Cancer patients' evaluations of their current health states: the influences of expectations, comparisons, actual health status, and mood.

A study was done to determine the extent to which patients' subjective evaluations of their current health are determined by their expectations, their actual health, and how they compare themselves with others. At the initiation of radiation therapy, 61 laryngeal cancer patients described the health status they expected at the end of therapy, using standardized and individualized dimensions. Objective summative scores were derived for these descriptions. At the end of therapy, these respondents described their current health status and the status they believed others their age were experiencing, on the same dimensions, and objective summative scores were derived for these actual and social comparison states. Rating scales and standard gambles were used to obtain values and utilities ("subjective evaluations") for current health at the end of therapy. Multiple linear regression was used to determine the extent to which variation in the subjective evaluations was explained by the objective scores for actual, expected, and social comparison states, under these different methodologic conditions. Actual health state was a consistently significant predictor. Most variance was explained in the model using individualized dimensions and value scores (r2 = 46.0%). Further investigation is needed to determine whether differences in the amounts of variance explained are due to aversion to gambling, dimension salience, order effects, or respondent fatigue.