Friedrich Michael, Zenger Markus, Hinz Andreas
Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
Faculty of Applied Human Studies, University of Applied Sciences Magdeburg-Stendal, Stendal, Germany.
Eur J Cancer Care (Engl). 2019 Mar;28(2):e12979. doi: 10.1111/ecc.12979. Epub 2018 Dec 6.
Measurements of quality of life (QoL) can be distorted by respondents adapting to new situations between measurement points and consequently having a changed frame of reference. To investigate this bias in breast cancer survivors, we compare their QoL with that of the general population and use two complementary methods for detecting this bias. Breast cancer survivors (n = 308, response rate: 91%) were tested with the QoL questionnaire European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. Response shift was examined with the thentest (retrospective judgements) and with the structural equation modelling (SEM) approach. Compared with the general population, breast cancer survivors showed impaired QoL in all functioning scales (Hedges' g: -0.56 to -0.93) and symptom scales (Hedges' g: 0.28-0.74).The thentest method indicated recalibration effects in several dimensions including social functioning. The SEM method detected a non-uniform recalibration effect for social functioning from pretest to posttest and from pretest to thentest, but no effect between thentest and posttest. Breast cancer survivors' QoL is clearly diminished. Comparing the two approaches for detecting response shift showed that it is also useful to apply SEM to retrospective judgements and that this can reveal response shift effects that would otherwise be overlooked.
生活质量（QoL）的测量可能会因受访者在测量点之间适应新情况并因此改变参照系而受到扭曲。为了调查乳腺癌幸存者中的这种偏差，我们将他们的生活质量与普通人群的生活质量进行比较，并使用两种互补方法来检测这种偏差。对308名乳腺癌幸存者（回复率：91%）进行了欧洲癌症研究与治疗组织生活质量问卷核心30的生活质量问卷调查。使用事后检验（回顾性判断）和结构方程模型（SEM）方法检查反应转移。与普通人群相比，乳腺癌幸存者在所有功能量表（Hedges'g：-0.56至-0.93）和症状量表（Hedges'g：0.28 - 0.74）上的生活质量受损。事后检验方法表明在包括社会功能在内的几个维度上存在重新校准效应。SEM方法检测到从预测试到后测试以及从预测试到事后检验，社会功能存在不均匀的重新校准效应，但在事后检验和后测试之间没有效应。乳腺癌幸存者的生活质量明显下降。比较两种检测反应转移的方法表明，将SEM应用于回顾性判断也很有用，并且这可以揭示否则会被忽视的反应转移效应。
