BRIEF RESEARCH REPORT article
Front. Psychol.
Sec. Psycho-Oncology
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1439655
Assessment of quality of life in cancer patients using anchoring vignettes: Comparisons between mixed cancer patients, patients receiving palliative care, and the general population
Provisionally accepted
Andreas Hinz1*
Ulrich Wedding2Thomas Schulte3
Michael Friedrich4
Anja Mehnert-Theuerkauf4
Astrid Schnabel5
Florian Lordick5- 1Leipzig University, Leipzig, Germany
- 2Department of Palliative Care, Comprehensive Cancer Center Central Germany, Jena, University Hospital Jena, Jena, Germany
- 3Clinic Bad Oexen, Bad Oeyenhausen, Germany
- 4Department of Medical Psychology and Medical Sociology, University Hospital Leipzig, Leipzig, Lower Saxony, Germany
- 5Department of Medicine (Oncology, Gastroenterology, Hepatology, Pulmonology), Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, Leipzig, Germany
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Objective: Quality of life (QoL) has become a relevant outcome criterion in oncology in general and in palliative care in particular. The aims of this study were to compare the QoL of cancer patients receiving palliative care with groups of mixed cancer patients and with the general population, and to test whether response shift effects influence the assessment of QoL.Methods: This study included data from several cross-sectional investigations: one sample of 152 cancer patients receiving palliative care, two samples of patients with mixed cancer diagnoses (n > 500), and two samples of the general population (n > 1000). QoL was assessed with the EORTC QLQ-C30 and with two anchoring vignettes for identifying response shift.Results: QoL was highest in the general population (EORTC QLQ-C30 mean sum score M = 87.4), followed by the mixed cancer patients (M = 70.9) and the palliative care group M = 58.2). Both groups of cancer patients rated the anchoring vignette, which presented a subject with mainly physical problems, as being healthier than the general population did.The results show in which specific dimensions advanced cancer patients report strong detriments in QoL. The different assessments of the vignettes indicate a response shift effect so that the cancer patients have changed their frames of reference for assessing QoL in such a way that they indicate less severe restrictions. This means that the reductions in QoL in cancer patients, as measured with standard questionnaires, tend to underestimate the true detriments.
Keywords: Palliative Care, Quality of Life, self-rated health, response shift, anchoring vignettes
Received: 28 May 2024; Accepted: 22 May 2025.
Copyright: © 2025 Hinz, Wedding, Schulte, Friedrich, Mehnert-Theuerkauf, Schnabel and Lordick. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Andreas Hinz, Leipzig University, Leipzig, Germany
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