Measuring Health-Related Quality of Life in Older Adults with Chronic Illness

描述(由申请人提供)：准确的健康相关生活质量(HRQOL)测量是评估健康和卫生保健干预措施成功与否的关键方面。然而，心理学研究表明，以记忆为基础的方法--HRQOL评估的典型代表--往往受到外部因素的偏见，比如评估时的情绪状态和容易想到的信息。这个应用程序的目的是评估现有的基于回忆的HRQOL测量方法与两个新的测量HRQOL的工具，这两个工具被设计为对记忆偏差具有健壮性。具体地说，我们建议检查生态瞬时评估(EMA)，它利用实时测量，因此不受记忆偏差的影响，以及一种基于日记的新的生活质量测量方法，即白天重建法(DRM)。DRM的设计类似于EMA，在对内存偏置具有健壮性方面，但负担和成本要小得多。我们打算开始在下肢骨关节炎患者(LE-OA)和健康老年人的对照组中测试这些措施的有效性和有效性。 我们的目标是1)确定在老年骨性关节炎人群中实施EMA和DRM测量的可行性，2)评估EMA和DRM作为HRQOL测量的有效性，以及3)确定基于DRM的HRQOL测量是否可以减少记忆偏差。为了实现这些目标，我们建议对两组老年人进行纵向观察研究，一组为LE-OA组，另一组为健康对照组。所有参与者都将佩戴Actiwatch，这是一种腕式加速计，还可以提示参与者在一天中多次回答一份简短的问卷。他们将佩戴这些设备一周，在这一周结束时，我们将实施传统的基于召回的措施，询问同一时间段的症状和功能。我们将在12个月后重复这一过程。 这些新方法可能会被证明对卫生保健研究人员非常有价值。DRM是一种先进的方法，比EMA方法成本和负担小得多，但据我们所知，它还没有作为一种测量患者HRQOL的方法进行测试。

DESCRIPTION (provided by applicant): Accurate health-related quality of life (HRQOL) measurement is a critical aspect of assessing health, and the success of health care interventions. However, psychological research indicates that memory-based methods, typical of HRQOL assessment, are often biased by extraneous factors, like mood state at the time of assessment and by information that comes easily to mind. The purpose of this application is to evaluate existing recall-based approaches to HRQOL measurement against two new tools for measuring HRQOL that have been designed to be robust to memory biases. Specifically, we propose to examine Ecological Momentary Assessment (EMA), which utilize real time measures and therefore are not subject to memory biases, and a new diary-based approach to measuring quality of life, the Day Reconstruction Method (DRM). The DRM is designed to be similar to EMA in terms of being robust to memory biases, but is much less burdensome and expensive. We intend to begin to test the usefulness and validity of these measures among lower extremity osteoarthritis patients (LE-OA) and in a comparison group of healthy older adults. Our aims are to 1) determine the feasibility of administering EMA and DRM measures in an older OA population, 2) evaluate the validity of EMA and DRM for use as HRQOL measures, and 3) determine whether a DRM-based HRQOL measure reduces memory bias. To achieve these aims, we propose a longitudinal observational study of two groups of older adults, a group with LE-OA and a healthy comparison group. All participants will wear Actiwatches, which are wrist watch accelerometers that can also prompt participants to respond to a short questionnaire several times throughout the day. They will wear these for one week, at the end of which we will we will administer traditional recall-based measures that ask about symptoms and function for this same period of time. We will repeat this procedure twelve months later. These new methods could prove to be extremely valuable for health care researchers. The DRM is a cutting edge methodology that is much less costly and burdensome than EMA methods but to our knowledge, it has not been tested as a method for measuring HRQOL measure in patients.