Face Validity of Four Preference-Weighted Quality-of-Life Measures in Residential Aged Care: A Think-Aloud Study

Lidia Engel (), Leona Kosowicz, Ekaterina Bogatyreva, Frances Batchelor, Nancy Devlin, Briony Dow, Andrew S. Gilbert, Brendan Mulhern, Tessa Peasgood and Rosalie Viney
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Lidia Engel: Monash University
Leona Kosowicz: National Ageing Research Institute
Ekaterina Bogatyreva: Monash University
Frances Batchelor: National Ageing Research Institute
Nancy Devlin: The University of Melbourne
Briony Dow: National Ageing Research Institute
Andrew S. Gilbert: National Ageing Research Institute
Brendan Mulhern: University of Technology Sydney
Tessa Peasgood: The University of Melbourne
Rosalie Viney: University of Technology Sydney

The Patient: Patient-Centered Outcomes Research, 2023, vol. 16, issue 6, No 7, 655-666

Abstract: Abstract Objective There is an increased use of preference-weighted quality-of-life measures in residential aged care to guide resource allocation decisions or for quality-of-care assessments. However, little is known about their face validity (i.e., how understandable, appropriate and relevant the measures are ‘on their face’ when respondents complete them). The aim of this study was to assess the face validity of four preference-weighted measures (i.e., EQ-5D-5L, EQ-HWB, ASCOT, QOL-ACC) in older people living in residential aged care. Methods Qualitative cognitive think-aloud interviews were conducted using both concurrent and retrospective think-aloud techniques. To reduce burden, each resident completed two measures, with the four measures randomised across participants. Audio recordings were transcribed and framework analysis was used for data analysis, based on an existing framework derived from the Tourangeau four-stage response model. Results In total, 24 interviews were conducted with residents living across three residential aged care facilities in Melbourne, Australia. Response issues were identified across all four measures, often related to comprehension and difficulty selecting a response level due to double-barrelled and ambiguous items that have different meanings in the residential aged care context. We also identified issues related to understanding instructions, non-adherence to the recall period, and noted positive responding that requires attention when interpreting the data. Conclusions Our findings provide further evidence on the appropriateness of existing measures, indicating numerous response issues that require further research to guide the selection process for research and practice.

Date: 2023
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DOI: 10.1007/s40271-023-00647-6

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