scholarly journals Response shift in health-related quality of life measures in the presence of formative indicators

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Silvia Testa ◽  
Daniela Di Cuonzo ◽  
Giuliana Ritorto ◽  
Laura Fanchini ◽  
Sara Bustreo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Latent Variable ◽  
Structural Equation ◽  
Response Shift ◽  
Measurement Model ◽  
Equation Modeling ◽  
Related Quality ◽  
Health Related ◽  
Formative Indicators

Abstract Background Response shift (RS) has been defined as a change in the meaning of an individual’s self-evaluation that needs to be accounted for when assessing longitudinal changes in health-related quality of life (HRQoL). RS detection through structural equation modeling is accomplished by adopting Oort’s procedure based on a measurement model in which the observed variables are defined as reflective indicators of the HRQoL latent variable; that is, the latent variable causes the variation in the reflective indicators. This study aims to propose a procedure that assesses RS when formative indicators are used in measuring HRQoL; in this last case, the latent variable is considered to be a function of some formative indicators. A secondary aim is to compare the new procedure with Oort’s procedure to highlight similarities and differences. Methods The data were retrieved from a consecutive series of 258 patients newly diagnosed with colorectal cancer and undergoing chemotherapy and/or surgery. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QOL-C30) was administered twice, once before and once six months after treatment. Structural equation modeling was used to evaluate RS and true change with the newly proposed method (in which fatigue and pain were defined as formative indicators) and with Oort’s procedure (in which fatigue and pain were defined as reflective indicators). Results According to the new procedure, there was no measurement bias, and on average, patients’ quality of life improved by 3.53 points (on a scale ranging from 0 to 100) at the 6-month follow-up. With Oort’s procedure, the loading of the pain indicator was not invariant across the two time points, suggesting the presence of reprioritization, whereas the estimation of true change was very similar to the previous one: 3.87. Conclusions RS and true change in HRQoL can be evaluated in the presence of formative indicators. Defining a measurement model by formative or reflective indicators can lead to different results.

scholarly journals Detecting Response Shift in Health-related Quality of Life Measurement among Patients with Hypertension Using Structural Equation Modeling.

2020 ◽  
Author(s):  
Hao Chen ◽  
Lin Zhu ◽  
Rui Zhou ◽  
Panpan Liu ◽  
Xiaoyang Lu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Disease Management ◽  
Structural Equation ◽  
Response Shift ◽  
Management Program ◽  
Equation Modeling ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Background: Outcomes derived from longitudinal self-reported health-related quality of life measures can be confounded by response shift. This study was aimed to detect response shift phenomena among patients with hypertension attending a community-based disease management program. Methods: 240 consecutive consulting or followed up patients with diagnosed hypertension were recruited. The SF-36 instruments were self-administered at 12 community health service stations and four weeks after attending the program. RS was assessed by the 4-step structural equation modeling approach. Results: Data from 203 (84.6%) patients were eligible for analyses (mean age 65.9±10.8 years, 46,3% female). The results showed uniform recalibration of social functioning ( X2SBdiff(1)=22.98, P<0.001), and non-uniform recalibration of role limitations due to physical problems ( X2SBdiff(1)=8.84, P=0.003), and bodily pain ( X2SBdiff(1)=17.41, P<0.001). The effects of response shift were calculated as “small”, but the influence on the measurement results was noticeable. After accounting for the response shift effect, the general physical health of participants was improved (+0.234, P<0.001), while a deterioration of general mental health (-0.165, P=0.025) was also found. Conclusions: Recalibration existed among patients with hypertension attending the disease management program. The adaptation to chronic illness might act as a catalyst that induced the response shift. We concluded that response shift should be considered in hypertension researches with longitudinal health-related quality of life data, and linking with measurement of the appraisal process was recommended.

A Theoretical Approach to Measuring Quality of Life

2002 ◽  
Vol 10 (1) ◽  
pp. 47-58 ◽  
Author(s):  
Karen H. Sousa ◽  
Fang Fang Chen
Keyword(s):  
Quality Of Life ◽  
Theoretical Approach ◽  
Latent Variables ◽  
Structural Equation ◽  
Factor Model ◽  
Measurement Model ◽  
Equation Modeling ◽  
Related Quality ◽  
Health Related

The purpose of this article is to discuss conceptual issues surrounding health-related quality of life (HRQOL) and to provide an example of how structural equation modeling can address some of these conceptual issues. This article reports the development of the measurement model for overall quality of life, a dimension of HRQOL as conceptualized by Wilson and Cleary (1995). The sample (N = 1410) is from the AIDS Time-Oriented Health Outcome Study (ATHOS) databank, a longitudinal observational database of persons with HIV-associated illness. The hypothesized second-order factor model consists of 5 latent variables and 17 measured items. The fit indicators (RMSEA = .0717; SRMR = .0450; CFI = .951) suggest that the model provides an adequate description of the pattern of relationships in the data. A theoretical approach to HRQOL will expand its clinical use as an outcome measure and increase its relevance.

scholarly journals Detecting response shift in health-related quality of life measurement among patients with hypertension using structural equation modeling

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Hao Chen ◽  
Lin Zhu ◽  
Rui Zhou ◽  
Panpan Liu ◽  
Xiaoyang Lu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Effect Size ◽  
Structural Equation ◽  
Response Shift ◽  
Management Program ◽  
Equation Modeling ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Background Outcomes derived from longitudinal self-reported health-related quality of life measures can be confounded by response shift. This study was aimed to detect response shift among patients with hypertension attending a community-based disease management program. Methods 240 consecutive consulting or follow-up patients with diagnosed hypertension were recruited. The Short Form 36-item Health Survey was self-administered at 12 community health service stations at baseline and four weeks after attending the program. The 4-step structural equation modeling approach assessed response shift. Results Data from 203 (84.6%) patients were eligible for analyses (mean age 65.9 ± 10.8 years, 46.3% female). The results showed uniform recalibration of social functioning ($${\upchi}_{\mathrm{SBdiff}}^{2}$$ χ SBdiff 2 (1) = 22.98, P < 0.001), and non-uniform recalibration of role limitations due to physical problems ($${\upchi}_{\mathrm{SBdiff}}^{2}$$ χ SBdiff 2 (1) = 8.84, P = 0.003), and bodily pain ($${\upchi}_{\mathrm{SBdiff}}^{2}$$ χ SBdiff 2 (1) = 17.41, P < 0.001). The effects of response shift on social functioning were calculated as “small” (effect-size = 0.35), but changed the observed changes from improvement (effect-size = 0.25) to slight deterioration (effect-size = -0.10). After accounting for the response shift effect, the general physical health of participants was improved (effect-size = 0.37), while deterioration (effect-size = -0.21) in the general mental health was also found. Conclusions Recalibration existed among patients with hypertension attending the disease management program. The interventions in the program might act as a catalyst that induced the response shift. We conclude that response shift should be considered in hypertension research with longitudinal health-related quality of life data.

scholarly journals Diabetes in women and health-related quality of life in the whole family: a structural equation modeling

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Mina Moeineslam ◽  
Parisa Amiri ◽  
Mehrdad Karimi ◽  
Sara Jalali-Farahani ◽  
Niloofar Shiva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Structural Equation ◽  
Diabetes Type 2 ◽  
Equation Modeling ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Mental Hrqol

Abstract Background Although several studies indicate the effects of diabetes type 2 on health-related quality of life (HRQoL) in female subjects, the related impact of the disease on HRQoL in their family members has rarely been the focus of the empirical research. In this study we aim to investigate associations between diabetes in women and the HRQoL in these women and their family members, using the structural equation modeling (SEM). Methods This family-based study was conducted on 794 women (11.1% with diabetes) as well as their spouses and children who participated in the Tehran Lipid and Glucose Study (TLGS) from 2014 to 2016. Data on HRQoL were collected using the Iranian version of the Short-Form 12-Item Health Survey version 2 (SF-12v2) and the Pediatric Quality of Life Inventory version™ 4.0 (PedsQL). SEM was conducted to evaluate the network of associations among studied variables. Data were analyzed using IBM SPSS Statistics & AMOS version 23 software. Results Mean age of women was 41.37 ± 5.32 years. Diabetes in women significantly affected their mental HRQoL (β = − 0.11, P < 0.01) but showed no significant direct associations with physical and mental HRQoL in their spouses or their children. However, poor mental HRQoL in women with diabetes was associated with decrease in both physical (β = − 0.02, P = 0.013) and mental (β = − 0.03, P < 0.01) HRQoL in their spouses and total HRQoL score in children (β = − 0.02, P < 0.01). Conclusions Among women with diabetes type 2, beyond its effect on their mental HRQoL per se, demonstrated a negative association with the self-assessment of health status in their spouses and children. Such familial consequences are mainly attributed to the negative effect of the disease on the mental rather than the physical HRQoL in women with diabetes.

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