ARTICLESResponse Shift: A Theoretical Exploration of Quality of Life Following Hematopoietic Cell TransplantationTierney, D. Kathryn PhD, RN; Facione, Noreen PhD, RN; Padilla, Geraldine PhD; Dodd, Marylin PhD, RNAuthor Information From the Stanford University Medical Center, Stanford (Dr Tierney); and University of California San Francisco School of Nursing, San Francisco, Calif (Drs Facione, Padilla, and Dodd). Corresponding author: D. Kathryn Tierney, PhD, RN, Stanford University Medical Center 300 Pasteur Drive, H3249 Stanford, CA 94305 (e-mail: email@example.com). Accepted for publication June 8, 2006. Cancer Nursing: March-April 2007 - Volume 30 - Issue 2 - p 125-138 doi: 10.1097/01.NCC.0000265002.79687.af Buy Metrics Abstract Quality of life (QOL) has become an important outcome measure for evaluating the impact of cancer therapy, especially aggressive cancer therapies such as hematopoietic cell transplantation (HCT). Despite the intense interest in examining the phenomenon of QOL, fundamental concerns remain. Most published QOL studies of HCT recipients do not state the theoretical model on which the investigation was designed. The absence of a theoretical foundation results in difficulties for healthcare professions to interpret the study's outcomes, generalize the findings and design and test theory-based interventions. Most HCT recipients report good to excellent QOL despite ongoing treatment-related sequela. This article explores the theoretical model of response shift as a means of understanding how HCT recipients maintain or improve their QOL after the treatment of life-threatening illness. Finally, a proposal for studying the QOL of HCT recipients based on the response shift model is offered, which includes a discussion of theory-based interventions. © 2007 Lippincott Williams & Wilkins, Inc.