Differences between individual and societal health state valuations: any link with personality?
Differences between individual and societal health state valuations: any link with personality?
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DOI：
10.1097/mlr.0b013e3181a8112e
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发表时间：
2009-08
期刊：
影响因子：
3
通讯作者：
Jerant A
中科院分区：
文献类型：
--
作者：
Chapman BP;Franks P;Duberstein PR;Jerant A
提出“适应”的概念是为了解释慢性病患者特定健康状态的个人和社会评价之间的差异。人们对适应能力的心理指标知之甚少，这些指标可以预测个人和社会对健康状况的评估差异。我们调查了慢性病患者的性格特征是否可以部分解释这种差异。随机对照试验的基线数据分析。三百七十名慢性病患者。 NEO 五因素人格量表、基于社会的 EuroQoL-5D (EQ-5D) 以及基于个体的健康评估 EQ 视觉模拟量表。回归分析以 Dev 为模型，衡量 EQ-视觉模拟量表和 EQ-5D 之间的差异，作为人格特征、社会人口因素和慢性疾病的函数。在责任心第二和第三四分位数的患者中，个人评价在临床上显着高于社会评价（Dev = 0.08，P = 0.01）；在协变量中，只有抑郁症（Dev = -0.04，P = 0.046）也与 Dev 相关。与特定健康状况的社会评价相比，责任心较高四分位的人报告与健康状况不佳相关的负效用较小。其效果大约是 EQ-5D 和抑郁症的最小重要临床差异的一些估计值的两倍。尽管社会偏好措施在总体水平上有用，但可能会系统性地低估更认真的个人的健康状况。未来的工作应该检查这对临床研究中个体患者结果评估的影响。
The concept of “adaptation” has been proposed to account for differences between individual and societal valuations of specific health states in patients with chronic diseases. Little is known about psychological indices of adaptational capacity, which may predict differences in individual and societal valuations of health states. We investigated whether such differences were partially explained by personality traits in chronic disease patients. Analysis of baseline data of randomized controlled trial. Three hundred seventy patients with chronic disease. The NEO-five factor inventory measure of personality, EuroQoL-5D (EQ-5D) societal-based, and the EQ visual analogue scale individually-based measures of health valuation. Regression analyses modeled Dev, a measure of difference between the EQ-Visual Analogue Scale and EQ-5D, as a function of personality traits, sociodemographic factors, and chronic diseases. Individual valuations were significantly and clinically higher than societal valuations among patients in the second and third quartile of conscientiousness (Dev = 0.08, P = 0.01); among covariates, only depression (Dev = -0.04, P = 0.046) was also associated with Dev. Compared with societal valuations of a given health state, persons at higher quartiles of conscientiousness report less disutility associated with poor health. The effect is roughly twice that of some estimates of minimally important clinical differences on the EQ-5D and of depression. Although useful at the aggregate level, societal preference measures may systematically undervalue the health states of more conscientious individuals. Future work should examine the impact this has on individual patient outcome evaluation in clinical studies.