Yifan Ding’s research while affiliated with Erasmus University Rotterdam and other places

Background The escalating globalization of health assessments underscores a pivotal challenge: Do Quality of Life (QoL) instruments, developed primarily in Western contexts, accurately reflect the perspectives of non-Western populations? This study evaluates the alignment of EQ-5D and EQ-HWB items with QoL dimensions identified in Chinese literature, and compares QoL perceptions between Chinese residents and those living abroad who may be influenced by Western values. Methods This study employed three successive rounds of participant recruitment to refine the concept mapping process. Initially, 13 bilingual QoL experts in the Netherlands piloted the methodology, providing feedback on item translation and expression. Subsequently, 18 Chinese expatriates in the Netherlands, with partial education abroad, reviewed the revised materials to represent perspectives influenced by Western culture. Finally, 20 native Chinese residents, who were born and educated in China, formed the target group. Utilizing feedback from the pilot stage, a pool of 54 QoL items derived from Chinese literature, plus an additional eight from the EQ-HWB, were assembled. The Group Concept Mapping (GCM) method was used, with participants organizing the items to reflect their interrelationships. Data were analyzed via Groupwisdom™, an online tool supporting multidimensional scaling (MDS) and cluster analysis, culminating in visual cluster rating maps that highlighted the item associations and groupings. Results In China, a five-cluster MDS map was identified: personal abilities, family and society, physical health, mental health, and self-cognition (stress value: 0.183), with physical health prioritized. Abroad, four clusters appeared: mental health, social connections, daily activities, and physical function (stress value: 0.185), prioritizing social connections. The EQ-5D missed the "family and society" cluster in China and "social connections" abroad. In contrast, the EQ-HWB covered all clusters in both groups. Conclusions The EQ-5D items align well with the somatic and partially with the mental clusters, while the EQ-HWB also covers the adaptation cluster and the remaining mental cluster aspects. Both instruments reflect the QoL perceptions of Chinese individuals, although EQ-5D focuses more on health than overall well-being. Cultural differences affect priorities: participants in China value physical health most, whereas those abroad emphasize social connections.

Purpose Health-related quality of life (HRQoL) is key for assessing healthcare outcomes in children and adolescents. The EQ-5D-Y-3 L, adapted from the adult version, is widely used to measure HRQoL among 8–18 year-olds. Despite its effectiveness, concerns about its content validity persist, particularly in Chinese populations. This study evaluates the EQ-5D-Y’s content validity in China, focusing on the comprehensiveness, relevance, and comprehensibility of its dimensions among both healthy and diseased children. Methods A qualitative study was conducted with 30 participants (15 healthy, 15 diseased) aged 8–18 in Shanghai, China. The interviews explored participants’ perspectives on the EQ-5D-Y’s five dimensions, guided by the World Health Organization’s (WHO) definition of health. Data were analyzed using a framework approach, with response challenges identified through an adapted model of response issues. Results A total of 126 codes were generated, with 87 retained and categorized into three themes: physical (n = 16), mental (n = 30), and social health (n = 4). While responses reflected all five EQ-5D-Y dimensions, social health was notably mentioned as crucial but was absent in the EQ-5D-Y. Participants suggested enhancements in mental health coverage and more specific examples for the current dimensions. Conclusion The EQ-5D-Y is relevant for assessing HRQoL in Chinese children and adolescents but requires improvements, especially in incorporating social health. Enhancing question clarity and specificity could also improve its effectiveness. These findings guide potential refinements to better capture the health experiences of children.

Purpose This systematic review aims to explore the conceptualization of health-related quality of life (HRQoL) in China. With HRQoL influenced by both modern medicine (MM) and traditional Chinese medicine (TCM), the study seeks to identify differences and common ground between the frameworks of MM and TCM as defined in the literature. Method A systematic literature search was conducted across three Chinese databases and four English databases. The data was extracted including title, author(s), publication year, region, aim, method, category, and result. When sorting data, we broke down the HRQoL frameworks into concepts, domains and facets, with a focus on overlapped facets between the frameworks of MM and TCM. Results A total of 31 studies were included. In the perspective of TCM, HRQoL is centered around three key 'concepts': (1) 'xingshentongyi' (unity of body and spirit), (2) 'tianrenheyi' (harmony between man and nature), and (3) 'qiqing' (seven emotional forms). In contrast, the MM framework comprises 'physical,' 'mental,' 'social,' and 'environment' domains. Out of the 59 unique facets identified, 28 are common to both TCM and MM, 9 specific to TCM, and 22 specific to MM. 'Appetite,' 'sleep,' and 'energy' are the most frequently mentioned facets in both frameworks. Conclusion The concept of HRQoL in China encompasses frameworks rooted in both TCM and MM. While TCM and MM have distinct healthcare approaches, they share overlapping domains when measuring HRQoL through questionnaires. Furthermore, TCM and MM demonstrate considerable convergence in terms of HRQoL facets, showing the potential for utilizing HRQoL instruments across different cultural settings.