Rapkin Bruce D, Garcia Iliana, Michael Wesley, Zhang Jie, Schwartz Carolyn E
Division of Community Collaboration & Implementation Science, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
Rare Patient Voice, LLC, Towson, MD, USA.
Qual Life Res. 2017 Oct;26(10):2815-2829. doi: 10.1007/s11136-017-1600-y. Epub 2017 Jun 7.
Cognitive appraisal of quality of life (QOL) differs across individuals in ways that explain otherwise paradoxical findings, such as similar QOL ratings among individuals in highly divergent health states. Although warranted by a growing body of evidence, routine assessment of appraisal in QOL research has been impeded by measurement challenges. This study describes the QOL Appraisal Profile-version 2 (QOLAPv2), a new measure that addresses these challenges.
A heterogeneous, on-line cohort of chronic disease patients and caregivers completed the QOLAPv2, along with demographics, PROMIS10 and Brief NEO Personality Inventory (NEO-PI). Analyses address the psychometric properties and construct validity of this new measure using principal components, bivariate, canonical correlation, and linear regression analyses.
Analysis including 4173 respondents yielded 12 second-order QOLAPv2 principal components. Appraisal components varied with age and disease duration. Appraisals involving "Wellness," "Health," and "Recent Challenges" were correlated with QOL and with NEO-PI scales of "Agreeableness" and "Conscientiousness." Canonical correlation analysis revealed that QOL scales were associated with appraisals involving "Spirituality," "Anticipating Decline," and "Lightness of Being." Appraisal dimensions of "Relationships," "Maintaining Roles," "Independence," "Pursuing Dreams," and "Lightness of Being" were also associated with personality scales. Appraisal measures accounted for significantly more variance in QOL than personality and demographics alone.
Findings corroborate the Rapkin and Schwartz QOL appraisal theory. QOL appraisal measures correlate as expected with personality scales, and explain more variance in QOL than does personality. The QOLAPv2 can be used across populations to provide insight into patients' concerns, salient experiences, and comparators.
生活质量（QOL）的认知评估在个体间存在差异，这种差异解释了一些看似矛盾的研究结果，比如健康状况差异很大的个体却有着相似的生活质量评分。尽管越来越多的证据表明有必要进行评估，但生活质量研究中评估的常规测量一直受到测量挑战的阻碍。本研究介绍了生活质量评估概况-第2版（QOLAPv2），这是一种应对这些挑战的新测量方法。
一个由慢性病患者和护理人员组成的异质性在线队列完成了QOLAPv2，以及人口统计学信息、患者报告结果测量信息系统10（PROMIS10）和大五人格简式量表（NEO-PI）。分析使用主成分分析、双变量分析、典型相关分析和线性回归分析来探讨这一新测量方法的心理测量特性和结构效度。
对4173名受访者的分析得出了12个二阶QOLAPv2主成分。评估成分随年龄和病程而变化。涉及“健康状态”“健康”和“近期挑战”的评估与生活质量以及NEO-PI量表中的“宜人性”和“尽责性”相关。典型相关分析表明，生活质量量表与涉及“精神性”“预期衰退”和 “存在的轻松感”的评估相关。“人际关系”“维持角色”“独立性”“追求梦想”和“存在的轻松感”等评估维度也与人格量表相关。评估指标在解释生活质量差异方面比单独的人格和人口统计学因素更显著。
研究结果证实了拉普金和施瓦茨的生活质量评估理论。生活质量评估指标与人格量表的相关性符合预期，并比人格因素能解释更多的生活质量差异。QOLAPv2可用于不同人群，以洞察患者的关切、显著经历和比较因素。
