Richard Sawatzky

Richard Sawatzky
Trinity Western University · School of Nursing

PhD

About

174
Publications
33,629
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
2,908
Citations
Introduction
Dr. Sawatzky leads a program of research on the validation and use of person-centred health outcomes measures and quality of life assessment instruments, with a particular emphasis on people who are living with chronic life-limiting illnesses. Examples include research on: 1) statistical methods for validation and use of patient-reported outcomes measures, 2) tailored people-centred health measurement, 3) quality of life assessment, and 4) person-centred outcomes for healthcare decision making.
Additional affiliations
April 2013 - present
Trinity Western University
Position
  • Canada Research Chair in Patient-Reported Outcomes
December 2011 - present
Providence Health Care
Position
  • Program Head in Patient-Reported Outcomes
January 2008 - December 2009
Education
September 2003 - November 2007
University of British Columbia - Vancouver
Field of study
  • Quality of Life Measurement

Publications

Publications (174)
Article
Full-text available
Purpose Mixture item response theory (MixIRT) models can be used to uncover heterogeneity in responses to items that comprise patient-reported outcome measures (PROMs). This is accomplished by identifying relatively homogenous latent subgroups in heterogeneous populations. Misspecification of the number of latent subgroups may affect model accuracy...
Article
Full-text available
Aim: Digital health for hypertension management holds potential for improving the quality of care but requires long-term patient engagement to track health data. We explored patient and hypertension specialist perceptions of clinical utility for data tracking including standardized patient-reported outcome measures (PROMs), home blood pressure (BP)...
Article
Full-text available
Purpose To support the use of quality of life (QOL) assessment tools for older adults, we developed knowledge translation (KT) resources tailored for four audiences: (1) older adults and their family caregivers (micro), (2) healthcare providers (micro), (3) healthcare managers and leaders (meso), and (4) government leaders and decision-makers (macr...
Article
Full-text available
Engagement with the historical and theoretical underpinnings of measuring quality of life (QoL) and patient‐reported outcomes (PROs) in healthcare is important. Ideas and values that shape such practices—and in the endgame, people's lives—might otherwise remain unexamined, be taken for granted or even essentialized. Our aim is to explicate and theo...
Article
Full-text available
Tools for measuring patients' perceived health and quality of life, such as patient-reported outcome measures (PROMs), inform clinical decisions for patients requiring radiation therapy. However, there may be inconsistencies in how patients interpret and respond to PROMs due to cultural, environmental, personal, or experiential factors. Differentia...
Article
Background Critical care physicians and nurses have significant roles in the complex process of end-of-life decision making. Objective To understand how nurses' and physicians' emotions, psychosocial factors and professional roles influence end-of-life decision making in critical care. Research design/methodology An interpretive descriptive quali...
Article
Context Socio-demographic differences, including place of residence, socio-economic status, ethnicity, and gender, have been associated with various inequities in cancer care outcomes. Objectives The aims were to distinguish subgroups of patients with different symptom patterns at the time of the initial oncology visit and determine which clinical...
Article
Introduction: The introduction of effective, evidence-based approaches to centredness in health care is hindered by the fact that research results are not easily accessible. This is partly due to the large volume of publications available and because the field is closely linked to and in some ways encompasses adjoining fields of research, for exam...
Article
Background: The Veterans RAND 12-Item Health Survey (VR-12) is a generic patient-reported outcome measure derived from the widely used 36- and 12-item Short Form Health Surveys. We aimed to estimate a Canadian preference-based scoring algorithm for the VR-12, enabling the derivation of health utility values for generating quality-adjusted life yea...
Article
Full-text available
Purpose The Working Group undertook a critical, comprehensive synthesis of the response shift work to date. We aimed to (1) describe the rationale for this initiative; (2) outline how the Working Group operated; (3) summarize the papers that comprise this initiative; and (4) discuss the way forward. Methods Four interdisciplinary teams, consisting...
Article
Full-text available
Purpose This work is part of an international, interdisciplinary initiative to synthesize research on response shift in results of patient-reported outcome measures. The objective is to critically examine current response shift methods. We additionally propose advancing new methods that address the limitations of extant methods. Methods Based on l...
Article
Full-text available
Purpose Results of patient-reported outcome measures (PROMs) are increasingly used to inform healthcare decision-making. Research has shown that response shift can impact PROM results. As part of an international collaboration, our goal is to provide a framework regarding the implications of response shift at the level of patient care (micro), heal...
Presentation
Full-text available
Aims: Two generic patient-reported outcome measures (PROMs; VR-12 and EQ-5D-5L) were fielded across Emergency Departments (EDs) in British Columbia (BC) to inform the selection of a PROM for understanding the health status of patients over time and across organizations. The study objectives were to use the BC PROMs data to compare the validity evid...
Article
In a cluster-randomized trial (CRT), the number of participants enrolled often varies across clusters. This variation should be considered during both trial design and data analysis to ensure statistical performance goals are achieved. Most methodological literature on the CRT design has assumed equal cluster sizes. This scoping review focuses on m...
Article
Objectives Patient-reported outcome measures (PROMs) are used widely to elicit patient's self-appraisal of their health status and quality of life. One fundamental assumption when measuring PROMs is that all individuals interpret questions about their health status in a consistent manner. However, subgroups of patients with a similar health conditi...
Article
Background There is international interest on the use of patient-reported outcomes (PROs) in nephrology.Objectives Our objectives were to develop a kidney-specific program theory about use of PROs in nephrology that may enhance person-centered care, both at individual and aggregated levels of care, and to test and refine this theory through a syste...
Article
Full-text available
Purpose Previous research about the health and quality of life of people with atrial fibrillation has typically identified a single health trajectory. Our study aimed to examine variability in health trajectories and patient characteristics associated with such variability. Methods We conducted a retrospective analysis of data collected between 20...
Article
Objectives: To a) estimate the relative value of older adults' healthcare experiences based on the Canadian Patient Experience Survey for Inpatient Care (CPES-IC) using an economic valuation technique, and b) compare the results with those of a conventional key-driver analysis of healthcare experiences based on bivariate correlations. Study desig...
Article
Full-text available
Background An assumption in many analyses of longitudinal patient-reported outcome (PRO) data is that there is a single population following a single health trajectory. One approach that may help researchers move beyond this traditional assumption, with its inherent limitations, is growth mixture modelling (GMM), which can identify and assess multi...
Article
Objective Distinct cognitive subgroups are seen in patients with long duration bipolar I disorder (BDI), possibly reflective of underlying pathophysiological differences. It is unknown whether such cognitive heterogeneity is present at illness onset. We applied latent class analysis (LCA) to cognitive test scores in first episode BDI patients. Expl...
Article
Full-text available
Importance International efforts are being made towards a person-centred care (PCC) model, but there are currently no standardised mechanisms to measure and monitor PCC at a healthcare system level. The use of metrics to measure PCC can help to drive the changes needed to improve the quality of healthcare that is person centred. Objective To devel...
Article
Objectives: Measuring the perceived mental and physical health status of older adults living in long-term residential care (LTRC) is central to patient-centered care. This study examined the qualitative content validity of the Veterans RAND 12 Item Health Survey (VR-12) for LTRC and, based on the findings, the authors developed an adapted version o...
Article
Full-text available
Background: The McGill Quality of Life Questionnaire - Expanded (MQOL-E) and the Quality of Life in Life-Threatening Illness-Family Carer/Caregiver version (QOLLTI-F) are developed for use with patients facing the end of life and their family carers, respectively. They are also developed for possible use as companion instruments. Contemporary meas...
Article
Full-text available
Background: Health literacy (HL) is a person's ability to practically apply a wide range of cognitive and non-cognitive skills in health-related decisions. HL includes five domains: navigate/access, understand, communicate, evaluate, and use of health information and services. Currently, no tool accurately captures and measures HL in adult patient...
Article
Full-text available
Background: Patient-reported outcomes (pros) are essential to capture the patient's perspective and to influence care. Although pros and pro measures are known to have many important benefits, they are not consistently being used and there is there no Canadian pros oversight. The Position Statement presented here is the first step toward supportin...
Article
Background and objectives: Our aim was to create a "storyline" that provides empirical explanation of stakeholders' perspectives underlying the use of patient- and family-reported outcome and experience measures to inform continuity across transitions in care for frail older adults and their family caregivers living at home. Research design and m...
Article
Full-text available
Background: Up to 1 in 5 patients who undergo total knee arthroplasty (TKA) express dissatisfaction with their surgery. Our goal was to understand the experiences of patients of South Asian origin who undergo TKA and to identify a research agenda for this patient population. Methods: We undertook a modified Delphi study in British Columbia to ge...
Article
Full-text available
To meet patients' information and communication needs over time in order to improve their recovery is particularly challenging for patients undergoing cancer surgery. The aim of the study was to evaluate whether an intervention with a person-centred approach to information and communication for patients diagnosed with colorectal cancer undergoing s...
Article
The Edmonton Symptom Assessment System (Revised) (ESAS-r) contains 9 questions pertaining to symptoms/well-being. It is a standardized patient-reported assessment instrument, but inconsistently used in palliative care. Thus, a problem exists in knowledge translation regarding routine use of the ESAS-r in palliative practice. The objective was to un...
Article
Full-text available
Background: Domains other than those commonly measured (physical, psychological, social, and sometimes existential/spiritual) are important to the quality of life of people with life-threatening illness. The McGill Quality of Life Questionnaire (MQOL) - Revised measures the four common domains. The aim of this study was to create a psychometricall...
Article
Background and purpose: A palliative approach involves adapting and integrating palliative care knowledge and expertise earlier on and across sectors of care for people who have life-limiting chronic conditions. This study explored the extent to which nurses' and care aides' self-perceived palliative care competence may explain variation in the ap...
Article
Introduction and aim: The British Columbia Adult Haemophilia Team recently adopted a patient-centred care approach. The team presented visual information on an individual's pharmacokinetic profile and bleed history and encouraged patients to participate in treatment decisions. This qualitative study explored how this approach changed patients' und...
Article
Full-text available
Objectives: The aim of this study was to investigate symptom prevalence, symptom relief, and palliative care indicators during the last week of life, comparing them for patients with motor neuron disease (MND), central nervous system tumors (CNS tumor), and other neurological diseases (OND). Material & methods: Data were obtained from the Swedis...
Article
Full-text available
Background Joint replacement, an increasingly common procedure amongst older adults, can substantially improve health-related quality of life (HRQoL). However, differential item functioning (DIF) may affect the accurate interpretation of differences in HRQoL amongst patients with different demographic and health status characteristics but the same...
Article
Full-text available
Background Clinical registries, which capture information about the health and healthcare use of patients with a health condition or treatment, often contain patient-reported outcomes (PROs) that provide insights about the patient’s perspectives on their health. Missing data can affect the value of PRO data for healthcare decision-making. We compar...
Article
Abstract Background Clinical registries, which capture information about the health and healthcare use of patients with a health condition or treatment, often contain patient-reported outcomes (PROs) that provide insights about the patient’s perspectives on their health. Missing data can affect the value of PRO data for healthcare decision-making....
Article
Full-text available
Healthcare services are increasingly being provided in the home. At the same time, these home contexts are changing as global migration has brought unprecedented diversity both in the recipients of care, and home health workers. In this paper, we present findings of a Canadian study that examined the negotiation of religious and ethnic plurality in...
Article
Full-text available
Purpose As patient-reported outcome measures (PROMs) increasingly become key outcome indicators in health care, there has been growing concern about the potential negative consequences that could result when interpretations are being made to inform clinical and policy decisions. Therefore, we explored theoretical issues, assumptions, and consequenc...
Article
Full-text available
Background Patient-reported outcomes and experience measures (jointly referred to here as PROs) are internationally recognized as a means for patients to provide information about their quality of life, symptoms, and experiences with care. Although increasingly recognized as key to improving the quality of healthcare at individual (e.g., patients,...
Article
Full-text available
Background Total knee arthroplasty (TKA) is the most common joint replacement surgery in Canada. Earlier Canadian work reported 1 in 5 TKA patients expressing dissatisfaction following surgery. A better understanding of satisfaction could guide program improvement. We investigated patient satisfaction post-TKA in British Columbia (BC). Methods A c...
Article
Full-text available
There is evidence that low suitability and comprehensibility of printed education materials (PEMs) affects patients’ and relatives’ ability to read and comprehend information. However, few instruments measure the suitability of written information, and none exist in the Swedish language. The aim was to describe the translation and adaptation of the...
Poster
Full-text available
Increasing evidence indicates that distress is an important mechanism through which chronic conditions affect health burden. However, the extent to which gender moderates this relationship remains unclear. Therefore, we examined the extent to which distress mediates the relationships between prevalent chronic conditions, and health burden, and whet...
Poster
Full-text available
As patient-reported outcomes measures (PROMs) increasingly become key outcome indicators assessing the impact of disease and its treatment, there has been growing concern about the potential for misinterpretation of these measures. Therefore, we explored potential theoretical issues, assumptions, and consequences of using PROMs in practice from a p...
Poster
Full-text available
Differential item functioning (DIF) and response shift (RS) can obscure the meaning of scores obtained from patient-reported outcome measures (PROMs). Although modern statistical methods are increasingly being developed to identify and accommodate for DIF and RS, there is limited awareness of these methods, and even of DIF and RS themselves, across...
Poster
Full-text available
The use of Patient-reported outcomes measures (PROMs) may enhance person-centred care in in long-term residential care (LTRC), however, the potential for cognitive impairment in LTRC residents has led to questions about the use of PROMs in these settings. If individuals with the same level of health interpret and respond to PROM items differently b...
Article
Full-text available
Purpose: This study describes the characteristics and quality of reporting for published computer simulation studies about statistical methods to analyze complex longitudinal (i.e., repeated measures) patient-reported outcomes (PROs); we included methods for longitudinal latent variable measurement and growth models and response shift. Methods:...
Article
Background: Many people with congenital heart disease (CHD) experience psychological distress related to medical complications and psychosocial issues related to the disease. Although studies show that social support and coping strategies are closely associated with psychological distress in people struggling with different chronic health challeng...
Article
Aims: The aim of this study was to assess the effect of multimorbidity on improvements in health-related quality of life (HRQoL) following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Patients and methods: Using data from a regional joint registry for 14 573 patients, HRQoL was measured prior and one year following surgery usi...
Article
Full-text available
Abstract Introduction Clinical registries are a potentially valuable resource to study the effects of medical interventions on outcomes, particularly patient-reported outcomes like health-related quality of life, which are not included in administrative data. However, because clinical registries are primarily intended for patient management and not...
Article
Background: The objective of this study was to validate the NCCN Distress Thermometer (DT), including the accompanying Problem List (PL), in a Swedish population of patients diagnosed with colorectal cancer (CRC). Methods: A total of 488 patients diagnosed with CRC completed the DT/PL and EORTC core quality-of-life questionnaire (QLQ-C30) before su...
Article
Full-text available
Purpose: Patient-reported outcome measures (PROMs) are frequently used in heterogeneous patient populations. PROM scores may lead to biased inferences when sources of heterogeneity (e.g., gender, ethnicity, and social factors) are ignored. Latent variable mixture models (LVMMs) can be used to examine measurement invariance (MI) when sources of het...
Article
Background: Cancer is a family disease, affecting the individual patient and the family. For Chinese patients and their families in Canada, adjusting to cancer may be particularly distressing when culture and language are not congruent with the mainstream model of care delivery. Objective: In view of the limited research on the cancer experience...
Article
Full-text available
Background: The assessment and evaluation of practical and sustainable development of health care has become a major focus of investigation in health services research. A key challenge for researchers as well as decision-makers in health care is to understand mechanisms influencing how complex interventions work and become embedded in practice, wh...
Article
Full-text available
Background: Response shift (RS) has been defined as a change in the meaning of an individual's self-evaluation of his/her health status and quality of life. Several statistical model- and design-based methods have been developed to test for RS in longitudinal data. We reviewed the uptake of these methods in patient-reported outcomes (PRO) literatu...
Article
This article applies a micro-meso-macro analytical framework to understand clinicians’ experiences and perspectives of using patient-reported outcome and experience measures (PROMs and PREMs) in routine hospital-based palliative care. We structure our discussion through qualitative analysis of a design and implementation project for using an electr...
Article
Objectives This study is part of an overarching research initiative on the development and integration of an electronic Quality of Life and Practice Support System (QPSS) that uses patient-reported outcome and experience measures in clinical practice. The current study focused on palliative nurse consultants trialing the QPSS with older hospitalize...
Article
Full-text available
Background Quality of life (QOL) assessment instruments, including patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs), are increasingly promoted as a means of enabling clinicians to enhance person-centered care. However, integration of these instruments into palliative care clinical practice has been inconsis...