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PubMed2001

The physical functioning inventory: a procedure for assessing physical function in adults.

The Physical Functioning Inventory, an instrument designed to assess changes in how and how often activities are performed in persons reporting difficulty with a task as well as in those who do not, is described. The measure is designed for adults. Interrater and test-retest reliability were assessed with active participants in the Baltimore Longitudinal Study of Aging (BLSA). Percentage agreement ranged from 63% to 100%. The instrument was also given to 392 inactive BLSA participants as part of a follow-up telephone interview. Fifty-eight percent of the respondents reported no difficulty in performing a task, yet reported a change in how often they performed that task. The results indicate that the instrument is reliable and effective in detecting early stages of disability in activities of daily living, instrumental activities of daily living, and mobility. The instrument is somewhat less reliable for moderate and strenuous physical activities.

Activities of Daily Living↗
PubMed1997

Worry about health status among the elderly: patient management and health policy implications.

Health care reform depends on reducing inappropriate utilization and improving access. Elderly people, major consumers of primary care, are a place to begin reforms, but progress has been slow. We combined primary care screening questions for objective (medical condition as wellness) and subjective (perception of health as worry) health in a study of 767 elderly people in Youngstown, Ohio. The worried well (31.2%), a group likely to consume medical care inappropriately, and unconcerned ill (4.4%), a group likely to avoid seeking necessary medical care, account for more than one-third of the elderly. The unconcerned well (57.0%) and worried ill (6.9%) pose fewer problems. Family physicians can predict utilization and access problems for targeted groups (older people, minorities, and women), along with health beliefs and other indicators of health status. Although findings in this study are preliminary, they do point to positive uses in health policy and patient management. Extensive usage of the sure would require financial reimbursement to health care providers.

Aged↗
PubMedDate not supplied

[Social profile of the black population in Brazil: implications for the nursing profession].

The discussion about the inequality conditions in which black population lives in Brazil, has been disguised by today's economical conjuncture which apparently sets with no restrictions the white, black and mestizos in absolute destitution conditions. Considered unracist, entitled by 'Folha de Sao Paulo/Datafolha' as Kind Racist, Brazil has being instituting way of living among races whose discrimination is expressed by the lack of opportunity and access to consumption services. This way, the insertion of the black in Brazilian society after slavery abolition is our study object. This bibliographical discusses social indicators aiming at describing this population strategies in conquering a social space. This study shows up the difficulties faced by this populational group regarding to its insertions to the work market as determinant factor to its social rising. We have included black male and female as citizens which compose the labor force in Nursing.

Black or African American↗
PubMed1983

Prognostic Nutritional Index: its usefulness as a predictor of clinical course.

Despite mounting evidence, a question still exists as to the true clinical relevance of varying degrees of malnutrition, the role of currently measured nutritional parameters in identifying malnutrition and predicting clinical risk in individual patients, and the efficacy of nutritional therapy. This study was designed to document the usefulness of the Prognostic Nutritional Index (PNI) as a predictor of clinical course. The nutritional assessments and clinical records of 328 subjects in a Veterans Administration Hospital were reviewed, PNI and complication rates were determined for each of the subjects, and the data statistically analyzed. The PNI was found to be a useful indicator of malnutrition and predictor of clinical course. The PNI appeared to be a more sensitive index of clinical outcome than did comparison of individual nutritional parameters to accepted norms, although it accounted for only 17% of the information needed to predict clinical course perfectly.

Adult↗
PubMed1982

Poverty: a major deterrent to America's good health.

Poverty has a major impact on the nation's state of health. Although its effects are difficult to separate from that of old age and the problems of minorities, there are definite correlations between indicators of economic well being and mortality/morbidity rates United States vital statistics and extensive health interview surveys provide ample documentation of the role of poverty as a health determinant. The success the Indian Health Service has had in lowering mortality rates mirrors the nation's as a whole and demonstrates what can be done if socioeconomic conditions, as well as health care delivery, is improved. The message should not be lost sight of it this era of cutbacks in social programs.

Adolescent↗
PubMed1991

Characteristics of respondents and nonrespondents in a prospective study of osteoporosis.

During 1981-1982, a cohort of elderly Japanese Americans living in Hawaii was recruited for an epidemiologic study of osteoporosis. The male subjects were simultaneously being examined for an epidemiologic study of heart disease. Baseline data collected from both the men and women at a previous heart disease examination were used to compare responders vs nonresponders. The target population for the osteoporosis study consisted of 1685 men and 1594 women. Of these, 1379 men (81.8%) and 1105 women (72.0%) participated in the initial osteoporosis examination. For each sex, nonrespondents were older and had higher systolic blood pressure levels than did the respondents. Male nonresponders had a higher stroke prevalence and more frequent recent use of vasodilator medicine. Female nonresponders had a less frequent history of having ever taken female hormones than did the responders. The responders and nonresponders were reasonably similar in other respects, as indicated by the comparison of more than 40 other variables. This suggests that nonresponse bias is probably not a major influence in exposure-disease associations in this osteoporosis cohort. We believe this is the first published report dealing with nonresponse characteristics in a cohort study of osteoporosis.

Aged↗
PubMed1995

The illusion of failure: trends in the self-reported health of the U.S. elderly.

Data from the National Health Interview Survey showed a trend toward worsening self-reported health among older American men and women during the 1970s. This evidence--combined with the significant declines in age-specific mortality observed since the 1960s--led some researchers to suggest that the health of the older population is declining. An examination of recent trends in self-reported health indicates that the health declines observed during the 1970s generally reversed during the 1980s. This reversal not only belies the argument that lower adult mortality implies worse health, but also challenges the belief that trends in self-reported health during the 1970s reflected actual health declines. A more plausible explanation is that changes in the social and economic forces, combined with earlier diagnosis of preexisting conditions, influenced the options available for responding to health problems.

Activities of Daily Living↗
PubMed1986

Predictive indices for the identification of high-risk patients.

In this article, the predictive indices which have been developed during the last decade to assess the risk of complications during hospitalization are reviewed. These indices are based on the evaluation of nutritional and immunological parameters and are particularly suitable for the identification of the surgical patient at risk for postoperative septic complications. The authors also review the methods which have been proposed for the classification of the severity of disease in critically ill subjects and the sepsis score method for the prediction of clinical outcome in severely septic surgical patients.

Health Status Indicators↗
PubMed1988

Rehabilitation status: a measure of medicosocial dysfunction.

The Edinburgh Rehabilitation Status Scale (ERSS) measures four dimensions in which changes may occur in the course of a disabling illness or during rehabilitation: independence; activity; social integration; and effects of symptoms on lifestyle. It provides a profile of measures, the scores of which can be summated to indicate the overall level of performance of individuals or groups. Studies of its inter-observer reliability and of its application in various disability groups indicate that the ERSS reliably defines the characteristics of individual patients and of groups. The scale can be used conveniently by professional staff working independently or by a multiprofessional rehabilitation team to assess status and changes in patients. It can also be used for measurement of the effectiveness of services and for purposes of research, teaching, and administration.

Activities of Daily Living↗
PubMedDate not supplied

Measuring alcohol abuse in the community: consumption, binge-drinking, and alcohol-related consequences ("alcoholism").

This study reported and compared community health indicators for the measurement of alcohol abuse. Using data from the 1989 Hamilton-Wentworth Health Survey, similar rates were found for four differing definitions of alcohol abuse: 1) drinking everyday (5.7%, 95% confidence limit (CL) = 3.8-7.7%), 2) drinking at least 14 drinks in the past seven days (12.1%, 95% CL = 9.2-15.1%), 3) frequent binging on 10 drinks or more (9.4%, 95% CL = 6.9-11.8%), and 4) "alcoholism" as defined by the Michigan Alcoholism Screening Test (MAST) (7.4%, 95% CL = 5.1-9.7%). Binging on five drinks or more occurred frequently (37.0, 95% CL = 32.8-41.1%). All indicators of alcohol abuse from the survey were significantly higher for males as compared to females (p < 0.05), and demonstrated varying distributions by age. Estimates of drinking consumption based on the sale of alcoholic beverages in the community were also examined and found to estimate consumption levels nearly double that of the self-reported survey data. Relevance to public health planning and monitoring is discussed.

Adolescent↗
PubMed1990

Death, AIDS morbidity, and HIV seroprevalence in New York City intravenous drug abusers.

Drug treatment programs represent a point of access to intravenous drug abusers and, as such, may also be useful in monitoring health status indicators among this population. Such a surveillance project was established in 1985 among drug treatment clinics in New York City to monitor the human immunodeficiency virus (HIV) epidemic. HIV seroprevalence was 54% (255/469) in 1985, 61% (159/262) in 1986, and 60% (133/222) in 1987. Of the 2500 cumulative enrollees in these clinics each year, 4 patients met the Centers for Disease Control acquired immunodeficiency syndrome (AIDS) surveillance definition in 1985, 37 in 1986, and 37 in 1987. There were 25 AIDS-related deaths in 1985, 8 in 1986, and 16 in 1987. These results suggest that by including drug treatment programs in a rational surveillance system, we may be able to monitor the HIV epidemic more closely. The public health significance of such a surveillance program is magnified given the association between intravenous drug abuse-associated AIDS and the prevalence of AIDS among women, children, and ethnic/racial minorities.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Measuring disability with parsimony.

PRIMARY OBJECTIVE: Health surveys, especially those for older persons, include numerous detailed items about disability. There has been little effort to develop a global disability item, that is, one question that covers the concept of disability briefly but well. This article discusses how parsimony can be achieved through a single item, or less desirably by reductions of detailed items. MAIN OUTCOME AND RESULTS: Results of three analyses on the issue of compact disability indicators, using public-use data sets (AHEAD, HRS, BRFSS), are presented. The analyses study relationships of global disability to both detailed disability items and global health. Overall, the results show that a global disability item has good coverage of specific disabilities and is distinct from self-rated health. CONCLUSIONS: Routine inclusion of a global disability item in surveys is recommended, and specific suggestions are made to aid its design.

Activities of Daily Living↗
PubMed1983

Health and health protection of the Polish population. Experience and the future.

This report, drafted by members of a discussion group (Experience and the Future) consisting primarily of Polish physicians, concerns the problems of personal health and of the health care system in Poland in recent years. Data are presented on key indicators of the health of the Polish population, including mortality, incidence rates of viral and infectious diseases, child health, occupational health, care of the disabled, and alcohol consumption, and a program for improving these indicators is set forth. In addition, achievable short- and long-term goals for the health sector are suggested. It is maintained that many of the unsolved problems in Poland's health sector result from its structure. The foundation on which the health pyramid should rest-primary care in local medical institutions--is the weakest element in the system, whereas the top of the pyramid--specialized, technologically oriented hospitals--is given highest priority.

Adolescent↗
PubMed1998

Measuring health-related quality of life in children: the development of the TACQOL parent form.

Health-related quality of life (HRQoL), conceptualized as patients' own evaluations of their health status, is an important criterion in evaluation health and health care and in the treatment of individual patients. Until now, few systematic attempts have been made to develop instruments to assess the HRQoL of children using such a conceptualization. This article describes the conceptualization and results of a study aiming to develop such an instrument for children aged 6-15 years using their parents as a proxy. The feasibility and psychometric performance of the instrument were evaluated in a study of 77 patients of the paediatric out-patient clinic of Leiden University Hospital. For each of the a priori-defined domains, a parent form scale could be constructed with satisfactory reliability and moderate correlations with the other scales. Only some of the parents indicating health status problems also signalled negative reactions to these problems. This is, in our view, a strong argument for the distinction between health status and quality of life (QoL). The correlation coefficients between the parent form and a children's questionnaire were low. Overall, the psychometric performance of the TACQOL parent form looks promising, which suggests that this instrument--with some modifications--can indeed be used to assess group differences in HRQoL in children. The results, however, should be replicated in larger samples, currently under study. The relation between parents' proxy reports on the HRQoL of their children and children's self-reports needs further investigation.

Adolescent↗
PubMed1977

Scaling indices of disablement.

Williams et al. (1976) have suggested the use of Guttman scaling for scoring an index of disability. Two examples confirm the applicability of this method in the context of survey research. One of these examples is of a disablement scale widely employed in local authority social services research. For the purpose of survey assessment of disabled populations, the precise choice of scaling method for scoring disability is often of little consequence.

Activities of Daily Living↗
PubMed1984

Selecting a health indicator for comparative health surveys among different social categories using employment as example.

In the last decade a number of subjective health indicators have been developed and validated. In view of the investment involved in developing a new one, a researcher designing a health survey will preferably choose one of the existing indicators. To facilitate such a choice, a set of criteria is developed. Six existing indicators are valued according to the stipulated criteria. Unemployment is taken as the example because there is a demand for comparative health surveys between unemployed and employed in order to validate findings in the unemployment literature. The comparison of the health of unemployed and employed is used as an example on the basis of which more general statements can be made about the comparison of the health of people in other polar social roles like divorced versus married, immigrants versus residents, that involve a transition from one social role to another.

Health Status Indicators↗
PubMed1975

The health and medical system in Japan.

This has been a brief sketch of the health and medical system in Japan. While many health indices have improved since the end of World War II, the health system still has many problems to be solved. The shortage of professional personnel remains a glaring one. And especially detrimental to the effective functioning of a good system is the fragmentation of various institutions, schemes and functions. It is necessary to integrate all of these things into a comprehensive health care system, and to establish a comprehensive plan for health and medical services.

Community Participation↗
PubMed2003

Health inequalities in the workforce: the labour market core-periphery structure.

OBJECTIVES: To explore health inequalities between six labour market groups ranging from permanent employees to the long-term unemployed receiving minimum daily allowance. METHODS: A sample of 15 468 employees or job seekers from a population survey. Their perceived health, diseases, and depression were measured. RESULTS: Compared with permanent employees, the odds for poor health were highest among the unemployed with low incomes irrespective of adjustments, across all health indicators and in both men and women. High odds were also found among the less disadvantaged unemployed and the employed with atypical contracts, but not among fixed-term employees. CONCLUSIONS: Rather than between the employed and the unemployed, it seems that health inequalities prevail across different labour market groups within the employed and the unemployed. Future studies should employ a more detailed classification of employment situation.

Adult↗