>The EQ-HWB-9 is a measure designed to capture health, social care, and caregiver-related quality of life across relevant populations. As part of ongoing development, modifications have been made to item wording, response scales, and layout informed by international collaborations. Qualitative evidence to support the content validity of the modified EQ-HWB-9 in the United States (US) is important to support its use in this major market. This study evaluated the comprehensibility, relevance, and comprehensiveness of the modified EQ-HWB-9 in US adults.</p><p><strong>Methods: </strong>US adults with chronic health conditions, serving as unpaid caregivers, and/or social care users were purposively recruited through an online panel. Participants independently completed an online, pre-interview survey including both experimental and modified EQ-HWB-9 versions and a cognitive interview conducted online using a semi-structured interview guide. Participants compared experimental and modified wording, response scales, layout, provided item-level interpretations and examples, and discussed perceived comprehensiveness of the measure. Interviews were conducted until thematic saturation was achieved. Verbatim transcripts were qualitatively coded and analyzed using the framework method.</p><p><strong>Results: </strong>Thirty-four participants (mean age 55; 71% female) completed interviews. Most items demonstrated strong face and content validity; participants readily interpreted daily activities, exhaustion, loneliness, anxiety, sadness/depression, and pain as intended and provided rich, relevant examples. However, the mobility item was identified by several participants as applying only to users of mobility devices. Across modifications, participants preferred \"difficulty\" over \"trouble\" (cognition), \"lack of control\" over \"no control,\" \"a little of the time\" over \"only occasionally,\" and \"moderate difficulty\" over \"some difficulty.\" Most participants found repeated question stems clearer than shared item stems. Half of respondents perceived the EQ-HWB-9 as comprehensive, with suggested additions (e.g., sleep, self-care) largely aligning with domains included in the long-form EQ-HWB.</p><p><strong>Conclusions: </strong>Findings provide qualitative support for the content validity of the modified EQ-HWB-9 in US populations and reinforce several proposed wording and response-scale refinements. Select issues identified with the wording of the mobility and control items can inform revisions in the wording of a finalized version of the EQ-HWB.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175846","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}