ORCID Profile
0000-0002-4720-5172
Current Organisations
The Hong Kong Polytechnic University
,
The Chinese University of Hong Kong
,
The University of Hong Kong
,
Anhui Medical University
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Publisher: Springer Science and Business Media LLC
Date: 27-01-2022
DOI: 10.1007/S00520-021-06762-0
Abstract: This study aimed to investigate the urban-rural differences in associations between financial toxicity (FT), physical health-related quality of life (HRQoL), negative emotional status, and the effect of patients' socioeconomic status and clinical and cost-related characteristics on the levels of FT in a s le of Chinese cancer survivors. Data were obtained from a cross-sectional survey conducted by the oncology department at two tertiary level hospitals in China. The COmprehensive Score for financial Toxicity, Euroqol five-level instrument (EQ-5D), and Depression Anxiety Stress Scale - 21 (DASS-21) were used to measure patients' FT, physical HRQoL, and negative emotional status. A latent class analysis was used to identify patient subgroups with distinct symptom experiences based on self-reported data on symptom occurrence using the EQ-5D and DASS-21. Four distinct latent classes were identified: all low (47.6%) high physical and low psych (18.6%) low physical and high psych (17.1%) and all high (17.1%). Rural patients younger than 50 years showed a statistically significantly higher FT than urban patients. Rural patients who were male, highly educated, insured, first hospitalization, new cases, received surgery or immunotherapy, and had low cancer-related costs in all low classes showed a higher FT than urban patients. Rural patients with cancer suffered from higher FT than their urban counterparts, and the negative impact of psychological distress on FT was higher than that of physical HRQoL.
Publisher: JMIR Publications Inc.
Date: 24-09-2021
DOI: 10.2196/26721
Abstract: Although previous studies have shown that a high level of health literacy can improve patients’ ability to engage in health-related shared decision-making (SDM) and improve their quality of life, few studies have investigated the role of eHealth literacy in improving patient satisfaction with SDM (SSDM) and well-being. This study aims to assess the relationship between patients’ eHealth literacy and their socioeconomic determinants and to investigate the association between patients’ eHealth literacy and their SSDM and well-being. The data used in this study were obtained from a multicenter cross-sectional survey in China. The eHealth Literacy Scale (eHEALS) and Investigating Choice Experiments Capability Measure for Adults were used to measure patients’ eHealth literacy and capability well-being, respectively. The SSDM was assessed by using a self-administered questionnaire. The Kruskal-Wallis one-way analysis of variance and Wilcoxon signed-rank test were used to compare the differences in the eHEALS, SSDM, and Investigating Choice Experiments Capability Measure for Adults scores of patients with varying background characteristics. Ordinary least square regression models were used to assess the relationship among eHealth literacy, SSDM, and well-being adjusted by patients’ background characteristics. A total of 569 patients completed the questionnaire. Patients who were male, were highly educated, were childless, were fully employed, were without chronic conditions, and indicated no depressive disorder reported a higher mean score on the eHEALS. Younger patients (SSDM≥61 years=88.6 vs SSDM16-30 years=84.2) tended to show higher SSDM. Patients who were rural residents and were well paid were more likely to report good capability well-being. Patients who had a higher SSDM and better capability well-being reported a significantly higher level of eHealth literacy than those who had lower SSDM and poorer capability well-being. The regression models showed a positive relationship between eHealth literacy and both SSDM (β=.22 P .001) and well-being (β=.26 P .001) after adjusting for patients’ demographic, socioeconomic status, lifestyle, and health status variables. This study showed that patients with a high level of eHealth literacy are more likely to experience optimal SDM and improved capability well-being. However, patients’ depressive status may alter the relationship between eHealth literacy and SSDM.
Publisher: Frontiers Media SA
Date: 03-12-2020
DOI: 10.3389/FPSYG.2020.583574
Abstract: The objective of this study was to evaluate the psychometric properties of the Chinese version of the decision regret scale (DRSc). The data of 704 patients who completed the DRSc were used for the analyses. We evaluated the construct, convergent/discriminant, and known-group validity internal consistency and test–retest reliability and the item invariance of the DRSc. A receiver operating characteristic (ROC) curve was employed to confirm the optimal cutoff point of the scale. A confirmatory factor analysis (CFA) indicated that a one-factor model fits the data. The internal consistency (α = 0.74) and test–retest reliability [intraclass correlation coefficient (ICC) = 0.71] of the DRSc were acceptable. The DRSc demonstrated unidimensionality and invariance for use across the sexes. It was confirmed that an optimal cutoff point of 25 could discriminate between patients with high and low decisional regret during clinical practice. The DRSc is a parsimonious instrument that can be used to measure the uncertainty inherent in medical decisions. It can be employed to provide knowledge, offer support, and elicit patient preferences in an attempt to promote shared decision-making.
Publisher: Springer Science and Business Media LLC
Date: 02-08-2021
Publisher: Springer Science and Business Media LLC
Date: 19-08-2022
DOI: 10.1038/S41598-022-18596-9
Abstract: This study aimed to examine the prevalence of unmet healthcare needs and clarify its impact on socioeconomic status (SES) and life satisfaction in a longitudinal cohort of the Chinese rural population. Data used in this study were obtained from a nationally representative s le of 1387 eligible rural residents from the Chinese Family Panel Studies. Generalized estimating equation (GEE) logistic regression models were used to examine the factors associated with unmet healthcare needs and the impact of unmet healthcare needs on respondents’ perceived SES and life satisfaction. Approximately 34.6% of respondents were male, 18.2% were ≤ 40 years, and 66.7% had completed primary education or below. Around 19% and 32.6% of in iduals who healthcare needs were met reported an above average socioeconomic status and life satisfaction, respectively in the baseline survey. GEE models demonstrated that unmet healthcare needs were significantly associated with low perceived SES (Odds ratio = 1.57, p 0.001) and life satisfaction (Odds ratio = 1.23, p = 0.03) adjusted by covariates. Respondents who were older, reported moderate or severe illness, and with chronic conditions were more likely to report the unmet healthcare needs.Unmet healthcare needs are longitudinally associated with low SES and life satisfaction among the Chinese rural population, the disparity in access to healthcare exists among this population.
Publisher: Wiley
Date: 06-10-2020
DOI: 10.1111/HEX.13140
Publisher: Frontiers Media SA
Date: 28-07-2021
DOI: 10.3389/FPSYG.2021.663035
Abstract: The primary objective was to translate the Recovering Quality of Life (ReQoL) measures from English to traditional Chinese and assess their psychometric properties in Hong Kong (HK) Chinese population. The secondary objective was to investigate the mental health-related quality of life (HRQoL) of this s le during the coronavirus disease 2019 (COVID-19) pandemic. Recovering Quality of Life was translated to Traditional Chinese adhering to standard guideline recommended by the official distributors. Five hundred members of the general population were successfully recruited to participate in a telephone-based survey. The following psychometric properties of the ReQoL were evaluated: construct, convergent, and known-group validity and internal consistency and test–retest reliability. The item measurement invariance was assessed on the basis of differential item functioning (DIF). Multiple regression analysis was used to assess the relationship between respondents’ characteristics and mental HRQoL. Results of confirmatory factor analysis (CFA) supported a two-factor structure of the ReQoL. The ReQoL showed significant correlations with the other mental health, quality of life, and well-being measures, which indicated a satisfactory convergent validity. Known-group validity confirmed that ReQoL is able to differentiate between people with different mental health status. The (Cronbach’s alpha = 0.91 and 0.76 for positive [PF] and negative [NF] factor), and McDonald’s omega of 0.89 (PF = 0.94, NF = 0.82) indicated the ReQoL has good reliability as well as test–retest reliability with an intraclass correlation coefficient of 0.75. Four items showed negligible DIF with respect to age. Respondents who were highly educated and without psychological problems reported a high ReQoL score. Traditional Chinese ReQoL was shown to be a valid and reliable instrument to assess the recovery-focused quality of life in HK general population. Future studies are needed to appraise its psychometric properties in local people experiencing mental disorders.
Publisher: Hindawi Limited
Date: 29-06-2022
DOI: 10.1155/2022/3511631
Abstract: Background. Social support is important for stroke rehabilitation. Conventionally, social support is evaluated from the level of support received. However, the bidirectional support hypothesis postulated that self-perceived social support is optimized if in iduals provide and receive social support in a balanced manner. The Brief 2-Way Social Support Scale (Brief 2-Way SSS) is a social support instrument measuring the reciprocity of receiving and giving emotional and instrumental social support. Objective. (1) To translate and culturally adapt the English version of the Brief 2-Way SSS into Chinese (Cantonese) (Brief 2-Way SSS-C), (2) to report the results of validation of the Brief 2-Way SSS-C, and (3) to investigate the level of social support in people with stroke in Hong Kong. Methods. The Brief 2-Way SSS-C was produced following the standard forward-backward translation model. People with stroke ( n = 109 ) and age-matched controls ( n = 53 ) were recruited through a university-affiliated neurorehabilitation laboratory. Results. The Brief 2-Way SSS-C demonstrated excellent content validity, acceptable to good internal consistency (Cronbach’s alpha of 0.74–0.88), and good test-retest reliability (intraclass correlation coefficient of 0.76–0.81). There were no ceiling or floor effects, and the MDC95 across all subscales was 4. The Brief 2-Way SSS-C subscales had significant correlations with various health-related outcome measures. People with stroke had a lower level of social support than the age-matched healthy controls. Conclusions. The Brief 2-Way SSS-C is a culturally relevant, reliable, and valid outcome measure for the level of social support in community-dwelling people with stroke.
Publisher: JMIR Publications Inc.
Date: 31-12-2020
Abstract: lthough previous studies have shown that a high level of health literacy can improve patients’ ability to engage in health-related shared decision-making (SDM) and improve their quality of life, few studies have investigated the role of eHealth literacy in improving patient satisfaction with SDM (SSDM) and well-being. his study aims to assess the relationship between patients’ eHealth literacy and their socioeconomic determinants and to investigate the association between patients’ eHealth literacy and their SSDM and well-being. he data used in this study were obtained from a multicenter cross-sectional survey in China. The eHealth Literacy Scale (eHEALS) and Investigating Choice Experiments Capability Measure for Adults were used to measure patients’ eHealth literacy and capability well-being, respectively. The SSDM was assessed by using a self-administered questionnaire. The Kruskal-Wallis one-way analysis of variance and Wilcoxon signed-rank test were used to compare the differences in the eHEALS, SSDM, and Investigating Choice Experiments Capability Measure for Adults scores of patients with varying background characteristics. Ordinary least square regression models were used to assess the relationship among eHealth literacy, SSDM, and well-being adjusted by patients’ background characteristics. total of 569 patients completed the questionnaire. Patients who were male, were highly educated, were childless, were fully employed, were without chronic conditions, and indicated no depressive disorder reported a higher mean score on the eHEALS. Younger patients (SSDM sub ≥61 years /sub =88.6 vs SSDM sub -30 years /sub =84.2) tended to show higher SSDM. Patients who were rural residents and were well paid were more likely to report good capability well-being. Patients who had a higher SSDM and better capability well-being reported a significantly higher level of eHealth literacy than those who had lower SSDM and poorer capability well-being. The regression models showed a positive relationship between eHealth literacy and both SSDM ( i β /i =.22 i P /i & .001) and well-being ( i β /i =.26 i P /i & .001) after adjusting for patients’ demographic, socioeconomic status, lifestyle, and health status variables. his study showed that patients with a high level of eHealth literacy are more likely to experience optimal SDM and improved capability well-being. However, patients’ depressive status may alter the relationship between eHealth literacy and SSDM. >
Publisher: Informa UK Limited
Date: 09-2017
DOI: 10.2147/PPA.S143944
Publisher: Oxford University Press (OUP)
Date: 12-2019
Abstract: The measurement of patients’ experience is an important performance indicator of health care service quality. A reliable and validated instrument to elicit patients’ experience is an important step. This study aimed to develop a generic instrument to elicit patients’ experience in specialist outpatient clinic provision with a rigorous and systematic methodology. The instrument framework was developed according to findings of a literature review, patient focus group discussions, in idual patient in-depth interviews and expert discussion. The framework was tested for psychometric performance with a cross-sectional telephone survey in terms of practicality, validity, reliability and responsiveness. 26 Public specialist outpatient clinics in Hong Kong were selected. Cantonese speaking patients aged 18 or above. Intervention(s): None. Main outcome measure(s): A validated generic patient experience questionnaire measuring Specialist Outpatient Service (SOPEQ). A proportional s le total of 513 patients from 26 specialist outpatient clinics were recruited, response rate of 56%. The findings indicated that the instrument is practicable and concise. A structure of nine dimensions with 47 items structure was confirmed based on exploratory factor analysis and content validity. These items showed satisfactory internal reliability consistency (α = 0.793) and test–retest reliability ranged from 0.618 to 0.829. The SOPEQ was established with satisfactory psychometric properties. A valid and reliable measure to evaluate patients’ experience is an important step in providing valuable input from patients’ perspective for policy makers to improve patient-centred services. It also serves as a platform to engage patients and thereby, in improving health care quality and enhancing health outcomes.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.JVAL.2019.02.014
Abstract: To establish a normative profile of health-related quality of life (HRQoL) for Hong Kong (HK) Chinese residents aged 18 years and above and to examine the relationship between socioeconomic characteristics and health conditions and the preference-based health index. We recruited 1014 representative Cantonese-speaking residents across 18 geographical districts. The normative profiles of HRQoL were derived using established HK value sets. Mean values were computed by sex, age group, and educational attainment to obtain the EQ-5D HK normative profile for the general HK population. To explore the relationships among potential covariates (socioeconomic characteristics and health conditions) and the HK health index, a multivariable homoscedastic Tobit regression model was employed for the analysis. The mean index value was 0.919 using the EQ-5D-5L HK value set. Younger ages reported greater problems with anxiety or depression than did older ages, whereas older ages reported greater problems with pain or discomfort than did younger ages. Persons with higher educational attainment and those who reported higher life satisfaction reported significantly higher health index scores (P < .05). On the contrary, receiving government allowance and having experienced a serious illness were significantly associated (P < .05) with a lower health index. The norm values fully represent the societal preferences of the HK population, and knowledge of societal preferences can enable policy makers to allocate resources and prioritize service planning. The study was conducted with the EuroQol International EQ-5D-5L Valuation Protocol and therefore enabled us to compare the EQ-5D-5L values with other countries to facilitate understanding of societal preferences in different jurisdictions.
Publisher: Springer Science and Business Media LLC
Date: 12-2020
DOI: 10.1186/S12909-020-02406-9
Abstract: The objective of this study was to ascertain the importance rankings of factors affecting the implementation of shared decision-making (SDM) in medical students in China and determine whether these factors were consistent across the respondents’ in idual characteristics. Students studying clinical medicine were recruited from three medical universities in China. A cross-sectional online survey using best-worst object scaling with a balanced incomplete block design was adopted to investigate their preference towards implementing SDM in China. Count analysis, multinomial logit analysis and mixed logit analysis were used to estimate the preference heterogeneity of the SDM factors among respondents. A total of 574 medical students completed the online survey. The three most important factors for implementing SDM were trust and respect, (providing) high-quality medical information and multi-disciplinary collaboration. The mixed logit regression model identified significant heterogeneity in SDM preferences among respondents, and sub-group analysis showed that some heterogeneities varied in respondents by sex, study programs and their experience of visiting doctors. The importance rankings provide rich information for implementing SDM and facilitate the reform of education in medical schools in China. However, the heterogeneities in SDM preference need further explorations.
Publisher: MDPI AG
Date: 11-11-2020
Abstract: Objective: This study aimed to assess the association of health-related quality of life (HRQoL) with financial burden among patients with non-Hodgkin’s lymphoma (NHL) in China. Methods: The data used for the analyses came from a nationwide survey to investigate the health status of patients with lymphomas in China. The EQ-5D and EORTC QLQ-C30 were used to assess the patients’ HRQoL. The financial burden was calculated using both subjective and objective methods. The chi-squared test, Kruskal–Wallis one-way analysis of variance, ordinal least squared model, and Tobit regression model were used to estimate the relationship between financial burden and HRQoL. Results: Data from 1549 patients who reported living with 11 subtypes of NHL were elicited for our analysis. Approximately 60% of respondents reported suffering moderate to high financial burdens. A significant relationship between increased financial burden and reduced HRQoL scores, including the EQ-Index, physical, emotional, and social functioning, was identified. Compared with using an objective method to measure financial burden, patients with NHL indicated a poorer HRQoL when using a subjective method to measure financial burden. Conclusion: Medical professionals should select highly cost-effective treatments and ensure that patients understand the potential financial consequences of those treatments.
Publisher: Frontiers Media SA
Date: 28-04-2020
Publisher: MDPI AG
Date: 23-10-2020
Abstract: Background: Generic health literacy measurement (GHLM) is an important tool to identify in iduals with limited health literacy and can assist the design of tailored interventions for improving public health literacy. However, there is no consensus on measuring generic health literacy. The present study aims to review current GHLM used for adults in the literature. Methods: A scoping review was undertaken to map the available measurements designed to assess generic health literacy. Results: The review identified 19 GHLM for adults. Most of them applied a multidimensional definition of health literacy with a focus on in iduals’ abilities to access, appraise, understand, and apply health information and services. Nutbeam’s conceptual model and Sørensen’s integrated model were widely used among the identified measures as the theoretical foundation. While the social determinants of health (SDH) were acknowledged in the two models, it remains unmentioned in many of the identified measures based on the Nutbeam’s model and needs further development in the measure based on the Sørensen’s model. A total of 39 different domains were assessed in the 19 measurements: prose was identified in 8 measurements and was the most prominent domain followed by numeracy (n = 7) and interactive (n = 7). SDH related domains such as social support (n = 3), social capital (n = 1) were seldom included in the identified measurements. Conclusions: Although current GHLM adopted a multidimensional construct, they mainly focused on in iduals’ abilities and SDH has not been well-developed in the assessment. Further research is required to advance the measuring of the interaction between SDH and health literacy.
Publisher: Informa UK Limited
Date: 03-2017
DOI: 10.2147/PPA.S126316
Publisher: Frontiers Media SA
Date: 06-12-2021
DOI: 10.3389/FPUBH.2021.757310
Abstract: Objective: This study aimed to investigate the importance of providing Internet-based healthcare services based on the preference of a s le of medical students in China. Methods: An online best-worst scaling (BWS) survey with Case 1 design was conducted. Balanced independent block design generated 12 choice task profiles for each participant to answer. Descriptive analysis was used to describe the respondents' characteristics Multinomial and mixed logit regression methods were used to investigate the importance of Internet-based services based on respondents' preferences. Results: A total of 1,296 students completed the online survey and rated “Clinical Service,” “Decision Aids,” and “Public health” as the three most important services that should be provided through an Internet-based healthcare system. Providing “Medical Education” via the Internet was chosen as the least important service by the respondents. Subgroup analysis indicated that students studying clinical medicine and non-clinical medicine considered providing “Medical Education” and “Public Health,” respectively, as more important services than others. Conclusions: This BWS study demonstrated that providing “Clinical Service,” “Decision Aids,” and “Public Health” through the Internet are the three most important services based on medical students' preferences in China. Further research is needed to investigate how to improve medical students' skills in using internet-based healthcare services in medical education programs.
Publisher: JMIR Publications Inc.
Date: 11-03-2020
Abstract: he rapid proliferation of web-based information on health and health care has profoundly changed in iduals’ health-seeking behaviors, with in iduals choosing the internet as their first source of information on their health conditions before seeking professional advice. However, barriers to the evaluation of people’s eHealth literacy present some difficulties for decision makers with respect to encouraging and empowering patients to use web-based resources. his study aims to examine the psychometric properties of a simplified Chinese version of the eHealth Literacy Scale (SC-eHEALS). ata used for analysis were obtained from a cross-sectional multicenter survey. Confirmatory factor analysis (CFA) was used to examine the structure of the SC-eHEALS. Correlations between the SC-eHEALS and ICEpop capability measure for adults (ICECAP-A) items and overall health status were estimated to assess the convergent validity. Internal consistency reliability was confirmed using Cronbach alpha (α), McDonald omega (ω), and split-half reliability (λ). A general partial credit model was used to perform the item response theory (IRT) analysis. Item difficulty, discrimination, and fit were reported. Item-category characteristic curves (ICCs) and item and test information curves were used to graphically assess the validity and reliability based on the IRT analysis. Differential item functioning (DIF) was used to check for possible item bias on gender and age. total of 574 respondents from 5 cities in China completed the SC-eHEALS. CFA confirmed that the one-factor model was acceptable. The internal consistency reliability was good, with α=0.96, ω=0.92, and λ=0.96. The item-total correlation coefficients ranged between 0.86 and 0.91. Items 8 and 4 showed the lowest and highest mean scores, respectively. The correlation coefficients between the SC-eHEALS and ICECAP-A items and overall health status were significant, but the strength was mild. The discrimination of SC-eHEALS items ranged between 2.63 and 5.42. ICCs indicated that the order of categories’ thresholds for all items was as expected. In total, 70% of the information provided by SC-eHEALS was below the average level of the latent trait. DIF was found for item 6 on age. he SC-eHEALS has been demonstrated to have good psychometric properties and can therefore be used to evaluate people’s eHealth literacy in China. >
Publisher: Springer Science and Business Media LLC
Date: 02-04-2020
Publisher: Springer Science and Business Media LLC
Date: 22-09-2020
Publisher: Frontiers Media SA
Date: 09-03-2022
DOI: 10.3389/FPSYT.2022.751412
Abstract: Depression is common among hospitalized patients and poses a significant threat to their quality of life. Patient engagement (PE) in healthcare has been shown to be associated with positive health outcomes. However, the relationship between PE and depression among hospitalized patients, with and without chronic conditions, has not yet been explored. This study aimed to investigate the association between patients' satisfaction with PE and self-reported depression in Chinese public hospitals. A multi-centered, cross-sectional survey was conducted in seven tertiary-level public hospitals in Guangdong province, China. Twelve items from a patient-centered care questionnaire and the Patient Health Questionnaire 2-item version were used were used to assess patients' satisfaction with PE and self-reported depression, respectively. Propensity score matching (PSM) approach was used to reduce selection bias and potential baseline differences between patients with and without chronic conditions. The relationship between satisfaction with PE and depression was assessed, using univariate and multivariate logistic regression analyses, respectively. A total of 1,974 hospitalized patients participated in the survey. After the PSM procedure, 604 patients were assigned to the chronic condition group, and another 604 patients were successfully matched in the comparison group with no differences in sex, age, educational level, and PE-related characteristics. Univariate logistic regression analysis indicated that high satisfaction with PE-related approaches significantly decreased the probability of developing depressive status. Multivariate logistic regression analysis further indicated that, after adjusting all PE-related approaches, “patient education” and “involvement in discharge planning” could significantly decrease the probability of patients developing depression. Our results indicate that encouraging PE and improving patients' satisfaction with PE interventions in clinical practice led to improved mental health outcomes among hospitalized patients in China.
Publisher: Public Library of Science (PLoS)
Date: 20-11-2019
Publisher: JMIR Publications Inc.
Date: 07-12-2020
DOI: 10.2196/18613
Abstract: The rapid proliferation of web-based information on health and health care has profoundly changed in iduals’ health-seeking behaviors, with in iduals choosing the internet as their first source of information on their health conditions before seeking professional advice. However, barriers to the evaluation of people’s eHealth literacy present some difficulties for decision makers with respect to encouraging and empowering patients to use web-based resources. This study aims to examine the psychometric properties of a simplified Chinese version of the eHealth Literacy Scale (SC-eHEALS). Data used for analysis were obtained from a cross-sectional multicenter survey. Confirmatory factor analysis (CFA) was used to examine the structure of the SC-eHEALS. Correlations between the SC-eHEALS and ICEpop capability measure for adults (ICECAP-A) items and overall health status were estimated to assess the convergent validity. Internal consistency reliability was confirmed using Cronbach alpha (α), McDonald omega (ω), and split-half reliability (λ). A general partial credit model was used to perform the item response theory (IRT) analysis. Item difficulty, discrimination, and fit were reported. Item-category characteristic curves (ICCs) and item and test information curves were used to graphically assess the validity and reliability based on the IRT analysis. Differential item functioning (DIF) was used to check for possible item bias on gender and age. A total of 574 respondents from 5 cities in China completed the SC-eHEALS. CFA confirmed that the one-factor model was acceptable. The internal consistency reliability was good, with α=0.96, ω=0.92, and λ=0.96. The item-total correlation coefficients ranged between 0.86 and 0.91. Items 8 and 4 showed the lowest and highest mean scores, respectively. The correlation coefficients between the SC-eHEALS and ICECAP-A items and overall health status were significant, but the strength was mild. The discrimination of SC-eHEALS items ranged between 2.63 and 5.42. ICCs indicated that the order of categories’ thresholds for all items was as expected. In total, 70% of the information provided by SC-eHEALS was below the average level of the latent trait. DIF was found for item 6 on age. The SC-eHEALS has been demonstrated to have good psychometric properties and can therefore be used to evaluate people’s eHealth literacy in China.
Publisher: Informa UK Limited
Date: 08-2019
DOI: 10.2147/PPA.S216891
Publisher: Wiley
Date: 08-11-2022
DOI: 10.1111/HEX.13651
Abstract: Health literacy (HL) refers to in iduals' abilities to process and use health information to promote health. This study aimed to develop the first HL measurement tool for the Chinese Hong Kong population. A two-phase methodology was adopted. In Phase I, evidence synthesis with a deductive method was conducted to formulate the item list from the literature. In Phase II, a modified e-Delphi survey was conducted among stakeholders (i.e., healthcare providers and healthcare consumers) to confirm the content validity of the item list. The stakeholders were invited to rate the relevance of each draft item on a 4-point scale and provide suggestions for revisions, removal or adding new items. In Phase I, a total of 34 items covering functional, interactive and critical HL were generated. In Phase II, to obtain a balanced view from experts and laypeople, healthcare professionals (n = 12) and consumers (n = 12) were invited to participate in the Delphi panel. The response rates of the three rounds were 100%. After the third round, the consensus was reached for 31 items, and no further comments for adding or revising items were received. All items exhibited excellent content validity (item content validity index: 0.79-1.00 K*: 0.74-1.00). A Health Literacy Scale for Hong Kong was developed. Compared with existing HL scales, the scale fully operationalized the skills involved in functional, interactive and critical HL. The Delphi study shows evidence supporting the high content validity of all items in the scale. In future studies, these items should undergo rigorous testing to examine their psychometric properties in our target population groups. By illuminating the details in the development process, this paper provides a deeper understanding of the scale's scope and limitations for others who are interested in using this tool. Public as healthcare consumers, in addition to healthcare providers, were involved in developing a new HL scale for this study. The input from the public contributed to examining the scale's content validity by judging whether all items reflected the skills that they need to find and use health-related information in their daily life.
Publisher: BMJ
Date: 09-2019
DOI: 10.1136/BMJOPEN-2019-032544
Abstract: To evaluate the effect of hypertension and related comorbidities on the health-related quality of life (HRQoL) using EuroQol 5-dimensions instrument with five-level scale (EQ-5D-5L) Hong Kong (HK) version. Data were analysed by a secondary data analysis based on a cross-sectional study assessing experience on public specialist outpatient service. A representative s le was recruited from 26 specialist outpatient clinics in HK. A total of 4528 patients with hypertension aged 18 or above who responded to the survey. EQ-5D-5L HK was applied to assess the HRQoL. The five-dimension descriptive system and the utility index of EQ-5D-5L were treated as the dependent variable in the current study. Regression modelling was applied to estimate the effect of hypertension and related comorbidities on health-related quality of life. More respondents were women (53.9%), aged ≥65 years old (60.1%), and with primary educational attainment or below (52.3%). A total of 1466 respondents (32.4%) also reported suffering from diabetes, heart disease (20.8%), vision problem (1.7%) and cancer (1.5%). In the ordinal least squares model, utility decreased most when patients reported having physical disability associated with hypertension (beta=−0.395, SE=0.047), and 0.128, 0.064, 0.05 and 0.048 for mental problem, cancer, vision problem and heart problem. In the Tobit model, the utility reduced most for comorbidity of physical disability, and then mental problem, cancer, vision problem, heart problem and diabetes. For first part of two-part model, respondents coliving with mental problem were 10% less likely to report a full health. For the second part of two-part model, the respondents with physical disability had 0.294 lower in utility. Respondents with hypertension reported a low EQ-5D utility score. Respondents were women, with a high education, fully employed and living with families reported better HRQoL. There is a significant effect of comorbidity influence on the decreased HRQoL, particularly those with physical disability and mental problem.
Publisher: Oxford University Press (OUP)
Date: 06-06-2017
Abstract: To elucidate the association between health-related quality of life and shared decision-making among patients in Hong Kong after adjustment for potential confounding variables. A telephone survey was conducted with patients attending all public specialist outpatient clinics in Hong Kong between July and December 2014. The Specialist Outpatient Patient Experience Questionnaire and EQ-5D questionnaire were used to evaluate shared decision-making and quality of life, respectively. We performed a Tobit regression analysis to examine the associations between shared decision-making and quality of life after adjustment for known social, economic and health-related factors. Twenty-six of the Hospital Authority's specialist outpatient clinics. Patients aged 18 years or older who attended one of the Hospital Authority's specialist outpatient clinics between July and November 2014. Shared decision-making and quality of life score. Overall, 13 966 patients completed the study. The group reporting partial involvement in decision-making had slightly higher EQ-5D scores than the 'not involved' group and the 'fully involved' group. EQ-5D scores were higher among subjects who were younger, male, and had a higher level of education. Respondents living alone and living in institutions scored lower on the EQ-5D than patients living with families. Important differences in the relationship between the attitudes towards shared decision-making and quality of life were identified among patients. These associations should be taken into consideration when promoting patient-centred care and improving health professional-patient communication.
Publisher: Springer Science and Business Media LLC
Date: 24-03-2021
Publisher: Springer Science and Business Media LLC
Date: 30-11-2021
DOI: 10.1007/S11136-021-03051-5
Abstract: This study's objective was to develop an algorithm that mapping the Haem-A-QoL scores to EQ-5D-5L utility scores in patients with hemophilia in China. A national s le of 862 patients with hemophilia completed both the EQ-5D-5L and Haem-A-QoL instruments. Eight regression models were selected to develop the mapping algorithm, they were: the ordinary least squares, general linear regression, Tobit regression, censored least absolute deviation, mixture beta regression, adjusted limited dependent variable mixture, the two-part, and robust MM-estimator model. Root mean squared error (RMSE), mean absolute error (MAE), and R-square (R Based on RMSE, MAE, and R Our mapping algorithm bolsters the calculation of QALYs while conducting an economic evaluation of hemophilia-related interventions when only Haem-A-QoL data are available. The external validity of the algorithm should be further assessed in the other populations.
Publisher: Springer Science and Business Media LLC
Date: 05-03-2020
DOI: 10.1007/S11136-020-02462-0
Abstract: This study aimed to estimate the health preference scores of the Chinese population with Diabetes Mellitus (DM) using the EQ-5D-5L Hong Kong (HK) population tariff according to different sociodemographic characteristics in HK. Data were obtained from a cross-sectional, territory-wide study of patient experience on specialist outpatient services in a public setting in HK. The EQ-5D-5L HK was used to collect the patients’ health status. A total of 2326 respondents were reported to suffer from DM, and their information was elicited and used for the analysis in this study. A robust ANOVA method was used to compare the differences in EQ-5D-5L index scores among subgroups. Binary logistic regressions were used to predict the probability of respondents reporting full health, and ordinal least square (OLS) model was used to assess the relationship between DM and health-related quality of life (HRQoL). The mean EQ-5D-5L index score for DM patients was 0.84. A total of 229 EQ-5D health states were reported. Altogether, 47.5% of the respondents reported having some problems with pain/discomfort, followed by mobility (26.4%), usual activities (26.0%), and anxiety/depression (23.5%). Logistic regression and OLS models indicated that male and fully employed respondents were less likely to report having problems with any of the five dimensions and index score of EQ-5D than female and non-fully employed respondents. The findings of OLS model also showed that DM patients that experience comorbidity with three and more chronic conditions were more likely to show a lower index score than respondents who reported living with DM alone. The EQ-5D index scores varied among DM patient characteristics and were more highly impaired with multimorbidity status. Interventions targeting at-risk subgroups, such as modifying single-diseased guidelines, might be helpful to improve their HRQoL.
Publisher: Informa UK Limited
Date: 09-2018
DOI: 10.2147/PPA.S171026
Publisher: BMJ
Date: 11-2020
DOI: 10.1136/BMJOPEN-2020-039397
Abstract: To estimate and report the minimally important difference (MID) of the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L) using the Hong Kong (HK) utility score among patients with either hypertension or diabetes or both. Data were analysed using secondary data analysis based on a cross-sectional study assessing patients’ experiences in HK. A representative s le was recruited from 26 specialist outpatient clinics in HK. We analysed data from 2231 and 662 patients who reported having hypertension or diabetes alone, respectively, and 874 patients had these two diseases. An instrument-defined approach was applied to estimate MID stratified according to sex and age for the three subpopulations. The overall MID (oMID) estimates were 0.089, 0.086 and 0.089 for patients with hypertension or diabetes alone and with these two diseases, respectively. The adjusted MID (aMID) estimate was smaller than the oMID, and the improved MID was larger than the deteriorated MID. Women had larger oMID but smaller aMID than men. Younger respondents had larger aMID than older respondents. Effect sizes ranged from 0.30 to 0.503, which fit our preset criteria. Four types of MID of the EQ-5D utility score for patients with hypertension or diabetes alone and with these two diseases were reported. Variations in the MID estimates should be further explored in other populations or using different statistical methods.
No related grants have been discovered for Richard Huan Xu.