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PubMedDate not supplied

Patient self-assessment of health status and function in glenohumeral degenerative joint disease.

One hundred three consecutive patients with primary glenohumeral degenerative joint disease completed standard questionnaires regarding their general health status (Short Form-36) and the function of their shoulder (Simple Shoulder Test). These patients' self-assessed health status indicated overall bodily pain, physical functioning, and physical role fulfillment scores that were significantly below those of population-based control groups. Self-assessed shoulder functions were likewise consistently below those of patients with normal shoulders. These deficits clearly indicated the problems that the patients desired to have resolved by treatment. The use of self-assessment questionnaires to routinely characterize patients with shoulder conditions is practical in the context of a busy practice. These data enable surgeons to understand the condition from the patient's perspective. This understanding should be central to the planning of treatment and to the evaluation of treatment effectiveness.

Female↗
PubMed2003

Reliability and validity of the SF-36 in HIV-infected homeless and marginally housed individuals.

OBJECTIVE: To assess the reliability and validity of the Short-Form 36 (SF-36) health survey as a health status indicator among HIV-infected homeless and marginally housed (HMH) individuals. METHODS: Between July 1996 and May 2000, a sample of HMH individuals completed interviews that included the SF-36. Responses to the SF-36 were analyzed for missing data, range, internal consistency, and construct validity. RESULTS: Among 330 individuals interviewed, 83% were male, 43% were African-American, and the median age was 39 years. All internal consistency reliability coefficients exceeded 0.70, all item-scale correlations exceeded 0.40, all items were more strongly correlated with their hypothesized scale than any other scale, and all reliability coefficients exceeded inter-scale correlations for the same scale. Three of four physical health scales were significantly associated with CD4 cell count and HIV viral load. All scales were significantly associated with depression. DISCUSSION: We found that scales were internally consistent, items correlated to an acceptable degree with their hypothesized scales, items were distinct from other scales, physical scales were associated with CD4 cell count and viral load, and all scales were associated with depression. These analyses provide evidence for the reliability and validity of the SF-36 as a measure of health status in HIV-positive HMH individuals.

Adult↗
PubMed1995

Carers' burden and adjustment to HIV.

Empirical evidence from well designed studies into the effects on carers of caring for a person with HIV is lacking. This study investigated the correlates of carers' burden and adjustment to their caring for a person with HIV. Thirty-four carers and their HIV-infected patients were interviewed and completed self-administered scales. Measures included two psychosocial adjustment indices, a Problem Checklist (burden) and two patient health status indices. The most common elements of carer's burden were distressing emotions, relationship difficulties, somatic symptoms, and grief. Demographic variables, patient's HIV stage, nature of caregiving relationship and duration of caregiving were unrelated to carers' burden or adjustment. However, living arrangement was found to be significantly associated with carers' burden, with those carers co-residing experiencing more burden than those living apart from the patient. Carers' coping strategies were only weakly related to carer's adjustment and burden. The patients' emotional and existential concerns were strongly positively related to carers' burden and all domains of adjustment, while patients' instrumental concerns and measures of patients' health status were positively related to carers' burden. As predicted, patients had significantly poorer levels of adjustment than carers. The findings supported the use of a reciprocal determinism approach for understanding the relationship between the patient and carer and adjustment outcomes.

Adaptation, Psychological↗
PubMed2005

Disparities in indigenous health: a cross-country comparison between New Zealand and the United States.

OBJECTIVES: We compared the health statuses of the indigenous populations of New Zealand and the United States with those of the numerically dominant populations of these countries. METHODS: Health indicators compared included health outcome measures, preventive care measures, modifiable risk factor prevalence, and treatment measures. RESULTS: In the case of nearly every health status indicator assessed, disparities (both absolute and relative) were more pronounced for Maoris than for American Indians/Alaska Natives. Both indigenous populations suffered from disparities across a range of health indicators. However, no disparities were observed for American Indians/Alaska Natives in regard to immunization coverage. CONCLUSIONS: Ethnic health disparities appear to be more pronounced in New Zealand than in the United States. These disparities are not necessarily intractable. Although differences in national health sector responses exist, New Zealand may be well placed in the future to evaluate the effectiveness of new strategies to reduce these disparities given the extent and quality of Maori-specific health information available.

Adult↗
PubMed2000

Characterising life-span variability in a population using the life-table-based Lorenz-curve analysis.

BACKGROUND: 'Life expectancy' (LE) is a health-status indicator in widespread use. However, LE is an index of central location, but not of dispersion. It cannot describe inter-individual variation in the life-span. This author proposes using the Gini coefficient, a summary index of the Lorenz curve, for characterising life-span variability. Like the LE, the proposed index is also based on a lifetable. METHOD: The method is a nonparametric approach that does not make specific assumptions about mortality rates. RESULTS: The author uses vital statistics from Taiwan as a demonstration and finds that the method provides information crucial to the understanding of the epidemiologic transitions of the past 20 years (Gini decreases from 0.1320 to 0.1130). It also quantifies the impacts of elimination of some selected causes of death in Taiwan. CONCLUSIONS: It is recommended that Gini be routinely compiled in official vital statistics, along with the LE.

Adolescent↗
PubMed2003

Is a fall just a fall: correlates of falling in healthy older persons. The Health, Aging and Body Composition Study.

OBJECTIVES: To identify factors associated with falling in well-functioning older people. DESIGN: Cross-sectional analyses of report of falls over the past 12 months using baseline data from the Health, Aging and Body Composition Study. SETTING: Clinic examinations in Pittsburgh, Pennsylvania, or Memphis, Tennessee. PARTICIPANTS: Three thousand seventy-five high-functioning black and white elderly aged 70 to 79 living in the community. MEASUREMENTS: Physical function assessed using self-report and performance measures. Health status indicators included diseases, medication use, and body composition measures. RESULTS: Almost one-quarter (24.1%) of women and 18.3% of men reported at least one fall within the year before the baseline examination. Fallers were more likely to be female; white; report more chronic diseases and medications; and have lower leg strength, poorer balance, slower 400-meter walk time, and lower muscle mass. In men, multivariate logistic regression models showed white race (adjusted odds ratio (OR) = 1.4, 95% confidence interval (CI) = 1.2-1.6), slower 6-meter walk speed (OR = 1.1, 95% CI = 1.0-1.3), poor standing balance (OR = 1.2, 95% CI = 1.0-1.4), inability to do 5 chair stands (OR = 1.7, 95% CI = 1.3-1.9), report of urinary incontinence (UI) (OR = 1.5, 95% CI = 1.1-2.0), and mid-quintile of leg muscle strength (OR = 0.6, 95% CI = 0.4-0.9) to be independently associated with report of falling. In women, benzodiazepine use (OR = 1.6, 95% CI = 1.0-2.6), UI (OR = 1.5, 95% CI = 1.2-1.9), and reported difficulty in rising from a chair (OR = 1.4, 95% CI = 1.2-1.6) were associated with past falls. CONCLUSION: Falls history needs to be screened in healthier older adults. Even for well-functioning older persons, specific correlates of falling can be identified to define those at risk.

Accidental Falls↗
PubMed1997

An evaluation of a measure of subjective oral health status in the UK.

OBJECTIVE: To evaluate the performance in the United Kingdom of an instrument to measure the subjective impact of oral conditions; that is, the functional restrictions and symptoms, as well as the disability and disadvantage experienced as a result of oral problems. BASIC RESEARCH DESIGN: The instrument tested was the Subjective Oral Health Status Indicators (SOHSI) that consists of a battery of eight subjective indicators and which has been developed and tested in Canada. A questionnaire containing these indicators was administered by post to two random samples of two hundred and fifty residents aged 60-65 years, one from an affluent and one from a deprived electoral ward in Liverpool. MAIN OUTCOME MEASURES: Reliability was assessed as test-retest, and internal consistency using Cronbach's alpha. Construct and concurrent validity were assessed by determining the association between the subjective indicators and dentate status, reported satisfaction and overall subjective assessment of oral health. The constituent concepts of the theoretical model on which the instrument is based were tested by correlating the subjective indicators and the self-reported number of teeth. CONCLUSIONS: The instrument was found to be reliable both in terms of test-retest reliability and internal consistency. It also demonstrated satisfactory construct and concurrent validity. Correlations between self-reported number of teeth and the subjective indicators confirm the strength of the theoretical model on which the instrument was based and provide further evidence of the content validity of this composite measure.

Aged↗
PubMedDate not supplied

The effect of economic changes on health care and health in Chile.

The existence of possible associations between the economy and health in Chile, 1974-1992, is documented. The gross domestic product fell in 1975-1976 and again in 1982-1983; at both times, the public expenditure on health care followed those falls. In addition, the sources of financing public expenditure and the patterns of health expenditure changed during the decades under study. Several indicators of health care activity, and of health and nutrition status consistently suggest an impact which results from the economic difficulties. Staffing levels and pay factors apparently played a role as intervening variables. The differences between the two crises are discussed, and reveal that the organization and programmes of the public health system seem to have been seriously affected. At the same time, they may still have played an important role in protecting the people--particularly, mothers and small children--from further damage.

Chile↗
PubMed2006

Differences in health-related socioeconomic characteristics among Pacific populations living in Auckland, New Zealand.

AIM: To describe, compare and contrast the health-related socioeconomic characteristics of the different Pacific ethnic groups surveyed in the Auckland Diabetes, Heart and Health Survey (DHHS). METHODS: The DHHS was carried out in Auckland in 2002-2003. Electoral roll based sampling and cluster sampling strategies were used to recruit a representative sample of Auckland Pacific populations. Participants answered a self-administered questionnaire about their demographic and socioeconomic position. RESULTS: The study surveyed 1011 Pacific people aged between 35-74 years of age. Of the 1011 Pacific participants, 484 were of Samoan, 255 Tongan, 116 Cook Island, 109 Niuean, 26 Fijian, and 21 were of 'Other Pacific' ethnic groups. Samoans were least likely to have no children, and most likely to hold a certificate qualification. Tongans were least likely to be born in New Zealand (NZ) and had the shortest residence time in NZ. Tongans were most likely to be married and had the largest families. Cook Islanders were most likely to be NZ-born and had the highest household income. Niueans were most likely to be in paid employment, to hold a diploma qualification, to own their own homes, and have the smallest families. CONCLUSIONS: In conclusion, a distinct pattern (continuum) emerged from the results. The Cook Island and Niuean ethnic groups generally had a similar and more favourable socioeconomic profile compared to the Samoan and Tongan ethnic groups. These differences are most likely to be related to the length of residence in NZ. As differences existed, each Pacific ethnic group should be investigated separately when there are sufficient numbers.

Adult↗
PubMed1998

Subjective health status as a determinant of mortality among African-American elders.

This study examines the efficacy of self-rated health as a determinant of 6-year survival among the 1209 African-American respondents in the Longitudinal Study on Aging (LSOA). The association between self-rated health and mortality risk has been established previously; however, this relationship has not been directly tested in a nonwhite sample. Findings indicate that self-rated health is a predictor of mortality that is independent of several control variables (income, sex, age, education, and marital status) and two objective health status indicators (bed days and doctor visits). However, it is not independent of limitations with activities of daily living. When all three objective health measures were included in a single model, self-rated health was not an independent predictor of mortality. However, when the full model was specified on sex-specific subsamples, the analysis found that self-rated health was an independent predictor of mortality for women, but not for men.

Activities of Daily Living↗