A Qualitative Study on Respondents’ Interpretation of the EQ-VAS in Ethiopia

OBJECTIVES: To explore how the general public and people with physical and/or mental health problems use and interpret the EQ-VAS in Ethiopia.

METHODS:

In-depth interviews were conducted with general public and individuals with mental health conditions (anxiety and/or depression) or physical health conditions (heart failure and/or hypertension). The interviews, carried out in public settings and hospitals in Ethiopia, were transcribed in Amharic and analysed using NVivo. Content analysis was conducted for each participant group separately, with comparisons made using cross-case analysis.

RESULTS:

The study involved 15 participants from the general public and 30 from a hospital setting. Findings were categorised into four codes, exploring views towards (1) ease of completion, (2) interpretation of health, (3) representation of a meaningful change on the 0-100 scale, and (4) best/worst imaginable health states. The majority of the general public found completing the EQ-VAS challenging due to lack of explanations for the scale’s numbers, which was less not observed in participants with a health condition. General public often used past health as a benchmark and referred to past health conditions, while those with physical or mental health problems focused on their current health and use of medication. Respondents suggested using 5- or 10-point hash marks over the current 1-point, reflecting respondents’ interpretation of a meaningful change on the EQ-VAS. Different interpretations for the best/worst imaginable health states were noted between the general public and individuals with a health condition. Achieving the best health state was considered unattainable by a few participants, with death infrequently mentioned as worst imaginable health state.

CONCLUSIONS:

This study provided further evidence related to the interpretation of the EQ-VAS and underscores the necessity for explanations of numbers. Further quantitative research is needed to examine what denotes a meaningful change on EQ-VAS across different disease areas.