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PubMed2003

Asthma health status: influence of disease severity categorized by peak expiratory flow.

To evaluate the health status of patients with stable asthma and determine how disease severity affects the status, 68 consecutive patients were recruited from an outpatient clinic at an university hospital. Health status was assessed with the St. George's Respiratory Questionnaire and the Asthma Quality of Life Questionnaire (AQLQ). The results of the questionnaires revealed that the mean % predicted peak expiratory flow (PEF) in the preceding 2 weeks correlated most significantly with each total score for the two health status measures. We also found that, in the groups classified by mean % predicted PEF (mild, PEF > or = 80%; moderate, 60 to 79%; severe, < 60%), there were significant differences in all SGRQ scores (p < 0.05). In a subgroup analysis, the scores for moderate and severe patients were significantly worse than for mild patients in all four components (p < 0.05). Almost the same tendency was observed in the score distribution on the AQLQ. We conclude that mean % predicted PEF correlated most with the health status of the patients. Patients with PEF higher than 80% of predicted value generally maintained a better health status than did those with less than 80% of predicted PEF. Achieving higher than 80% of predicted PEF is important in managing asthma from the viewpoint of health status.

Adult↗
PubMed2003

Test-retest reliability of an abbreviated self-report overall health status measure.

STUDY DESIGN: Test-retest reliability study. OBJECTIVE: To assess test-retest reliability and estimate minimal detectable change of an overall measure and 2 summary measures of patient self-report of health status. BACKGROUND: Change in patient self-report of health status is a common outcome measure following rehabilitation. Because collection of health status data takes time and clinicians are required to be productive, selected items from reliable instruments were used to form a new, abbreviated instrument of health status relevant to patients in outpatient rehabilitation. There are no test-retest reliability statistics of these health status measures in this population. METHODS AND MEASURES: A convenience sample of 71 patients (mean age +/- SD, 41.9 +/- 17.9 years; age range, 15-83 years; sex, 35% male), with a variety of orthopaedic diagnoses, seeking rehabilitation in 2 outpatient facilities, volunteered. Patients completed health status questionnaires at initial evaluation and at 24 to 72 hours following evaluation. Intraclass correlation coefficients (ICC2.1) were used to estimate test-retest reliability and to estimate measurement error and minimal detectable changes. RESULTS: ICCs with a 1-sided lower limit 95% confidence intervals (CI) of the Overall Health Status measure and the Physical and Mental Component Summary measures for patients with chronic symptoms were 0.92 (0.85), 0.82 (0.68), and 0.85 (0.74), respectively. Minimal detectable changes (90% CI) were +/-12 (scale range, 100), +/- 9 (scale range, 60), and +/- 9 (scale range, 60) scale points, respectively, for the same measures. CONCLUSIONS: Results support the test-retest reliability of the Overall Health Status measure and summary measures for patients with chronic symptoms and demonstrate ability of the Overall Health Status and Physical Summary Scale measures to detect improvement of patient self-report of health status within the first few days of rehabilitation.

Adolescent↗
PubMed1990

Measurement of health status in the 1990s.

The use of health-related quality of life measures, especially those based on function, are likely to increase during the next decade. This increase, however, is most likely to occur in clinical research and clinical practice. Unless the necessary political will, resources, data, and policy researchers coexist, there will be relatively little advance in the use of health status measures for decision-making and policy. This prediction is based on the observation that policy research tends to rely on available national data, that currently these data provide limited information about health status, and that there appears to be insufficient interest and resources to broaden data collection or to develop methods that incorporate a broad spectrum of health outcomes (e.g. death, impairment, functional status, and perceptions) into a single instrument or measure of health on large populations and communities. This state of affairs is particularly unfortunate as we face a decade in which available health and medical care may become more limited and social inequity in access and health status may become more marked. The effect of social inequities and restrictions to health care on the health of the nation cannot continue to be determined with reference only to the structure and process of the health care system. Health and quality of life outcomes are what count. And, these outcomes cannot be determined without appropriate and inclusive measures of health-related quality of life. Of course, we hope our prediction is wrong and that the motivation and resources will be found to help resolve methodologic issues in the measurement of population health status and quality of life and to provide the necessary data. We hope that government agencies, employers, and private providers will begin to collect health-related quality of life data on the constituents and populations they serve. Even if these data are imperfect or primitive, the effects of improving accessibility and quality of health care can only be assessed adequately in terms of the health-related quality of life of the nation.

Community Health Services↗
PubMed1985

Comparative measurement efficiency and sensitivity of five health status instruments for arthritis research.

Five health status instruments were administered in random order to 50 arthritis patients before and after total joint arthroplasty. Relative efficiency and sensitivity in measurement of change in pain, mobility and physical function, social role and social activity, and global health were assessed. The instruments had highly correlated scores, but had differences in certain dimensions. Inter-instrument differentials were larger for social and global outcomes than for pain or mobility. NO single instrument consistently outperformed the others. A method for determining relative efficiency is described.

Activities of Daily Living↗
PubMed1976

The sickness impact profile: validation of a health status measure.

The Sickness Impact Profile (SIP), a measure of health status, is being developed as an outcome measure of health care. A preliminary study of the validity of the SIP was conducted on a sample of 278 subjects who were grouped into four subsamples differing in kind and severity of sickness. Selfassessment of health status, clinician assessment of health status, and other measures of dysfunction were used as criteria. SIP scores discriminated among subsamples, and correlations between criterion measures and SIP scores provided evidence for the validity of the SIP. Differences among the correlations obtained for each criterion measure with SIP score are discussed in terms of the need for the development of criterion measures that can be expected to differentially relate to the constructs inherent in the SIP.

Activities of Daily Living↗
PubMedDate not supplied

Growth and health status of preschool Karen highlanders.

The physical growth and health status of preschool (< 6 years) Karen highlanders belonging to the Pwo (212 males, 227 females) and Sgaw (107 males, 101 females) ethnic groups, and residing in northwest Thailand are described in the present report. The growth and health status of Thai tribal groups, including the Karen, is generally assumed to be substantially poorer than those of Thai lowlanders, who are primarily of Thai ancestry. However, the Karen highlanders in the present report fell within the range of variation in growth and health status found in lowland southeast Asians. Also, the growth and health status of Pwo preschool children tended to be significantly poorer than those of Sgaw children, despite the fact that both groups reside in isolated villages within the same ecozone and utilize similar food production techniques. The cause of these differences cannot be determined at the present time, but several potential factors are discussed.

Arm↗
PubMed1993

Influence of age on measurement of health status in patients undergoing elective surgery.

PURPOSE: To assess the influence of age on the relationships between global measures of health and specific health dimensions. DESIGN: Cross-sectional cohort study. SETTING: University tertiary care hospital. PATIENTS: Patients older than 50 years admitted for major elective non-cardiac surgery. MEASUREMENTS: Consenting patients underwent preoperative evaluations including a medical history, physical examination, and administration of health status assessment instruments. Global health status was measured with the Medical Outcomes Study Short Form (SF-36) and with a 0 to 100 verbal measure of global health. Specific health dimensions (physical function, role function, social function, mental health, energy and fatigue, and pain) were measured using the SF-36. Subjects also completed a second validated measure of physical functioning, the Specific Activity Scale (SAS). RESULTS: Although patients aged > 70 years (n = 276) had poorer role function, energy, and fatigue scores and poorer physical function on both the SF-36 and SAS than younger patients (n = 469) (P < 0.05), they had similar overall health perception. In the entire population, global health status as measured with the SF-36 health perception scale had the greatest correlation with the energy and fatigue scale (r = .45), correlated moderately with mental health (r = .35), social function (r = .32), and physical function (r = .33), and correlated less well with the surgically remediable dimension of pain (r = .23). However, correlations of global health perception with pain and global health perception with role functioning were significantly (P < or = 0.05) lower in older patients when compared with subjects 70 years or younger (r = .13 vs .28 and r = .19 vs .33, respectively). CONCLUSION: Despite poorer role function, poorer energy and fatigue scores, and poorer physical function, elderly persons have similar global health perception when compared with younger individuals. These data indicate that global health perception may be determined by different factors in the elderly or that the elderly have fundamentally different expectations of what their global health status should be. Our findings emphasize the importance of multidimensional scales when evaluating quality of life because, particularly in the elderly, the use of global measures alone may not reflect critically important dimension-specific impairments in health.

Activities of Daily Living↗
PubMed2005

Changes in the health status of women during and after pregnancy.

OBJECTIVE: To characterize the changes in health status experienced by a multi-ethnic cohort of women during and after pregnancy. DESIGN: Observational cohort. SETTING/PARTICIPANTS: Pregnant women from 1 of 6 sites in the San Francisco area (N=1,809). MEASUREMENTS AND MAIN RESULTS: Women who agreed to participate were asked to complete a series of telephone surveys that ascertained health status as well as demographic and medical factors. Substantial changes in health status occurred over the course of pregnancy. For example, physical function declined, from a mean score of 95.2 prior to pregnancy to 58.1 during the third trimester (0-100 scale, where 100 represents better health), and improved during the postpartum period (mean score, 90.7). The prevalence of depressive symptoms rose from 11.7% prior to pregnancy to 25.2% during the third trimester, and then declined to 14.2% during the postpartum period. Insufficient money for food or housing and lack of exercise were associated with poor health status before, during, and after pregnancy. CONCLUSIONS: Women experience substantial changes in health status during and after pregnancy. These data should guide the expectations of women, their health care providers, and public policy.

Adolescent↗
PubMed2004

Social transfers and the health status of mothers in Norway and Canada.

The unconditional health status of lone mothers is worse than that of married mothers in Canada but not in Norway. Even controlling for demographic characteristics and health behaviours in Canada, the health status of lone mothers is worse. Only after we control for income does the differential in health status between married and lone mothers in Canada disappear. An important difference between the countries is that lone mothers are much less likely to be poor in Norway because they receive more generous social transfers. A simulation which involves 'giving Canadian mothers Norwegian transfers,' illustrates the possibility of significant gains in socioeconomic status and health of poor mothers in Canada.

Adult↗
PubMed2001

Developing and evaluating complementary therapy services: part 2. Examining the effects of treatment on health status.

OBJECTIVES: To investigate the effect on patient health status of an outpatient service providing acupuncture, osteopathy, and homeopathy. DESIGN: Pragmatic quasiexperimental design with waiting-list control group. SETTING: A district general hospital in the United Kingdom. SUBJECTS: All patients referred to the service during the study period. OUTCOME MEASURES: The Short Form 36-Item Health Status Survey (SF-36). RESULTS: With the exception of the Physical Functioning scale, statistical differences in scores were found between the treatment and control group on all SF-36 scales. Sensitivity analysis designed to deal with nonresponse supports the robustness of the results. CONCLUSION: This study provides evidence for the effectiveness of an outpatient acupuncture, osteopathy and homeopathy service in terms of benefits to patients' health status.

Acupuncture↗
PubMed1983

Supportive exchange: an exploration of the relationship between social contacts and perceived health status in the elderly.

While social ties are known to bear an important relationship to health status among the elderly, the components of that association remain unclear. This study explored the hypothesis that 'supportive exchange', or the giving and seeking of advice and other forms of assistance, bears an important relationship to perceived health status. Six-hundred and seventy-eight elderly residents of Alameda County, CA, participated in this survey research study, which examined social ties, supportive exchange, and health status. A strong relationship was found between a key dimension of supportive exchange - the giving and seeking of advice - and self-reported health status. The association between advice seeking and health status was particularly high, demonstrating that advice seeking may be as strongly associated with health status as social ties. While it is important to develop refined indices for the measurement of other dimensions of supportive exchange, this exploratory study suggests that the concept may be a useful one in furthering research on the relationship between health status and social contacts among the elderly.

Aged↗
PubMed1999

The relationship between health status, social support and satisfaction with medical care among patients with systemic lupus erythematosus.

OBJECTIVE: To examine the effect of physical and mental health status and social support on patient satisfaction with health care in patients with systemic lupus erythematosus (SLE). STUDY DESIGN: Using a cross-sectional design, 220 SLE patients were recruited from rheumatology departments in two hospitals in the Montreal (Canada) area. Data comprised physician-rated indices of health status and patient-completed questionnaires. MEASURES: Independent variables included demographics, disease duration, physician-rated indices of disease activity (SLAM-R) and disease damage (SLICC/ACR), patient self-reported health status (SF-36), and perceived social support (ISEL). Patient satisfaction with medical care (PSQ-IV) was the dependent variable. ANALYSES: Univariate analyses were performed to describe the sample and examine univariate associations between the independent variables and patient satisfaction with medical care. A hierarchical multiple linear regression analysis was computed to determine the relative importance of physician-rated indices of health status, self-reported physical and mental health status and social support on patient satisfaction after controlling for demographic variables. RESULTS: A multivariate hierarchical regression computed to predict patient satisfaction included the following variables in the equation: age, education, income (step 1), disease duration, SLAM-R, SLICC/ACR (step 2), mental and physical health status (step 3), and perceived social support (step 4). Less education (P< 0.01), better self-reported mental (P< 0.05) and physical health status (P< 0.005) and higher perceived social support (P< 0.005) were significant predictors of patient satisfaction (R2 = 0.15, P< 0.0001). CONCLUSION: The findings suggest that self-reported physical and mental health status and social support are more important than clinical status variables in understanding patient satisfaction with medical care.

Adult↗
PubMed2003

Health status of adult long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.

CONTEXT: Adult survivors of childhood cancer are at risk for medical and psychosocial sequelae that may adversely affect their health status. OBJECTIVES: To compare the health status of adult survivors of childhood cancer and siblings and to identify factors associated with adverse outcomes. DESIGN, SETTING, AND PARTICIPANTS: Health status was assessed in 9535 adult participants of the Childhood Cancer Survivor Study, a cohort of long-term survivors of childhood cancer who were diagnosed between 1970 and 1986. A randomly selected cohort of the survivors' siblings (n = 2916) served as a comparison group. MAIN OUTCOME MEASURES: Six health status domains were assessed: general health, mental health, functional status, activity limitations, cancer-related pain, and cancer-related anxiety/fears. The first 4 domains were assessed in the control group. RESULTS: Survivors were significantly more likely to report adverse general health (odds ratio [OR], 2.5; 95% confidence interval [CI], 2.1-3.0; P<.001), mental health (OR, 1.8; 95% CI, 1.6-2.1; P<.001), activity limitations (OR, 2.7; 95% CI, 2.3-3.3; P<.001), and functional impairment (OR, 5.2; 95% CI, 4.1-6.6; P<.001), compared with siblings. Forty-four percent of survivors reported at least 1 adversely affected health status domain. Sociodemographic factors associated with reporting at least 1 adverse health status domain included being female (OR, 1.4; 95% CI, 1.3-1.6; P<.001), lower level of educational attainment (OR, 2.0; 95% CI, 1.8-2.2; P<.001), and annual income less than 20 000 dollars (OR, 1.8; 95% CI, 1.6-2.1; P<.001). Relative to those survivors with childhood leukemia, an increased risk was observed for at least 1 adverse health status domain among those with bone tumors (OR, 2.1; 95% CI, 1.8-2.5; P<.001), central nervous system tumors (OR, 1.7; 95% CI, 1.5-2.0; P<.001), and sarcomas (OR, 1.2; 95% CI, 1.1-1.5; P =.01). CONCLUSION: Clinicians caring for adult survivors of childhood cancer should be aware of the substantial risk for adverse health status, especially among females, those with low educational attainment, and those with low household incomes.

Adolescent↗
PubMed1985

A cross-cultural comparison of health status values.

The extent to which the values attached to health states are similar in different cultures or social groups is important for understanding health and illness behaviors and for developing standardized health status measures. A cross-cultural study was conducted to compare the health status values obtained in a United States population (Seattle, Washington) with those from another English-speaking culture (London, England) on the Sickness Impact Profile, a standardized measure composed of 136 items. London judges rated the severity of dysfunction described in each item on an equal interval scale using the same methods of scaling and analysis employed in the Seattle study. A regression of English mean item values on US mean values yielded a slope of 1.00 and an intercept of -0.07, indicating that judges gave strikingly similar ratings to most items. Agreement was higher at the more severe end of the dysfunction continuum than at the least severe end, a finding consistent with the notion that what constitutes health is more difficult to define than what constitutes illness. While a universal conception of dysfunction may exist in English-speaking societies, the social and cultural determinants of health status values deserve more systematic study.

Activities of Daily Living↗
PubMed1980

A quantitative approach to perceived health status: a validation study.

The current recognition of the importance of perceived health status as a predictor of need for, and utilisation of, health services has led to attempts to produce indicators which assess subjective rather than objective health problems. The development of the Nottingham Health Profile is described, together with a study which tested the validity of the instrument on four groups of elderly people differing in health status. The results showed that the profile was capable of discriminating between groups differing in terms of diagnosed chronic illness, number of consultations at primary care level, and physiological fitness. Age, sex, and marital status were not significant overall in affecting scores. In these elderly subjects, perceived health status accorded well with objective health status. Further tests of the profile are now taking place on younger groups of subjects.

Affective Symptoms↗
PubMed2002

Reversible bronchial obstruction and disease-related health status in COPD.

We aimed to assess whether partially reversible and fixed airway obstructions are associated with different health status profiles of chronic obstructive pulmonary disease (COPD) patients. We characterized health status profiles of outpatients over 64 years suffering from COPD with fixed (n = 181) or partially reversible obstruction (n = 95) and from chronic bronchitis with forced expiratory volume in the first second (FEV1) > 69% of that predicted (n = 109) on the basis of the Saint George Respiratory Questionnaire (SGRQ) and indexes assessing cognitive (Mini Mental State), affective (15-item Geriatric Depression Scale) and physical status (Index of Barthel, six-minute walking test) and quality of sleep (Index of disturbed sleep). The degree of group-specificity of health status profiles was assessed by discriminant analysis. The 54.1% of COPD patients with partially reversible obstruction were recognized to have a distinctive health status profile characterized by a moderate to severe impairment of all components ('Symptoms', 'Activity', 'Impacts') of the SGRQ and of select indexes of performance. According to logistic regression analysis, this health status profile was associated with FEV < 46% of that predicted (odds ratio (OR): 1.6, 95% confidence interval (CI): 1.07-2.38), the use of at least three respiratory drugs (OR: 2.28, CI: 1.46-3.57) and living alone (OR: 2.01, 95% CI: 1.3-2.29). COPD patients with fixed obstruction had a very heterogeneous health status. Research is needed to verify whether the unfavorable health status profile typical of a subset of COPD patients is associated with a distinctive prognosis and can be improved by dedicated therapeutic interventions.

Affect↗
PubMed2006

Risk factors for impaired health status differ in women and men treated with percutaneous coronary intervention in the drug-eluting stent era.

OBJECTIVES: In patients treated with percutaneous coronary intervention (PCI) in the drug-eluting stent era, we compared women's and men's health status 6 and 12 months post-PCI and investigated whether predictors of poor health status at 12 months are similar for women and men. METHODS: Consecutive patients (n=692; 28% women) treated with PCI completed the 36-item Short-Form Health Survey (SF-36) 6 and 12 months post-PCI. RESULTS: There was a significant improvement in health status over time (P<.001), but women experienced a significantly poorer health status compared with men (P<.001) at 6 and 12 months, adjusting for differences in baseline characteristics and health status at 6 months. Predictors of impaired health status were generally different for women and men. In women, the predominant predictors were previous coronary artery bypass graft (CABG) surgery, renal impairment, and older age; in contrast, in men, older age was associated with better functioning. In women, previous CABG was associated with a 4-15 fold increased risk of impaired health status. Health status at 6 months was a predictor of all SF-36 domains at 12 months in both women and men. CONCLUSIONS: Women reported poorer health status compared with men 6 and 12 months post-PCI, and predictors of impaired health status generally differed for women and men. Further studies examining risk factors for adverse outcomes for women and men separately, which will lead to better risk stratification in research and clinical practice, are warranted.

Administration, Topical↗