title: Response shift: a theoretical exploration of quality of life following hematopoietic cell transplantation.
abstract: Quality of life (QOL) has become an important outcome measure for evaluating the impact of cancer therapy, especially aggressive cancer therapies such as hematopoietic cell transplantation (HCT). Despite the intense interest in examining the phenomenon of QOL, fundamental concerns remain. Most published QOL studies of HCT recipients do not state the theoretical model on which the investigation was designed. The absence of a theoretical foundation results in difficulties for healthcare professions to interpret the study's outcomes, generalize the findings and design and test theory-based interventions. Most HCT recipients report good to excellent QOL despite ongoing treatment-related sequela. This article explores the theoretical model of response shift as a means of understanding how HCT recipients maintain or improve their QOL after the treatment of life-threatening illness. Finally, a proposal for studying the QOL of HCT recipients based on the response shift model is offered, which includes a discussion of theory-based interventions.
authors.affiliation: Stanford University Medical Center, Stanford, CA 94305, USA. dtierney@standfordmed.org
authors.forename: D Kathryn
authors.initials: DK
authors.lastname: Tierney
authors.forename: Noreen
authors.initials: N
authors.lastname: Facione
authors.forename: Geraldine
authors.initials: G
authors.lastname: Padilla
authors.forename: Marylin
authors.initials: M
authors.lastname: Dodd
mesh_terms: D000223:Adaptation, Psychological; D005260:Female; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000451:nursing / Q000517:prevention & control* / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008960:Models, Psychological; D009859:Oncology Nursing / Q000379:methods; D010147:Pain Measurement; D011788:Quality of Life; D012680:Sensitivity and Specificity; D018434:Sickness Impact Profile