Background COVID-19 has spread rapidly throughout the world, causing thousands of illnesses and deaths. To fight this pandemic, almost all governments and health authorities have focused on prevention. In March or April, most countries' officials imposed home quarantine and lockdown measures nationwide. Purpose This study sought to assess health-related quality of life (HRQoL) and anxiety levels among people in Portugal under mandatory home quarantine due to the COVID-19 pandemic. The results were compared to the general Portuguese population's HRQoL before the COVID-19 outbreak. This research also aimed to understand the factors that can influence the respondents' HRQoL. Methods A sample of Portugal's population quarantined at home (n = 904) filled in an online survey comprising the Generalized Anxiety Disorder 7-item and the EQ-5D-5L and other questions about sociodemographic characteristics, feelings, duties and activities during the quarantine. The sample was weighted to mirror the general population's gender, age and education. Descriptive analyses and correlation coefficients were used to evaluation the respondents' anxiety and HRQoL. Generalised linear models were estimated to identify determinants of HRQoL during the COVID-19 quarantine. Results The results show that individuals quarantined at home reported higher anxiety and lower HRQoL levels and that people with more anxiety tended to have a lower HRQoL. Females and elderly individuals experienced the highest levels of anxiety and poorest HRQoL. In addition, HRQoL during the quarantine can be explained by various occupational and attitudinal variables, as well as sociodemographic variables. Conclusion Individuals' mental health should be taken into consideration during pandemics or other emergency situations. Anxiety and other factors can decrease people's HRQoL, in conjunction with the pandemic's social and economic consequences.

This research provides the Portuguese EQ-5D value set based on the preferences of the Portuguese general population as measured by the TTO. This value set is recommended for use in CUA conducted in Portugal.

This study provides Portuguese population health-related quality of life data measured by the EQ-5D that can be used as population norms. These norms can be used to inform Portuguese policy makers, health care professionals and researchers in issues related to health care policy and planning and quantification of treatment effects on health status.

BackgroundSome studies have reported a ceiling effect in EQ-5D-3L, especially in healthy and/or young individuals. Recently, two further levels have been included in its measurement model (EQ-5D-5L). The purposes of this study were (1) to assess the properties of the EQ-5D-5L in comparison with the standard EQ-5D-3L in a sample of young adults, (2) to foreground the importance of collecting qualitative data to confirm, validate or refine the EQ-5D questionnaire items and (3) to raise questions pertaining to the wording in these questionnaire items.MethodsThe data used came from a sample of respondents aged 30 or under (n = 624). They completed both versions of the EQ-5D, which were compared in terms of feasibility, level of inconsistency and ceiling effect. Agreement between the instruments was assessed using correlation coefficients and Bland-Altman plots. Known-groups validity of the EQ-5D-5L was also assessed using non-parametric tests. The discriminative properties were compared using receiver operating characteristic curves. Finally, four interviews were conducted for retrospective reports to elicit respondents’ understanding and perceptions of the format, instructions, items, and responses.ResultsQuantitative results show a ceiling effect reduction of 25.3 % and a high level agreement between both indices. Known-groups validity was confirmed for the EQ-5D-5L. Explorative interviews indicated ambiguity and low degree of certainty in regards to conceptualizing differences between levels moderate-slight across three dimensions.ConclusionsThe EQ-5D-5L performed better than the EQ-5D-3L. However, the explorative interviews demonstrated several limitations in the EQ-5D questionnaire wording and high context-dependent answers point to lack of illnesses’ experience amongst young adults.

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Purpose Little is known about how tourists’ eating habits change between everyday life and holidays. This study aims to identify market segments based on changes in food consumption and experiences of a sun-and-sea destination’s local food. The authors evaluate to what extent tourists consume local food and assess the contribution of local food experiences to the tourists’ overall experience. Design/methodology/approach The target population was all tourists visiting the Algarve in the Summer 2018 and included both domestic and international sun-and-sea tourists. A sample of 378 valid questionnaires was collected. Data analysis included descriptive analysis, statistical tests and cluster analysis. Findings Cluster analysis identified three segments: non-foodies, selective foodies and local gastronomy foodies. Results indicate that tourists change their eating habits during holidays, eating significantly more seafood and fish and less legumes, meat, fast food and cereals and their derivatives. International and domestic sun-and-sea tourists reported that eating local food contributes significantly to their overall tourism experience. Practical implications Sun-and-sea destinations should promote the offer of local dishes, especially those that include locally produced fish and seafood, to improve the tourist experience, differentiate the destination and increase sustainability. Originality/value The authors address three identified research gaps: a posteriori segmentation based on tourists’ food consumption behaviour; measurement of changes in eating practices between home and in a sun-and-sea destination; and assessment of the role of food experiences to overall tourism experience of tourists visiting a sun-and-sea destination.

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