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PubMed1999

Concurrent child health status and maternal recall of events in infancy.

BACKGROUND: Obtaining information on children's health and health events is heavily dependent on maternal report. Experience as to what factors influence accuracy of reporting varies, and few studies have examined the influence of current child health status on recall. METHODS: A prospective cohort study involving 1833 children who were assessed in infancy and at 8 to 10 years of age was conducted to assess maternal reports of birth weight, gestational age, neonatal transport, length of neonatal hospitalization, and rehospitalizations in the first year compared with data collected in infancy overall, and as a function of concurrent child functional health status, socioemotional health, and ratings of child health. RESULTS: Maternal recall of neonatal events was accurate but not that of rehospitalizations in the first year. Concurrent child health problems affected accuracy but not sufficiently to make information unusable. CONCLUSION: Maternal recall of neonatal events 8 to 10 years later is accurate; however, the influence of current child health status on recall may be important in research on the cognitive processes underlying health questionnaire responses.

Birth Weight↗
PubMedDate not supplied

A comparison of oral health status and need for dental care between abused/neglected children and nonabused/non-neglected children.

This paper compares oral health status and presence of untreated, decayed permanent teeth in abused/neglected children with nonabused/non-neglected controls. The sample comprised 903 children between 5 and 13 years old; 30 were confirmed cases of child abuse and 873 served as controls. Their oral health status was assessed by two calibrated dentists using the DMFS index. Presence of untreated, decayed teeth was determined from the decayed and unfilled component of the DMFS score. The data were analyzed using logistic regression so that the influence of other explanatory variables (sociodemographic characteristics) on oral health status and presence of untreated, decayed teeth could be controlled while the influence of abuse status was evaluated. Results show that abuse status is an important explanatory variable for both oral health status and presence of untreated, decayed teeth. While the impact of abuse status on oral health status is obscured by interactions with other explanatory variables, its impact on the presence of untreated, decayed teeth is clear. Abused children are eight times more likely to have untreated, decayed permanent teeth than nonabused children. Accordingly, it is recommended that confirmed cases of child abuse/neglect should be referred routinely for dental screening as part of their overall rehabilitation.

Adolescent↗
PubMed1997

Health status measurement in computer-based patient record systems.

As requests for information about quality of health care have increased, purchasers of computer-based patient record (CPR) systems are demanding information regarding the manner in which these systems can assist in measuring health care quality. The type of information requested by purchasers of health care, accrediting agencies, and consumer groups is shifting toward more complex measures of health status. Both provider and patient perceptions of health status are relevant in measuring the impact of health care interventions. Standardized coding and classification systems and standardized health status measurement instruments each offer utility in capturing and representing health status in CPR systems.

Humans↗
PubMed1995

A comparison of health status between rural and urban adults.

The objective of the study was to examine and compare health status between rural and urban adults. The data are from a 1993 statewide probability-based telephone survey of adult Kentuckians (n = 662). Metropolitan Statistical Area (MSA) residents (n = 264) and nonMSA residents (n = 398) were compared using the Medical Outcomes Study, Short Form Health Survey (SF-20). Self-perceived urban (n = 406) and rural (n = 256) residents were also compared. Additional analyses were stratified by the age categories of 18-44, 45-64, and > or = 65 years of age. Few differences in health status existed between rural and urban adults. However, rural elders (> or = 65 years) had significantly poorer health status than urban elders. After controlling for demographic variables in multiple regressions, rural elders had significantly poorer functioning (all p < .05) than urban elders as measured by the SF-20 subscales of a) physical functioning, b) role functioning, c) social functioning, d) general mental health, and e) general health perceptions. No differences between rural and urban residents were noted for the pain subscale. Although the health status of rural and urban adults is generally similar, the rural elderly have significantly worse health status than their urban counterparts.

Adult↗
PubMed1999

Do better quality consultations result in better health? Relationship between quality of consultations and health status of patients with non-acute abdominal complaints in general practice.

BACKGROUND: In theory, a positive relationship is expected between the quality of a consultation and a patient's subsequent health status. However, such a relationship has not yet been firmly established in daily practice. OBJECTIVE: We aimed to study the relationship between the quality of the first consultation in a new episode of non-acute abdominal complaints and subsequent health status of patients in general practice. METHODS: Quality scores for 743 consultations were calculated on the basis of review criteria developed by expert panels. Functional health status was measured by the SIP (Sickness Impact Profile) at baseline, and at 1 and 6 months after the consultation. Multilevel regression analysis was used to examine the relationship between the quality of consultations and health status, and to identify factors of influence on this relationship. RESULTS: In the majority of these patients (97%) health status improved regardless of consultation quality. In patients with malignant disease, and chronic colitis, however, an association between consultation quality and subsequent health status was found: in those with a high consultation quality score (>66-percentile) the health status deteriorated in the first month but improved over the following 5 months; in those with a low consultation quality score (<33-percentile) it deteriorated continuously. CONCLUSION: For the great majority of patients we found no relation between the quality of consultation and health status. However, for a very small subgroup of patients there is proof of benefit from better quality consultations.

Abdominal Pain↗
PubMed2005

Grip strength, postural control, and functional leg power in a representative cohort of British men and women: associations with physical activity, health status, and socioeconomic conditions.

BACKGROUND: Understanding the health, behavioral, and social factors that influence physical performance in midlife may provide clues to the origins of frailty in old age and the future health of elderly populations. The authors evaluated muscle strength, postural control, and chair rise performance in a large representative prospective cohort of 53-year-old British men and women in relation to functional limitations, body size, health and activity, and socioeconomic conditions. METHODS: Nurses interviewed 2984 men and women in their own homes in England, Scotland, and Wales and conducted physical examinations in 2956 of them. Objective measures were height, weight, and three physical performance tests: handgrip strength, one-legged standing balance time, and time to complete 10 chair rises. Functional limitations (difficulties walking, stair climbing, gripping, and falls), health status, physical activity, and social class were obtained using a structured questionnaire. RESULTS: Those with the worst scores on the physical performance tests had higher rates of functional limitations for both upper and lower limbs. Women had much weaker handgrip strength, somewhat poorer balance time, and only slightly poorer chair rise time compared with men. In women, health problems and low levels of physical activity contributed to poor physical performance on all three measures. In men, physical activity was the predominant influence. Heavier weight and poorer socioeconomic conditions contributed to poorer balance and chair rise times. CONCLUSIONS: In this representative middle-aged group, physical performance levels varied widely, and women were seriously disadvantaged compared with men. In general, physical performance was worse for men and women living in poorer socioeconomic conditions with greater body weight, poorer health status, and inactive lifestyles. These findings support recommendations for controlling excess body weight, effective health interventions, and the maintenance of active lifestyles during aging.

Cohort Studies↗
PubMed1991

Health perceptions and survival: do global evaluations of health status really predict mortality?

Self-evaluations of health status have been shown to predict mortality, above and beyond the contribution to prediction made by indices based on the presence of health problems, physical disability, and biological or life-style risk factors. Several possible reasons for this association are discussed: (a) methodological shortcomings of previous studies render the association spurious; (b) other psychosocial influences on mortality are involved and explain the association; and (c) self-evaluations of health status have a direct and independent effect of their own. Four-year follow-up mortality data from the Yale Health and Aging Project (N = 2812) are used to explore these possibilities. The analysis controls for the contribution of numerous indicators of health problems, disability and risk factors, and also makes adjustments of standard errors for the complex sample design. The findings favor the third possibility, an independent effect, to the extent that the particular set of psychosocial factors examined did not explain the basic association, and to the extent that the control variables were an adequately comprehensive set.

Activities of Daily Living↗
PubMed1997

Baseline and post-treatment assessment of the general health status of head and neck cancer patients compared with United States population norms.

BACKGROUND: It is a common perception that the overall health of patients with head and neck cancer (HNC) is likely to be poor compared with the general population. This project was undertaken to investigate the pre- and post-treatment, global health status of HNC patients in comparison with age-matched, U.S. population norms using a self-administered general health status survey. METHODS: Between July 1, 1993, and May 1, 1996, 180 patients underwent pretreatment and 6 month follow-up evaluation with the standard version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The SF-36 scale scores, means, standard deviations, and 95% confidence intervals were calculated for each SF-36 scale as well as for physical-health-component summary scores (PCS) and mental-health-component summary scores (MCS). Comparisons of these scores were made to U.S. population normative data. Pretreatment and 6-month follow-up SF-36 scores were compared. RESULTS: In the 45-54-year age group, all 8 SF-36 scale scores, the PCS, and MCS scores were significantly worse for the HNC patients in comparison with age-matched norms (p < .05). In the 55-64-year age group, the HNC patients were worse in 5 of the 8 SF-36 scale scores and the MCS score in comparison with age-matched norms (p < .05). In the 65-74-year age group, the HNC patients scored significantly worse in the mental health scale. In the comparison of pretreatment and 6-month follow-up scores, the HNC patients had significant decreases in the physical functioning scale (p = .003) and the PCS score (p = .047). The HNC patients showed significant improvement in the mental health scale (p = .049) and improvement in the bodily-pain scale, which approached significance (p = .053) at 6-month follow-up. The HNC patients showed a marked decrease in general health status with increasing stage of HNC. CONCLUSIONS: This work provides objective support for the perception that many HNC patients are initially seen for treatment with baseline health status functioning significantly below their age-matched contemporaries in the general population. An educated evaluation of global health outcomes following treatment in the HNC patient population must begin with an accurate pretreatment assessment of these parameters. Self-reported health-status assessment (HSA) is a useful means of evaluating global health status in this patient population.

Adult↗
PubMed1999

Distinguishing between quality of life and health status in quality of life research: a meta-analysis.

Despite the increasing acceptance of quality of life (QOL) as a critical endpoint in medical research, there is little consensus regarding the definition of this construct or how it differs from perceived health status. The objective of this analysis was to understand how patients make determinations of QOL and whether QOL can be differentiated from health status. We conducted a meta-analysis of the relationships among two constructs (QOL and perceived health status) and three functioning domains (mental, physical, and social functioning) in 12 chronic disease studies. Instruments used in these studies included the RAND-36, MOS SF-20, EORTC QLQ-30, MILQ and MQOL-HIV. A single, synthesized correlation matrix combining the data from all 12 studies was estimated by generalized least squares. The synthesized matrix was then used to estimate structural equation models. The meta-analysis results indicate that, from the perspective of patients, QOL and health status are distinct constructs. When rating QOL, patients give greater emphasis to mental health than to physical functioning. This pattern is reversed for appraisals of health status, for which physical functioning is more important than mental health. Social functioning did not have a major impact on either construct. We conclude that quality of life and health status are distinct constructs, and that the two terms should not be used interchangeably. Many prominent health status instruments, including utility-based questionnaires and health perception indexes, may be inappropriate for measuring QOL. Evaluations of the effectiveness of medical treatment may differ depending on whether QOL or health status is the study outcome.

Health Status↗
PubMed1991

The clinical and health status of patients with recent-onset rheumatoid arthritis.

This study was designed to document the clinical and health status of patients with recent-onset rheumatoid arthritis (RA). Three groups were studied: 108 patients who had had RA for greater than 1 year (established RA group), 313 patients who had had RA for less than or equal to 1 year (recent-onset RA group), and 188 healthy friend of the patients with recent-onset RA (no RA group). Clinical status was measured using tender joint count, erythrocyte sedimentation rate, and overall physician assessment. Health status was measured using the physical, psychological, pain, and arthritis impact scores of the Arthritis Impact Measurement Scales. Scores on all clinical and health status measures indicated substantial disease effects in the group with recent-onset RA. For most of these measures, effect size analysis indicated that clinical and health status impacts in the recent-onset RA group were similar in magnitude to those found in the groups with more established disease, with scores in both groups being substantially different from those found in the no RA group. These results document the magnitude of the clinical and health status impacts in recent-onset RA. They lend support to recent arguments advocating aggressive therapy earlier in the course of this frequently disabling disease.

Arthritis, Rheumatoid↗
PubMed2006

Association of parental and children behaviors with the health status of preschool children.

BACKGROUND: Parental and children behaviors can be associated with health promotion and illness prevention in preschool children. METHODS: We interviewed mothers of 804 out of 1000 households with children aged 3 to 5 years randomly sampled in Tokyo, in 1997. Child health status was categorized as: "good", that is, good general health with no sick days; "poor", that is, fair to poor with frequent sick days; or "moderate". RESULTS.: Good health status was associated with playing outside (OR=1.19, 95% CI: 1.03, 1.37) and family income (OR=1.38-1.78, depending on family income). Mothers of children with poor health were less likely to have good health behavior themselves (OR=0.76, 95% CI: 0.64, 0.90) and were more often sick (OR=1.55, 95% CI: 1.24, 1.94). CONCLUSION: Outdoor playing, good health practice of the mother and high income are associated with a better health status of urban preschool children.

Child Welfare↗
PubMed1990

[Problem of physical development and health status of schoolchildren].

Dynamic observation of schoolers' physical development and health status was carried out during 1973-1983. The study indicated decrease in acceleration rates and changes in morbidity trends. The correlation between health status and physical development and somatotype was demonstrated. When assessing the impact of ecologic situation on population's health it was necessary to take into account child group morbidity, physical development and health status.

Adolescent↗
PubMed2002

Measuring trauma and health status in refugees: a critical review.

CONTEXT: Refugees experience multiple traumatic events and have significant associated health problems, but data about refugee trauma and health status are often conflicting and difficult to interpret. OBJECTIVES: To assess the characteristics of the literature on refugee trauma and health, to identify and evaluate instruments used to measure refugee trauma and health status, and to recommend improvements. DATA SOURCES: MEDLINE, PsychInfo, Health and PsychoSocial Instruments, CINAHL, and Cochrane Systematic Reviews (searched through OVID from the inception of each database to October 2001), and the New Mexico Refugee Project database. STUDY SELECTION: Key terms and combination operators were applied to identify English-language publications evaluating measurement of refugee trauma and/or health status. DATA EXTRACTION: Information extracted for each article included author; year of publication; primary focus; type (empirical, review, or descriptive); and type/name and properties of instrument(s) included. Articles were excluded from further analyses if they were review or descriptive, were not primarily about refugee health status or trauma, or were only about infectious diseases. Instruments were then evaluated according to 5 criteria (purpose, construct definition, design, developmental process, reliability and validity) as described in the published literature. DATA SYNTHESIS: Of 394 publications identified, 183 were included for further analyses of their characteristics; 91 (49.7%) included quantitative data but did not evaluate measurement properties of instruments used in refugee research, 78 (42.6%) reported on statistical relationships between measures (presuming validity), and 14 (7.7%) were only about statistical properties of instruments. In these 183 publications, 125 different instruments were used; of these, 12 were developed in refugee research. None of these instruments fully met all 5 evaluation criteria, 3 met 4 criteria, and 5 met only 1 of the criteria. Another 8 standard instruments were designed and developed in nonrefugee populations but adapted for use in refugee research; of these, 2 met all 5 criteria and 6 met 4 criteria. CONCLUSIONS: The majority of articles about refugee trauma or health are either descriptive or include quantitative data from instruments that have limited or untested validity and reliability in refugees. Primary limitations to accurate measurement in refugee research are the lack of theoretical bases to instruments and inattention to using and reporting sound measurement principles.

Health Status↗
PubMed2005

Housing related difficulties, housing tenure and variations in health status: evidence from older people in Wales.

This study aimed to examine housing-related difficulties, the relationship with housing tenure and the subsequent influences on health status in a population sample of older people in Wales. Comparisons with health status normative data were undertaken to determine any geographical differences. A random sample of respondents were interviewed in their own homes (N=423). Data included demographic information, self-reported health status, housing problems, tenure and factors relating to energy efficiency. Univariate analysis found that owner occupiers reported the least housing difficulties and the best health status. Those in public rented properties experienced the most difficulties and the poorest health. The health status of the sample was generally poorer than the norms. Multivariate analysis found that housing difficulties, being cold with current heating and hours spent at home predicted poorer health status. This suggests that characteristics of the home environment may help to explain the differences between tenure and health. Considerable financial outlay may be required to meet policy initiatives that support older people remaining independent, autonomous and able to 'age in place'.

Aged↗
PubMed2005

Predictors of self-rated health status among Texas residents.

INTRODUCTION: The purpose of this study was to investigate the predictors of self-rated health status for Texas adults using the current 2003 Behavioral Risk Factor Surveillance System data. Self-rated health is generally accepted as a valid measure of health status in population studies, and understanding its correlates may help public health professionals prioritize health-promotion and disease-prevention interventions. METHODS: The two research questions addressed by this study involved the predictors of self-rated health: 1) "Do demographic characteristics, health care coverage, leisure-time physical activity, and body mass index predict self-rated health status for Texas residents aged 18 to 64 years?" and 2) "Does choice of interview language (English vs Spanish) predict self-rated health status for Texas residents of Hispanic ethnicity aged 18 to 64 years?" Key analysis variables were identified, and descriptive statistics were used to describe the major variables and determine whether the number of respondents for each variable was sufficient for analysis. Multivariate regression analysis was used to assess the variables. RESULTS: Multiple logistic regression analysis (controlling for diabetes and arthritis) of the self-rated health predictors indicated that older age, lack of health care coverage, lack of a college education, being Hispanic, having a lower income, obesity, and not exercising explained 19.4% of the variance of fair and poor self-rated health. The interview language (English or Spanish), age, sex, education, income, obesity, health insurance coverage, and physical activity (controlling for chronic illness) explained 22.8% of the variance in fair and poor self-rated health for Hispanic respondents. CONCLUSION: The results of this study suggest that a college education, a lower body mass index, non-Hispanic ethnicity, and participation in physical activity are associated with good, very good, or excellent self-rated health status. The finding that the interview language significantly predicted fair and poor self-rated health substantiates previous research and emphasizes the importance of culturally sensitive approaches to health care services.

Adolescent↗
PubMed1995

The contributions of sleep to perceived health status during adolescence.

The purposes of this correlational study were to examine the relationships of three dimensions of sleep quality (sleep disturbance, sleep effectiveness, and sleep supplementation) and sleep quantity (the amount of sleep obtained per day) to perceived health status in early, middle, and late adolescents. The samples consisted of 106 early adolescents (aged 12 to 14), 111 middle adolescents (aged 15 to 17), and 113 late adolescents (aged 18 to 21). In classroom settings, all subjects completed the VSH Sleep Scale, which measures sleep disturbance, sleep effectiveness, and sleep supplementation (the amount of sleep per day was calculated from two items on the scale); the General Health Rating Index, which measures perceived health status; and a demographic data sheet. Pearson product moment correlation coefficients between the sleep variables and perceived health status were not statistically significant for early and late adolescents. For middle adolescents, however, the correlations between sleep disturbance and perceived health status, between sleep effectiveness and perceived health status, and between amount of sleep per day and perceived health status were statistically significant, but the correlation between sleep supplementation and perceived health status was not. A post hoc regression analysis indicated that the sleep variables explained a small, but statistically significant, amount of variance in perceived health status for middle adolescents. Findings are discussed in light of theories guiding the study, and implications for nursing practice are addressed.

Adolescent↗
PubMed1995

The impact of lower urinary tract symptoms on general health status and on the use of prostatectomy.

Our objective was to determine the extent to which lower urinary tract symptoms affect the general health status of men and contribute to the decision to undergo surgery. A cross-sectional population survey using postal questionnaires was conducted in the North West Thames health region, followed by a prospective cohort study of men undergoing prostatectomy (North West Thames and Oxford regions). The subjects in the first survey were 221 men aged 55 and over with previously reported mild, moderate or severe urinary symptoms; subjects in the second study were 388 men undergoing prostatectomy. Main outcome measures were self-reported symptom severity, bothersomeness and general health status (Nottingham Health Profile, Part 1). The response rate among eligible responders in the population survey was 85.7%. Increasing symptom severity was associated with worsening NHP scores for energy, emotional reactions, sleep and physical mobility (p < 0.01). Increasing bothersomeness of symptoms was associated with emotional reactions, sleep and pain (p < 0.05). Men undergoing surgery reported worse health status than men in the population with the same severity of symptoms as regards emotional reactions, energy and pain. For a given level of symptom severity, the impact of those symptoms on aspects of a man's general health status may be the determinant of seeking and undergoing surgery. Greater understanding of the factors that affect a man's response to his symptoms is needed in interpreting the decision to seek and accept treatment.

Aged↗
PubMed2006

Do health-status measures play a role in improving treatment in chronic obstructive pulmonary disease?

During the past few decades, health status has become increasingly important in the clinical research of chronic obstructive pulmonary disease. The use of health-status questionnaires in routine practice can enhance understanding about the impact of the disease on the patient, improve standardisation and increase compliance through increased patient satisfaction. However, before health-status measurement in individual patients can be used in routine practice, questionnaires have to be validated on an individual level. In this article, the authors suggest a new method of assessing this individual validity, to enhance the use of health-status instruments in daily clinical practice, and thus improve treatment in chronic obstructive pulmonary disease.

Health Status↗