The impact of considering adaptation in health state valuation
The impact of considering adaptation in health state valuation
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DOI：
10.1016/j.socscimed.2004.11.060
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发表时间：
2005-07-01
影响因子：
5.4
通讯作者：
Ubel, PA
中科院分区：
文献类型：
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作者：
Damschroder, LJ;Zikmund-Fisher, BJ;Ubel, PA
患有慢性疾病的患者通常认为自己的生活质量 (QoL) 明显高于非患者。对这种差异的一种解释是，非患者关注疾病发作的负面方面，尤其是人们第一次经历衰弱疾病时所面临的早期困难，而不考虑患者随着时间的推移可以适应它。为了检验这一假设，我们让 359 人在一项在线调查中进行了人员权衡 (PTO) 启发，改变了正在考虑的治疗方案是否挽救了患者的生命 (a) 已有截瘫的患者； (b) 会出现新发截瘫的人。每组中有一半人完成了“适应练习”，鼓励他们考虑自己在情感上适应一般负面事件的能力，特别是截瘫的能力。相对于拯救健康生命而言，适应操作增加了参与者对已有截瘫（p = 0.03）和新发截瘫（p = 0.05）的重视。此外，适应练习极大地将先前存在的截瘫和新发截瘫的评估之间的差异缩小到 2% 以内。我们的研究结果表明，在给予生活质量评级之前要求非患者进行适应练习可能有助于缩小患者和公民非患者之间的评级差距。由爱思唯尔有限公司出版
Patients with chronic health conditions often rate their quality of life (QoL) significantly higher than non-patients. One explanation for this discrepancy is that non-patients focus on the negative aspects of the onset of a condition, especially the early difficulties people face when they first experience a debilitating condition, without considering that patients can adapt to it over time. To test this hypothesis, we had 359 people perform person tradeoff (PTO) elicitations in an online survey, varying whether the treatment programs under consideration saved the lives of patients (a) with pre-existing paraplegia; or (b) who would experience new onset of paraplegia. Half of each group completed an "adaptation exercise" which encouraged them to consider their own ability to emotionally adapt to negative events in general and specifically to having paraplegia. The adaptation manipulation increased the value participants placed on pre-existing paraplegia (p = 0.03) and on new onset paraplegia (p = 0.05), relative to saving healthy lives. Moreover, the adaptation exercise dramatically reduced the differences between evaluations of pre-existing and new onset paraplegia to values within 2% of each other. Our findings suggest that asking non-patients to do an adaptation exercise before giving QoL ratings may help close the gap in ratings between patients and citizen non-patients. Published by Elsevier Ltd.