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- Title
Detecting response shift in health-related quality of life measurement among patients with hypertension using structural equation modeling.
- Authors
Chen, Hao; Zhu, Lin; Zhou, Rui; Liu, Panpan; Lu, Xiaoyang; Patrick, Donald L.; Edwards, Todd C.; Wang, Hongmei
- Abstract
<bold>Background: </bold>Outcomes derived from longitudinal self-reported health-related quality of life measures can be confounded by response shift. This study was aimed to detect response shift among patients with hypertension attending a community-based disease management program.<bold>Methods: </bold>240 consecutive consulting or follow-up patients with diagnosed hypertension were recruited. The Short Form 36-item Health Survey was self-administered at 12 community health service stations at baseline and four weeks after attending the program. The 4-step structural equation modeling approach assessed response shift.<bold>Results: </bold>Data from 203 (84.6%) patients were eligible for analyses (mean age 65.9 ± 10.8 years, 46.3% female). The results showed uniform recalibration of social functioning ([Formula: see text](1) = 22.98, P < 0.001), and non-uniform recalibration of role limitations due to physical problems ([Formula: see text](1) = 8.84, P = 0.003), and bodily pain ([Formula: see text](1) = 17.41, P < 0.001). The effects of response shift on social functioning were calculated as "small" (effect-size = 0.35), but changed the observed changes from improvement (effect-size = 0.25) to slight deterioration (effect-size = -0.10). After accounting for the response shift effect, the general physical health of participants was improved (effect-size = 0.37), while deterioration (effect-size = -0.21) in the general mental health was also found.<bold>Conclusions: </bold>Recalibration existed among patients with hypertension attending the disease management program. The interventions in the program might act as a catalyst that induced the response shift. We conclude that response shift should be considered in hypertension research with longitudinal health-related quality of life data.
- Subjects
QUALITY of life measurement; STRUCTURAL equation modeling; QUALITY of life; HYPERTENSION; COMMUNITY health services
- Publication
Health & Quality of Life Outcomes, 2021, Vol 19, Issue 1, p1
- ISSN
1477-7525
- Publication type
journal article
- DOI
10.1186/s12955-021-01732-w