Lix Lisa M, Chan Eric K H, Sawatzky Richard, Sajobi Tolulope T, Liu Juxin, Hopman Wilma, Mayo Nancy
Department of Community Health Sciences, College of Medicine, University of Manitoba, Winnipeg, MB, R3E 0W3, Canada.
Measurement, Evaluation, and Research Methodology (MERM) Program, University of British Columbia, Vancouver, Canada.
Qual Life Res. 2016 Jul;25(7):1751-60. doi: 10.1007/s11136-015-1188-z. Epub 2015 Nov 20.
Response shift (RS) may mask true change in health-related quality of life in longitudinal studies. People with chronic conditions may experience RS as they adapt to their disease, but it is unknown whether fluctuations in disease activity will influence the presence of RS. The study purpose was to test for RS in individuals with inflammatory bowel disease (IBD), a condition characterized by periods of symptom flares and remission.
Data were from the Manitoba IBD Cohort Study (N = 388). Multi-group confirmatory factor analysis (MG-CFA) and a RS detection method based on structural equation modeling were used to test for reconceptualization, reprioritization, and recalibration RS in participants with consistent active, consistent inactive, and inconsistent disease activity over a 6-month period on the SF-36.
The MG-CFA revealed that a weak invariance model with equal factor loadings across groups was the best fit to the baseline SF-36 data. Reconceptualization, uniform recalibration, and non-uniform recalibration RS was detected in the consistent active group, but effect sizes were small. For the consistent inactive group, recalibration RS was observed and effect sizes were small to moderate. For the inconsistent disease activity group, small-to-moderate recalibration RS effects were observed. There was no evidence of reprioritization.
Individuals with a chronic disease may exhibit RS even if they are not actively experiencing symptoms on a consistent basis. Heterogeneity in the type and magnitude of RS effects may be observed in chronic disease patients who experience changes in disease symptoms.
在纵向研究中，反应转移（RS）可能掩盖与健康相关生活质量的真实变化。患有慢性病的人在适应疾病时可能会经历反应转移，但疾病活动的波动是否会影响反应转移的存在尚不清楚。本研究的目的是检测炎症性肠病（IBD）患者中的反应转移，IBD的特征是症状发作和缓解期。
数据来自曼尼托巴IBD队列研究（N = 388）。多组验证性因素分析（MG-CFA）和基于结构方程模型的反应转移检测方法用于测试在6个月期间SF-36上疾病活动持续活跃、持续不活跃和不一致的参与者中的重新概念化、重新排序和重新校准反应转移。
MG-CFA显示，跨组因素负荷相等的弱不变性模型最适合基线SF-36数据。在持续活跃组中检测到重新概念化、统一重新校准和非统一重新校准反应转移，但效应量较小。对于持续不活跃组，观察到重新校准反应转移，效应量小到中等。对于疾病活动不一致组，观察到小到中等的重新校准反应转移效应。没有重新排序的证据。
患有慢性病的个体即使没有持续出现症状，也可能表现出反应转移。在经历疾病症状变化的慢性病患者中，可能会观察到反应转移效应的类型和程度的异质性。
