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@ARTICLE{Buchholz:285349,
      author       = {Buchholz, Maresa and Engel, Lidia and Xie, Feng and
                      Michalowsky, Bernhard},
      title        = {{E}xamining the face validity of the {EQ}-{HWB}-9 in
                      dementia: caregiver interpretation across '{T}oday' and
                      '7-{D}ay' recall periods.},
      journal      = {Health and quality of life outcomes},
      volume       = {24},
      number       = {1},
      issn         = {1477-7525},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DZNE-2026-00215},
      pages        = {22},
      year         = {2026},
      abstract     = {This study aimed to assess the face validity of the EQ
                      Health and Wellbeing 9 (EQ-HWB-9) for use as a proxy by
                      informal caregivers of community-dwelling people living with
                      dementia (PlwD). It explored how caregivers understand and
                      interpret the EQ-HWB-9 items when using two different recall
                      periods (today vs. 7-days).Qualitative interviews were
                      conducted with 73 informal caregivers of PlwD in Germany.
                      Participants were randomly assigned to one of two recall
                      period groups of the EQ-HWB-9 ('today' vs. '7 days'), and
                      underwent an interview, designed to evaluate the
                      appropriateness of the EQ-HWB-9. Interviews were
                      audio-recorded, transcribed verbatim, and analyzed using
                      qualitative content analysis.Caregivers were, on average,
                      70.6 years old and mainly female $(72.6\%).$ Most caregivers
                      found the EQ-HWB-9 acceptable, highlighting its broad health
                      coverage, clear structure, and suitability of the five-point
                      response scale. Criticisms included the brevity and
                      insufficient depth to capture the PlwD's health status
                      fully. Caregivers tended to focus on observable aspects,
                      such as daily activities, concentration, and mobility, while
                      internal states, like loneliness, sadness, and anxiety, were
                      more challenging to assess, often relying on indirect cues.
                      The 7-day recall period was associated with lower adherence
                      and more frequent deviations from recall instructions
                      compared to the 'Today' recall. Overall, caregivers adhered
                      well to the instructed proxy-proxy perspective but reported
                      uncertainty in selecting the most appropriate responses.The
                      EQ-HWB-9 is generally acceptable and feasible for proxy
                      assessments in PlwD. However, challenges regarding recall
                      periods, proxy interpretation, and response certainty
                      require further investigation.},
      keywords     = {Humans / Female / Caregivers: psychology / Dementia:
                      psychology / Male / Aged / Middle Aged / Mental Recall /
                      Germany / Reproducibility of Results / Qualitative Research
                      / Surveys and Questionnaires: standards / Interviews as
                      Topic / Quality of Life: psychology / Aged, 80 and over /
                      Activities of Daily Living / Psychometrics / Health Status /
                      Dementia (Other) / EQ-HWB-9 (Other) / Health fluctuations
                      (Other) / Informal caregivers (Other) / Proxy-proxy
                      perspective (Other)},
      cin          = {AG Michalowsky},
      ddc          = {610},
      cid          = {I:(DE-2719)5000067},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41606591},
      pmc          = {pmc:PMC12924600},
      doi          = {10.1186/s12955-026-02478-z},
      url          = {https://pub.dzne.de/record/285349},
}