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| Integrating response shift into health-related quality of life research: a theoretical model |
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| Author(s): Sprangers MAG, Schwartz CE |
| Source: SOCIAL SCIENCE & MEDICINE Volume: 48 Issue: 11 Pages: 1507-1515 Published: JUN 1999 |
| Times Cited: 400 References: 60 |
| Abstract: Patients confronted with a life-threatening or chronic disease are faced with the necessity to accommodate to their illness, An important mediator of this adaptation process is 'response shift' which involves changing internal standards, values and the conceptualization of quality of life (QOL). Integrating response shift into QOL research would allow a better understanding of how QOL is affected by changes in health status and would direct the development of reliable and valid measures for assessing changes in QOL, A theoretical model is proposed to clarify and predict changes in QOL as a result of the interaction of: (a) a catalyst, referring to changes in the respondent's health status; (b) antecedents, pertaining to stable or dispositional characteristics of the individual (e.g. personality) (c) mechanisms, encompassing behavioral, cognitive, or affective processes to accommodate the changes in health status (e.g, initiating social comparisons, reordering goals); and (d) response shift, defined as changes in the meaning of one's self-evaluation of QOL resulting from changes in internal standards, values, or conceptualization. A dynamic feedback loop aimed at maintaining or improving the perception of QOL is also postulated. This model is illustrated and the underlying assumptions are discussed. Future research directions are outlined that may further the investigation of response shift, by testing specific hypotheses and predictions about the QOL domains and the clinical and psychosocial conditions that would potentiate or prevent response shift effects. (C) 1999 Elsevier Science Ltd, All rights reserved. |
| Document Type: Article |
| Language: English |
| Reprint Address: Sprangers, MAG (reprint author), Univ Amsterdam, Acad Hosp, Dept Psychol Med, Meibergdreef 15, NL-1105 AZ Amsterdam, Netherlands |
Addresses:
1. Univ Amsterdam, Acad Hosp, Dept Psychol Med, NL-1105 AZ Amsterdam, Netherlands
2. Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Dept Psychiat, Boston, MA 02115 USA |
| Publisher: PERGAMON-ELSEVIER SCIENCE LTD, THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND |
| Subject Category: Public, Environmental & Occupational Health; Social Sciences, Biomedical |
| IDS Number: 202NW |
| ISSN: 0277-9536 |
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