中華心理衛生協會

Purpose: Quality of life (QoL) studies of patients with chronic kidney disease (CKD) showed that the QoL of dialysis patients is not worse than the QoL of patients with earlystage CKD who do not need dialysis. According to response shift theory, this result may be due to a change in the individual’s internal standards (recalibration) or values (reprioritization), or due to a reconceptualization of QoL. This study aimed to test the response shift theory to determine whether the equivalence in QoL of these two groups is due to a response shift for the dialysis patients. We hypothesized that patients would generate a response shift only if they had a have-want discrepancy. Methods: A total of 85 patients were recruited from February to November 2013, including 28 (mean age was 56.5, 14 male) with stage 3-5 CKD, and 57 (mean age was 48.1, 31 male) who had been undergoing dialysis for their past year. All patients completed the Schedule for Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW) twice with three months between tests and then test. Have-want discrepancy was the average absolute difference of ideal scores and satisfaction of each domains of SEIQoL-DW. Results: The two-way repeated measures ANCOVA showed no significant difference in QoL between the dialysis group and the non-dialysis group. Neither was the difference of response shift indices between these two groups significant. Patients were divided into high, middle, and low discrepancy groups according to their have-want discrepancy. A two-way repeated measures ANCOVA revealed that the high discrepancy group significantly raised their reported QoL. The recalibration and reconceptualization indices also differed significantly between the two groups. Conclusions: This study supported the response shift theory and identified the havewant discrepancy as one of the mechanisms triggering a response shift.