Improving the conceptualisation and measurement of quality of life of patients with multiple chronic morbidities, exemplified by patients with cardiac disease undergoing cardiac intervention.
Despite apparent changes in health, patients may report surprisingly stable quality of life (QoL).Two key causes are addressed that are generally ignored in QoL research: (1) standard QoL questionnaires predominantly tap stable (trait) rather than changeable (state) components of QoL; and (2) they do not take changes in internal standards, values and conceptualisation of QoL (so called response shifts) into account.
The overall objective is to improve the conceptualisation of QoL and enhance the sensitivity and comprehensiveness of its measurement by taking the trait-state distinction and response shift into account.
This project offers: (1) a new theoretical approach of QoL from a narrative perspective incorporating a theory of contingency, to evaluate the implications of the trait-state distinction of QoL and response shift; (2) an Ecological Momentary Assessment (EMA) application of QoL involving repeated sampling of subjects’ current QoL in real-time (assessing state), using iPods; (3) guidelines integrating state and trait components of QoL and response-shift assessments to enhance QoL research.
We will target patients with cardiac disease having multiple morbidities because these conditions are highly prevalent and are associated with high patient burden and societal costs. Moreover, these patients are perfectly suitable for testing the proposed methodology.
This study will provide insight into the indicators of these patients’ QoL. Moreover, the innovative and fundamental conceptualisation and measurement of QoL is, in principle, applicable to other disease groups and care innovations, and will enhance the evidence base for care provision, allocation and reimbursement.