Abstract
Mounting evidence for response shifts in quality of life (QOL) appraisal indicates the need to include direct measurement of the appraisal process itself as a necessary part of QOL assessment. We propose that directly assessing QOL appraisal processes will not only improve our ability to interpret QOL scores in the traditional sense, but will also yield a deeper understanding of the appraisal process in the attribution of and divergence in meaning. The published evidence for response shift is reviewed, and an assessment paradigm is proposed that includes the explicit measurement of QOL appraisal process parameters: 1) induction of a frame of reference; 2) recall and sampling of salient experiences; 3) standards of comparison used to appraise experiences; and 4) subjective algorithm used to prioritize and combine appraisals to arrive at a QOL rating. A QOL Appraisal Profile, which measures key appraisal processes, is introduced as an adjunct to existing QOL scales. The proposed theoretical model, building on the Sprangers and Schwartz (1999) model and highlighting appraisal processes, provides a fully testable theoretical treatment of QOL and change in QOL, suggesting hypothesized causal relationships and explanatory pathways for both cross-sectional and longitudinal QOL research.
Highlights
Background on response shiftThe concept of response shift is grounded in research on educational training interventions [21,22,23,24,25] and organizational change [26]
In this paper, we attempt to resolve these problems by introducing new models incorporating constructs based on Schwartz and Sprangers' work and direct measures of QOL appraisal processes to account for unexplained change in QOL ratings
Rees and colleagues found that recalibration response shifts are more likely in the first few months after a threatening event, that patients with more severe symptoms engage in recalibration response shifts longer than patients with milder symptoms [35], and that considering recalibration response shift produced a 10% increase in estimated QOL in prostate cancer patients [35]
Summary
The concept of response shift is grounded in research on educational training interventions [21,22,23,24,25] and organizational change [26]. Given this formulation, a measurement model for qt can be formally represented in terms of information about the appraisal processes that constrain and qualify QOL, as follows: Equation 1 (Induction): {FRt} ⊂ {Kkt}k = 1→K The induction of a frame of reference for QOL: A person's frame of reference for responding to a particular QOL scale or item is represented by the symbol {FRt}, depicted as a set comprising one or more subsets {Kt} These subsets can be understood as categories of experiences or events that the individual considers relevant to that QOL scale at that time. We expect that responses to item 12d will be related to changes in standards of comparison, it is possible that the reasons given for discrepant ratings may reflect changes in the meaning of the term "overall health" (frame of reference) or the salience of different experiences. Response shift cannot be considered merely a statistical artifact
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
