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PubMed1996

A comparison of five health status instruments in patients with systemic lupus erythematosus (SLE).

The aim of the present investigation was to assess and compare health status instruments in SLE. One hundred and twenty-five patients completed five health status instruments: the Health Assessment Questionnaire (HAQ), Functional Ability Index, the Fatigue Severity Scale (FSS), the Disability Days Measure (DDM), the Centre for Epidemiological Studies-Depression Scale (CES-D), and the Medical Outcomes Study (MOS) Short Form Health Survey during their Clinic visit. Disease activity was measured using the SLE Disease Activity Index (SLEDAI). All instruments described a spectrum of quality of life outcomes in these patients. An inter-instrument correlation analysis revealed that components of the MOS correlated significantly with each of the other instruments used. There was no correlation between any of the instruments used and the SLEDAI. We conclude that health status assessment as measured by the MOS short form is a valid independent outcome measure in patients with SLE.

Adolescent↗
PubMed2003

Income inequality, household income, and health status in Canada: a prospective cohort study.

OBJECTIVES: This study sought to determine whether income inequality, household income, and their interaction are associated with health status. METHODS: Income inequality and area income measures were linked to data on household income and individual characteristics from the 1994 Canadian National Population Health Survey and to data on self-reported health status from the 1994, 1996, and 1998 survey waves. RESULTS: Income inequality was not associated with health status. Low household income was consistently associated with poor health. The combination of low household income and residence in a metropolitan area with less income inequality was associated with poorer health status than was residence in an area with more income inequality. CONCLUSIONS: Household income, but not income inequality, appears to explain some of the differences in health status among Canadians.

Canada↗
PubMed1980

Measuring health status in arthritis. The arthritis impact measurement scales.

A multidimensional index that measures the health status of individuals with arthritis has been developed. The Arthritis Impact Measurement Scales (AIMS) are a combination of previously studied and newly created health status scales which assess physical, emotional, and social well-being. The self-administered AIMS questionnaire has been pilot tested in a mixed arthritis population. Results indicate that the instrument is practical and that it generates scalable, reliable, and valid measures of both aggregated and disaggregated health status. The AIMS approach to health status measurement should prove useful for evaluating the outcomes of arthritis treatments and programs.

Activities of Daily Living↗
PubMed1998

Proxy use of the Canadian SF-36 in rating health status of the disabled elderly.

Professionals have often depended on proxies to assess health status of elderly individuals unable to provide this information. This study set out to estimate agreement between elderly subjects and their proxies on perceptions of health status, when patients were inpatients in a rehabilitation setting or outpatients in a day hospital, and to determine if there were overestimations or underestimations by proxies. Eighty-three consenting elderly patients living in Montreal, Canada, completed a generic health-status questionnaire, the SF-36, and named a significant other and a health care provider who knew them well. These individuals completed the same questionnaire on behalf of the patients. Agreement between patient and proxy was assessed pairwise (patient/health professional and patient/significant other) using intraclass correlation coefficients. The possibility of a biased rating by type of proxy was determined via paired t-tests. When concordance within respondent pairs was examined, results indicated only poor to moderate agreement regardless of setting and type of proxy for all scales. A trend toward underestimating by proxies was found. Proxy completion of health status questionnaires did not provide similar information, but these preliminary findings need replication.

Aged↗
PubMed1991

An evaluation of a brief health status measure in elderly veterans.

OBJECTIVE: To examine the feasibility of a brief 36-item health status measure in elderly male veterans, by comparing it with the 136-item Sickness Impact Profile. DESIGN: Cross-sectional study in which all subjects completed both measures in a random order. SETTING: Durham VAMC General Medicine and Geriatrics Clinics. PATIENTS: Convenience sample of 25 male veterans aged 65 and older (mean age = 73.5 years; 68% white; 68% currently married; mean annual income = $7,000). MAIN OUTCOME MEASURES: Two well-validated health status measures, the Sickness Impact Profile and the SF-36. RESULTS: The SF-36 took less time to administer than the Sickness Impact Profile in both the Geriatrics Clinic (mean: 15 vs 33 minutes) and General Medicine Clinic (mean: 14 vs 21 minutes). Although SIP scores consistently displayed a more optimistic picture of respondents' health compared with the SF-36, the two instruments were highly correlated: overall functioning (r = 0.73), physical functioning (r = 0.78), and social functioning (r = 0.67). CONCLUSIONS: These two measures provide a similar ranking of elderly male veterans' health status. The significantly shorter administration time of the SF-36 is an attractive feature for both researchers and clinicians interested in assessing health status.

Aged↗
PubMed2001

Measuring health status of people who are wheelchair-dependent: validity of the Sickness Impact Profile 68 and the Nottingham Health Profile.

PURPOSE: Several questionnaires measuring health status are available, but their validity and correspondence between them in people with severe physical disabilities is not well known. In this study, the equivalence of the Nottingham Health Profile (NHP) and the Sickness Impact Profile 68 (SIP68) was examined. METHODS: Patients were 111 people who were wheelchair-bound due to spinal cord injuries (45%), rheumatic diseases (27%) or other causes (28%). Internal consistency, associations between scales of both questionnaires and with criterion variables (reflecting upper and lower extremity function, perceived health, social functioning and well-being) were examined. RESULTS: Both the NHP and the SIP68 were of acceptable clinimetric quality (Cronbach's alpha 0.53-0.85). Agreement between scales of both questionnaires was moderate for scales reflecting emotional health (0.56) and for scales reflecting physical (0.22-0.68) and social functioning (0.28-0.35). CONCLUSION: The NHP reflects perceived health, whereas the SIP68 reflects functional health status. In rehabilitation research, a careful choice between available health status measures must be made.

Persons with Disabilities↗
PubMed2005

The health status of rural caregivers.

The purposes of this study were to examine the relationships among stress, caregiver burden, and the health status of rural caregivers and assess whether caregiver burden and stress predict the physical health status of caregivers in the rural setting. A descriptive-correlational design was used to explore the caregiver health status of 63 informal caregivers in rural Alabama and Mississippi. The relationships among stress, burden, and health status in rural caregivers were significantly related (p .000) and significant variance in health status (p .000) was accounted for by the model variables of stress and caregiver burden. Rural caregivers experienced difficulty with transportation to the hospital and their physicians, and complained of experiencing uncomfortable physical symptoms.

Adult↗
PubMed1995

Clinical practice and patients' health status: how are the two related?

Now that we have the ability to measure patients' health outcomes, physicians and health care systems need to know how to manage these outcomes. What are the causal pathways that link clinical and health status concepts? What are the key points at which physicians and health care systems can intervene in effective and cost-effective ways? We have argued that the elegant biomedical model that physicians use to understand disease is a blunt tool in the dissection of illness and that valid, reliable, and richly descriptive measures of HRQL fail at clinical tasks because causal linkages between clinical processes and health status outcomes have not yet been made convincingly, at either the conceptual or the empiric level. One approach to this problem is to develop and test causal models that explore the relationships among different measures of health status in an attempt to elucidate the "genesis" and "pathogenesis" of disorders of HRQL. Once physicians and health care systems know more about the determinants of poor health status and the mechanisms by which it occurs, creative attempts to intervene at multiple points in a causal pathway may be possible, making outcomes management a more realistic goal.

Health Status↗
PubMed2003

Health status of patients with chronic pain attending a pain center.

This study aimed to determine whether the health status of patients with chronic pain improved after attending the pain center. The study used a pre-post survey design and was conducted at a pain center in Western Sydney. A convenience sample of patients with chronic pain who attended the pain center between December 1998 and February 2000 were involved in the study. The Medical Outcomes Study Short-Form 36 measured health status of the participants in eight general areas, including physical functioning, role limitations resulting from physical health problems, bodily pain, general health, vitality, social functioning, role limitations resulting from emotional problems, and mental health. A significant improvement in bodily pain was demonstrated by the total group. The other variables measured remained unaffected. The study sample was divided into subgroups based on gender, age, and presenting symptom. Within the subgroups, a significant improvement in bodily pain was shown by the male participants, patients younger than 65 years of age, and those who presented with different types of chronic pain other than back pain. This preliminary study was done to monitor the health status of people with chronic pain. A holistic approach to improve the health status of people with chronic pain seems to be necessary. Further studies should use a combination of generic outcome measures and disease-specific indicators to measure health outcomes.

Activities of Daily Living↗
PubMed1992

Diabetes mellitus in the transition to adulthood: adjustment, self-care, and health status.

A cross-sectional study of health and adjustment among 18 to 22-year-old patients with insulin-dependent diabetes mellitus (IDDM) is reported. Objectives were to examine coping with IDDM in this age group; to identify predictors of health status, treatment adherence, and health care use; and to provide a retrospective evaluation of the persistence of IDDM-specific adjustment from earlier through later adolescence. Multiple validated measures, interviews of independent informants, and biochemical assays were used to assess psychological, behavioral, and metabolic status. Patients and parents completed a retrospective measure of the patient's adjustment to IDDM during earlier adolescence. Findings (n = 81) indicated: (1) normal rates of general psychopathology but some evidence of poorer adjustment to IDDM relative to other age groups, (2) poor diabetic control and high incidence of microalbuminuria, (3) specific factors associated differentially with treatment compliance, health care use, diabetic control, and microalbuminuria among late adolescents, and (4) evidence that poor adjustment to IDDM in earlier adolescence persists into the transition to adulthood. The findings imply that late adolescents with IDDM are at risk of various unfavorable behavioral and health outcomes and that adjustment to the disease during earlier adolescence may be a predictor of subsequent health-related behavior and health status. A longitudinal study is needed to confirm these findings.

Adaptation, Psychological↗
PubMed1999

Health status in veterans undergoing noninvasive lower extremity arterial evaluation.

The health status of outpatients (n = 299) undergoing lower extremity arterial Doppler studies (LES) in a Veterans Affairs Medical Center-based vascular laboratory was assessed from 9/95 through 6/96 using the SF-36 Health Survey. The purpose of this study was to compare health status of these outpatients to national norms and to determine whether Doppler-derived ankle/brachial indices (ABI) correlated with the eight health concepts measured by the SF-36 Health Survey. Physical functioning (PF), role limitations by physical illness (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role limitations by emotional illness (RE), and mental health (MH) were more impaired in study patients (65.9 +/- 9.6 years of age) undergoing LES than national norms for males >/=65 years old (P < 0.0001). In fact, each health concept was below the 25th percentile of the national norms. PF was 33.4 +/- 22.4 for outpatients compared to the national norm of 65.8 +/- 28.3. Physical functioning was the only SF-36 health concept defined above which correlated with lowest ABI (r = 0.15; P = 0.012), adjusting for age but not comorbidities. Veterans undergoing only carotid duplex during the study period (n = 169) were compared to the veterans undergoing only LES (n = 251) during the study. PF, RP, BP, GH, VT, SF, and RE were significantly more impaired in those undergoing only LES compared with carotid duplex (P < 0.05). Veteran outpatients referred to a vascular laboratory have broad-based and profound impairments in health status. In addition, only physical functioning correlated with ABI, a measure of lower extremity arterial disease severity.

Aged↗
PubMedDate not supplied

Embedding child health within a framework of regional health: population health status and sociodemographic indicators.

OBJECTIVE: The description of regional variation in children's health requires regional population-based context. But what is the best way to measure the health of a region's population? METHODS: The use of two indicators is described--one a health status measure and the other a measure of socioeconomic wellbeing. It is well known that the population's premature mortality rate (PMR), the age/sex-adjusted rate of death before age 75 years, is highly related to overall health status of an area's residents. Socioeconomic characteristics of an area's residents are also indicative (and likely causative) of health status differences. RESULTS: The Socioeconomic Factor Index (SEFI) was developed at the Manitoba Centre for Health Policy, using a Principal Components Analysis of census data. PMR and SEFI are highly correlated (Spearman's correlation coefficient r = 0.85, p < 0.0001). CONCLUSION: PMR can be used as a surrogate measure for both the health status and socioeconomic well-being of regional populations in Manitoba.

Adolescent↗
PubMed2003

Depressive symptoms are the strongest predictors of short-term declines in health status in patients with heart failure.

OBJECTIVES: The purpose of this study was to assess whether depressive symptoms are independently associated with changes in heart failure (HF)-specific health status. BACKGROUND: Depression is common in patients with HF, but the impact of depressive symptoms on the health status of these patients over time is unknown. METHODS: We conducted a multicenter prospective cohort study of outpatients with HF. Data from 460 patients who completed a baseline Medical Outcomes Study-Depression Questionnaire and both a baseline and follow-up (6 +/- 2 weeks) Kansas City Cardiomyopathy Questionnaire (KCCQ) were analyzed. The KCCQ measures HF-specific health status, including symptoms, physical and social function, and quality of life. Multivariable regression was used to evaluate depressive symptoms as a predictor of change in KCCQ scores, adjusting for baseline KCCQ scores and other patient variables. The primary outcome was change in KCCQ summary scores (range 0 to 100; higher scores indicate better health status; 5 points is a clinically meaningful change). RESULTS: Approximately 30% (139/460) of the patients had significant depressive symptoms at baseline. Depressed patients had markedly lower baseline KCCQ summary scores (beta = -19.6; p < 0.001). After adjustment for potential confounders, depressed patients were at risk for significant worsening of their HF symptoms, physical and social function, and quality of life (average change in KCCQ summary score = -7.1 points; p < 0.001). Depressive symptoms were the strongest predictor of decline in health status in the multivariable models. CONCLUSIONS: Depressive symptoms are a strong predictor of short-term worsening of HF-specific health status. The recognition and treatment of depression may be an important component of HF care.

Aged↗
PubMed1985

Health status, sociodemographic factors, and the use of prescribed psychotropic drugs.

The relations among sociodemographic factors, health status, and use of prescribed sleeping pills and tranquilizers are examined. The data are from the Rand Health Insurance Experiment, which has a random sample of the nonaged, noninstitutionalized, civilian population in six U.S. sites. Information on sociodemographic factors, health status, and the use of prescribed psychotropic drugs during the previous 3 months was obtained from self-report questionnaires collected at enrollment. Mental and physical health status have large independent and significant effects on the probability of use of both prescribed tranquilizers (P less than 0.0001) and sleeping pills (P less than 0.0001), whether or not we remove the effects of sociodemographic factors. For the probability of tranquilizer use, there is no significant interaction between gender and mental health or between mental health and physical health. Age and gender have large and significant effects on the use of prescribed psychotropic drugs even after controlling for differences in health status and other demographic factors. The effects of site and socioeconomic status are modest compared with the effects of health, age, and gender.

Adult↗
PubMedDate not supplied

Health knowledge, health behaviour and health status among a 65-74-year-old population in eastern Finland.

Health knowledge, health behaviour and health status was studied among a 65-74-year-old population in eastern Finland by using self-administered questionnaires, interviews and health examination. Among men, low health knowledge was related to smoking and poor self-perceived health status. Among women, low health knowledge was related to poor self-perceived health status, lowered functional capacity, abstinence from alcohol, high fat consumption, and low coffee consumption. These findings were discussed in the light of their implications for health education.

Aged↗
PubMed1992

The relationship between work stress and oral health status.

This study investigated whether oral health status is associated with work stress. 164 male workers aged from 35 to 44 years, equally distributed over four socio-economic groups took part in the study. Three work characteristics related to stress were studied: mental demand, control and variety. Age, socio-economic status, sugar consumption, frequency of dental attendance, toothbrushing frequency, type of toothpaste used, years of residence in Belo Horizonte and marital quality were considered in the data analysis. The results of simple regression analysis (dental caries data) and simple logistic regression analysis (periodontal data) showed a significant relationship between periodontal health status and work-related mental demand (P < 0.001), marital quality (P < 0.01) and socio-economic status (P < 0.05). Dental caries status was significantly associated with age (P < 0.001), socio-economic status (P < 0.05), sugar consumption (P < 0.01) and marital quality (P < 0.0001). Socio-economic status did not remain significantly associated with dental caries after adjusting for all the variables studied.

Adult↗
PubMed2005

Changes in health status experienced by women with gestational diabetes and pregnancy-induced hypertensive disorders.

OBJECTIVE: To examine changes in health status among women with gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH). METHODS: We examined perceived health status changes from the prepregnancy, as recalled at 12-20 weeks gestation, to the postpartum period in women with GDM (n = 64) vs. unaffected gravidas (n = 1233) and women diagnosed with PIH (n = 148) vs. unaffected gravidas. We used patient survey and medical record data from a prospective cohort study. Health status measures included the Short Form-36 scales for physical function, vitality, and self-rated health and the Center for Epidemiologic Studies-Depression Scale (CES-D). Multivariate logistic regression models controlled for age, parity, race, education, prepregnancy body mass index (BMI) and exercise levels, food insufficiency, and GDM or PIH during a prior pregnancy. RESULTS: Women with PIH more often reported a significant decline in vitality (odds ratio [OR] 1.51, 95% confidence interval [CI] 1.02-2.23) and self-rated health (OR 2.12, 95% CI 1.19- 3.77) and an increase in depressive symptoms from prepregnancy to postpartum compared with unaffected women (OR 1.84, 95% CI 1.11-3.05). Decline in self-rated health was partially mediated by cesarean birth and preterm delivery. Similar proportions of women with GDM and unaffected women reported declines in health status measures. CONCLUSIONS: Women with PIH, but not GDM, more often experience significant declines in health status from prepregnancy to postpartum than unaffected women.

Adult↗
PubMedDate not supplied

Perceptions of one African American community about its' health, health status and safety.

African Americans remain at the low end of the socio-economic stratum, have less health care access, and have the highest mortality from illnesses. This supports a need for African American nurses to enter African American communities to offer health education/literacy sessions. This project conducted a survey to determine the health status of African Americans living in a select section eight housing area and their perception of their health, health status and safety. Participants identified their health and health status as good. They had a high concern about safety in their neighborhood. Earlier reports from the county and state do not support the respondents' belief about their health or health status. These same reports do support the respondents concern for safety.

Adolescent↗