Developing a quality of life framework from the perspective of laypeople: a qualitative comparison with the EQ-HWB framework

Introduction The EuroQol health and well-being instrument (EQ-HWB™) measures quality of life (QoL) outcomes in health, public health, and social care settings. Its conceptual framework is rooted in QoL theory, a multidimensional concept encompassing social, psychological, and physical aspects influenced by cultural factors. The content validity of the EQ-HWB remains unexplored in China. This study addressed this gap through qualitative interviews with Chinese laypeople, uncovering their QoL conceptual framework and comparing it with the EQ-HWB’s to evaluate how well it captures its intended outcomes. Methods Quota sampling recruited respondents from two regions in China, ensuring diversity in age, gender, education, health conditions, and caregiving experience. Semi-structured qualitative interviews were conducted, transcribed verbatim, and analyzed by two coders using a thematic framework approach. The coders refined codes through consensus, removed irrelevant ones based on set criteria, and organized the remaining codes into sub-themes and themes to develop a Chinese QoL conceptual framework. Lastly, this Chinese QoL framework was compared with the EQ-HWB conceptual framework. Results Thirty respondents were recruited and interviewed, achieving data saturation in the last three interviews. From 221 initial codes, 187 were retained to develop a conceptual framework comprising eight themes: feeling and emotion, cognition, self-identity, coping, physical sensation, relationship, activity, and mindset. This framework largely aligned with the EQ-HWB conceptual framework, except for the absence of the ‘mindset’ theme. Conclusion The conceptual framework of the EQ-HWB is well-represented within the QoL framework. The findings support the content validity of the EQ-HWB among laypeople in the Chinese context.