Are Asians comfortable with discussing death in health valuation studies? A study in multi-ethnic Singapore


Wee, HL; LI, SC; Xie, F; Zhang, XH; Luo, N; Cheung, YB; Machin, D; Fong, KY; Thumboo, J; (2006) Are Asians comfortable with discussing death in health valuation studies? A study in multi-ethnic Singapore. Health and Quality of Life Outcomes, 4. ISSN 1477-7525 DOI: https://doi.org/10.1186/1477-7525-4-93

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Abstract

Background: To characterize ease in discussing death (EID) and its influence on health valuation in a multi-ethnic Asian population and to determine the acceptability of various descriptors of death and "pits"/"all-worst" in health valuation. Methods: In-depth interviews ( English or mother-tongue) among adult Chinese, Malay and Indian Singaporeans selected to represent both genders and a wide range of ages/educational levels. Subjects rated using 0 - 10 visual analogue scales ( VAS): ( 1) EID, ( 2) acceptability of 8 descriptors for death, and ( 3) appropriateness of "pits" and "all-worst" as descriptors for the worst possible health state. Subjects also valued 3 health states using VAS followed by time trade-off (TTO). The influence of sociocultural variables on EID and these descriptors was studied using univariable analyses and multiple linear regression ( MLR). The influence of EID on VAS/TTO utilities with adjustment for sociocultural variables was assessed using MLR. Results: Subjects (n = 63, 35% Chinese, 32% Malay, median age 44 years) were generally comfortable with discussing death ( median EID: 8.0). Only education significantly influenced EID ( p = 0.045). EID correlated weakly with VAS/TTO scores ( range: VAS: - 0.23 to 0.07; TTO: - 0.14 to 0.11). All subjects felt "passed away", " departed" and "deceased" were most acceptable ( median acceptability: 8.0) while " sudden death" and " immediate death" were least acceptable ( median acceptability: 5.0). Subjects clearly preferred " all-worst" to "pits" (63% vs. 19%, p < 0.001). Conclusion: Singaporeans were generally comfortable with discussing death and had clear preferences for several descriptors of death and for " all-worst". EID is unlikely to influence health preference measurement in health valuation studies.

Item Type: Article
Keywords: VISUAL ANALOG SCALE, QUALITY-OF-LIFE, STATE VALUATIONS, QUESTIONNAIRE, RELIABILITY, UTILITIES, EUROQOL
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Tropical Epidemiology Group
PubMed ID: 17147791
Web of Science ID: 242990100001
URI: http://researchonline.lshtm.ac.uk/id/eprint/10581

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