Presentation (CTI)

OBJECTIVES: The distinction between subjective well-being (SWB) and health-related quality of life (HRQoL) remains conceptually ambiguous in the literature. While HRQoL predominantly focuses on health functioning, SWB encompasses a broader evaluation of life, extending beyond health-specific domains. Despite some conceptual overlap, these constructs are not interchangeable. This study aims to explore the empirical relationships between SWB, measured using a new preference-based Disability Wellbeing Index (DWI), and HRQoL, measured by the Child Health Utility 9D (CHU9D) and EQ-5D-5L (with psychosocial bolt-ons), among Australian adolescents aged 15 to 19 years.
METHODS: A nationwide, quota-based online survey was administered to Australian adolescents aged 15 to 19 years. The survey included the DWI, CHU9D, EQ-5D-5L with psychosocial bolt-ons, and a series of sociodemographic questions. Psychometric analyses, including exploratory factor analyses (EFA), were conducted to examine the underlying structures and interrelationships among these instruments.
RESULTS: Self-reported data were collected from 1,133 adolescents (45% female). Among them, 582 completed the CHU9D, and 585 completed the EQ-5D-5L and psychosocial bolt-ons; all adolescents completed the DWI. Only one CHU9D dimension (“sad”) and one EQ-5D-5L dimension (“anxiety”) showed strong correlations (Spearman’s ρ > 0.5) with the “mental health” domain of the DWI. EFAs further revealed limited overlap in latent constructs between the DWI and HRQoL measures, revealing that SWB and HRQoL measures capture distinct yet complementary aspects of adolescent health and well-being.
CONCLUSIONS: SWB and HRQoL instruments are not substitutes but provide complementary insights. Incorporating both types of measures in health economic evaluations may offer a more comprehensive understanding of adolescents’ overall well-being.