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Impact of reconceptualization response shift on rating of quality of life over time among people with advanced cancer

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Abstract

Background

People with cancer may experience change in what constitutes quality of life (QOL) over time as a result of the cancer progression (true change) or adaptation to the experience, considered as a response shift phenomenon. As individualized measures are ideally suited to explore response shift, this study aimed to estimate the extent to which reconceptualization response shift occurred over time in a cancer population and the impact of this response shift on estimates of change on QOL measures.

Methods

Ninety-seven people with advanced cancer completed the study measures including the Patient-Generated Index (PGI) at diagnosis (T0) and 1 year later (T1). The response shift indicator was the change in the number of areas nominated (range − 4 to + 3). Multivariate linear regression was used to estimate the effect of changing areas on change in the PGI score, single indicators of global QOL, and the EQ-5Dindex adjusted for age and sex.

Results

Approximately 72% of people in this sample either added or dropped areas over time. People who dropped more than two areas had higher PGI scores at T1 than T0 while people who added areas showed low PGI score.

Conclusion

The results are consistent with the PGI framework as areas nominated tend to focus on negative aspects of QOL.

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Funding

This research was supported by a grant from the Terry Fox Research Institute and by the Cancer Research Society/Rob Lutterman Pancreatic Cancer Research Grant. B Gagnon is a recipient of “Chercheur-clinicien Boursier” award from Fond de Recherche Santé Québec, Québec, Canada.

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Correspondence to Ala’ S. Aburub.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Aburub, A.S., Gagnon, B., Ahmed, S. et al. Impact of reconceptualization response shift on rating of quality of life over time among people with advanced cancer. Support Care Cancer 26, 3063–3071 (2018). https://doi.org/10.1007/s00520-018-4156-7

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  • DOI: https://doi.org/10.1007/s00520-018-4156-7

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