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Sokolova V, Faller J, Asfia SKBM, Engel L. Assessing the psychometric performance of the EQ-5D-5L among informal caregivers of people with dementia. Qual Life Res 2024:10.1007/s11136-024-03737-6. [PMID: 39046615 DOI: 10.1007/s11136-024-03737-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2024] [Indexed: 07/25/2024]
Abstract
PURPOSE This study aimed to examine the psychometric performance of the EQ-5D-5L in informal caregivers of people with dementia. METHODS Data were obtained from an online survey administered to informal caregivers of people with dementia in Australia. Known-group comparisons were examined by formulating 15 a priori hypotheses, where a difference was made between weak and strong hypotheses. Group comparisons were tested using the non-parametric Wilcoxon-rank and the Kruskal-Wallis test, as well as regression analysis. Floor and ceiling effects were considered to be present if more than 15% of respondents achieved the lowest or highest possible score, respectively. RESULTS In total, 212 informal caregivers of people with dementia were included in the analysis. On average, participants were 47 years old (SD: 17) and 61% of them were female. The mean EQ-5D-5L utility score was 0.88 (SD: 0.16) and the mean EQ-VAS was 72.47 (SD: 17.86). While there was no floor effect, 26% reported full health. Nine strong and three weak hypotheses were confirmed, supporting the ability of the EQ-5D-5L to discriminate between groups with respect to: self-reported health status, happiness levels, presence of mental or physical health conditions, ability to engage in enjoyable activities, and availability of support. CONCLUSION Findings provide supporting evidence for the EQ-5D-5L in terms of its discriminant validity in informal caregivers of patients with dementia. However, the present ceiling effect suggests that the sensitivity of the EQ-5D-5L to detect improvements may be limited. Further studies are warranted examining other psychometric criteria, including reliability and responsiveness to change.
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Affiliation(s)
- Valeriia Sokolova
- School of Public Health and Preventive Medicine, Monash University Health Economics Group, Monash University, Melbourne, VIC, Australia.
| | - Jan Faller
- School of Public Health and Preventive Medicine, Monash University Health Economics Group, Monash University, Melbourne, VIC, Australia
| | | | - Lidia Engel
- School of Public Health and Preventive Medicine, Monash University Health Economics Group, Monash University, Melbourne, VIC, Australia
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Read S, Hicks B, Budden E, Douglass J, Grahamslaw A, Herrero E, Joseph G, Kirkup C, Pusey M, Russell A, Sondh H, Sondh S, Storey B, Towson G, Baxter K, Birks Y, Brayne C, Colclough C, Dangoor M, Dixon J, Donaghy P, Gridley K, Harris PR, Hu B, King D, Knapp M, Miles E, Mueller C, Perach R, Robinson L, Rusted J, Thomas AJ, Wittenberg R, Banerjee S. Long-term impact of the COVID-19 pandemic on the quality of life of people with dementia and their family carers. Age Ageing 2024; 53:afad233. [PMID: 38275095 PMCID: PMC10811518 DOI: 10.1093/ageing/afad233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION Few studies have longitudinally mapped quality of life (QoL) trajectories of newly diagnosed people with dementia and their carers, particularly during coronavirus disease-2019 (COVID-19). METHODS In a UK cohort study, 261 newly diagnosed people with dementia and 206 family carers were assessed prior to the pandemic (July 2019-March 2020), followed up after the first lockdown (July-October 2020) and then again a year and 2 years later. Latent growth curve modelling examined the level and change of QoL over the four time-points using dementia-specific QoL measures (DEMQOL and C-DEMQOL). RESULTS Despite variations in individual change scores, our results suggest that generally people with dementia maintained their QoL during the pandemic and experienced some increase towards the end of the period. This contrasted with carers who reported a general deterioration in their QoL over the same period. 'Confidence in future' and 'Feeling supported' were the only carer QoL subscales to show some recovery post-pandemic. DISCUSSION It is positive that even during a period of global disruption, decline in QoL is not inevitable following the onset of dementia. However, it is of concern that carer QoL declined during this same period even after COVID-19 restrictions had been lifted. Carers play an invaluable role in the lives of people with dementia and wider society, and our findings suggest that, post-pandemic, they may require greater support to maintain their QoL.
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Affiliation(s)
- Sanna Read
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Ben Hicks
- Brighton and Sussex Medical School, Centre for Dementia Studies, University of Sussex, Brighton, UK
| | - Emily Budden
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | | | | | - Elena Herrero
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Gregory Joseph
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Martha Pusey
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Alice Russell
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | | | - Sharon Sondh
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Bryony Storey
- Gateshead Health NHS Foundation Trust, Gateshead, UK
| | | | - Kate Baxter
- Social Policy Research Unit, Faculty of Social Sciences, University of York, York, UK
| | - Yvonne Birks
- Social Policy Research Unit, Faculty of Social Sciences, University of York, York, UK
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | | | - Margaret Dangoor
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Josie Dixon
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Paul Donaghy
- Kings College London, Institute of Psychiatry, London, UK
| | - Kate Gridley
- Social Policy Research Unit, Faculty of Social Sciences, University of York, York, UK
| | - Peter R Harris
- School of Psychology, University of Sussex, Brighton, UK
| | - Bo Hu
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Derek King
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Eleanor Miles
- School of Psychology, University of Sussex, Brighton, UK
| | | | - Rotem Perach
- School of Psychology, University of Sussex, Brighton, UK
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | | | - Alan J Thomas
- Institute for Ageing, Newcastle University, Newcastle, UK
| | - Raphael Wittenberg
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Sube Banerjee
- Faculty of Health, University of Plymouth, Plymouth, UK
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Yu Y, Xiao L, Ullah S, Meyer C, Wang J, Pot AM, Shifaza F. The Experiences of Informal Caregivers of People With Dementia in Web-Based Psychoeducation Programs: Systematic Review and Metasynthesis. JMIR Aging 2023; 6:e47152. [PMID: 37247218 DOI: 10.2196/47152] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/19/2023] [Accepted: 05/01/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Informal caregivers of people living with dementia experience a higher level of physical and mental stress compared with other types of caregivers. Psychoeducation programs are viewed as beneficial for building caregivers' knowledge and skills and for decreasing caregiver stress. OBJECTIVE This review aimed to synthesize the experiences and perceptions of informal caregivers of people with dementia when participating in web-based psychoeducation programs and the factors that enable and impede informal caregivers' engagement in web-based psychoeducation programs. METHODS This review followed the Joanna Briggs Institute protocol of systematic review and meta-aggregation of qualitative studies. We searched 4 English databases, 4 Chinese databases, and 1 Arabic database in July 2021. RESULTS A total of 9 studies written in English were included in this review. From these studies, 87 findings were extracted and grouped into 20 categories. These categories were further synthesized into 5 findings: web-based learning as an empowering experience, peer support, satisfactory and unsatisfactory program content, satisfactory and unsatisfactory technical design, and challenges encountered in web-based learning. CONCLUSIONS High-quality and carefully designed web-based psychoeducation programs offered positive experiences for informal caregivers of people living with dementia. To meet broader caregiver education and support needs, program developers should consider information quality and relevancy, the support offered, individual needs, flexibility in delivery, and connectedness between peers and program facilitators.
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Affiliation(s)
- Ying Yu
- College of Nursing and Health Sciences, Flinders University, South Australia, Australia
| | - Lily Xiao
- College of Nursing and Health Sciences, Flinders University, South Australia, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Claudia Meyer
- Bolton Clarke Research Institute, Melbourne, Victoria, Australia
- Ageing and Independent Living Research Centre, Monash University, Melbourne, Victoria, Australia
- Centre for Health Communication and Participation, La Trobe University, Melbourne, Victoria, Australia
| | - Jing Wang
- Faculty of Nursing, Health Science Center, Xi'an Jiao tong University, Xi'an, Shanxi, China
| | - Anne Margriet Pot
- Erasmus School of Health Policy & Management, Erasmus University Amsterdam, Amsterdam, Netherlands
- Optentia, North-West University, Vanderbijlpark, South Africa
| | - Fathimath Shifaza
- College of Nursing and Health Sciences, Flinders University, South Australia, Australia
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Decomposition analysis of health inequalities between the urban and rural oldest-old populations in China: Evidence from a national survey. SSM Popul Health 2022; 21:101325. [PMID: 36618546 PMCID: PMC9816804 DOI: 10.1016/j.ssmph.2022.101325] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 12/15/2022] [Accepted: 12/18/2022] [Indexed: 12/25/2022] Open
Abstract
The number of Chinese oldest-old (aged 80+) is growing rapidly and some studies have shown that the health status is unequal among older persons in different regions. However, to the best of our knowledge, no study to date has analyzed health inequalities among the oldest-old in urban and rural areas in China. This study therefore aimed to examine the correlation between health inequalities among the oldest-old in urban and rural areas of China. From the 8th wave of the Chinese Longitudinal Health Longevity Survey (CLHLS), we selected 8124 oldest-old participants who met the requirements of the study. Chi-square tests were used to analyze the distribution characteristics of indicators and a logistic model was performed to determine the factors associated with different self-rated health (SRH). The Fairlie model was adopted to decompose the causes and related contributions to health inequality. Our results found that of the Chinese oldest-old, 46.57% were in good health. Urban residents reported significantly better SRH than rural residents (50.17% vs. 45.13%). Variables associated with good and poor SRH had different distribution characteristics. The logistic model suggested that marital status, alcohol consumption, and annual income were important factors underlying the SRH differences. Our decomposition analysis indicated that 76.64% of the SRH differences were caused by observational factors, and validated that the difference in SRH between urban and rural areas was significantly (P<0.05) associated with exercise status (45.44%), annual income (37.64%), social activity status (3.75%), age (-5.27%), and alcohol consumption (-2.66%). Therefore, socioeconomic status and individual lifestyle status were the main factors underlying the health inequality between urban and rural Chinese oldest-old.
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Sabatini S, Martyr A, Gamble LD, Jones IR, Collins R, Matthews FE, Victor CR, Quinn C, Pentecost C, Thom JM, Clare L. Profiles of social, cultural, and economic capital as longitudinal predictors of stress, positive experiences of caring, and depression among spousal carers of people with dementia. Aging Ment Health 2022:1-9. [PMID: 35899421 DOI: 10.1080/13607863.2022.2098920] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE We explored (1) social, cultural, and economic capital in spousal carers of people with dementia; (2) profiles of carers with different levels of capital; (3) whether the identified profiles differ in levels of stress and positive experiences of caring, and likelihood of depression over time. METHODS Baseline (2014-2016), 12-month, and 24-month follow-up data were analyzed for 984 coresident spousal carers of people with dementia. We assessed social, cultural, and economic capital, stress, positive experiences of caring, depression. RESULTS On average, carers reported infrequent social and cultural participation. Most carers were not socially isolated, trusted their neighbours, had education at least to age 16, and had an income aligned with the 2014 UK average. We identified four groups of carers with different levels of capital. Although on average stress was low, depression was infrequent, and positive experiences of caring were moderately frequent, the group of carers with lowest capital was the least stressed and reported the most positive experiences of caring over time. Compared to the two groups with better capital, those with poorer capital were more likely to be depressed over time. CONCLUSION Social, cultural, and economic resources may decrease likelihood of depression, but not stress, in carers of people with dementia.
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Affiliation(s)
- Serena Sabatini
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Anthony Martyr
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Laura D Gamble
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Ian R Jones
- Wales Institute for Social and Economic Research and Data (WISERD), Cardiff University, Cardiff, United Kingdom
| | - Rachel Collins
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Fiona E Matthews
- Wales Institute for Social and Economic Research and Data (WISERD), Cardiff University, Cardiff, United Kingdom
| | - Christina R Victor
- Department of Health Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Bath, United Kingdom
| | - Catherine Quinn
- The Centre for Applied Dementia Studies, University of Bradford, Bradford, United Kingdom.,Wolfson Centre for Applied Health Research, Bradford, United Kingdom
| | - Claire Pentecost
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Jeanette M Thom
- Faculty of Medicine and Health, University of New South Wales (UNSW), Sydney, Australia
| | - Linda Clare
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom.,NIHR Applied Research Collaboration South, West Peninsula, United Kingdom
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Hicks B, Read S, Hu B, Wittenberg R, Grahamslaw A, Karim A, Martin E, Nuzum E, Reichental J, Russell A, Siddle E, Storey B, Tipping E, Baxter K, Birks Y, Brayne C, Brimblecombe N, Dangoor M, Dixon J, Gridley K, Harris PR, Knapp M, Miles E, Perach R, Robinson L, Rusted J, Stewart R, Thomas AJ, Banerjee S. A cohort study of the impact of COVID-19 on the quality of life of people newly diagnosed with dementia and their family carers. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12236. [PMID: 35509503 PMCID: PMC9060551 DOI: 10.1002/trc2.12236] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/23/2021] [Accepted: 11/23/2021] [Indexed: 01/10/2023]
Abstract
Introduction COVID-19 has impacted people with dementia and their family carers, yet little is known about effects on overall quality of life. Methods In a UK cohort study, pre- and post-pandemic data were collected from 114 carers and 93 recently diagnosed people with dementia. Latent growth curve modeling examined change in quality of life. Results Carers reported significant decline in quality of life, although no change was demonstrated by people with dementia. In multivariable analyses, higher levels of cognitive impairment, deprivation, study site, and lower number of memory clinic contacts were associated with greater decline in carer quality of life. Discussion Maintaining life quality for people with dementia during the pandemic appears to have come at the expense of their family carers. This inequity has fallen hardest on those caring for people with more severe dementia, in deprived areas, and with least support from memory services. These effects may be prevented or reversed by post-diagnostic care.
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Affiliation(s)
- Ben Hicks
- Brighton and Sussex Medical SchoolUniversity of SussexBrightonUK
| | - Sanna Read
- Care Policy and Evaluation CentreLondon School of Economics and Political ScienceLondonUK
| | - Bo Hu
- Care Policy and Evaluation CentreLondon School of Economics and Political ScienceLondonUK
| | - Raphael Wittenberg
- Care Policy and Evaluation CentreLondon School of Economics and Political ScienceLondonUK
| | | | | | - Evelyn Martin
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Eleanor Nuzum
- South London and Maudsley NHS Foundation TrustLondonUK
| | | | | | | | | | - Eva Tipping
- Sussex Partnership NHS Foundation TrustWorthingUK
| | - Kate Baxter
- Social Policy Research UnitUniversity of YorkYorkUK
| | - Yvonne Birks
- Social Policy Research UnitUniversity of YorkYorkUK
| | - Carol Brayne
- Cambridge Public HealthUniversity of CambridgeCambridgeUK
| | - Nicola Brimblecombe
- Care Policy and Evaluation CentreLondon School of Economics and Political ScienceLondonUK
| | - Margaret Dangoor
- Care Policy and Evaluation CentreLondon School of Economics and Political ScienceLondonUK
| | - Josie Dixon
- Care Policy and Evaluation CentreLondon School of Economics and Political ScienceLondonUK
| | - Kate Gridley
- Social Policy Research UnitUniversity of YorkYorkUK
| | | | - Martin Knapp
- Care Policy and Evaluation CentreLondon School of Economics and Political ScienceLondonUK
| | | | - Rotem Perach
- School of PsychologyUniversity of SussexBrightonUK
| | - Louise Robinson
- Population Health Sciences InstituteNewcastle UniversityNewcastleUK
| | | | - Rob Stewart
- Institute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
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7
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Fung SF, Kong CYW, Liu YM, Huang Q, Xiong Z, Jiang Z, Zhu F, Chen Z, Sun K, Zhao H, Yu P. Validity and Psychometric Evaluation of the Chinese Version of the 5-Item WHO Well-Being Index. Front Public Health 2022; 10:872436. [PMID: 35433612 PMCID: PMC9005828 DOI: 10.3389/fpubh.2022.872436] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/08/2022] [Indexed: 01/05/2023] Open
Abstract
Aims This article evaluates the psychometric properties of the Chinese version of the 5-item WHO Well-Being Index (WHO-5) in mainland China. Methods Two cross-sectional studies with 1,414 participants from a university in China were conducted. The Chinese version of the WHO-5 was assessed to determine its internal consistency, concurrent validity, factorial validity, and construct validity. Results The results indicate that the WHO-5 is unidimensional and has good internal consistency, with Cronbach's a = 0.85 and 0.81 in Study 1 (n = 903) and Study 2 (n = 511), respectively. The findings also demonstrate that the WHO-5 has good concurrent validity with other well-established measures of wellbeing, self-efficacy, self-esteem, and mental wellbeing. The results of confirmatory factor analysis also suggest that the scale has a good model fit. Conclusions This study provides empirical data demonstrating that the Chinese version of the WHO-5 has good psychometric properties. The scale can be a useful measure in epistemological studies and clinical research related to wellbeing in Chinese populations.
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Affiliation(s)
- Sai-Fu Fung
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Chris Yiu Wah Kong
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Yi-Man Liu
- School of Economics, Finance and Marketing, Royal Melbourne Institute of Technology, Melbourne, VIC, Australia.,University Administrative Office, Guangzhou Huashang College, Guangzhou, China
| | - Qian Huang
- Department of Sports Training, Xi'an Physical Education University, Xi'an, China
| | - Zike Xiong
- University Administrative Office, Guangzhou Huashang College, Guangzhou, China
| | - Zhiquan Jiang
- Society Hub, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, China
| | - Fangfang Zhu
- School of Economics and Trade, Guangzhou Huashang College, Guangzhou, China
| | - Zhenting Chen
- School of Data Sciences, Guangzhou Huashang College, Guangzhou, China
| | - Kun Sun
- School of Economics and Trade, Guangzhou Huashang College, Guangzhou, China
| | - Huiqin Zhao
- School of Economics and Trade, Guangzhou Huashang College, Guangzhou, China
| | - Ping Yu
- Managing Director Office, Global Business College of Australia, Melbourne, VIC, Australia.,General Manager Office, Edvantage Institute Australia, Melbourne, VIC, Australia
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