City Research Online

Abstract

The central premise of this thesis is that the generation of a response to a questionnaire item on subjective health perceptions is highly complex, dynamic, and contextualised within an individual’s unique frame of reference. Consequently, an integrative framework for the investigation of response processes and subjective health was adopted, informed by psychological theory, and techniques drawn from qualitative, cognitive, survey and psychometric traditions.

The focus of research involved the detailed examination of a single health status measure, the SF-12v2 (a brief, multi-dimensional health status measure), completed by comparative samples of university and HIV participants (representing nominally healthy and health problem groups). The use of the SF-12v2 and the two samples allowed comparisons to be made between methods and samples throughout the research.

Qualitative (cognitive) techniques provided rich and useful information on response processes used when completing the health status measure, with considerable variation in item interpretation and clear contextual influences on response strategies employed. Nevertheless, differences in response processes between samples generally related to substantive health problems, which could be summarised and investigated quantitatively.

The quantitative research indicated that the SF-12v2 possessed generally good psychometric properties, although not identical for the two samples, and that the relationship between contextual factors, response process and response could be meaningfully examined. Finally, path analyses demonstrated that a unified model of response could be developed and tested, linking contextual factors, response strategy and SF-12v2 scores. The results showed that personality and objective health factors influenced physical and mental health scale scores, although direct and mediated pathways differed by outcome and sample.

In conclusion, this research framework has offered important insights into the response processes involved in the completion of a health status measure. The use of multiple qualitative and quantitative techniques has provided a more detailed understanding of response from different methodological perspectives. Nonetheless, further work is required to more fully develop this contextual model of response.

Publication Type:	Thesis (Doctoral)
Subjects:	H Social Sciences > HM Sociology
Departments:	Doctoral Theses School of Policy & Global Affairs School of Policy & Global Affairs > Sociology & Criminology

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