DOES THE EQ-HWB-9 CAPTURE CAREGIVER BURDEN? EVIDENCE FROM FAMILY CAREGIVERS OF PEOPLE WITH SCHIZOPHRENIA IN CHINA
Author(s)
Luying Wang, PhD1, Yuyanzi Zhang, BS1, Xiuchen Zhan, PhD1, Peng Dai, PhD2, Chen Jiang, BS3, XinDi Wang, BS1, Nan Luo, PhD4, Xin Guan, PhD1.
1China Pharmaceutical University, Nanjing, China, 2the Second People’s Hospital of Jiangning District, Nanjing, China, 3China Pharmaceutical University, Nanjing, China, 4National University of Singapore, Singapore, Singapore.
1China Pharmaceutical University, Nanjing, China, 2the Second People’s Hospital of Jiangning District, Nanjing, China, 3China Pharmaceutical University, Nanjing, China, 4National University of Singapore, Singapore, Singapore.
OBJECTIVES: This study examined the construct validity of the 9-item EQ Health and Wellbeing instrument (EQ-HWB-9) in caregivers of people with schizophrenia. We also explored how the psychometric performance of EQ-HWB-9 and EQ-5D-5L differed in this caregiver population.
METHODS: Primary family caregivers of people with schizophrenia were recruited from a mental health hospital in Nanjing, China, between January and November 2025. Caregivers completed paper-based questionnaires including sociodemographic questions, ZBI-22, EQ-5D-5L, and EQ-HWB-9. EQ-5D-5L and EQ-HWB-9 index scores were derived using the Chinese and experimental UK value sets, respectively. Convergent construct validity was assessed using correlations with ZBI-22. Known-groups validity was assessed by comparing groups known to differ in daily caregiving hours, patient stable status duration, and caregivers’ health conditions using Cohen’s effect size (ES) and relative efficiency (RE).
RESULTS: Among 300 caregivers, mean age was 57.0 years and 33.0% were female. Mean EQ-5D-5L, EQ-HWB-9, and ZBI-22 scores were 0.879, 0.809, and 32.6, respectively. Exhaustion was the most frequently affected EQ-HWB-9 dimension (65.4%). ZBI-22 was strongly correlated with the EQ-HWB-9 index (r=-0.68), and moderately correlated with the EQ-5D-5L index (r=-0.45). At the item level, ZBI-22 was strongly correlated with six EQ-HWB-9 items (r=0.50-0.60), but only with the EQ-5D-5L anxiety/depression dimension (r=0.53). Both ZBI-22 and EQ-HWB-9 scores significantly differentiated all caregiver subgroups. However, EQ-5D-5L index scores of subgroups differing in patient stable status duration were not significantly different. EQ-HWB-9 showed greater discrimination in caregiving hours (ES: 0.60 vs 0.37; RE=2.68) and patient stable status duration (ES: 0.35 vs 0.02; RE=709.76), whereas EQ-5D-5L discriminated better for caregivers’ own health conditions (ES: 0.58 vs 0.38; RE=2.33).
CONCLUSIONS: EQ-HWB-9 demonstrated good construct validity among Chinese family caregivers of people with schizophrenia. Although EQ-5D-5L captured caregiver burden to some extent, EQ-HWB-9 appeared more sensitive to differences in caregivers’ wellbeing.
METHODS: Primary family caregivers of people with schizophrenia were recruited from a mental health hospital in Nanjing, China, between January and November 2025. Caregivers completed paper-based questionnaires including sociodemographic questions, ZBI-22, EQ-5D-5L, and EQ-HWB-9. EQ-5D-5L and EQ-HWB-9 index scores were derived using the Chinese and experimental UK value sets, respectively. Convergent construct validity was assessed using correlations with ZBI-22. Known-groups validity was assessed by comparing groups known to differ in daily caregiving hours, patient stable status duration, and caregivers’ health conditions using Cohen’s effect size (ES) and relative efficiency (RE).
RESULTS: Among 300 caregivers, mean age was 57.0 years and 33.0% were female. Mean EQ-5D-5L, EQ-HWB-9, and ZBI-22 scores were 0.879, 0.809, and 32.6, respectively. Exhaustion was the most frequently affected EQ-HWB-9 dimension (65.4%). ZBI-22 was strongly correlated with the EQ-HWB-9 index (r=-0.68), and moderately correlated with the EQ-5D-5L index (r=-0.45). At the item level, ZBI-22 was strongly correlated with six EQ-HWB-9 items (r=0.50-0.60), but only with the EQ-5D-5L anxiety/depression dimension (r=0.53). Both ZBI-22 and EQ-HWB-9 scores significantly differentiated all caregiver subgroups. However, EQ-5D-5L index scores of subgroups differing in patient stable status duration were not significantly different. EQ-HWB-9 showed greater discrimination in caregiving hours (ES: 0.60 vs 0.37; RE=2.68) and patient stable status duration (ES: 0.35 vs 0.02; RE=709.76), whereas EQ-5D-5L discriminated better for caregivers’ own health conditions (ES: 0.58 vs 0.38; RE=2.33).
CONCLUSIONS: EQ-HWB-9 demonstrated good construct validity among Chinese family caregivers of people with schizophrenia. Although EQ-5D-5L captured caregiver burden to some extent, EQ-HWB-9 appeared more sensitive to differences in caregivers’ wellbeing.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
P2
Topic
Methodological & Statistical Research, Patient-Centered Research
Topic Subcategory
Instrument Development, Validation, & Translation, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Mental Health (including addiction)