The Unfolding Method to Explore Health-Related Quality of Life Constructs in a Chinese General Population

Health-related quality of life (HRQOL) is a complicated concept that can be measured using multiple health items. Although HRQOL is closely associated with people’s subjective assessment of their own health, a limited number of studies have investigated which health items are considered most importa...

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Bibliographic Details
Published in:Value in health 2021-06, Vol.24 (6), p.846-854
Main Authors: Mao, Zhuxin, Ahmed, Shenaz, Graham, Christopher, Kind, Paul
Format: Article
Language:English
Subjects:
Adult
Asians
Body Constitution
China
Cultural Characteristics
Demography
Diagnostic Self Evaluation
Female
Health care
Health Status
Health Status Indicators
HRQOL
Humans
Interviews
Interviews as Topic
Male
Middle Aged
multidimensional scaling
Population studies
Qualitative Research
Quality of Life
ranking data
Sleep
Sleep Quality
Spirituality
Studies
subjective health status
unfolding
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Summary:Health-related quality of life (HRQOL) is a complicated concept that can be measured using multiple health items. Although HRQOL is closely associated with people’s subjective assessment of their own health, a limited number of studies have investigated which health items are considered most important and relevant by the general population. Even fewer empirical studies have investigated how HRQOL is understood in non-Western populations. This study used multidimensional unfolding analysis in a Chinese general population to explore the constructs of HRQOL. A scoping review of Chinese generic HRQOL measures and a series of qualitative interviews produced a list of 42 potentially important health items in a Chinese cultural setting; 110 Chinese participants in face-to-face interviews ranked the health items from most important to least important. Responses were coded into a rectangular 110 × 42 matrix, and multidimensional unfolding was conducted to analyze participants’ preferences for health items. It was found that demographic characteristics and one’s health condition affected views of HRQOL. Meanwhile, 3 health items were considered to be most important across the whole sample: sleep quality, body constitution, and spiritual appearance. This study used a novel approach to explore how people coming from a Chinese cultural setting may perceive HRQOL and which aspects of HRQOL are most important to them. The study shows that multidimensional unfolding is a feasible approach to assess preferences in a general population. Future studies using this approach are recommended to further explore the constructs of HRQOL in other general populations. •Health-related quality of life (HRQOL) is a complex concept that consists of multiple domains with a diverse list of items that can be included in each domain.•Whereas a limited number of studies have investigated which components of HRQOL are considered most important and relevant by general populations for use in evaluating HRQOL, this study addressed this issue across a sample of a general population to explore the conceptualization of HRQOL.•This study argues that it is crucial to be “person centered” and to pay adequate attention to general populations’ understanding and experience of health.
ISSN:1098-3015
1524-4733
DOI:10.1016/j.jval.2020.12.014