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PubMed2003

Predictors of follow-up health status in the Drug Abuse Treatment Outcome Study (DATOS).

This study examined the predictors of self-reported health status at follow-up in the Drug Abuse Treatment Outcomes Study (DATOS), a longitudinal study of drug abuse treatment programs and patients in 1991-1993. Baseline and follow-up interviews of 2966 patients in 75 programs were performed. The follow-up assessment was targeted to occur 12 months after treatment terminated; long-term methadone patients in treatment for the entire 12-month period were interviewed 24 months after intake. A composite measure, developed through principal component analysis, assessed health status. A multivariate hierarchical linear regression model adjusted for identified independent baseline predictors of health status at follow-up. Poor physical health status (including the composite measure, comorbid conditions and pain) and greater severity of psychiatric symptoms at baseline were the strongest predictors of poor health status at follow-up. Other predictors of worse health status included older age, public insurance coverage and unemployment. We conclude that baseline health status and psychiatric symptoms predict the subsequent health status of patients in substance abuse treatment patients as in other clinical populations. Future research should examine whether early identification and treatment of physical and mental health problems among patients in addiction treatment programs might remediate their adverse effects on long-term health status outcomes.

Adult↗
PubMed1992

Relationship between health utility and psychometric health status measures.

This study examined the relationship between health utility and psychometric health status measures. Utility scores derived by standard gamble and categorical rating methods were also compared to determine if they produce equivalent preference scales. Health status and utility was assessed in 73 chronic renal disease patients with anemia (hematocrit less than or equal to 30) participating in a 48-week clinical study. Patient preferences for current health and three hypothetical states were assessed using standard gamble and categorical rating procedures. Standard gamble utility was related to home management (P less than .05); categorical rating utility was related to home management (P less than .05), energy (P less than .05), alertness behavior (P less than .05), social interaction (P less than .05), and life satisfaction scale scores (P less than .05). Only 25-27% of the variance in utility scores was explained by the health status measures. Standard gamble utilities were consistently higher than categorical rating values for end-stage renal disease with hemodialysis (P less than .0001) and severe anemia requiring blood transfusions (P less than .0001). Patient preferences for current health may be influenced in part by their functional status and well-being, risk aversion or risk-taking attitudes, and the cognitive evaluation processes involved in making judgments necessary for the measurement task, as well as their actual preferences.

Choice Behavior↗
PubMed2004

Older adults with intellectual disability in residential care centers in Israel: health status and service utilization.

To determine their health status, we studied 2,282 Israeli adults with intellectual disability who were at least 40 years of age and lived in residential care. Results showed that age is a significant factor in health status. The frequency of different disease categories (e.g., cardiovascular disease, cancer, and sensory impairments) increased significantly with age for both genders. Cardiovascular disease in this population was less prevalent when compared to the general population, suggesting that underdiagnosis of some diseases or conditions may be prevalent in this population. The patterns of organ-system morbidity with increasing age were similar to those in other studies conducted in several countries, suggesting that health status and outcomes could be independent of cultural factors.

Adult↗
PubMed1999

Pain, psychological distress, health status, and coping in patients with breast cancer scheduled for autotransplantation.

PURPOSE/OBJECTIVES: To describe pain, psychological distress, health status, and coping that patients with breast cancer who were scheduled for autotransplantation experienced; the strength and direction of relationships among pain, psychological distress, health status, and coping; and the percentage of variance within the concept of health status that age, pain, psychological distress, and coping. DESIGN: Descriptive, correlational. SETTING: An urban, National Cancer Institute-designated comprehensive cancer center located in the eastern United States. SAMPLE: A convenience sample of 83 female patients with breast cancer scheduled for autotransplantation. The population age ranged from 22-59 years (X = 44.47 years) and was comprised of 72 (88%) Caucasians, 6 (7%) African Americans, and 4 (5%) from other minorities. METHODS: An oncology clinical nurse specialist in the outpatient medical oncology clinic collected the data during a regularly scheduled visit approximately 20 days prehospitalization for high-dose chemotherapy and autotransplantation. Data were collected using a demographic data from and self-report instruments (Gaston-Johansson Painometer, State-Trait Anxiety Inventory, Beck Depression Inventory, Medical Outcomes Study Short-Form General Health Survey, and Coping Strategies Questionnaire). MAIN RESEARCH VARIABLES: Pain, psychological distress, health status, and coping. FINDINGS: Although the subjects experienced low pain intensity, the range of reported pain intensity ratings was wide. Pain locations varied but were reported mainly in the vagina, chest, shoulder, and arm. Although subjects reported primarily mild depression and mild state anxiety, the range of depression and state anxiety scores was wide. Coping strategies used most frequently to deal with pain included positive coping statements, diverting attention, praying and hoping, increasing activity level, and ability to control and decrease pain. Subjects reported moderate total health status and low role functioning. Moderate, positive correlations were seen between state anxiety and depression and physical functioning and role functioning. Sixty-five percent of the variance in health status was explained by sensory pain depression, and catastrophizing. CONCLUSIONS: Patients with breast cancer who are scheduled for autotransplantation may experience pain, psychological distress, and alterations in coping and perceived health status. Total pain intensity, sensory pain, depression, and catastrophizing appear to be important variables related to the patient's perceived health status. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses need to include assessment of pain, psychological distress, health status, and coping in their routine patient assessment prior to autotransplantation to provide appropriate care and make necessary multidisciplinary referrals. Future nursing research should be directed toward the implementation and evaluation of interventions that promote the use of comprehensive coping strategies to decrease pain, anxiety, and depression.

Adaptation, Psychological↗
PubMed1997

Evaluation and use of an index of oral health status.

OBJECTIVES: The goals of this investigation were (1) to evaluate the Oral Health Status Index in relation to demographic characteristics, socioeconomic status, and preventive behaviors of an adult population; and (2) to understand how individual index components performed as indicators of oral health status compared to the composite index. METHODS: The Oral Health Status Index (OHSI) was used on a probability sample of adults, aged 18-93 years, living in the Detroit tricounty area. Data were collected on 509 subjects via in-home dental examinations. Bivariate and multivariate analyses were used to compare the OHSI and its components, including decayed, missing, and replaced teeth, free ends, and moderate and severe periodontal disease measures. RESULTS: The mean OHSI score for subjects was 77.3 (SE = 1.83) with a range of -8.0 to 100.0. In regression analyses, OHSI scores were positively correlated with subjects' education level, self-rated oral health scores, and frequency of dental checkups and negatively correlated with age, nonwhite race, and smoking. Of the index components, missing teeth performed well as an indicator of oral health status. Missing teeth were positively correlated with age, nonwhite race, and smoking and negatively correlated with education level, self-rated oral health, and use of Medicaid. About 53 percent of variance in OHSI scores was explained by the multivariate models, compared to 46 percent for missing teeth. CONCLUSIONS: Choosing an indicator of oral health status likely will depend upon the characteristics of the population to be studied. As a composite measure of oral health status, the OHSI performed acceptably; however, missing teeth, an index component, also worked well. Continued evaluation of the OHSI is warranted.

Adolescent↗
PubMed2000

The stability of health status measurement (SF-36) in a working population.

This study tests the stability of health status measurement (SF-36) in a working population. A total of 4,225 employees from two sectors (one state agency, one private company) enrolled in three health plans at Trigon BlueCross/BlueShield of Virginia. An eight-dimension short-form health survey (SF-36) was first tested on a cross-sectional basis for its validity. Then, a panel study was established to test for the stability of health status instrument over time. Structural equation modeling built on equality constraint conditions was the statistical technique for this study. Data were collected through two-wave mail surveys. Both comprehensive (original eight scales) and parsimonious (revised five scales) models of health status were found fit into the data quite well. Furthermore, the revised parsimonious model was shown highly stable over time. Within a working population aged 18 to 64, people are relatively healthy. Their perception of health issues is reflected mainly on "physical health status," as indicated by physical functionings or role limitations. The high stability of revised health status model warrants the possibility of using a more concise health status instrument for the majority of people in working force.

Adult↗
PubMed1976

The sickness impact profile: conceptual formulation and methodology for the development of a health status measure.

The development of a health status measure, the Sickness Impact Profile (SIP), is described in terms of both its conceptualization and methodology. The need for a health status measure that is sensitive and appropriate, based on sickness-related behavior, and culturally unbiased, is discussed. A model of sickness behavior is presented as a guide for methodological development. The description of the initial developmental stage of the SIP includeds detailed discussion and documentation of the collection, sorting and grouping of items that comprise the SIP, scaling of the items, scoring of the instrument, and testing and revision of the prototype instrument. Results of preliminary tests of reliability, validity, and administrative feasibility are presented. Subsequent steps in revision and finalization, now under way, are outlined.

Attitude to Health↗
PubMed1983

Health status of the Cuban population.

The health status of the Cuban population is an expression of the social development attained by the Cuban Revolution. A comparative analysis is presented of the behavior of the main components that express health status (natality, mortality, other demographic indicators, morbidity, disability, and physical development) from the triumph of the Revolution until the present. The statistics demonstrate the radical and positive transformation of the health of the population. The trend toward social homogeneousness in health in Cuba is also assessed.

Adolescent↗
PubMed2003

Is position in the occupational hierarchy a determinant of decline in perceived health status?

This study examines the extent to which position in the occupational hierarchy is predictive of declines in perceived health status over a 48 month period in a representative sample of the Canadian labor force. We hypothesized that the proportion of workers reporting a decline in health status would be greater among persons in lower position in the occupational hierarchy, and that these differences in risk would primarily be explained by characteristics of the psychosocial work environment and secondarily by the baseline prevalence of adverse health behaviors. The study cohort was defined as labor force participants aged 18-64 who reported good, very good or excellent health in the 1994 baseline wave of Canada's National Population Health Survey and who participated in the 1998 follow-up survey. Between 1994 and 1998, 16.6% of labor force participants reporting excellent, very good or good health status at baseline reported a decline in perceived health status. For men, the age-adjusted odds of decline in perceived health status were 1.80 (95% CI: 1.24-2.63) and 1.74 (95% CI: 1.19-2.54) for the two lowest occupational classes relative to the highest occupational class. There was no association between position in the occupational hierarchy and the prospective risk of health status decline for women. For men, the association between position in the occupational hierarchy and decline in perceived health status was moderately reduced but remained statistically significant following adjustment for baseline health, health behaviors and psychosocial work exposures. Adjustment for household income did not alter these findings. When stratified by gender, position in the occupational hierarchy was associated with the prospective risk of health status decline for men but not for women. Among men, the collective influence of health behaviors and psychosocial work exposures explained a moderate component of the decline in perceived health status. A more robust measurement of the characteristics of labor market experiences would be expected to improve understanding of the relationship between work and health in this sample.

Adolescent↗
PubMed1987

Health status adjustments for Medicare capitation.

The issue of biased selection has taken on increased importance because of the growing numbers of Medicare beneficiaries enrolled in capitated systems. One way to deal with biased selection is through adjusting payment to health plans to reflect enrollee health status. This paper reviews proposed health status adjustors based on perceived health status, functional health status, health service use, program entitlement data, mortality, and risk factors. There is evidence that almost all of these could perform better in a statistical sense than the current Medicare HMO payment formula. For policy purposes, the most practical adjustors at present are measures based on prior use of services. These could be tested and perhaps implemented now as work proceeds on other adjustors.

Capitation Fee↗
PubMed1996

Health status at entry to methadone maintenance treatment using the SF-36 health survey questionnaire.

This study used the SF-36 general health questionnaire to measure the health status of heroin users at entry to a public methadone maintenance programme. Their results were compared to those from the general population and from three clinical groups: patients with minor medical, major medical and psychiatric problems. One hundred consecutive clients were interviewed in the first week on the programme using the SF-36 health questionnaire. Data were also gathered on their drug use, use of medical services and HIV risk behaviour. The results showed that heroin users at entry to the methadone maintenance programme had significantly worse physical and psychological health than the general population. Their scores were most similar to the psychiatrically depressed patients, although they had worse physical health than this comparison group. The greater the amount of heroin used by clients before entering the programme, the more pain they reported. Alcohol and marijuana use were associated with better social and physical health. The relationship between general health status and amount or frequency of drug use is not a clear one. Heroin users experience severe emotional and physical problems at the time of entering methadone maintenance treatment.

Adolescent↗
PubMed2003

Spirituality and sexual orientation: relationship to mental well-being and functional health status.

BACKGROUND: Research has shown that spirituality has a positive effect on physical and mental health; however, few studies have explored the influence of spirituality and sexuality on mental well-being and functional health status in people with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). AIM: This descriptive cross-sectional study was designed to examine the relationships among spirituality, sexual orientation, mental well-being and aspects of functional health status (physical, role, social and cognitive functioning) in a sample of 117 African-American men and women living with HIV/AIDS. METHODS: Spirituality was measured using the Spiritual Well-Being Scale. A demographic questionnaire gathered data on sexual orientation, age and gender. The Medical Outcomes Study Questionnaire-30 assessed aspects of functional health status and mental well-being. The HIV Symptom Checklist for Persons With HIV disease was used to collect data on HIV symptoms. The data were collected in 1996. FINDINGS: The findings indicate that spirituality had a direct relationship with cognitive and social functioning and was inversely related to HIV symptoms. Sexual orientation had direct relationships with mental well-being, cognitive, physical, social and role functioning. t-Tests showed that heterosexual participants reported poorer mental well-being and functional health status compared with homosexual participants. Regression analysis showed that spirituality, sexual orientation, age and HIV symptoms contributed significantly to mental well-being and functional health status. CONCLUSIONS: The regression analysis showed that spirituality, sexual orientation, age and HIV symptoms contributed significantly to mental well-being and functional health status. Further research is needed to explore the various ways that sexual orientation influences health status findings in those with HIV disease in certain segments of the population. The findings support the inclusion of spirituality as a variable when examining mental well-being and physical health. Finally, given the limitations of the design, more rigorous methods should be employed to understand further the contribution of spirituality to the health status of African-Americans living with HIV, because of its social importance to this particular community.

Adult↗
PubMed2002

First-year university students' health status and socio-demographic determinants of their self-rated health.

This study surveys university students' physical and psychological health status and socio-demographic determinants of their self-rated health (SRH). The study population consists of all first-year students enrolled on the three programs offered at a Swedish university in the autumn of 1998 (3,229 students). In the spring of 1999, a self-administered questionnaire (44 forced-response questions) dealing with health status, life-style and living conditions was sent to the students at their home address (response rate 70%). Associations between overall health and its physical and psychological components were measured, and ANOVAs were conducted to establish the variation in physical, psychological and overall SRH explained by a series of socio-demographic variables. Most students rated their psychological and physical health as good or very good, and restrictions on life activities - when experienced - were found to be considerably more common for physical than for psychological problems. Symptoms related to psychological problems were more frequent among female than male students. Country of birth of student was the strongest predictor of self-rated physical health, and the second strongest predictor of psychological and overall health (following sex of student). Parental educational attainment was a weak but significant predictor of psychological and physical SRH among students, but not of their overall SRH. Overall, physical and psychological SRH, though strongly inter-correlated, are not necessarily redundant measures of one and the same thing. The variation in self-ratings cannot be explained simply with reference to one set of socio-demographic variables.

Adolescent↗
PubMedDate not supplied

Health status of a low-income vulnerable population in a community health center.

Healthcare safety net providers are under increasing pressure to meet the physical and mental health--as well as the range of social service-needs of traditionally vulnerable and hard-to-reach populations. The extent to which health center patients are less well and in poorer health than is the rest of society, thus requiring greater depth and breadth of service, has not generally been the focus of systematic assessment. This case study uses the 12-Item Short-Form Health Survey (SF-12) and selected years of healthy life questions from the National Health Interview Survey to assess the self-perceived health status of patients at one Section 330 community health center in central Massachusetts. Five hundred thirteen patients completed all questions on the SF-12; 619 completed each of the years of healthy life questions. Respondents' physical and mental component summary scores were significantly lower than national norms for all age groups (P < .001). Respondents were also significantly more likely than the civilian noninstitutionalized population to be unable to perform major activities (P < .0001) and to be in fair or poor health (P < .0001). Analyses give an indication of the magnitude of difference in self-perceived health status between this poor, vulnerable population and the citizenry at large and suggest implications for policy related to safety net healthcare facilities.

Adult↗
PubMed1987

Inter-area variations in age-adjusted health status.

Data from the 1980 to 1981 National Health Interview Survey on morbidity, principally bed-disability days, was age standardized and indexed by region of the United States and metropolitan and nonmetropolitan residence within region. There were substantial differences in both age-specific and age-adjusted morbidity by place of residence. Age-specific hospital days as a percent of bed-disability days also showed striking differences by geographic area. Age- and morbidity-adjusted data on hospital use for the 31 largest standard metropolitan statistical areas (SMSAs) add considerably to the little information available on inter-city differences in health status and hospital use. Indirectly age-standardized data for the 31 SMSAs show large variations in both bed-disability days and the proportion of such days occurring in hospitals. These data seriously challenge the premise that age is a reliable proxy for health status when comparing hospital (or surgical) use of populations residing in different locales (e.g., small area variations in health care use). Dependence on age instead of health status to identify high and low hospital use areas will systematically favor areas where the population has low morbidity (age adjusted) and be adverse to areas that have high morbidity.

Adolescent↗
PubMed2001

Child health status and parental employment.

OBJECTIVE: To understand the relationship between several measures of child health status and the employment of parents. DESIGN: A cross-sectional study using 1994 National Health Interview Survey on Disability data. PARTICIPANTS: A nationally representative sample of children and their parents. OUTCOME MEASURES: Maternal and paternal employment (measured separately). INTERVENTION: We use a series of logistic regression models with maternal and paternal employment as the dependent variables and the health status of the child with the poorest health status in the family as the primary independent variable. Models additionally include sociodemographic correlates of employment. RESULTS: Having a child with poor health status, as measured by general reported health, hospitalizations, activity limitations, and chronic condition or disability status, is associated with reduced employment of mothers and fathers. For example, the odds ratios of being employed for having a child with an activity limitation are 0.75 for mothers (95% confidence interval, 0.67-0.85) and 0.66 for fathers (95% confidence interval, 0.53-0.82). CONCLUSIONS: Having a child with poor health status is associated with reduced maternal and paternal employment. Further studies are needed to determine whether poor child health status causes reductions in parental labor force participation. If such a causal relationship exists, it has important implications for social policy, employment policy, and clinical anticipatory guidance.

Adolescent↗
PubMed1987

Sensitivity to change and the effect of mode of administration on health status measurement.

A measure of global health status, the McMaster Health Index Questionnaire (MHIQ), was assessed to determine two important measurement properties related to its reliability and validity--sensitivity to change and the effect of mode of administration. Ninety-six patients in a physiotherapy clinic were randomly assigned to three mode-of-administration study groups, administered the MHIQ at four points in time including at admission and discharge from the clinic, and assessed for change by their physiotherapist. MHIQ physical function, social function, and emotional function retest scores obtained by self-completion within a 1-week interval were most stable. Physical function scores by any of self-completion, telephone interview, or personal interview were sensitive to change, that is, they improved dramatically by the time of discharge from the clinic. Mode of administration did not affect the size of the change scores. Changes reflected by the physical function scores correlated with changes in physical function reported by a patient's physiotherapist. No systematic changes occurred with social and emotional function scores; this is not surprising in a group of patients with predominantly physical function problems.

Activities of Daily Living↗
PubMed2003

Two views of self-rated general health status.

Global self-evaluations of health have proven to be sensitive predictors of morbidity and mortality. Yet researchers have only a limited understanding of how these self-evaluations are reached. This research compares two interpretations of self-rated health, as reflecting either a spontaneous assessment of one's health status and related practices, or an aspect of one's enduring self-concept. Using longitudinal data from successive waves of the National Population Health Survey in Canada (Statistics Canada, 1994-95, 1996-97, NPHS public use microdata documentation. Ottawa, Ontario: Statistics Canada; n = 7505), our analysis tests a model of change in self-rated health as predicted by respondents' baseline physical and mental health symptoms, social support, leisure physical activity, smoking, body mass index, and 2-yr changes in these characteristics. As in past research, self-rated health was sensitive to improvement or decline in these predictors. Much of the explained variance, however, was unique to respondents' self-rated health 2 yr earlier. Moreover, the effect of several predictors on respondents' self-rated health varied according to whether respondents intended to improve specific health-related behaviours in the future. These findings suggest that self-rated health is not only a spontaneous assessment of one's health status and related practices; like a self-concept, self-rated health may be regulated by efforts to achieve one's relatively important health-related goals.

Adult↗