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Development of a practical outcome measure to account for individual differences in quality-of-life appraisal: the Brief Appraisal Inventory

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Abstract

Background

The present study evaluated the distributional and structural characteristics and explanatory power of the 23-item Brief Appraisal Inventory (BAI), a more practical appraisal measure for use in clinical research and practice.

Methods

A heterogeneous, online cohort of chronic disease patients and caregivers completed the BAI, along with demographics, comorbidities, PROMIS-10, and the Brief NEO Personality Inventory. Principal components, bivariate, and linear and logistic regression analyses addressed BAI item distributions, structure, and construct validity.

Results

The study sample (n = 592) had a mean age of 43.8 (SD = 18.5), and was 79% female. The BAI items exhibited good distributions, and principal component analysis yielded five composite scores: (1) Health Worries; (2) Interpersonal and Independence concerns; (3) Accomplishing Goals and Problem-Solving; (4) Calm, Peaceful, and Active; (5) Spiritual Growth and Altruism. The construct validity of appraisal factors is supported by their zero-order correlations with demographic, health, personality, and health-related QOL measures. Comparisons of appraisal-correlates among comorbidity-burden subgroups shed light on the mediating role that appraisal may play in adapting to chronic illness. Appraisal moderated the influence of comorbidities on emotional but not physical functioning. The performance of the BAI in explaining unique variance in physical and emotional functioning is comparable to results obtained with earlier measures.

Conclusions

The BAI provides a practical, short tool for evaluating appraisal in a wide range of assessment situations. Future research might utilize the BAI in longitudinal research aimed at detecting response-shift effects over time, and in clinical settings to improve patient-provider communication about concerns related to health, health care, or QOL.

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Acknowledgements

This work was funded in part by a grant from the Patient-Centered Outcome Research Institute (PCORI #ME-1306-00781) to Dr. Rapkin. We are grateful to Victoria Powell, M.P.H., for assistance with data management.

Author information

Authors and Affiliations

  1. Division of Community Collaboration and Implementation Science, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

    Bruce D. Rapkin & Iliana Garcia

  2. Rare Patient Voice, LLC, Towson, MD, USA

    Wesley Michael

  3. DeltaQuest Foundation, Inc., Sc.D., 31 Mitchell Road, 01742, Concord, MA, USA

    Jie Zhang & Carolyn E. Schwartz

  4. Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, USA

    Carolyn E. Schwartz

Authors
  1. Bruce D. Rapkin
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  2. Iliana Garcia
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  3. Wesley Michael
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  4. Jie Zhang
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  5. Carolyn E. Schwartz
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Corresponding author

Correspondence to Carolyn E. Schwartz.

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Conflict of interest

Dr. Rapkin declares that he is the author of the QOL Appraisal Profile, but has no conflict of interest. Ms. Garcia, Mr. Michael, and Dr. Schwartz declare that they have no potential conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Rapkin, B.D., Garcia, I., Michael, W. et al. Development of a practical outcome measure to account for individual differences in quality-of-life appraisal: the Brief Appraisal Inventory. Qual Life Res 27, 823–833 (2018). https://doi.org/10.1007/s11136-017-1722-2

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  • DOI: https://doi.org/10.1007/s11136-017-1722-2

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