TY - JOUR
T1 - How do patients with HIV/AIDS understand and respond to health value questions?
AU - Sherman, Susan N.
AU - Mrus, Joseph M.
AU - Yi, Michael S.
AU - Feinberg, Judith
AU - Tsevat, Joel
N1 - Funding Information:
The authors greatly appreciate the interest and support of the faculty and staff of the Infectious Diseases Center at the University of Cincinnati Medical Center. Further, we sincerely value their patients" willingness to participate in multiple studies and to speak with such frankness about the impact of HIV on their lives, This study was funded by the Health Services Research & Development Service, Department of Veterans Affairs (grant # ECI 01-195) and by the National Center for Complementary and Alternative Medicine (grant # 1 R01 AT01147). Dr. Tsevat is supported by a National Center for Complementary and Alternative Medicine award (grant # K24 AT001676); Dr. Mrus was supported by a Department of Veterans Affairs Health Services Research & Development Research Career Development Award (grant # RCD-01011-2) at the time this study was conducted; Dr, Yi is supported by a National Institute of Child Health and Human Development Career Development Award (K23HD046690); and Drs, Feinberg, Tsevat, and Mrus are or were supported by an AIDS Clinical Trials Unit grant from the National Institute of Allergy and Infectious Diseases (grant # UO 1A125897).
PY - 2006/12
Y1 - 2006/12
N2 - BACKGROUND: Utility assessment involves assigning values to experienced or unfamiliar health states. Pivotal to utility assessment, then, is how one conceptualizes health states such as "current health" and "perfect health." The purpose of this study was to ascertain how patients with HIV think about and value health and health states. METHODS: We conducted open-ended in-depth interviews with 32 patients with HIV infection purposefully sampled from a multicenter study of quality of life in HIV. After undergoing computer-assisted utility assessment using the rating scale, time tradeoff, and standard gamble methods, patients were asked how they thought about the utility tasks and about the terms "current health" and "perfect health." RESULTS: Patients understood the health valuation tasks but conceptualized health states in different ways. Many patients believed that "perfect health" was a mythical health state, and some questioned whether it was even desirable. "Current health" was variably interpreted as the status quo; deteriorating over time; or potentially improving with the hope of a cure. CONCLUSION: Patients with HIV infection vary in the way they conceptualize health states central to utility assessment, such as perfect health and current health. Better understanding of these issues could make important methodologic and policy-level contributions.
AB - BACKGROUND: Utility assessment involves assigning values to experienced or unfamiliar health states. Pivotal to utility assessment, then, is how one conceptualizes health states such as "current health" and "perfect health." The purpose of this study was to ascertain how patients with HIV think about and value health and health states. METHODS: We conducted open-ended in-depth interviews with 32 patients with HIV infection purposefully sampled from a multicenter study of quality of life in HIV. After undergoing computer-assisted utility assessment using the rating scale, time tradeoff, and standard gamble methods, patients were asked how they thought about the utility tasks and about the terms "current health" and "perfect health." RESULTS: Patients understood the health valuation tasks but conceptualized health states in different ways. Many patients believed that "perfect health" was a mythical health state, and some questioned whether it was even desirable. "Current health" was variably interpreted as the status quo; deteriorating over time; or potentially improving with the hope of a cure. CONCLUSION: Patients with HIV infection vary in the way they conceptualize health states central to utility assessment, such as perfect health and current health. Better understanding of these issues could make important methodologic and policy-level contributions.
KW - Acquired immunodeficiency syndrome
KW - HIV
KW - Qualitative research
KW - Quality of life
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U2 - 10.1111/j.1525-1497.2006.00647.x
DO - 10.1111/j.1525-1497.2006.00647.x
M3 - Article
C2 - 17083502
AN - SCOPUS:33750484326
SN - 0884-8734
VL - 21
SP - S56-S61
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
IS - SUPPL. 5
ER -