Integrating response shift into health-related quality of life research: a theoretical model
Integrating response shift into health-related quality of life research: a theoretical model
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DOI：
10.1016/s0277-9536(99)00045-3
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发表时间：
1999-06-01
影响因子：
5.4
通讯作者：
Schwartz, CE
中科院分区：
文献类型：
--
作者：
Sprangers, MAG;Schwartz, CE
面对危及生命或慢性疾病的患者面临着适应疾病的必要性，这种适应过程的一个重要中介是“反应转变”，它涉及改变内部标准，价值观和生活质量（QOL）的概念。将反应转移纳入生活质量研究将有助于更好地理解健康状况变化对生活质量的影响，并将指导发展可靠有效的生活质量变化评估指标。本文提出了一个理论模型来阐明和预测生活质量变化是以下因素相互作用的结果：（a）催化剂，指被调查者健康状况的变化;（B）前因，与个体的稳定或性格特征有关（c）机制，包括适应健康状况变化的行为、认知或情感过程（例如，启动社会比较，重新排序目标）;（d）反应转移，定义为由于内在标准、价值观或概念化的改变而导致的自我生活质量评价意义的改变。一个动态的反馈回路，旨在维持或改善感知的生活质量也被假定。该模型的说明和基本假设进行了讨论。未来的研究方向进行了概述，可能会进一步调查的反应转变，通过测试特定的假设和预测的生活质量领域和临床和心理社会条件，将加强或防止反应转变的影响。(C)1999 Elsevier Science Ltd，保留所有权利。
Patients confronted with a life-threatening or chronic disease are faced with the necessity to accommodate to their illness, An important mediator of this adaptation process is 'response shift' which involves changing internal standards, values and the conceptualization of quality of life (QOL). Integrating response shift into QOL research would allow a better understanding of how QOL is affected by changes in health status and would direct the development of reliable and valid measures for assessing changes in QOL, A theoretical model is proposed to clarify and predict changes in QOL as a result of the interaction of: (a) a catalyst, referring to changes in the respondent's health status; (b) antecedents, pertaining to stable or dispositional characteristics of the individual (e.g. personality) (c) mechanisms, encompassing behavioral, cognitive, or affective processes to accommodate the changes in health status (e.g, initiating social comparisons, reordering goals); and (d) response shift, defined as changes in the meaning of one's self-evaluation of QOL resulting from changes in internal standards, values, or conceptualization. A dynamic feedback loop aimed at maintaining or improving the perception of QOL is also postulated. This model is illustrated and the underlying assumptions are discussed. Future research directions are outlined that may further the investigation of response shift, by testing specific hypotheses and predictions about the QOL domains and the clinical and psychosocial conditions that would potentiate or prevent response shift effects. (C) 1999 Elsevier Science Ltd, All rights reserved.