Article

OBJECTIVE: To determine whether response shift (a change in the self-perceived
meaning of health-related quality of life [HRQL]) was present in a model of
physical function over time poststroke. DESIGN: Secondary data analysis of a
longitudinal observational study. SETTING: Community. PARTICIPANTS: A consecutive
sample of stroke survivors (N=677) at 1, 3, 6, and 12 months poststroke was
included. Sixty-seven individuals were approached, but refused. Sixty-seven
percent completed the study at 12 months. Mean age was 68 years; 45% of the
participants were women. INTERVENTIONS: Not applicable. MAIN OUTCOMES MEASURES:
The Medical Outcomes Study 36-Item Short-Form Health Survey, Euroqol, Stroke
Impact Scale, Preference-Based Stroke Index, and the Health Utilities Index.
RESULTS: Structural equation modeling was used to identify response shift. A
chi-square difference test between constrained and unconstrained longitudinal
models suggested the presence of response shift in the data. Reprioritization
response shift, a change in relative importance of domains, was observed for
physical activites. Recalibration response shift, a change in internal standards
of measurement, was observed in physical activities, stairs, walking, and hand
function. CONCLUSIONS: Response shift has implications for the measurement of
change in physical function. Measures that focus on difficulty in task
performance may be sensitive to response shift, resulting in a change in
perceived HRQL over time. This has implications for choosing self-perceived or
performance-based measures to detect change in physical function.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS