Response shift effects in the judgment of quality of life: an individualized approach using case vignettes

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People adapt their assessments of their health situation to changing conditions. This has an impact on examinations of changes of quality of life, since the assessment criteria are not constant. Changes in these frames of reference are called response shift. The most often used method to assess response shift is the thentest method. Here the subjects are asked to evaluate their actual health state, and in addition they have to recall the situation in the past and to judge the recalled situation. In the response shift literature, the thentest studies generally report comparisons between past examinations and recalled examinations on the basis of mean scores, averaged across the participants of the study. Recently, an own study (Hinz et al., 2011) dem-onstrated (by means of ultra-short instruments) that individualized analyses of response shift phenomena are possible and informative. The planned project enlarges this study in three dimensions. Firstly, beyond the ultra-short questionnaires, validated questionnaires will be used. Secondly, the project will not only include patients suffering from prostate cancer, but also patients with other diseases. Thirdly, the examination will include the vignette approach. Using this technique, the patients are asked to evaluate their own health status, and in addition they evaluate the health status of cases that are described as short vignettes. A study published by Korfage et al. (2007) seems to be the only study that used this vignette technique in response shift research so far. The comparison between assessments of the own health state and the assessments attributed to the vignettes, together with their changes, will provide insight in the mechanisms of changes of frames of reference. The hypotheses derived from these approaches will be tested using three different samples of patients (N=150 each): urologic cancer patients, breast cancer survivors, and participants of a cardiovascular rehabilitation program. The results of the project will provide a deeper insight in the mechanisms and conditions of individual recalibration processes.