Quality of life in a broader perspective: Does ASCOT reflect the capability approach?

Loon, Miriam S. van; Leeuwen, Karen M van; Ostelo, R. W. J. G.; Bosmans, Judith E.; Widdershoven, Guy

doi:10.1007/s11136-017-1756-5

Cited by 14 publications

(7 citation statements)

References 42 publications

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“…The AQoL-8D is an Australian-based PBM [15,56], which was included as it has a strong focus on psychosocial domains. The ICECAP-O [19] and ASCOT [20] were included given that their focus on social care and capabilities is relevant to elderly populations [57,58]. DEMQOL-U [26,59] and AD-5D [28,29] were considered because of their focus on dementia-specific issues.…”

Section: Methodsmentioning

confidence: 99%

A qualitative exploration of the content and face validity of preference-based measures within the context of dementia

Engel

Bucholc

Mihalopoulos

et al. 2020

Health Qual Life Outcomes

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Background Assessing the cost-effectiveness of interventions for people with dementia, based on cost per quality-adjusted life years (QALYs) gained, requires that the measures used to derive QALYs are preference-based whilst also being valid, feasible to use, comprehensible and acceptable for people with dementia. The aim of this study was to assess the content and face validity of six preference-based measures (PBMs) within the context of dementia. Methods Qualitative focus groups and interviews were conducted with community-dwelling individuals with mild dementia and carers of people with dementia. After exploring participants’ understanding of ‘quality of life’ (QoL), six PBMs were assessed for content and face validity: two measures assessing health-related QoL (EQ-5D-5L and AQoL-8D); two covering broader aspects of capability wellbeing and social care-related QoL (ICECAP-O and ASCOT); and two dementia-specific QoL measures (DEMQOL-U and AD-5D). A random mix of one health-related QoL measure, one wellbeing measure, and one dementia-specific measure was explored in each session. All sessions were audiotaped and transcribed verbatim. Data were analysed thematically. Results Nine individuals with mild dementia and 17 carers of people with dementia participated across 4 focus groups and 10 interviews. Participants perceived 9 broad QoL domains as relevant to them: Activity, Autonomy, Cognition, Communication, Coping, Emotions, End-of-Life, Physical Functioning, and Relationships. These domains had limited overlap with the content of the six PBMs. Assessment of face validity was summarized into eight themes: (1) ambiguous questions, (2) double –barrelled questions, (3) difficult/abstract questions, (4) judgemental/confronting questions, (5) lack of relevance and comprehensiveness, (6) response options, (7) layout/format and (8) proxy-response. There was no clear preference for one of the six measures explored; participants identified advantages and disadvantages across all measures. Although particularly designed for individuals with dementia, dementia-specific QoL measures were not always favoured over non-specific measures. Conclusion Given the shortcomings of PBMs identified in this study, further empirical comparative analyses are necessary to guide the selection of PBMs for future dementia research.

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Section: Methodsmentioning

confidence: 99%

A qualitative exploration of the content and face validity of preference-based measures within the context of dementia

Engel

Bucholc

Mihalopoulos

et al. 2020

Health Qual Life Outcomes

View full text Add to dashboard Cite

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“…As an alternative measure, it might be interesting for future studies to use a cancer-specific, or even palliative cancer-specific utility instrument alongside the EQ-5D to investigate the cost-utility of supportive care interventions among incurably ill cancer patients [ 33 ]. In addition, it might be worthwhile to measure HRQOL from a broader perspective than just the ‘health perspective’; for example by using the Adult Social Care Outcomes Toolkit (ASCOT) [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Cost-Utility of the eHealth Application ‘Oncokompas’, Supporting Incurably Ill Cancer Patients to Self-Manage Their Cancer-Related Symptoms: Results of a Randomized Controlled Trial

et al. 2022

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Evidence on the cost-effectiveness of eHealth in palliative care is scarce. Oncokompas, a fully automated behavioral intervention technology, aims to support self-management in cancer patients. This study aimed to assess the cost-utility of the eHealth application Oncokompas among incurably ill cancer patients, compared to care as usual. In this randomized controlled trial, patients were randomized into the intervention group (access to Oncokompas) or the waiting-list control group (access after three months). Healthcare costs, productivity losses, and health status were measured at baseline and three months. Intervention costs were also taken into account. Non-parametric bootstrapping with 5000 replications was used to obtain 95% confidence intervals around the incremental costs and quality-adjusted life years (QALYs). A probabilistic approach was used because of the skewness of cost data. Altogether, 138 patients completed the baseline questionnaire and were randomly assigned to the intervention group (69) or the control group (69). In the base case analysis, mean total costs and mean total effects were non-significantly lower in the intervention group (−€806 and −0.01 QALYs). The probability that the intervention was more effective and less costly was 4%, whereas the probability of being less effective and less costly was 74%. Among patients with incurable cancer, Oncokompas does not impact incremental costs and seems slightly less effective in terms of QALYs, compared to care as usual. Future research on the costs of eHealth in palliative cancer care is warranted to assess the generalizability of the findings of this study.

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“…In this way, the CA can help to understand what really matters to older adults who receive care. A previous study showed that the ASCOT can be regarded as an operationalization of the CA (Van Loon, Van Leeuwen, Ostelo, Bosmans, & Widdershoven, 2018). The answer options in the additional domains of the EQLT are also in line with the CA, as they are operationalized as functionings.…”

Section: Discussionmentioning

confidence: 99%

‘Implementing a broad quality of life tool for determining care wishes and needs of older adults living at home

Loon

Widdershoven

Leeuwen³

et al. 2021

Home Health Care Services Quarterly

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The aim was to investigate the views of stakeholders on the practical relevance of a broad quality of life (QoL) outcome tool for care in older adults: the Extended Quality of Life Tool (EQLT). We conducted individual interviews and focus groups with a variety of stakeholders involved in the care for older adults which were analyzed using a framework analysis. Stakeholders considered relevant: focus on the client perspective; perspective on QoL broader than health; the possibility to take diversity into account; and the possibility to determine a minimum level of QoL. Three facilitators for implementation of the tool were mentioned as well as four barriers. The EQLT can support conversations with clients about their needs and wishes, thus enabling decisions about care services based on a broad set of domains of QoL. Implementation of the tool should take into account the facilitators and barriers identified in the current study.

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Quality of life in a broader perspective: Does ASCOT reflect the capability approach?

Cited by 14 publications

References 42 publications

A qualitative exploration of the content and face validity of preference-based measures within the context of dementia

A qualitative exploration of the content and face validity of preference-based measures within the context of dementia

Cost-Utility of the eHealth Application ‘Oncokompas’, Supporting Incurably Ill Cancer Patients to Self-Manage Their Cancer-Related Symptoms: Results of a Randomized Controlled Trial

‘Implementing a broad quality of life tool for determining care wishes and needs of older adults living at home

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