An application of structural equation modeling to detect response shifts and true change in quality of life data from cancer patients undergoing invasive surgery
An application of structural equation modeling to detect response shifts and true change in quality of life data from cancer patients undergoing invasive surgery
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DOI：
10.1007/s11136-004-0831-x
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发表时间：
2005-04-01
影响因子：
3.5
通讯作者：
Sprangers, MAG
中科院分区：
文献类型：
--
作者：
Oort, FJ;Visser, MRM;Sprangers, MAG
其目的是显示如何结构方程模型可以用来检测接受侵入性手术的癌症患者的生活质量数据中的重新概念化，重新确定优先级和重新校准响应变化。纳入了170例新诊断的癌症患者的连续系列，这些患者与癌症部位不同。患者在手术前和手术后3个月接受SF-36和简短版本的多维疲劳量表。五个SF-36量表的反应转移效应的迹象被发现：“一般健康”的重新概念化，“社会功能”的重新优先级，并重新校准“角色-身体”，“身体疼痛”和“活力”。考虑到这些反应变化，我们发现身体健康状况恶化，一般健康状况恶化，心理健康状况改善。对观察到的变化的响应偏移效应的大小是很小的。然而，考虑到重新校准反应的变化，身体健康的真实变化的估计值确实从中等变化到大。结构方程建模方法被发现是有用的，在检测响应偏移效应。在何种程度上的程序是由主观决定进行了讨论。
The objective is to show how structural equation modeling can be used to detect reconceptualization, reprioritization, and recalibration response shifts in quality of life data from cancer patients undergoing invasive surgery. A consecutive series of 170 newly diagnosed cancer patients, heterogeneous to cancer site, were included. Patients were administered the SF-36 and a short version of the multidimensional fatigue inventory prior to surgery, and 3 months following surgery. Indications of response shift effects were found for five SF-36 scales: reconceptualization of 'general health', reprioritization of 'social functioning', and recalibration of 'role-physical', 'bodily pain', and 'vitality'. Accounting for these response shifts, we found deteriorated physical health, deteriorated general fitness, and improved mental health. The sizes of the response shift effects on observed change were only small. Yet, accounting for the recalibration response shifts did change the estimate of true change in physical health from medium to large. The structural equation modeling approach was found to be useful in detecting response shift effects. The extent to which the procedure is guided by subjective decisions is discussed.