Department of Quality Management and Social Medicine, University Freiburg-Medical Center, Freiburg, Germany.
Disabil Rehabil. 2012;34(8):671-80. doi: 10.3109/09638288.2011.619616. Epub 2011 Oct 21.
To examine the extent and type of influence of response shift (RS) (reconceptualization, reprioritization, recalibration) on the assessment of changes in health-related quality of life (HRQoL) after the inpatient rehabilitation of patients with chronic back pain and chronic ischaemic heart disease.
RS was assessed using the then-test and structural equation modelling (SEM) approaches. HRQoL was recorded in a questionnaire study at the start and end of rehabilitation using disease-specific instruments. Global items were also developed to collect data on HRQoL at the start and end of rehabilitation, as well as for the retrospective evaluation of HRQoL at the beginning of rehabilitation via the then-test.
There are small recalibration effects in the then-test in both diseases in nearly every item which may underestimate the actual effects of change. Using the SEM approach, uniform and non-uniform recalibration effects appear in a few of the scales that cause true change scores to be under- and over-estimated.
RS reflects a phenomenon that should be included when assessing HRQoL to allow a more valid interpretation of treatment effects. The results of SEM approach, however, suggest that RS does not lead to fundamentally different results in rehabilitation effects.
探讨反应转移（RS）（重新概念化、重新优先化、重新校准）对慢性腰痛和慢性缺血性心脏病患者住院康复后健康相关生活质量（HRQoL）变化评估的影响程度和类型。
采用即时测试和结构方程模型（SEM）方法评估 RS。使用特定于疾病的工具在康复开始和结束时在问卷研究中记录 HRQoL。还开发了全球项目，以收集康复开始和结束时的 HRQoL 数据，以及通过即时测试对康复开始时的 HRQoL 进行回顾性评估。
在两种疾病中，几乎每个项目的即时测试中都存在较小的重新校准效应，这可能低估了实际变化的影响。使用 SEM 方法，在少数几个量表中出现了统一和非统一的重新校准效应，导致真实变化得分被低估和高估。
RS 反映了一种现象，在评估 HRQoL 时应将其纳入，以更有效地解释治疗效果。然而，SEM 方法的结果表明，RS 不会导致康复效果产生根本不同的结果。
