Department of Pharmacy, National University of Singapore, Singapore.
Value Health. 2012 Jan-Feb;15(1 Suppl):S72-8. doi: 10.1016/j.jval.2011.11.011.
To investigate the influence of response shift (RS) on health-related quality of life (HRQOL) and utility assessment among patients undergoing total knee replacement.
Consenting patients undergoing total knee replacement were interviewed to determine their HRQOL by using the six-dimensional health state short form, derived from SF-36, and the EuroQol five-dimensional questionnaire at baseline (pretest 1) and the six-dimensional health state short form, derived from SF-36, at 6 (pretest 2) and 18 months after surgery (post-test). RS was studied by using a "then-test" approach by contacting participants 18 months after surgery and asking them to evaluate their HRQOL at baseline (then-test 1) and at 6 (then-test 2) and 18 months after surgery. RS was calculated as the score difference between pretest and then-test scores for a given time point. Relationships between RS and external variables were explored by using univariate and multiple liner regression analyses.
In 74 subjects (63% response rate, median age 68 years), median (interquantile range) six-dimensional health state short form, derived from SF-36, scores for then-tests at baseline (0.48 [0.42-0.49]) and at 6 months (0.72 [0.66-0.79]) after surgery were significantly different from respective pretest scores (0.61 [0.58-0.68] at baseline, P = 0.000; 0.69 [0.63-0.72] at 6 months, P = 0.000), showing RS at both time points. RS at baseline (0.14 [0.08-0.20]) was significantly larger than that at 6 months (-0.05 [0.14 to 0.00], P = 0.000). EuroQol five-dimensional questionnaire pretest and then-test scores at baseline also differed significantly (0.69 [0.17-0.73] vs. -0.18 [-0.23 to 0.00], P = 0.000). RS at baseline was not affected by assessed demographic or medical variables. RS at 6 months was greater in subjects with more years of education (16% of variance in multiple liner regression, P < 0.01).
RS was present and impacted HRQOL and utility assessment among patients undergoing total knee replacement before and 6 months after surgery.
探讨反应转移（RS）对全膝关节置换患者健康相关生活质量（HRQOL）和效用评估的影响。
对同意接受全膝关节置换的患者进行访谈，以使用六维健康状态简表（源自 SF-36）和 EuroQol 五维问卷确定他们的 HRQOL，基线时（预测试 1）和术后 6 个月（预测试 2）和 18 个月（后测试）。通过联系术后 18 个月的参与者并要求他们评估基线时（后测 1）和 6 个月（后测 2）和 18 个月后的 HRQOL，使用“然后测试”方法研究 RS。RS 计算为给定时间点的预测试和后测试得分之间的分数差异。通过单变量和多元线性回归分析探讨 RS 与外部变量之间的关系。
在 74 名患者（63%的回复率，中位年龄 68 岁）中，基线（四分位间距）六维健康状态简表（源自 SF-36）的中位数（四分位间距）得分分别为术后 6 个月（0.48 [0.42-0.49]）和术后 18 个月（0.72 [0.66-0.79]）。与各自的预测试得分相比，手术（基线时为 0.61 [0.58-0.68]，P = 0.000；术后 6 个月时为 0.69 [0.63-0.72]，P = 0.000）存在 RS，表明在这两个时间点均存在 RS。基线时的 RS（0.14 [0.08-0.20]）明显大于 6 个月时的 RS（-0.05 [0.14 至 0.00]，P = 0.000）。EuroQol 五维问卷的预测试和基线时的后测试评分也有显著差异（0.69 [0.17-0.73] vs. -0.18 [-0.23 至 0.00]，P = 0.000）。基线时的 RS 不受评估的人口统计学或医学变量的影响。在接受更多教育年限的患者中，6 个月时的 RS 更高（多元线性回归中的 16%差异，P <0.01）。
RS 存在于全膝关节置换患者术前和术后 6 个月的 HRQOL 和效用评估中，并对其产生影响。
