Feasibility of self-reported health related quality of life assessment with older people in residential care: insights from the application of eye tracking technology

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Abstract

Purpose

Increasingly there are calls to routinely assess the health-related quality of life (HRQoL) of older people receiving aged care services, however the high prevalence of dementia and cognitive impairment remains a challenge to implementation. Eye-tracking technology facilitates detailed assessment of engagement and comprehension of visual stimuli, and may be useful in flagging individuals and populations who cannot reliably self-complete HRQoL instruments. The aim of this study was to apply eye-tracking technology to provide insights into self-reporting of HRQoL among older people in residential care with and without cognitive impairment.

Methods

Residents ( n = 41), recruited based on one of three cognition subgroups (no, mild, or moderate cognitive impairment), completed the EQ-5D-5L on a computer with eye tracking technology embedded. Number and length of fixations (i.e., eye gaze in seconds) for key components of the EQ-5D-5L descriptive system were calculated.

Results

For all dimensions, participants with no cognitive impairment fixated for longer on the Area of Interest (AOI) for the response option they finally chose, relative to those with mild or moderate cognitive impairment. Participants with cognitive impairment followed similar fixation patterns to those without. There was some evidence that participants with cognitive impairment took longer to complete and spent relatively less time attending to the relevant AOIs, but these differences did not reach statistical significance generally.

Conclusions

This exploratory study applying eye tracking technology provides novel insights and evidence of the feasibility of self-reported HRQoL assessments in older people in aged care settings where cognitive impairment and dementia are highly prevalent.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11136-023-03488-w.

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Most cited references 57

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Is Open Access

EQ-5D and the EuroQol Group: Past, Present and Future

Nancy J Devlin, Richard Brooks (2017)

Over the period 1987–1991 an inter-disciplinary five-country group developed the EuroQol instrument, a five-dimensional three-level generic measure subsequently termed the ‘EQ-5D’. It was designed to measure and value health status. The salient features of its development and its consolidation and expansion are discussed. Initial expansion came, in particular, in the form of new language versions. Their development raised translation and semantic issues, experience with which helped feed into the design of two further instruments, the EQ-5D-5L and the youth version EQ-5D-Y. The expanded usage across clinical programmes, disease and condition areas, population surveys, patient-reported outcomes, and value sets is outlined. Valuation has been of continued relevance for the Group as this has allowed its instruments to be utilised as part of the economic appraisal of health programmes and their incorporation into health technology assessments. The future of the Group is considered in the context of: (1) its scientific strategy, (2) changes in the external environment affecting the demand for EQ-5D, and (3) a variety of issues it is facing in the context of the design of the instrument, its use in health technology assessment, and potential new uses for EQ-5D outside of clinical trials and technology appraisal. Electronic supplementary material The online version of this article (doi:10.1007/s40258-017-0310-5) contains supplementary material, which is available to authorized users.

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Author and article information

Contributors

Rachel Milte:

ORCID: http://orcid.org/0000-0001-7533-6260

rachel.milte@flinders.edu.au

Journal

Journal ID (nlm-ta): Qual Life Res

Journal ID (iso-abbrev): Qual Life Res

Title: Quality of Life Research

Publisher: Springer International Publishing (Cham )

ISSN (Print): 0962-9343

ISSN (Electronic): 1573-2649

Publication date (Electronic): 20 July 2023

Publication date PMC-release: 20 July 2023

Publication date (Print): 2023

Volume: 32

Issue: 12

Pages: 3557-3569

Affiliations

[1 ]Caring Futures Institute, Flinders University, ( https://ror.org/01kpzv902) GPO Box 2100, Adelaide, SA 5001 Australia

[2 ]Centre for Health Economics Research and Evaluation, University of Technology Sydney, ( https://ror.org/03f0f6041) Ultimo, NSW Australia

[3 ]Curtin School of Population Health, Curtin University, ( https://ror.org/02n415q13) Bentley, WA Australia

Author information

Rachel Milte http://orcid.org/0000-0001-7533-6260

Article

Publisher ID: 3488

DOI: 10.1007/s11136-023-03488-w

PMC ID: 10624716

PubMed ID: 37474850

SO-VID: 31a82b35-f93b-4e8b-9f68-1f4c5e04170a

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date accepted : 12 July 2023

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100006419, EuroQol Research Foundation;

Award ID: 194-2020RA

Award Recipient : Julie Ratcliffe

Funded by: Flinders University

Open Access :

Open Access funding enabled and organized by CAUL and its Member Institutions

Custom metadata

ScienceOpen disciplines: Public health

Keywords: quality of life,eq-5d-5l,cognitive impairment,older adult,eye-tracking,feasibility

Data availability:

ScienceOpen disciplines: Public health

Keywords: quality of life, eq-5d-5l, cognitive impairment, older adult, eye-tracking, feasibility

Feasibility of self-reported health related quality of life assessment with older people in residential care: insights from the application of eye tracking technology

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Karger: Neurology and Neuroscience

Most cited references 57

The Mini-Mental State Examination: A Comprehensive Review

Response strategies for coping with the cognitive demands of attitude measures in surveys

EQ-5D and the EuroQol Group: Past, Present and Future

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