IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v21y2001i3p190-199.html
   My bibliography  Save this article

Do Nonpatients Underestimate the Quality of Life Associated with Chronic Health Conditions because of a Focusing Illusion?

Author

Listed:
  • Peter A. Ubel

    (Veterans Affairs Medical Center, Ann Arbor, Michigan, Division of General Internal Medicine, University of Michigan School of Medicine, Ann Arbor, Program for Improving Health Care Decisions, Ann Arbor, Michigan)

  • George Loewenstein

    (Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania)

  • John Hershey

    (Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, the Wharton School, University of Pennsylvania, Philadelphia)

  • Jonathan Baron

    (Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Department of Psychology, University of Pennsylvania, Philadelphia)

  • Tara Mohr

    (Division of General Internal Medicine, University of Pennsylvania, Philadelphia)

  • David A. Asch

    (Division of General Internal Medicine, University of Pennsylvania, Philadelphia, Veterans Affairs Medical Center, Philadelphia, Pennsylvania)

  • Christopher Jepson

    (Division of General Internal Medicine, University of Pennsylvania, Philadelphia)

Abstract

Background . A number of studies show that the general public often estimates that the quality of life (QOL) associated with various health conditions is worse than patients say it is. These studies raise the possibility that people overestimate the impact that unfamiliar health conditions will have on their quality of life. One possible reason people overestimate this is because they are susceptible to a focusing illusion—when asked to imagine themselves in unfamiliar circumstances, people overestimate the emotional impact of those features of their life that would change. Methods . The authors surveyed members of the general public to test the hypothesis that their QOL ratings of hypothetical health conditions would be higher (indicating a better quality of life) after thinking about how the health condition would affect a broad range of life domains. Across 3 experiments, the authors varied the health conditions people were asked to consider (either paraplegia, below-the-knee amputation, or partial blindness), the life domains they were asked to consider, the response mode with which they evaluated how each health condition would affect each life domain, whether subjects rated the health condition before and after considering life domains or only after, and whether subjects rated their own current quality of life first. Results . Across 3 experiments, using 10 different questionnaire versions, only 1 instance was found in which subjects’ ratings were significantly higher after thinking about the effect of the health condition on life domains than before, and the magnitude of this increase was small. Conclusion . It could not be established that a focusing illusion contributes significantly to the discrepancy in QOL ratings of patients and nonpatients. Further research should explore other factors that could contribute to the discrepancy or other ways of testing for the influence of a focusing illusion.

Suggested Citation

  • Peter A. Ubel & George Loewenstein & John Hershey & Jonathan Baron & Tara Mohr & David A. Asch & Christopher Jepson, 2001. "Do Nonpatients Underestimate the Quality of Life Associated with Chronic Health Conditions because of a Focusing Illusion?," Medical Decision Making, , vol. 21(3), pages 190-199, May.
    • Handle: RePEc:sae:medema:v:21:y:2001:i:3:p:190-199
    DOI: 10.1177/0272989X0102100304
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X0102100304
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X0102100304?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Sprangers, Mirjam A. G. & Schwartz, Carolyn E., 1999. "Integrating response shift into health-related quality of life research: a theoretical model," Social Science & Medicine, Elsevier, vol. 48(11), pages 1507-1515, June.
    2. Gibbons, F. X., 1999. "Social comparison as a mediator of response shift," Social Science & Medicine, Elsevier, vol. 48(11), pages 1517-1530, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Paul Dolan & Daniel Kahneman, 2008. "Interpretations Of Utility And Their Implications For The Valuation Of Health," Economic Journal, Royal Economic Society, vol. 118(525), pages 215-234, January.
    2. Witt, Ulrich & Binder, Martin, 2013. "Disentangling motivational and experiential aspects of “utility” – A neuroeconomics perspective," Journal of Economic Psychology, Elsevier, vol. 36(C), pages 27-40.
    3. Schünemann, Johannes & Strulik, Holger & Trimborn, Timo, 2017. "Going from bad to worse: Adaptation to poor health health spending, longevity, and the value of life," Journal of Economic Behavior & Organization, Elsevier, vol. 140(C), pages 130-146.
    4. van Praag, Bernard M. S. & Ferrer-i-Carbonell, Ada, 2001. "Age-Differentiated QALY Losses," IZA Discussion Papers 314, Institute of Labor Economics (IZA).
    5. Cass R. Sunstein, 2008. "Illusory Losses," The Journal of Legal Studies, University of Chicago Press, vol. 37(S2), pages 157-194, June.
    6. Burstrom, Kristina & Johannesson, Magnus & Diderichsen, Finn, 2006. "A comparison of individual and social time trade-off values for health states in the general population," Health Policy, Elsevier, vol. 76(3), pages 359-370, May.
    7. Paul Dolan, 2011. "Thinking about it: thoughts about health and valuing QALYs," Health Economics, John Wiley & Sons, Ltd., vol. 20(12), pages 1407-1416, December.
    8. A. Pickard & Rima Tawk & James Shaw, 2013. "The effect of chronic conditions on stated preferences for health," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(4), pages 697-702, August.
    9. Damschroder, Laura J. & Zikmund-Fisher, Brian J. & Ubel, Peter A., 2005. "The impact of considering adaptation in health state valuation," Social Science & Medicine, Elsevier, vol. 61(2), pages 267-277, July.
    10. Björn Sossong & Stefan Felder & Malte Wolff & Klaus Krüger, 2017. "Evaluating the consequences of rheumatoid arthritis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(6), pages 685-696, July.
    11. John Feddersen & Robert Metcalfe & Mark Wooden, 2012. "Subjective Well-Being: Weather Matters; Climate Doesn't," Melbourne Institute Working Paper Series wp2012n25, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
    12. Peña-Longobardo, L.M. & Rodríguez-Sánchez, B. & Oliva-Moreno, J., 2021. "The impact of widowhood on wellbeing, health, and care use: A longitudinal analysis across Europe," Economics & Human Biology, Elsevier, vol. 43(C).
    13. Dolan, Paul & Metcalfe, Robert, 2010. "'Oops...I did it again': Repeated focusing effects in reports of happiness," Journal of Economic Psychology, Elsevier, vol. 31(4), pages 732-737, August.
    14. Octave Jokung & Serge Macé, 2013. "Long-term health investment when people underestimate their adaptation to old age-related health problems," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(6), pages 1003-1013, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Damschroder, Laura J. & Zikmund-Fisher, Brian J. & Ubel, Peter A., 2005. "The impact of considering adaptation in health state valuation," Social Science & Medicine, Elsevier, vol. 61(2), pages 267-277, July.
    2. Kaiser, Caspar, 2022. "Using memories to assess the intrapersonal comparability of wellbeing reports," Journal of Economic Behavior & Organization, Elsevier, vol. 193(C), pages 410-442.
    3. Katrin Boström & Gerd Ahlström & Helena Sunvisson, 2006. "Being the Next of Kin of an Adult Person With Muscular Dystrophy," Clinical Nursing Research, , vol. 15(2), pages 86-104, May.
    4. Dibb, Bridget & Yardley, Lucy, 2006. "How does social comparison within a self-help group influence adjustment to chronic illness? A longitudinal study," Social Science & Medicine, Elsevier, vol. 63(6), pages 1602-1613, September.
    5. Wim Groot, 2003. "Scale of reference bias and the evolution of health," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 4(3), pages 176-183, September.
    6. Maes, Kenneth C. & Hadley, Craig & Tesfaye, Fikru & Shifferaw, Selamawit, 2010. "Food insecurity and mental health: Surprising trends among community health volunteers in Addis Ababa, Ethiopia during the 2008 food crisis," Social Science & Medicine, Elsevier, vol. 70(9), pages 1450-1457, May.
    7. Winter, Laraine & Parker, Barbara, 2007. "Current health and preferences for life-prolonging treatments: An application of prospect theory to end-of-life decision making," Social Science & Medicine, Elsevier, vol. 65(8), pages 1695-1707, October.
    8. Valentina Piwowar & Felicitas Thiel, 2014. "Evaluating Response Shift in Training Evaluation," Evaluation Review, , vol. 38(5), pages 420-448, October.
    9. Julie Yun Chen & Eric Yuk Fai Wan & Edmond Pui Hang Choi & Anca Ka Chun Chan & Karina Hiu Yen Chan & Joyce Pui Yan Tsang & Cindy Lo Kuen Lam, 2017. "The Health-Related Quality of Life of Chinese Patients on Hemodialysis and Peritoneal Dialysis," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 10(6), pages 799-808, December.
    10. Joseph T. King Jr. & Joel Tsevat & Judith R. Lave & Mark S. Roberts, 2005. "Willingness to Pay for a Quality-Adjusted Life Year: Implications for Societal Health Care Resource Allocation," Medical Decision Making, , vol. 25(6), pages 667-677, November.
    11. de Hond, Anne & Bakx, Pieter & Versteegh, Matthijs, 2019. "Can time heal all wounds? An empirical assessment of adaptation to functional limitations in an older population," Social Science & Medicine, Elsevier, vol. 222(C), pages 180-187.
    12. Chia-Huei Wu, 2009. "Enhancing quality of life by shifting importance perception among life domains," Journal of Happiness Studies, Springer, vol. 10(1), pages 37-47, March.
    13. Nele Van Hecke & Claudia Claes & Wouter Vanderplasschen & Jessica De Maeyer & Nico De Witte & Stijn Vandevelde, 2018. "Conceptualisation and Measurement of Quality of Life Based on Schalock and Verdugo’s Model: A Cross-Disciplinary Review of the Literature," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 137(1), pages 335-351, May.
    14. Paul Dolan & Daniel Kahneman, 2008. "Interpretations Of Utility And Their Implications For The Valuation Of Health," Economic Journal, Royal Economic Society, vol. 118(525), pages 215-234, January.
    15. Raphaële R. L. van Litsenburg & Annemieke Kunst & Jaap Huisman & Johannes C. F. Ket & Gertjan J. L. Kaspers & Reinoud J. B. J. Gemke, 2014. "Health Status Utilities in Pediatrics," Medical Decision Making, , vol. 34(1), pages 21-32, January.
    16. Chan-Hee Park & Eunhee Park & Hyun-Min Oh & Su-Jin Lee & Sun-Hee Park & Tae-Du Jung, 2022. "Health-Related Quality of Life According to Sociodemographic Characteristics in the South Korean Population," IJERPH, MDPI, vol. 19(9), pages 1-9, April.
    17. Lazarevič, Patrick & Brandt, Martina, 2020. "Diverging ideas of health? Comparing the basis of health ratings across gender, age, and country," Social Science & Medicine, Elsevier, vol. 267(C).
    18. Carolyn Schwartz & Penelope Keyl & John Marcum & Rita Bode, 2009. "Helping Others Shows Differential Benefits on Health and Well-being for Male and Female Teens," Journal of Happiness Studies, Springer, vol. 10(4), pages 431-448, August.
    19. Ann Bowling & Zahava Gabriel, 2004. "An Integrational Model of Quality of Life in Older Age. Results from the ESRC/MRC HSRC Quality of Life Survey in Britain," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 69(1), pages 1-36, October.
    20. Grzegorz Zurek & Agata Goraczko & Alina Żurek & Maciej Lachowicz & Katarzyna Kujawa, 2022. "Restored Life of Elite Athletes after Spinal Cord Injury," IJERPH, MDPI, vol. 19(14), pages 1-13, July.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:21:y:2001:i:3:p:190-199. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.