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  • 1.
    Araya, Mesfin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Chotai, Jayanti
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Komproe, Ivan H
    de Jong, Joop TVM
    Effect of trauma on quality of life as mediated by mental distress and moderated by coping and social support among postconflict displaced Ethiopians2007Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 16, nr 6, s. 915-927Artikel i tidskrift (Refereegranskat)
  • 2.
    Atroshi, Isam
    et al.
    Department of Clinical Sciences, Lund University, Lund, Sweden.
    Lyrén, Per-Erik
    Umeå universitet, Samhällsvetenskapliga fakulteten, Beteendevetenskapliga mätningar.
    Gummesson, Christina
    Department of Health Sciences, Division of Physiotherapy, Lund University, 22100 Lund, Sweden.
    The 6-item CTS symptoms scale: a brief outcomes measure for carpal tunnel syndrome2009Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 18, nr 3, s. 347-358Artikel i tidskrift (Refereegranskat)
  • 3. Bengtsson-Tops, Anita
    et al.
    Hansson, Lars
    Sandlund, Mikael
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Bjarnason, Olafur
    Korkeila, Jyrki
    Merinder, Lars
    Nilsson, Liselotte
    Sørgaard, Knut Wollo
    Vinding, Hanne R
    Middelboe, Thomas
    Subjective versus interviewer assessment of global quality of life among persons with schizophrenia living in the community: a Nordic multicentre study.2005Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 14, nr 1, s. 221-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Only a moderate correlation between subjective and interviewer-assessed global quality of life was found, implying that the sources of assessment differed, as was also shown in subsequent regression models. It is concluded that both perspectives on the patient's quality of life may be valuable for treatment planning, especially in cases where differences in quality of life assessment related to the patient's psychopathology may be expected.

  • 4.
    Björklund, Martin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Ga¨vle.
    Wiitavaara, Birgitta
    Heiden, Marina
    Responsiveness and minimal important change for the ProFitMap-neck questionnaire and the Neck Disability Index in women with neck-shoulder pain2017Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 26, nr 1, s. 161-170Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: The aim was to determine the responsiveness and minimal important change (MIC) of the questionnaire ProFitMap-neck that measures symptoms and functional limitations in women with neck pain. The same measurement properties were determined for Neck Disability Index (NDI) for comparison purposes.

    METHODS: Longitudinal data were derived from two randomized controlled trials, including 103 and 120 women with non-specific neck pain, with questionnaire measurements performed before and after interventions. Sensitivity and specificity to discriminate between improved and not or little changed participants, based on categorization of a global rating of change scale (GRCS), were determined for the ProFitMap-neck indices and NDI by using area under receiver operating characteristic curves (AUC). Correlations between the GRCS anchor and change scores of the questionnaires were also used to assess responsiveness. The change score that showed the highest combination of sensitivity and specificity was set for MIC.

    RESULTS: The ProFitMap-neck indices showed similar responsiveness as NDI with AUC exceeding 0.70 (Range: ProFitMap-neck, 0.74-0.83; NDI, 0.75-0.86). The MIC in the two samples ranged between 6.6 and 13.6 % for ProFitMap-neck indices and 5.2 and 6.3 % for NDI. Both questionnaires had significant correlations with GRCS (Spearman's rho 0.47-0.72).

    CONCLUSIONS: Validity of change scores was endorsed for the ProFitMap-neck indices and NDI with adequate ability to discriminate between improved and not or little changed participants. Values of minimal important change were presented.

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  • 5. Chaplin, John
    et al.
    Nilsson, Evalill
    Blomqvist, Ida
    Stackelberg, Martin
    Ericsson, Mats
    Henje, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap.
    Wicksell, Rikard
    Blomberg, Karin
    Dennhag, Inga
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap.
    Translation and cross-cultural adaptation of ten pediatric PROMIS (R) item banks into Swedish2020Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 29, s. S175-S176Artikel i tidskrift (Övrigt vetenskapligt)
  • 6.
    Domellöf, Erik
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Kolbäcken Child Rehabilitation Centre, Umeå, Sweden .
    Hedlund, Ludmilla
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Ödman, Pia
    Avd för sjukgymnastik, Institutionen för medicin och hälsa, Linköpings universitet.
    Health-related quality of life of children and adolescents with functional disabilities in a northern Swedish county2014Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 23, nr 6, s. 1877-1882Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: Health-related quality of life (HRQoL) studies in children and adolescents with disabilities tend to report lower self-reported health than in the typical population. However, reports are not always consistent and HRQoL appears to vary depending on diagnosis, cultural setting and clinical context. The aim of this study was to explore HRQoL in children and adolescents with various disabilities in Västerbotten County, Sweden.

    METHODS: A total of 175 children and adolescents [57 girls, 118 boys; mean age 11.7 years (range 7-17 years)] divided into four different diagnostic groups (intellectual disabilities, autism spectrum disorders, movement disorders and hearing disabilities) participated in the study. The EuroQol Five Dimensions Health Questionnaire, Youth version (EQ-5D-Y) was used as HRQoL measure.

    RESULTS: Significant differences in various EQ-5D-Y dimensions between the different diagnostic groups were found, but no differences in overall health status. HRQoL in children and adolescents with hearing disabilities was found similar to the typical child population in Sweden whereas children and adolescents with other diagnoses reported evidently more problems.

    CONCLUSIONS: Findings suggest that there is an increased risk for children with functional disabilities other than hearing disabilities in northern Sweden to experience difficulties in various health domains and lowered general health.

  • 7. Henoch, Ingela
    et al.
    Axelsson, Bertil
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Bergman, Bengt
    The assessment of quality of life at the end of life (AQEL) questionnaire: a brief but comprehensive instrument for use in patients with cancer in palliative care2010Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 19, nr 5, s. 739-750Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study provided some evidence for the validity of the AQEL and its feasibility in patients with cancer in palliative care.

  • 8.
    Herraiz-Adillo, Ángel
    et al.
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Ahlqvist, Viktor H.
    Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
    Daka, Bledar
    School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Wångdahl, Josefin
    Aging Research Center, Karolinska Institutet & Stockholm University, Stockholm, Sweden; Department of Public Health & Caring Sciences, Uppsala University, Uppsala, Sweden.
    Wennberg, Patrik
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Carlsson, Jakob
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Higueras-Fresnillo, Sara
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.
    Lenander, Cecilia
    Department of Clinical Sciences in Malmö, Centre for Primary Health Care Research, Lund University, Lund, Sweden.
    Östgren, Carl Johan
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Centre of Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
    Berglind, Daniel
    Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden.
    Rådholm, Karin
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; The George Institute for Global Health, University of New South Wales, Sydney, Australia.
    Henriksson, Pontus
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Life’s Essential 8 in relation to self-rated health and health-related quality of life in a large population-based sample: the SCAPIS project2024Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To monitor cardiovascular health, in 2022, the American Heart Association (AHA) updated the construct “Life’s Simple 7” (LS7) to “Life’s Essential 8” (LE8). This study aims to analyze the associations and capacity of discrimination of LE8 and LS7 in relation to self-rated health (SRH) and health-related quality of life (HRQoL).

    Methods: This study from the Swedish CArdioPulmonary bioImage Study (SCAPIS) included 28 731 Swedish participants, aged 50–64 years. Three different scores were derived from the SF-12 questionnaire: 1-item question SRH (“In general, would you say your health is …?”), mental-HRQoL and physical-HRQoL. Logistic regression, restricted cubic splines, and ROC analysis were used to study the associations between the AHA scores in relation to SRH and HRQoL.

    Results: Compared to those with a LE8 score of 80, participants with a LE8 score of 40 were 14.8 times more likely to report poor SRH (OR: 14.8, 95% CI: 13.0–17.0), after adjustments. Moreover, they were more likely to report a poor mental-HRQoL (OR: 4.9, 95% CI: 4.2–5.6) and a poor physical-HRQoL (OR: 8.0, 95% CI: 7.0–9.3). Area under curves for discriminating poor SRH were 0.696 (95% CI: 0.687–0.704), 0.666 (95% CI: 0.657–0.674), and 0.643 (95% CI: 0.634–0.651) for LE8, LS7 (0–14), and LS7 (0–7), respectively, all p values < 0.001 in the DeLong’s tests.

    Conclusion: LE8 and LS7 had strong and inverse associations with SRH, mental-HRQoL, and physical-HRQoL, though LE8 had a somewhat higher capacity of discrimination than LS7. The novel LE8, a construct initially conceived to monitor cardiovascular health, also conveys SRH and HRQoL.

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  • 9.
    Karlsson Rosenblad, Andreas
    et al.
    Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden; Division of Clinical Diabetology and Metabolism, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Statistics, Uppsala University, Uppsala, Sweden.
    Westman, Bodil
    Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden; Department of Care Science, Sophiahemmet University, Stockholm, Sweden.
    Bergkvist, Karin
    Department of Care Science, Sophiahemmet University, Stockholm, Sweden; Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Segersvärd, Ralf
    Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden; Department of Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
    Roos, Nathalie
    Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden; Division of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Bergenmar, Mia
    Department of Care Science, Sophiahemmet University, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
    Sharp, Lena
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden.
    Differences in health-related quality of life between native and foreign-born gynaecological cancer patients in Sweden: a five-year cross-sectional study2023Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To examine differences in health-related quality of life (HRQoL) between native and foreign-born gynaecological cancer patients in Sweden, taking into account clinical, demographic, and socioeconomic factors.

    Methods: The 30-item European Organisation for Research and Treatment of Cancer quality of life questionnaire (QLQ-C30) and a study-specific questionnaire covering demographic and socioeconomic factors were answered by 684 women aged ≥ 18 years old, diagnosed in 2014, 2016, or 2018 with gynaecological cancer in the Stockholm-Gotland health care region, Sweden. Clinical data were obtained from the Swedish Cancer Register. Data were analysed using the Kruskal–Wallis test and linear regression.

    Results: The women had a mean age of 65.4 years, with 555 (81.1%) born in Sweden, 54 (7.9%) in other Nordic countries (ONC), 43 (6.3%) in other European countries (OEC), and 32 (4.7%) in non-European countries (NEC). HRQoL differed significantly between the four groups for 14 of the 15 QLQ-C30 scales/items. On average, Swedish-born women scored 2.0, 15.2, and 16.7 points higher for QoL/functioning scales/items and 2.2, 14.1, and 18.7 points lower for symptom scales/items, compared with ONC-, OEC-, and NEC-born women, respectively. In adjusted analyses, none of the differences between Swedish-born and ONC-born women were significant, while for OEC- and NEC-born women the differences were significant for most QLQ-C30 scales/items.

    Conclusion: HRQoL differs between native and foreign-born gynaecological cancer patients in Sweden, with lower HRQoL the further from Sweden the women are born. A more individualised cancer care, with tailored support to optimize HRQoL is needed for this vulnerable group of patients.

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  • 10.
    Kephart, George
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, NS, Halifax, Canada; School of Health Administration, Dalhousie University, Halifax, Canada.
    Packer, Tanya
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Health Administration, Dalhousie University, Halifax, Canada; School of Occupational Therapy, Dalhousie University, Halifax, Canada.
    Audulv, Åsa
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Chen, Yu-Ting
    School of Occupational Therapy, Dalhousie University, Halifax, Canada.
    Robinson, Alysia
    Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, NS, Halifax, Canada.
    Olsson, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Warner, Grace
    School of Occupational Therapy, Dalhousie University, Halifax, Canada.
    Item selection, scaling and construct validation of the Patient-Reported Inventory of Self-Management of Chronic Conditions (PRISM-CC) measurement tool in adults2022Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 31, nr 9, s. 2867-2880Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To select and scale items for the seven domains of the Patient-Reported Inventory of Self-Management of Chronic Conditions (PRISM-CC) and assess its construct validity.

    Methods: Using an online survey, data on 100 potential items, and other variables for assessing construct validity, were collected from 1055 adults with one or more chronic health conditions. Based on a validated conceptual model, confirmatory factor analysis (CFA) and item response models (IRT) were used to select and scale potential items and assess the internal consistency and structural validity of the PRISM-CC. To further assess construct validity, hypothesis testing of known relationships was conducted using structural equation models.

    Results: Of 100 potential items, 36 (4–8 per domain) were selected, providing excellent fit to our hypothesized correlated factors model and demonstrating internal consistency and structural validity of the PRISM-CC. Hypothesized associations between PRISM-CC domains and other measures and variables were confirmed, providing further evidence of construct validity.

    Conclusion: The PRISM-CC overcomes limitations of assessment tools currently available to measure patient self-management of chronic health conditions. This study provides strong evidence for the internal consistency and construct validity of the PRISM-CC as an instrument to assess patient-reported difficulty in self-managing different aspects of daily life with one or more chronic conditions. Further research is needed to assess its measurement equivalence across patient attributes, ability to measure clinically important change, and utility to inform self-management support.

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  • 11. Kephart, George
    et al.
    Packer, Tanya L.
    Audulv, Åsa
    Department of Nursing, Mid-Sweden University, Sundsvall, Sweden.
    Warner, Grace
    The structural and convergent validity of three commonly used measures of self-management in persons with neurological conditions2019Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 28, nr 2, s. 545-556Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: Self-management ability is commonly assessed in chronic disease research and clinical practice. The purpose of this study was to assess the structural and convergent validity of three commonly used self-management outcome measures in a sample of persons with neurological conditions.

    METHODS: We used data from a Canadian survey of persons with neurological conditions, which included three commonly used self-management measures: the Partners in Health Scale (PIH), the Patient Activation Measure (PAM), and the Self-Efficacy for Managing a Chronic Disease Scale (SEMCD). Confirmatory factor analysis was used to assess the structural and convergent validity of the three measures.

    RESULTS: When treated as single-factor constructs, none of the measurement models provided a good fit to the data. A four-domain version of the PIH was the best fitting model. Confirmatory factor analysis suggests that the three tools measure different, but correlated constructs.

    CONCLUSIONS: While the PAM, PIH and SEMCD scales are all used as measures of patient self-management, our study indicates that they measure different, but correlated latent variables. None, when treated as single, uni-dimensional construct, provides an acceptable fit to our data. This is probably because self-management is multi-dimensional, as is consistently shown by qualitative evidence. While these measures may provide reliable summative measures, multi-dimensional scales are needed for clinical use and more detailed research on self-management.

  • 12.
    Kiadaliri, Ali
    et al.
    Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden; Arthro Therapeutics, Malmö, Sweden; Clinical Epidemiology Unit, Skåne University Hospital, Lund, Sweden.
    Cronström, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering. Department of Health Sciences, Lund University, Lund, Sweden.
    Dahlberg, Leif E.
    Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden; Arthro Therapeutics, Malmö, Sweden.
    Lohmander, L. Stefan
    Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden; Arthro Therapeutics, Malmö, Sweden.
    Patient acceptable symptom state and treatment failure threshold values for work productivity and activity Impairment and EQ-5D-5L in osteoarthritis2024Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To estimate patient acceptable symptom state (PASS) and treatment failure (TF) threshold values for Work Productivity and Activity Impairment (WPAI) measure and EQ-5D-5L among people with hip or knee osteoarthritis (OA) 3 and 12 months following participation in a digital self-management intervention (Joint Academy®).

    Methods: Among the participants, we computed work and activity impairments scores (both 0–100, with a higher value reflecting higher impairment) and the Swedish hypothetical- (range: − 0.314 to 1) and experience-based (range: 0.243–0.976) EQ-5D-5L index scores (a higher score indicates better health status) at 3- (n = 14,607) and 12-month (n = 2707) follow-ups. Threshold values for PASS and TF were calculated using anchor-based adjusted predictive modeling. We also explored the baseline dependency of threshold values according to pain severity at baseline.

    Results: Around 42.0% and 48.3% of the participants rated their current state as acceptable, while 4.2% and 2.8% considered the treatment had failed at 3 and 12 months, respectively. The 3-month PASS/TF thresholds were 16/29 (work impairment), 26/50 (activity impairment), 0.92/0.77 (hypothetical EQ-5D-5L), and 0.87/0.77 (the experience-based EQ-5D-5L). The thresholds at 12 months were generally comparable to those estimated at 3 months. There were baseline dependencies in PASS/TF thresholds with participants with more severe baseline pain considering poorer (more severe) level of WPAI/EQ-5D-5L as satisfactory.

    Conclusion: PASS and TF threshold values for WPAI and EQ-5D-5L might be useful for meaningful interpretation of these measures among people with OA. The observed baseline dependency of estimated thresholds limits their generalizability and values should be applied with great caution in other settings/populations.

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  • 13.
    Meili, Kaspar Walter
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Mulhern, Brendan
    Centre for Health Economics Research and Evaluation, University of Technology Sidney, Ultimo, Australia.
    Ssegonja, Richard
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Respiratory, Allergy and Sleep Medicine Research Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Norström, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Feldman, Inna
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Månsdotter, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Hjelte, Jan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Lindholm, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Eliciting a value set for the Swedish capability-adjusted life years instrument (CALY-SWE)2023Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Our aim was to elicit a value set for Capability-Adjusted Life Years Sweden (CALY-SWE); a capability-grounded quality of life instrument intended for use in economic evaluations of social interventions with broad consequences beyond health.

    Methods: Building on methods commonly used in the quality-adjusted life years EQ-5D context, we collected time-trade off (TTO) and discrete choice experiment (DCE) data through an online survey from a general population sample of 1697 Swedish participants. We assessed data quality using a score based on the severity of inconsistencies. For generating the value set, we compared different model features, including hybrid modeling of DCE and TTO versus TTO data only, censoring of TTO answers, varying intercept, and accommodating for heteroskedasticity. We also assessed the models’ DCE logit fidelity to measure agreement with potentially less-biased DCE data. To anchor the best capability state to 1 on the 0 to 1 scale, we included a multiplicative scaling factor.

    Results: We excluded 20% of the TTO answers of participants with the largest inconsistencies to improve data quality. A hybrid model with an anchor scale and censoring was chosen to generate the value set; models with heteroskedasticity considerations or individually varying intercepts did not offer substantial improvement. The lowest capability weight was 0.114. Health, social relations, and finance and housing attributes contributed the largest capability gains, followed by occupation, security, and political and civil rights.

    Conclusion: We elicited a value set for CALY-SWE for use in economic evaluations of interventions with broad social consequences.

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  • 14. Melder, Cecilia
    et al.
    Santamäki Fischer, Regina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Åbo Akademi University, Finland.
    Nygren, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Uppsala University.
    Validating WHOQOL-SRPB in Sweden: instrument adaption for measuring existential aspects of health-related quality of life [HRQL] in secular contexts2016Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 25, nr Suppl 1, s. 100-100, artikel-id 1056Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To present the validation process of WHOQOL-SRPB andWHOQOL-SRPB BREF in Sweden, one of the most secular countriesin the world though multi-religious, thus emphasising the need forprerequisite adjustments for cultural validation of the spirituality,religiousness and personal beliefs facets [SRPB].

    Methods: Theprocess adopted here follows WHO guidelines for translation andadaptation of instruments: Forward and Back translation, Pre-testing,Cognitive Interviewing, and Final version. Four bilingually and biculturally experienced researchers worked in two groups, comprisingexperience of either the Swedish translation of WHOQOL-100, -Brefand -OLD, or research into existential public health. Based on initialindependent translations from each, a final version was then developed through consensus translation, which was then back-translated.A pre-testing phase was conducted with individuals representingdifferent religious and non-religious worldviews. The final Swedishversion was completed by 170 persons, aging between 21 and 89(m = 46.6), with 105 women, and comprising both ‘‘healthy’’ individuals and individuals with mental health or somatic issues.

    Results:It was found that the instruction and particularly SRPB items thatused religious terminology needed adjustment. For example, ‘‘Spiritual being’’ was replaced with ‘‘Spiritual dimension’’, ‘‘Belief’’ with‘‘Your belief/idea’’, and ‘‘higher and more powerful’’ (instructiontext) was translated to ‘‘force/power/dimension’’. The pre- test resultswere useful in this process, especially qualitative information fromindividuals representing secular existential worldviews includingdifferent philosophical and political traditions. The internal consistency reliability of the overall SRPB-module was high (alpha = .97)as well as for the 8 facets (alpha ranging .80–.97). Test- retest(n = 19) showed r = .83 (p\.01). There were strong correlationsbetween all facets, the overall SRPB-module, and the overall qualityof life general health perceptions. No difference was found betweenwomen and men in the overall SRPB-module but in the ‘‘Connect’’facet, women scored higher (p = .02) whereas in ‘‘Peace’’ menscored higher (p = .04).

    Conclusions: The significance found throughusing existing translation/adaption guidelines, confirms that not onlyis it possible, but also relevant to include culturally validated existential aspects in studies of HRQL even in contexts that are largelysecular.

  • 15.
    Möllestam, Kamelia
    et al.
    Department of Clinical Sciences Lund - Orthopedics, Lund University, Lund, Sweden; Department of Orthopedics, Hässleholm-Kristianstad Hospitals, Hässleholm, Sweden.
    Rosales, Roberto S.
    Hand Surgery and Microsurgery Unit, GECOT, La Laguna, Tenerife, Spain.
    Lyrén, Per-Erik
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för tillämpad utbildningsvetenskap, Beteendevetenskapliga mätningar (BVM).
    Atroshi, Isam
    Department of Clinical Sciences Lund - Orthopedics, Lund University, Lund, Sweden; Department of Orthopedics, Hässleholm-Kristianstad Hospitals, Hässleholm, Sweden.
    Measuring symptoms severity in carpal tunnel syndrome: score agreement and responsiveness of the Atroshi-Lyrén 6-item symptoms scale and the Boston symptom severity scale2022Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 31, nr 5, s. 1553-1560Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To assess score agreement between the Atroshi-Lyrén 6-item symptoms scale and the Boston 11-item symptom severity scale and compare their responsiveness in patients with carpal tunnel syndrome before and after carpal tunnel release surgery.

    Methods: This prospective cohort study included 3 cohorts that completed the A-L and Boston scales (conventional score 1–5) on the same occasion: a preoperative and short-term postoperative cohort (212 patients), a mid-term postoperative cohort (101 patients), and a long-term postoperative cohort (124 patients). Agreement was assessed with Lin’s concordance correlation coefficient and Passing-Bablok regression analysis. Analyses using item response theory were conducted on responses from the preoperative/short-term postoperative cohort including testing of item infit/outfit. Reliability was assessed with Cronbach alpha. Overall and sex-specific effect sizes were calculated using Cohen’s d.

    Results: Lin’s CCCs were high (0.81–0.91). Passing-Bablok analysis showed constant and proportional differences in all cohorts except preoperative to short-term postoperative change. Both scales showed high reliability (alpha, 0.88–0.93). The IRT-based analyses showed infit/outfit values within the desired range. With IRT-based scoring, the A-L scale had significantly higher responsiveness than the Boston scale, overall (d, 2.02 vs 1.59), in women (d, 2.22 vs 1.77) and in men (d, 1.74 vs 1.36).

    Conclusion: The Atroshi-Lyrén 6-item symptoms scale and the Boston 11-item symptom severity scale show good agreement but are not equivalent in measuring CTS-related symptoms severity. When using IRT-based scoring, the Atroshi-Lyrén scale demonstrated significantly higher responsiveness.

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  • 16. Ngan, Tran Thu
    et al.
    Quynh Mai, Vu
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.
    Minh, Hoang Van
    Donnelly, Michael
    O'Neill, Ciaran
    Health-related quality of life among breast cancer patients compared to cancer survivors and age-matched women in the general population in Vietnam2022Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 31, s. 777-787Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: This study compared the health-related quality of life (HRQoL) of breast cancer (BC) patients, survivors, and age-matched women from the general population in Vietnam to address the paucity of HRQoL research and contribute to the robust assessment of BC screening and care in Vietnam.

    Methods: The standardised EQ-5D-5L instrument was incorporated in an online survey and a hospital-based face-to-face survey, and together with data from the Vietnam EQ-5D-5L norms study. χ2 tests assessed EQ-5D health profile associations and a Tobit regression model investigated the association between overall health status (EQ-VAS/utility scores) and sociodemographic and clinical characteristics.

    Results: A total of 309 participants (107 patients undergoing treatment and 202 survivors who had completed treatment) provided usable responses. The dimensions that affected mostly the HRQoL of women with BC were pain/discomfort and anxiety/depression. Current patients and survivors differed significantly regarding HRQoL dimensions of mobility, self-care, usual activities, and anxiety/depression. Their health utilities were 0.74 and 0.84, respectively, compared with 0.91 for age-matched Vietnamese women in the general population (p < 0.001). Treatment status (survivor vs patient), younger age, higher monthly household income, and higher education levels were associated with higher health utility.

    Conclusions: The results point to unmet needs in mental health support and well-being and for attention to be given to the development of a biopsychosocial system of cancer diagnosis, treatment, and care. The results will also inform future assessments of the comparative value for money of interventions intended to impact on breast cancer in Vietnam.

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  • 17.
    Niklasson, Johan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Conradsson, Mia
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Hörnsten, Carl
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Nyqvist, Fredrica
    Umeå universitet, Samhällsvetenskapliga fakulteten, Centrum för befolkningsstudier (CBS).
    Padyab, Mojgan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Nygren, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Olofsson, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lövheim, Hugo
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Psychometric properties and feasibility of the Swedish version of the Philadelphia Geriatric Center Morale Scale2015Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 24, nr 11, s. 2795-2805Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: Morale is related to psychological well-being and quality of life in older people. The Philadelphia Geriatric Center Morale Scale (PGCMS) is widely used to assess morale. The purpose of this study was to evaluate the psychometric properties and feasibility of the Swedish version of the 17-item PGCMS among very old people.

    METHODS: The Umea 85+/GERDA study included Swedish-speaking people aged 85, 90 and 95 years and older, from Sweden and Finland. Participants were interviewed in their own homes using a predefined set of questions. In the main sample, 493 individuals answered all 17 PGCMS items (aged 89.0 +/- 4.3 years). Another 105 answered between 1 and 16 questions (aged 89.6 +/- 4.4 years). A convenience sample was also collected, and 54 individuals answered all 17 PGCMS items twice (aged 84.7 +/- 6.7 years). The same assessor restated the questions within 1 week.

    RESULTS: Cronbach's alpha was 0.74 among those who answered all 17 questions in the main sample. Confirmatory factor analysis was used to test the construct validity of the most widely used version of the PGCMS, with 17 items and three factors, and showed a generally good fit. Among those answering between 1 and 17 PGCMS questions, 92.6 % (554/598) answered 16 or 17. The convenience sample was used for intra-rater test-retesting, and the intraclass correlation coefficient (ICC) was 0.89. The least significant change between two assessments, with 95 % confidence interval, was 3.53 PGCMS points.

    CONCLUSION: The Swedish version of the PGCMS seems to have satisfactory psychometric properties and feasibility among very old people.

  • 18.
    Näsvall, Pia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi. Department of Surgery, Sunderby Hospital/Umeå University, 97180 Luleå, Sweden.
    Dahlstrand, Ursula
    Löwenmark, Thyra
    Rutegård, Jörgen
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Gunnarsson, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Strigård, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Quality of life in patients with a permanent stoma after rectal cancer surgery2017Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 26, nr 1, s. 55-64Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: Health-related quality of life (HRQoL) assessment is important in understanding the patient's perspective and for decision-making in health care. HRQoL is often impaired in patients with stoma. The aim was to evaluate HRQoL in rectal cancer patients with permanent stoma compared to patients without stoma.

    METHODS: 711 patients operated for rectal cancer with abdomino-perineal resection or Hartman's procedure and a control group (n = 275) operated with anterior resection were eligible. Four QoL questionnaires were sent by mail. Comparisons of mean values between groups were made by Student´s independent t test. Comparison was made to a Swedish background population.

    RESULTS: 336 patients with a stoma and 117 without stoma replied (453/986; 46 %). A bulging or a hernia around the stoma was present in 31.5 %. Operation due to parastomal hernia had been performed in 11.7 % in the stoma group. Mental health (p = 0.007), body image (p < 0.001), and physical (p = 0.016) and emotional function (p = 0.003) were inferior in patients with stoma. Fatigue (p = 0.019) and loss of appetite (p = 0.027) were also more prominent in the stoma group. Sexual function was impaired in the non-stoma group (p = 0.034). However in the stoma group, patients with a bulge/hernia had more sexual problems (p = 0.004). Pain was associated with bulge/hernia (p < 0.001) and fear for leakage decreased QoL (p < 0.001). HRQoL was impaired compared to the Swedish background population.

    CONCLUSION: Overall HRQoL in patients operated for rectal cancer with permanent stoma was inferior compared to patients without stoma. In the stoma group, a bulge or a hernia around the stoma further impaired HRQoL.

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  • 19. Orru, Kati
    et al.
    Orru, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Maasikmets, Marek
    Hendrikson, Reigo
    Ainsaar, Mare
    Well-being and environmental quality: Does pollution affect life satisfaction?2016Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 25, nr 3, s. 699-705Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: We aimed to explore the effect of ambient air pollution on individual persons' levels of subjective well-being. Our research question was: to what extent is an individual's life satisfaction shaped by exposure to PM10?

    METHODS: We used regression models to analyse data on subjective well-being indicators from the last two waves of the European social survey (ESS) and detailed information on local levels of the air pollutant PM10.

    RESULTS: An increase in PM10 annual concentrations by 1 μg/m(3) was associated with a significant reduction in life satisfaction of .017 points on the ESS 10-point life satisfaction scale.

    CONCLUSIONS: Our findings suggest that even in cases of relatively low levels of PM10 air pollution (mean annual concentration of 8.3 ± 3.9 μg/m(3)), in addition to the effects on physical health, exposure negatively affects subjective assessments of well-being.

  • 20. Packer, Tanya L.
    et al.
    Kephart, George
    Ghahari, Setareh
    Audulv, Åsa
    School of Occupational Therapy, Dalhousie University, Halifax, Canada; Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
    Versnel, Joan
    Warner, Grace
    The Patient Activation Measure: a validation study in a neurological population2015Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 24, nr 7, s. 1587-1596Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To assess the validity of the Patient Activation Measure (PAM13) of patient activation in persons with neurological conditions.

    METHODS: "The Everyday Experience of Living with and Managing a Neurological Condition" (The LINC study) surveyed 948 adults with neurological conditions residing in Canada in 2011 and 2012. Using data for 722 respondents who met coding requirements for the PAM-13, we examined the properties of the measure using principle components analysis, inter-item correlations and Cronbach's alpha to assess unidimensionality and internal consistency. Rasch modeling was used to assess item performance and scaling. Construct validity was assessed by calculating associations between the PAM and known correlates.

    RESULTS: PAM-13 provides a suitably reliable and valid instrument for research in patients with neurological conditions, but scaling problems may yield measurement error and biases for those with low levels of activation. This is of particular importance when used in clinical settings or for individual client care. Our study also suggests that measurement of activation may benefit from tailoring items and scaling to specific diagnostic groups such as people with neurological conditions, thus allowing the PAM-13 to recognize unique attributes and management challenges in those conditions.

    CONCLUSIONS: The PAM-13 is an internally reliable and valid tool for research purposes. The use of categorical activation "level" in clinical settings should be done with caution.

  • 21.
    Rosenblad, Andreas Karlsson
    et al.
    Regional Cancer Centre Stockholm-Gotland, Region Stockholm, Box 6909, Stockholm, Sweden; Department of Medical Sciences, Division of Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden.
    Sundqvist, Pernilla
    Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Westman, Bodil
    Regional Cancer Centre Stockholm-Gotland, Region Stockholm, Box 6909, Stockholm, Sweden; Department of Care Science, Sophiahemmet University, Stockholm, Sweden.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    A psychometric evaluation of the Functional assessment of cancer therapy—kidney symptom index (FKSI-19) among renal cell carcinoma patients suggesting an alternative two-factor structure2021Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 30, nr 9, s. 2663-2670Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To psychometrically evaluate the hypothesized four-factor structure of the 19-item Functional Assessment of Cancer Therapy—Kidney Symptom Index (FKSI-19) health-related quality of life (HRQoL) instrument in a sample of surgically treated renal cell carcinoma (RCC) patients and examine if an alternative factor structure with good psychometric properties may be derived from the available items.

    Methods: The model fit of the hypothesized four-factor structure was examined using confirmatory factor analysis on cohort data from 1731 individuals included in the National Swedish Kidney Cancer Register who had undergone surgery for RCC during the three years 2016–2018 and answered the FKSI-19 instrument within 6–12 months after surgery. Exploratory factor analysis was applied to the same dataset to derive a possible alternative factor solution.

    Results: The four-factor structure did not reach the thresholds for good model fit using the normed χ2-value or the Comparative Fit Index, although the Standardized Root Mean Square Residual and Root Mean Square Error of Approximation measures indicated good and acceptable model fits, respectively. An alternative 14-item trimmed FKSI version (FKSI-14) with a two-factor structure derived from the available FKSI-19 items was found to measure the same aspects of HRQoL as the full FKSI-19 instrument.

    Conclusion: The present study is the first to use psychometric methods for examining the factor structure of the FKSI-19 instrument. The hypothesized four-factor structure of FKSI-19 provided a barely acceptable model fit. The two-factor FKSI-14 structure may be used as an alternative or complement to the four-factor structure when interpreting the FKSI-19 instrument.

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  • 22. Sellberg, Fanny
    et al.
    Possmark, Sofie
    Willmer, Mikaela
    Tynelius, Per
    Persson, Margareta
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Berglind, Daniel
    Meeting physical activity recommendations is associated with health-related quality of life in women before and after Roux-en-Y gastric bypass surgery2019Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 28, nr 6, s. 1497-1507Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: Meeting physical activity (PA) recommendations is positively associated with health-related quality of life (HRQoL), but it is still unclear whether PA (specifically objectively measured) is associated with HRQoL in bariatric surgery candidates, both before and after surgery. Thus, the aim of this study was to examine the cross-sectional association between meeting objectively measured PA recommendations and HRQoL before and after Roux-en-Y gastric bypass (RYGB) surgery.

    METHODS: Sixty-six women undergoing RYGB with pre-surgery and 62 women with post-surgery valid PA and HRQoL data were included from the control group of a RCT study aiming at improving HRQoL and PA post-RYGB surgery. Measures before and 12 months after RYGB included the Short Form Health Survey (SF-36) and objectively measured PA, sedentary time (ST), and step counts with GT3X+ accelerometers. Multiple linear regression models were used to analyze the associations between PA and HRQoL.

    RESULTS: Participants who engaged in more than 150 min of moderate to vigorous PA (MVPA)/week (PA recommendations) had considerably higher SF-36 scores (HRQoL) than those who did not, both pre and 12-month post-surgery, with greatest difference in the subscale bodily pain, 15.5 (p = 0.021) higher score (higher scores means less pain) pre-surgery and a 19.7 (p = 0.004) higher score post-surgery. Higher LPA and step counts and lower ST also showed positive associations in some of the subscales of SF-36.

    CONCLUSIONS: Meeting the PA recommendations and overall engaging in more PA was associated with higher HRQoL, pre-, and post-RYGB surgery, highlighting the importance of PA both pre- and post-surgery.

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  • 23.
    Teni, Fitsum Sebsibe
    et al.
    Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Gerdtham, Ulf-G.
    Department of Economics, Lund University, Lund, Sweden; Health Economics Unit, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden.
    Leidl, Reiner
    Institute for Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Munich Center of Health Sciences, Ludwig-Maximilians University, Munich, Germany.
    Henriksson, Martin
    Center for Medical Technology Assessment, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Åström, Mimmi
    Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Equity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
    Sun, Sun
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Burström, Kristina
    Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Equity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
    Inequality and heterogeneity in health-related quality of life: findings based on a large sample of cross-sectional EQ-5D-5L data from the Swedish general population2022Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 31, nr 3, s. 697-712Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: This study aimed to investigate inequality and heterogeneity in health-related quality of life (HRQoL) and to provide EQ-5D-5L population reference data for Sweden.

    Methods: Based on a large Swedish population-based survey, 25,867 respondents aged 30‒104 years, HRQoL is described by sex, age, education, income, economic activity, health-related behaviours, self-reported diseases and conditions. Results are presented by EQ-5D-5L dimensions, respondents rating of their overall health on the EQ visual analogue scale (EQ VAS), VAS index value and TTO (time trade-off) index value allowing for calculation of quality-adjusted life years (QALYs). Ordinary Least Squares and multivariable logistic regression analyses were used to study inequalities in observed EQ VAS score between socioeconomic groups and the likelihood to report problems on the dimensions, respectively, adjusted for confounders.

    Results: In total, 896 different health states were reported; 24.1% did not report any problems. Most problems were reported with pain/discomfort. Women reported worse HRQoL than men, and health deteriorated with age. The strongest association between diseases and conditions and EQ VAS score was seen for depression and mental health problems. There was a socioeconomic gradient in HRQoL; adjusting for health-related behaviours, diseases and conditions slightly reduced the differences between educational groups and income groups, but socioeconomic inequalities largely remained.

    Conclusion: EQ-5D-5L population reference (norms) data are now available for Sweden, including socioeconomic differentials. Results may be used for comparisons with disease-specific populations and in health economic evaluations. The observed socioeconomic inequality in HRQoL should be of great importance for policy makers concerned with equity aspects.

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  • 24.
    Tietjen, Anna Katharina
    et al.
    University of Lübeck, Ratzeburger Allee 160, Lübeck, Germany.
    Ghandour, Rula
    Epidemiology Unit, Said Khoury Building for Development Studies, Institute of Community and Public Health, Birzeit University, P.O.Box 14, Birzeit, Palestine.
    Mikki, Nahed
    St. John Eye Hospital, Sheikh Jarrah, P.O.Box 19960, East Jerusalem, Palestine.
    Jerdén, Lars
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Eriksson, Jan W.
    Dept of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Norberg, Margareta
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Husseini, Abdullatif
    Epidemiology Unit, Said Khoury Building for Development Studies, Institute of Community and Public Health, Birzeit University, P.O.Box 14, Birzeit, Palestine.
    Quality of life of type 2 diabetes mellitus patients in Ramallah and al-Bireh Governorate–Palestine: a part of the Palestinian diabetes complications and control study (PDCCS)2021Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 30, nr 5, s. 1407-1416Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Type 2 diabetes mellitus (T2DM) is a considerable impact on physical health as well as on emotional and social wellbeing. This study aimed to investigate the quality of life and its associated factors among Palestinians with T2DM. Methods: A cross-sectional study including 517 patients (68% female) was conducted in eleven primary health care clinics located in Ramallah and al-Bireh governorate of the West Bank. To assess socio-demographic data, risk factors and diabetes control, interviews, physical examinations, anthropometric measurements, and blood and urine tests were performed. The validated Arabic version of the Audit of Diabetes-Dependent Quality of Life (ADDQoL) questionnaire was carried out on all patients to measure Quality of Life (QoL). A multivariable regression analysis was performed. Results: The average weighted impact (AWI) score was −3.38 (95% CI: −3.55 to −3.21, range: −9.00 to 0.12). This indicates that diabetes was perceived as having a considerable negative impact on the quality of life. The life domains 'freedom to eat', 'physical activities', and 'work-life' were the most negatively impacted. Males and individuals living with diabetes for a prolonged time were associated with a more significant negative impact on quality of life. Conclusion: The study showed that diabetes generally had a negative impact on QoL and identified the demand for diabetes management programs tailored to patient needs and different patient groups, as well as health policies that put patients in the center of diabetes care.

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  • 25. Tungu, Malale
    et al.
    Frumence, Gasto
    Mwangu, Mughwira
    Hurtig, Anna-Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Lindholm, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Can survey data facilitate local priority setting?: Experience from the Igunga and Nzega districts in Tanzania2020Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: This study aimed to investigate whether a local survey applying EQ-5D and SAGE could provide data valuable in setting priorities.

    Methodology: A cross-sectional household survey was used to collect information from a total of 1,899 elderly individuals aged 60 years and over living in the Nzega and Igunga districts using the WHO-SAGE and EQ-5D questionnaires. QALY weights were generated using the average of an EQ-5D index. A multivariable regression model was performed to analyse the effect of socioeconomic factors and self-rated health status on the EQ-5D index, using a linear regression model.

    Results: The confidence interval estimates indicate higher HRQoL among men, married, urban dwellers, and elderly rated with good health than in women, unmarried, rural dwellers, and elderly rated with bad/moderate health, and it decreases with age. Income and education level have a positive relationship with HRQoL. The regression analysis; Model 1 (not adjusted with SAGE variables): age in all groups (p = 0.01, 0.00 and 0.02) and marital status (p = 0.01) have an influence on HRQoL. Model 2 (adjusted with SAGE variables): self-rated health (p < 0.00), the age for the 80–89 group (p = 0.01), marital status (not married), and high income have an influence on HRQoL. Sex, education, and residence were not statistically significant (in either model) to affect the HRQoL of the elderly.

    Conclusion: Local surveys, applying a combination of EQ-5D and SAGE, generate relevant and valuable information for policy makers when setting priorities at the district level. Therefore, this paper provides an empirical analysis for decision makers to consider the importance of combining EQ-5D, SAGE, and socioeconomic factors when setting priorities to improve HRQoL among the elderly.

  • 26.
    Voormolen, Daphne C.
    et al.
    Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
    Polinder, Suzanne
    Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
    von Steinbuechel, Nicole
    Institute of Medical Psychology and Medical Sociology, Georg-August-University, Göttingen, Germany.
    Feng, Yan
    Centre for Primary Care and Public Health, Queen Mary University of London, London, UK.
    Wilson, Lindsay
    Department of Psychology, University of Stirling, Stirling, UK.
    Oppe, Mark
    Axentiva Solutions, C/Calvario, 271-B 1º IZQ, Tacoronte, Santa Cruz de Tenerife, Spain.
    Haagsma, Juanita A.
    Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
    Koskinen, Lars-Owe D. (Medarbetare/bidragsgivare)
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Neurovetenskaper.
    Sundström, Nina (Medarbetare/bidragsgivare)
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Neurovetenskaper.
    Health-related quality of life after traumatic brain injury: deriving value sets for the QOLIBRI-OS for Italy, The Netherlands and The United Kingdom2020Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 29, nr 11, s. 3095-3107Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The Quality of Life after Brain Injury overall scale (QOLIBRI-OS) measures health-related quality of life (HRQoL) after traumatic brain injury (TBI). The aim of this study was to derive value sets for the QOLIBRI-OS in three European countries, which will allow calculation of utility scores for TBI health states.

    Methods: A QOLIBRI-OS value set was derived by using discrete choice experiments (DCEs) and visual analogue scales (VAS) in general population samples from the Netherlands, United Kingdom and Italy. A three-stage procedure was used: (1) A selection of health states, covering the entire spectrum of severity, was defined; (2) General population samples performed the health state valuation task using a web-based survey with three VAS questions and an at random selection of sixteen DCEs; (3) DCEs were analysed using a conditional logistic regression and were then anchored on the VAS data. Utility scores for QOLIBRI-OS health states were generated resulting in estimates for all potential health states.

    Results: The questionnaire was completed by 13,623 respondents. The biggest weight increase for all attributes is seen from “slightly” to “not at all satisfied”, resulting in the largest impact on HRQoL. “Not at all satisfied with how brain is working” should receive the greatest weight in utility calculations in all three countries.

    Conclusion: By transforming the QOLIBRI-OS into utility scores, we enabled the application in economic evaluations and in summary measures of population health, which may be used to inform decision-makers on the best interventions and strategies for TBI patients.

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  • 27.
    Vu Quynh, Mai
    et al.
    Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.
    Sun, Sun
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Research group Health Outcomes and Economic Evaluation, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Minh, Hoang Van
    Hanoi University of Public Health, Hanoi, Vietnam.
    Luo, Nan
    Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
    Giang, Kim Bao
    Hanoi Medical University, Hanoi, Vietnam.
    Lindholm, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Sahlen, Klas-Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    An EQ-5D-5L value set for Vietnam2020Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 29, s. 1923-1933Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: The objective of this study was to develop an EQ-5D-5L value set based on the health preferences of the general adult population of Vietnam.

    METHODS: The EQ-VT protocol version 2.1 was applied. Multi-stage stratified cluster sampling was employed to recruit a nationally representative sample. Both composite time trade-off (C-TTO) and discrete choice experiment (DCE) methods were used. Several modelling approaches were considered including hybrid; tobit; panel and heteroscedastic models. First, models using C-TTO or DCE data were tested separately. Then possibility of combining the C-TTO and DCE data was examined. Hybrid models were tested if it was sensible to combine both types of data. The best-performing model was selected based on both the consistency of the results produced and the degree to which models used all the available data.

    RESULTS: Data from 1200 respondents representing the general Vietnamese adult population were included in the analyses. Only the DCE Logit model and the regular Hybrid model that uses all available data produced consistent results. As the priority was to use all available data if possible, the hybrid model was selected to generate the Vietnamese value set. Mobility had the largest effect on health state values, followed by pain/discomfort, usual activities, anxiety/depression and self-care. The Vietnam values ranged from - 0.5115 to 1.

    CONCLUSION: This is the first value set for EQ-5D-5L based on social preferences obtained from a nationally representative sample in Vietnam. The value set will likely play a key role in economic evaluations and health technology assessments in Vietnam.

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  • 28.
    Vu Thi Quynh, Mai
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.
    Giang, Kim Bao
    Hanoi Medical University, Hanoi, Sweden.
    Minh, Hoang Van
    Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam; National Institute of Health Sciences, Bach Mai Hospital (NIHS), Hanoi, Vietnam.
    Lindholm, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Sun, Sun
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Research Group Health Outcomes and Economic Evaluation, Department of Learning, Informatics, Management and Ethics, Karolinska Instiutet, Solna, Sweden.
    Sahlen, Klas-Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Reference data among general population and known-groups validity among hypertensive population of the EQ-5D-5L in Vietnam2022Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 31, s. 539-550Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: This study aims to provide EQ-5D-5L population norms among the general population in Vietnam and to test EQ-5D-5L’ construction validity among people living with hypertension there.

    Methods: Descriptive statistics of the five dimensions and five levels, EQ-VAS and EQ-5D-5L indexes were categorised into gender and age groups for the EQ-5D-5L population norms. Known-groups testing was set for lower EQ-5D-5L outcomes among people who were aware of their hypertensive status, females, people with more comorbidities, less education, older ages, and higher body mass indexes. Level of confident interval was 95%.

    Results: The mean EQ-VAS and EQ-5D-5L indexes were 81.10 (SD: 13.35) and 0.94 (SD: 0.09) among the general population. The EQ-5D-5L outcomes were better among younger people, males, people with more education, employees, and single people. Respondents reported fewer problems with self-care and usual activities and tend to have problems at higher levels across older ages. The known-group testing showed statistically significant results. The mean EQ-VAS and EQ-5D-5L indexes of people in the diagnosed hypertensive group (71.48 and 0.94, respectively) were statistically significantly smaller than they were in the non-hypertensive and undiagnosed hypertensive group (76.65 and 0.97; 76.95 and 0.96 accordingly). Statistically significant associations of lower EQ-5D-5L indexes and EQ-VAS were found among people diagnosed for hypertension, people suffering from an incremental comorbidity, and obese people.

    Conclusion: This study has provided EQ-5D-5L population norms for the general population and evidence for known-groups validity of the EQ-5D-5L instrument among hypertensive people in Vietnam.

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