ArticleJournal of patient-reported outcomes2026
Face validity of the EQ health and wellbeing instrument (EQ-HWB) in Hong Kong.
Article in Journal of patient-reported outcomes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe EuroQol Health and Wellbeing (EQ-HWB™) measures quality-of-life (QoL) across healthcare and social care settings. Its framework integrates physical, social, and psychological domains, shaped by cultural influences. Despite global validation, evidence supporting its applicability in Asian contexts, particularly in Hong Kong, is limited. This study evaluated the face validity of the Traditional Chinese version of the EQ-HWB among Hong Kong adults, focusing on its conceptual adequacy and comprehensiveness in the local setting.
methodsA qualitative study was conducted between August 2023 and August 2024, 30 participants were recruited through quota sampling stratified by age, sex, and education levels. The sample included healthy individuals, those with chronic conditions, and informal caregivers. Cognitive debriefing interviews using the 'think-aloud' method assessed the comprehensibility, relevance, and appropriateness of the 25-item EQ-HWB. Thematic analysis focused on seven predetermined questions addressing clarity, conceptual meaning, and social desirability.
resultsMost EQ-HWB items were well-understood, though linguistic ambiguities (e.g., idioms like "exhausted") and overlapping concepts (e.g., "no support from others" vs. "accepted by others") posed challenges. Participants reported difficulties distinguishing response scales (e.g., "occasionally" vs. "sometimes") and suggested simplifying examples and refining scales. No social desirability bias was observed, with confidentiality highlighted as essential for honest responses.
conclusionThe EQ-HWB exhibits strong face validity in Hong Kong but requires cultural and linguistic adjustments to improve clarity. Recommendations include revising ambiguous phrasing, clarifying conceptually similar items, and optimizing response options. These refinements will enhance the tool's suitability for local economic evaluations and cross-sectoral wellbeing assessments.
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