Relationship between first-aid literacy, coping style, family functioning and mental health of caregivers of children with asthma.

Health-related quality of life (HRQOL) is a common outcome measured in residential aged care facilities (RACF) []. The EuroQol 5-Dimension questionnaire (EQ-5D) has often been used to measure the HRQOL because this scale is short and easy to administer, enables comparability of outcomes across different health conditions, and allows estimation of health utilities for economic evaluations []. Of the three versions of EQ-5D, the EuroQol 5-Dimension 5-Level questionnaire (5Q-5D-5L) shows good measurement properties across various adult populations, conditions, and settings [], with improvements in ceiling effects that can capture health issues better than the EuroQol 5-Dimension 3-Level questionnaire (EQ-5D-3 L) [, ]. In RACFs, because many residents experience cognitive impairment and cannot answer EQ-5D-5L on their own, staff usually complete the EQ-5D-5L on residents’ behalf [, ]. Literature suggested that there were discrepancies between self-and proxy reports of the quality of life on EQ-5D-5L [, ], and evidence of the responsiveness of the EQ-5D-5L was still limited []. The measurement properties of the proxy reports of residents’ HRQOL on the EQ-5D-5L are less well-researched than the self-report []. A recent systematic review of proxy reports of residents’ HRQOL on EQ-5D reported inconsistent findings on construct validity, poor to moderate interrater reliability and limited evidence on responsiveness []. This systematic review recommended conducting more validation studies of proxy reports of residents’ HRQOL using the EQ-5D []. Australia has 185,000 people aged 65 and over living in RACFs []. The Royal Commission recommended using quality indicators for service evaluation and continuous improvement [13], HRQOL has usually been measured. Despite the recent introduction of the Quality of Life – Aged Care Consumers (QOL-ACC) [] for use in Australian aged care, the EQ-5D-5L remains valuable. Yet, to date, only one study has validated the measurement properties of EQ-5D-5L in Australian RACFs []. This study reported that EQ-5D-5L had satisfactory convergent and known group validity for different clinically recognised cognitive and physical functioning thresholds []. However, the study analysed EQ-5D-5L data from pooled data from residents and their proxies, which limited the evaluation of the measurement properties of the proxy reports of residents’ HRQOL using EQ-5D-5L. This study employed a cross-sectional design, which limited its examination of the responsiveness of the EQ-5D-5L. The understanding of the resident-proxy agreement (inter-rater reliability) regarding the EQ-5D-5L for residents in RACFs in Australia needs to be clarified. For these reasons, further evaluation of the measurement properties of the proxy reports of residents’ HRQOL using EQ-5D-5L among Australian RACF residents is necessary.