Understanding appraisal processes underlying the thentest: a mixed methods investigation

Area of Science:

• Psychology
• Health Services Research
• Quality of Life Research

Background:

• Retrospective pretest (thentest) measures are used to assess changes in quality of life (QOL).
• Recalibration response shift (RS) is a cognitive phenomenon that can influence thentest scores.
• Understanding the cognitive processes behind RS is crucial for accurate QOL assessment.

Purpose of the Study:

• To investigate the cognitive processes underlying retrospective pretest (thentest) discrepancy scores, specifically recalibration response shift (RS).
• To compare ipsative and normative discrepancy scores and their relationship with appraisal changes.
• To examine the influence of recall bias on thentest scores in individuals with HIV/AIDS.

Main Methods:

• Mixed methods approach using interviews with 521 people with HIV/AIDS at baseline and 6 months.
• Utilized Quality of Life (QOL) Appraisal Profile, Rand-36, General Health thentest, and recall items.
• Employed factor analysis, coding of open-ended questions, and comparison of ipsative and normative discrepancy scores, controlling for covariates.

Main Results:

• Ipsative and normative discrepancy scores showed convergence but differed in their association with appraisal changes.
• Thentest effect sizes were larger than standard change scores, even after accounting for recall bias.
• Multivariate models incorporating appraisal parameters explained additional variance in QOL outcomes compared to standard models.

Conclusions:

• Ipsative and normative discrepancy scores represent distinct constructs and are not solely explained by recall bias.
• Thentest measures capture a range of health- and self-care-related concerns, not just recalibration.
• These findings highlight the importance of considering cognitive shifts in QOL research and clinical practice.