A 'short walk' is longer before radiotherapy than afterwards: a qualitative study questioning the baseline and follow-up design

Health and Quality of Life Outcomes

Research

Florence J van Zuuren¹  Bruce D Rapkin²  Mechteld RM Visser³  Margot A Koeneman⁴  Elsbeth F Taminiau-Bloem⁴  Mirjam AG Sprangers⁴  Caro CE Koning⁵ 

[1] Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands;Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, USA;Department of General Practice, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;Department of Radiotherapy, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;

关键词: Cognitive Process;    Target Construct;    Short Walk;    Radiotherapeutic Treatment;    Salient Content;   

DOI  :  10.1186/1477-7525-8-69

 received in 2010-01-15, accepted in 2010-07-16,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundNumerous studies have indirectly demonstrated changes in the content of respondents' QoL appraisal process over time by revealing response-shift effects. This is the first known study to qualitatively examine the assumption of consistency in the content of the cognitive processes underlying QoL appraisal over time. Specific objectives are to examine whether the content of each distinct cognitive process underlying QoL appraisal is (dis)similar over time and whether patterns of (dis)similarity can be discerned across and within patients and/or items.MethodsWe conducted cognitive think-aloud interviews with 50 cancer patients prior to and following radiotherapy to elicit cognitive processes underlying the assessment of 7 EORTC QLQ-C30 items. Qualitative analysis of patients' responses at baseline and follow-up was independently carried out by 2 researchers by means of an analysis scheme based on the cognitive process models of Tourangeau et al. and Rapkin & Schwartz.ResultsThe interviews yielded 342 comparisons of baseline and follow-up responses, which were analyzed according to the five cognitive processes underlying QoL appraisal. The content of comprehension/frame of reference changed in 188 comparisons; retrieval/sampling strategy in 246; standards of comparison in 152; judgment/combinatory algorithm in 113; and reporting and response selection in 141 comparisons. Overall, in 322 comparisons of responses (94%) the content of at least one cognitive component changed over time. We could not discern patterns of (dis)similarity since the content of each of the cognitive processes differed across and within patients and/or items. Additionally, differences found in the content of a cognitive process for one item was not found to influence dissimilarity in the content of that same cognitive process for the subsequent item.ConclusionsThe assumption of consistency in the content of the cognitive processes underlying QoL appraisal over time was not found to be in line with the cognitive processes described by the respondents. Additionally, we could not discern patterns of (dis)similarity across and within patients and/or items. In building on cognitive process models and the response shift literature, this study contributes to a better understanding of patient-reported QoL appraisal over time.

【 授权许可】

CC BY   
© Taminiau-Bloem et al; licensee BioMed Central Ltd. 2010