Changes in quality of life in patients with advanced cancer: evidence of response shift and response restriction

Response shift is a process argued to facilitate adjustment to illness. This study investigated the relationship between response shift and adjustment.

Fifty-six patients with metastatic cancer were interviewed using SEIQoL-DW and asked to nominate the five areas of most importance to them. Surviving patients were re-interviewed 3 (n=38) and 6 months (n=28) later.

The majority of patients showed evidence of restricted priorities close to the diagnosis of metastatic cancer. Approximately half the sample shifted their priorities from one area to another over time. Response shift was found to be helpful for those who nominated life domains that were poorly rated, but unhelpful, for those who shifted from a highly rated life domain.

These results suggest that response shift is common during adjustment to illness. However, response shift can be helpful or unhelpful depending upon the context. The clinical and theoretical implications of these findings are discussed.