Impact of reconceptualization response shift on rating of quality of life over time among people with advanced cancer
- 115 Downloads
People with cancer may experience change in what constitutes quality of life (QOL) over time as a result of the cancer progression (true change) or adaptation to the experience, considered as a response shift phenomenon. As individualized measures are ideally suited to explore response shift, this study aimed to estimate the extent to which reconceptualization response shift occurred over time in a cancer population and the impact of this response shift on estimates of change on QOL measures.
Ninety-seven people with advanced cancer completed the study measures including the Patient-Generated Index (PGI) at diagnosis (T0) and 1 year later (T1). The response shift indicator was the change in the number of areas nominated (range − 4 to + 3). Multivariate linear regression was used to estimate the effect of changing areas on change in the PGI score, single indicators of global QOL, and the EQ-5Dindex adjusted for age and sex.
Approximately 72% of people in this sample either added or dropped areas over time. People who dropped more than two areas had higher PGI scores at T1 than T0 while people who added areas showed low PGI score.
The results are consistent with the PGI framework as areas nominated tend to focus on negative aspects of QOL.
KeywordsResponse shift Reconceptualization Individualized measures Patient-Generated Index (PGI) Quality of life
This research was supported by a grant from the Terry Fox Research Institute and by the Cancer Research Society/Rob Lutterman Pancreatic Cancer Research Grant. B Gagnon is a recipient of “Chercheur-clinicien Boursier” award from Fond de Recherche Santé Québec, Québec, Canada.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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 was obtained from all individual participants included in the study.
- 7.Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, Haes JCJM, Kaasa S, Klee M, Osoba D, Razavi D, Rofe PB, Schraub S, Sneeuw K, Sullivan M, Takeda F (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376CrossRefPubMedGoogle Scholar
- 12.Dabakuyo TS, Guillemin F, Conroy T, Velten M, Jolly D, Mercier M, Causeret S, Cuisenier J, Graesslin O, Gauthier M, Bonnetain F (2013) Response shift effects on measuring post-operative quality of life among breast cancer patients: a multicenter cohort study. Qual Life Res 22(1):1–11CrossRefPubMedGoogle Scholar
- 44.Mayo NE, Aburub A’, Brouillette MJ, Kuspinar A, Moriello C, Rodriguez AM, Scott S (2017) In support of an individualized approach to assessing quality of life: comparison between Patient Generated Index and standardized measures across four health conditions. Qual Life Res 26(3):601–609CrossRefPubMedGoogle Scholar