Oort Frans J, Visser Mechteld R M, Sprangers Mirjam A G
Department of Medical Psychology, Academic Medical Centre, University of Amsterdam, The Netherlands.
Qual Life Res. 2005 Apr;14(3):599-609. doi: 10.1007/s11136-004-0831-x.
The objective is to show how structural equation modeling can be used to detect reconceptualization, reprioritization, and recalibration response shifts in quality of life data from cancer patients undergoing invasive surgery. A consecutive series of 170 newly diagnosed cancer patients, heterogeneous to cancer site, were included. Patients were administered the SF-36 and a short version of the multidimensional fatigue inventory prior to surgery, and 3 months following surgery. Indications of response shift effects were found for five SF-36 scales: reconceptualization of 'general health', reprioritization of 'social functioning', and recalibration of 'role-physical', 'bodily pain', and 'vitality'. Accounting for these response shifts, we found deteriorated physical health, deteriorated general fitness, and improved mental health. The sizes of the response shift effects on observed change were only small. Yet, accounting for the recalibration response shifts did change the estimate of true change in physical health from medium to large. The structural equation modeling approach was found to be useful in detecting response shift effects. The extent to which the procedure is guided by subjective decisions is discussed.
目的是展示如何使用结构方程模型来检测接受侵入性手术的癌症患者生活质量数据中的概念重新界定、优先级重新排序和重新校准反应偏移。纳入了连续的170例新诊断癌症患者，这些患者的癌症部位各不相同。患者在手术前和手术后3个月接受了SF-36和多维疲劳量表简版的测试。在SF-36的五个量表中发现了反应偏移效应的迹象：“总体健康”的概念重新界定、“社会功能”的优先级重新排序以及“角色-身体”、“身体疼痛”和“活力”的重新校准。考虑到这些反应偏移，我们发现身体健康状况恶化、总体健康状况恶化以及心理健康状况改善。反应偏移效应对观察到的变化的影响程度较小。然而，考虑到重新校准反应偏移确实将身体健康真实变化的估计从中等变为了较大。发现结构方程模型方法在检测反应偏移效应方面很有用。讨论了该程序受主观决策指导的程度。
