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24-02-2017

Changes in quality of life from a homelessness intervention: true change, response shift, or random variation

Auteurs: Guido Antonio Powell, Carol E. Adair, David L. Streiner, Nancy Mayo, Eric Latimer

Gepubliceerd in: Quality of Life Research | Uitgave 7/2017

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Abstract

Background and objective

Participants experiencing homelessness and mental illness who received housing and support through the At Home/Chez Soi trial showed modest gains in quality of life (QOL) compared to treatment as usual participants. Participants’ QOL ratings over time may have been affected by either response shift triggered by new life circumstances or by random variation in the meaning of QOL ratings. This study seeks to identify both phenomena to estimate the intervention’s effect on true change in QOL.

Methods

Using the residuals from a regression model of the global item of Lehman’s 20-item quality of life interview (QOLI-20), latent trajectory analysis was used to identify response shift, while a measure of overall variability in residuals identified random variation of QOL. The latter was used to adjust group comparisons of QOLI-20 total scores and the global item.

Results

Equivalent distributions of both groups’ participants across latent trajectory classes (χ2 = 2.97, p = .397) suggest that the intervention did not trigger response shift. However, random variation interacted significantly with the treatment effect on global item ratings. For every increase of one standard deviation of residuals, treatment odds ratios decreased by a factor of 0.70 (SE 1.18, p = .036, 95% CI 0.50–0.98).

Conclusions

Measuring random variation in QOL ratings from the standard deviation of residuals offers the ability to approximate, although indirectly, how participants’ QOL is truly affected by a housing intervention. Specifically, we found that QOL improvement is more evident when QOL ratings have a consistent meaning over time.
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Literatuur
1.
go back to reference Sprangers, M. A., & Schwartz, C. E. (1999). Integrating response shift into health-related quality of life research: A theoretical model. Social Science and Medicine (1982), 48(11), 1507–1515.CrossRef Sprangers, M. A., & Schwartz, C. E. (1999). Integrating response shift into health-related quality of life research: A theoretical model. Social Science and Medicine (1982), 48(11), 1507–1515.CrossRef
2.
go back to reference Mayo, N. E., Scott, S. C., Dendukuri, N., Ahmed, S., & Wood-Dauphinee, S. (2008). Identifying response shift statistically at the individual level. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 17(4), 627–639. doi:10.1007/s11136-008-9329-2.CrossRef Mayo, N. E., Scott, S. C., Dendukuri, N., Ahmed, S., & Wood-Dauphinee, S. (2008). Identifying response shift statistically at the individual level. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 17(4), 627–639. doi:10.​1007/​s11136-008-9329-2.CrossRef
3.
go back to reference Schwartz, C. E., Bode, R., Repucci, N., Becker, J., Sprangers, M. A. G., & Fayers, P. M. (2006). The clinical significance of adaptation to changing health: A meta-analysis of response shift. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 15(9), 1533–1550. doi:10.1007/s11136-006-0025-9.CrossRef Schwartz, C. E., Bode, R., Repucci, N., Becker, J., Sprangers, M. A. G., & Fayers, P. M. (2006). The clinical significance of adaptation to changing health: A meta-analysis of response shift. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 15(9), 1533–1550. doi:10.​1007/​s11136-006-0025-9.CrossRef
4.
go back to reference Schwartz, C. E., Merriman, M. P., Reed, G. W., & Hammes, B. J. (2004). Measuring patient treatment preferences in end-of-life care research: Applications for advance care planning interventions and response shift research. Journal of Palliative Medicine, 7(2), 233–245. doi:10.1089/109662104773709350.CrossRefPubMed Schwartz, C. E., Merriman, M. P., Reed, G. W., & Hammes, B. J. (2004). Measuring patient treatment preferences in end-of-life care research: Applications for advance care planning interventions and response shift research. Journal of Palliative Medicine, 7(2), 233–245. doi:10.​1089/​1096621047737093​50.CrossRefPubMed
7.
go back to reference Goering, P. N., Streiner, D. L., Adair, C., Aubry, T., Barker, J., Distasio, J., … Zabkiewicz, D. M. (2011). The At Home/Chez Soi trial protocol: A pragmatic, multi-site, randomised controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities. BMJ Open, 1(2), e000323–e000323. doi:10.1136/bmjopen-2011-000323.CrossRefPubMedPubMedCentral Goering, P. N., Streiner, D. L., Adair, C., Aubry, T., Barker, J., Distasio, J., … Zabkiewicz, D. M. (2011). The At Home/Chez Soi trial protocol: A pragmatic, multi-site, randomised controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities. BMJ Open, 1(2), e000323–e000323. doi:10.​1136/​bmjopen-2011-000323.CrossRefPubMedPubMedCentral
8.
9.
go back to reference Atkinson, M., Zibin, S., Chuang, H., & others (1997). Characterizing quality of life among patients with chronic mental illness: A critical examination of the self-report methodology. American Journal of Psychiatry, 154(1), 99–105.CrossRefPubMed Atkinson, M., Zibin, S., Chuang, H., & others (1997). Characterizing quality of life among patients with chronic mental illness: A critical examination of the self-report methodology. American Journal of Psychiatry, 154(1), 99–105.CrossRefPubMed
10.
go back to reference Ahmed, S., Mayo, N., Scott, S., Kuspinar, A., & Schwartz, C. (2011). Using latent trajectory analysis of residuals to detect response shift in general health among patients with multiple sclerosis. [corrected]. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 20(10), 1555–1560. doi:10.1007/s11136-011-0005-6.CrossRef Ahmed, S., Mayo, N., Scott, S., Kuspinar, A., & Schwartz, C. (2011). Using latent trajectory analysis of residuals to detect response shift in general health among patients with multiple sclerosis. [corrected]. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 20(10), 1555–1560. doi:10.​1007/​s11136-011-0005-6.CrossRef
13.
go back to reference Stergiopoulos, V., Hwang, S. W., Gozdzik, A., Nisenbaum, R., Latimer, E., Rabouin, D., Goering, P. N. (2015). Effect of scattered-site housing using rent supplements and intensive case management on housing stability among homeless adults with mental illness: A Randomized Trial. JAMA: The Journal of The American Medical Association, 313(9), 905. doi:10.1001/jama.2015.1163.CrossRefPubMed Stergiopoulos, V., Hwang, S. W., Gozdzik, A., Nisenbaum, R., Latimer, E., Rabouin, D., Goering, P. N. (2015). Effect of scattered-site housing using rent supplements and intensive case management on housing stability among homeless adults with mental illness: A Randomized Trial. JAMA: The Journal of The American Medical Association, 313(9), 905. doi:10.​1001/​jama.​2015.​1163.CrossRefPubMed
14.
go back to reference Aubry, T., Goering, P., Veldhuizen, S., Adair, C. E., Bourque, J., Distasio, J., Streiner, D. L. (2015). A randomized controlled trial in five Canadian cities of the effectiveness of housing first with assertive community treatment for persons with serious mental illness and a history of homelessness. Psychiatric Services, 67(3), 275–281.CrossRefPubMed Aubry, T., Goering, P., Veldhuizen, S., Adair, C. E., Bourque, J., Distasio, J., Streiner, D. L. (2015). A randomized controlled trial in five Canadian cities of the effectiveness of housing first with assertive community treatment for persons with serious mental illness and a history of homelessness. Psychiatric Services, 67(3), 275–281.CrossRefPubMed
15.
go back to reference Sheehan, D., & Lecrubier, Y. (2010). The Mini International Neuropsychiatric Interview Version 6.0 (MINI 6.0). Jacksonville, FL: Medical Outcomes System Inc. Sheehan, D., & Lecrubier, Y. (2010). The Mini International Neuropsychiatric Interview Version 6.0 (MINI 6.0). Jacksonville, FL: Medical Outcomes System Inc.
18.
go back to reference Lam, J. A., & Rosenheck, R. A. (2000). Correlates of improvement in quality of life among homeless persons with serious mental illness. Psychiatric Services (Washington, D.C.), 51(1), 116–118.CrossRef Lam, J. A., & Rosenheck, R. A. (2000). Correlates of improvement in quality of life among homeless persons with serious mental illness. Psychiatric Services (Washington, D.C.), 51(1), 116–118.CrossRef
19.
20.
go back to reference Lehman, A. F., Postrado, L. T., & Rachuba, L. T. (1993). Convergent validation of quality of life assessments for persons with severe mental illnesses. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 2(5), 327–333.CrossRef Lehman, A. F., Postrado, L. T., & Rachuba, L. T. (1993). Convergent validation of quality of life assessments for persons with severe mental illnesses. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 2(5), 327–333.CrossRef
22.
go back to reference Lehman, A. F., Dixon, L. B., Kernan, E., DeForge, B. R., & Postrado, L. T. (1997). A randomized trial of assertive community treatment for homeless persons with severe mental illness. Archives of General Psychiatry, 54(11), 1038–1043.CrossRefPubMed Lehman, A. F., Dixon, L. B., Kernan, E., DeForge, B. R., & Postrado, L. T. (1997). A randomized trial of assertive community treatment for homeless persons with severe mental illness. Archives of General Psychiatry, 54(11), 1038–1043.CrossRefPubMed
23.
go back to reference Lehman, A. F., Kernan, E., DeForge, B. R., & Dixon, L. B. (1995). Effects of homelessness on the quality of life of persons with severe mental illness. Psychiatric Services (Washington, D.C.), 46(9), 922–926.CrossRef Lehman, A. F., Kernan, E., DeForge, B. R., & Dixon, L. B. (1995). Effects of homelessness on the quality of life of persons with severe mental illness. Psychiatric Services (Washington, D.C.), 46(9), 922–926.CrossRef
24.
go back to reference Statistics Canada. (2005). Canadian Community Health Survey (Survey). Ottawa, ON: Statistical Society of Canada. Statistics Canada. (2005). Canadian Community Health Survey (Survey). Ottawa, ON: Statistical Society of Canada.
26.
go back to reference Corrigan, P. W., Salzer, M., Ralph, R. O., Sangster, Y., & Keck, L. (2004). Examining the Factor Structure of the Recovery Assessment Scale. Schizophrenia Bulletin, 30(4), 1035–1041.CrossRefPubMed Corrigan, P. W., Salzer, M., Ralph, R. O., Sangster, Y., & Keck, L. (2004). Examining the Factor Structure of the Recovery Assessment Scale. Schizophrenia Bulletin, 30(4), 1035–1041.CrossRefPubMed
27.
go back to reference Barker, S., Barron, N., McFarland, B. H., & Bigelow, D. A. (1994). A community ability scale for chronically mentally ill consumers: Part I. Reliability and validity. Community Mental Health Journal, 30(4), 363–383.CrossRefPubMed Barker, S., Barron, N., McFarland, B. H., & Bigelow, D. A. (1994). A community ability scale for chronically mentally ill consumers: Part I. Reliability and validity. Community Mental Health Journal, 30(4), 363–383.CrossRefPubMed
30.
go back to reference Ware, J., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233.CrossRefPubMed Ware, J., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233.CrossRefPubMed
31.
go back to reference Dennis, M. L., Chan, Y.-F., & Funk, R. R. (2006). Development and validation of the GAIN Short Screener (GSS) for internalizing, externalizing and substance use disorders and crime/violence problems among adolescents and adults. The American Journal on Addictions/American Academy of Psychiatrists in Alcoholism and Addictions, 15 (Suppl 1), 80–91. doi:10.1080/10550490601006055.CrossRef Dennis, M. L., Chan, Y.-F., & Funk, R. R. (2006). Development and validation of the GAIN Short Screener (GSS) for internalizing, externalizing and substance use disorders and crime/violence problems among adolescents and adults. The American Journal on Addictions/American Academy of Psychiatrists in Alcoholism and Addictions, 15 (Suppl 1), 80–91. doi:10.​1080/​1055049060100605​5.CrossRef
32.
go back to reference Boucekine, M., Boyer, L., Baumstarck, K., Millier, A., Ghattas, B., Auquier, P., & Toumi, M. (2015). Exploring the response shift effect on the quality of life of patients with schizophrenia: An application of the random forest method. Medical Decision Making: An International Journal of the Society for Medical Decision Making, 35(3), 388–397. doi:10.1177/0272989X14559273.CrossRef Boucekine, M., Boyer, L., Baumstarck, K., Millier, A., Ghattas, B., Auquier, P., & Toumi, M. (2015). Exploring the response shift effect on the quality of life of patients with schizophrenia: An application of the random forest method. Medical Decision Making: An International Journal of the Society for Medical Decision Making, 35(3), 388–397. doi:10.​1177/​0272989X14559273​.CrossRef
34.
go back to reference Zissi, A., Barry, M. M., & Cochrane, R. (1998). A mediational model of quality of life for individuals with severe mental health problems. Psychological Medicine, 28(5), 1221–1230.CrossRefPubMed Zissi, A., Barry, M. M., & Cochrane, R. (1998). A mediational model of quality of life for individuals with severe mental health problems. Psychological Medicine, 28(5), 1221–1230.CrossRefPubMed
35.
go back to reference Lehman, A. F. (1983). The well-being of chronic mental patients. Archives of General Psychiatry, 40(4), 369–373.CrossRefPubMed Lehman, A. F. (1983). The well-being of chronic mental patients. Archives of General Psychiatry, 40(4), 369–373.CrossRefPubMed
36.
37.
go back to reference StataCorp (2013). Stata Statistical Software: Release 13. College Station, TX: StataCorp LP. StataCorp (2013). Stata Statistical Software: Release 13. College Station, TX: StataCorp LP.
39.
go back to reference Barclay-Goddard, R., Epstein, J. D., & Mayo, N. E. (2009). Response shift: A brief overview and proposed research priorities. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 18(3), 335–346. doi:10.1007/s11136-009-9450-x.CrossRef Barclay-Goddard, R., Epstein, J. D., & Mayo, N. E. (2009). Response shift: A brief overview and proposed research priorities. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 18(3), 335–346. doi:10.​1007/​s11136-009-9450-x.CrossRef
40.
go back to reference Schwartz, C. E., Quaranto, B. R., Rapkin, B. D., Healy, B. C., Vollmer, T., & Sprangers, M. A. G. (2014). Fluctuations in appraisal over time in the context of stable versus non-stable health. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 23(1), 9–19. doi:10.1007/s11136-013-0471-0.CrossRef Schwartz, C. E., Quaranto, B. R., Rapkin, B. D., Healy, B. C., Vollmer, T., & Sprangers, M. A. G. (2014). Fluctuations in appraisal over time in the context of stable versus non-stable health. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 23(1), 9–19. doi:10.​1007/​s11136-013-0471-0.CrossRef
42.
go back to reference Hubley, A. M., Russell, L. B., Palepu, A., & Hwang, S. W. (2014). Subjective quality of life among individuals who are homeless: A review of current knowledge. Social Indicators Research, 115(1), 509–524. doi:10.1007/s11205-012-9998-7.CrossRef Hubley, A. M., Russell, L. B., Palepu, A., & Hwang, S. W. (2014). Subjective quality of life among individuals who are homeless: A review of current knowledge. Social Indicators Research, 115(1), 509–524. doi:10.​1007/​s11205-012-9998-7.CrossRef
43.
go back to reference Evans, S., & Huxley, P. (2005). Adaptation, response-shift and quality of life ratings in mentally well and unwell groups. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 14(7), 1719–1732.CrossRef Evans, S., & Huxley, P. (2005). Adaptation, response-shift and quality of life ratings in mentally well and unwell groups. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 14(7), 1719–1732.CrossRef
44.
go back to reference Ruta, D. A., Garratt, A. M., Leng, M., Russell, I. T., & MacDonald, L. M. (1994). A new approach to the measurement of quality of life: The patient-generated index. Medical Care, 32(11), 1109–1126.CrossRefPubMed Ruta, D. A., Garratt, A. M., Leng, M., Russell, I. T., & MacDonald, L. M. (1994). A new approach to the measurement of quality of life: The patient-generated index. Medical Care, 32(11), 1109–1126.CrossRefPubMed
45.
go back to reference Ahmed, S., Mayo, N. E., Wood-Dauphinee, S., Hanley, J. A., & Cohen, S. R. (2005). Using the patient generated index to evaluate response shift post-stroke. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 14(10), 2247–2257. doi:10.1007/s11136-005-8118-4.CrossRef Ahmed, S., Mayo, N. E., Wood-Dauphinee, S., Hanley, J. A., & Cohen, S. R. (2005). Using the patient generated index to evaluate response shift post-stroke. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 14(10), 2247–2257. doi:10.​1007/​s11136-005-8118-4.CrossRef
46.
go back to reference Schwartz, C. E., Sprangers, M. A. G., Oort, F. J., Ahmed, S., Bode, R., Li, Y., & Vollmer, T. (2011). Response shift in patients with multiple sclerosis: An application of three statistical techniques. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 20(10), 1561–1572. doi:10.1007/s11136-011-0056-8.CrossRef Schwartz, C. E., Sprangers, M. A. G., Oort, F. J., Ahmed, S., Bode, R., Li, Y., & Vollmer, T. (2011). Response shift in patients with multiple sclerosis: An application of three statistical techniques. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 20(10), 1561–1572. doi:10.​1007/​s11136-011-0056-8.CrossRef
Metagegevens
Titel
Changes in quality of life from a homelessness intervention: true change, response shift, or random variation
Auteurs
Guido Antonio Powell
Carol E. Adair
David L. Streiner
Nancy Mayo
Eric Latimer
Publicatiedatum
24-02-2017
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 7/2017
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-017-1522-8