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PubMed1995

The relationship between health status, motivation and work efficiency of forest workers.

The influence of psychological factors on the health status and work efficiency was investigated in a sample of 909 forest workers whose typical diseases had been previously defined. Data concerning the motivation for work were taken during obligatory medical tests. Medical variables (health status, diagnoses, number of diagnoses per worker), psychological variables (job satisfaction, wish to change the job), and work-related variables (fulfillment of job norms) were used. Hypotheses of the relationship between the selected pairs od variables were tested by contingency tables. The lifetime trends of each variable were modelled by means of linear functions. The presumed influence was confirmed by the results obtained. Negative motivation appeared to be a very significant factor of the forest workers' health status and their work efficiency.

Adolescent↗
PubMed2003

Changes in self-efficacy and health status over 5 years: a longitudinal observational study of 306 patients with rheumatoid arthritis.

OBJECTIVE: To investigate changes in self-efficacy and health status over 5 years in patients with rheumatoid arthritis (RA), the relationships between these changes, and the influence of baseline values on subsequent changes. METHODS: 306 adult patients with RA, born in 1926 or later, were examined by questionnaire in 1994 and again in 1999. We analyzed data regarding pain (visual analogue scale [VAS], Arthritis Impact Measurement Scale [AIMS2] symptom scale, Short Form-36 [SF-36] pain scale), fatigue (VAS, SF-36 vitality scale), mental distress (AIMS2 affect scale, SF-36 mental health scale) and self-efficacy (Arthritis Self-Efficacy Scales for pain and for other symptoms). RESULTS: On group level, all health status measures were numerically somewhat improved, and self-efficacy slightly reduced. Changes in self-efficacy and in corresponding health status measures were significantly correlated. For patients with above average educational level self-efficacy for pain at baseline was positively correlated to improvement in pain measures. Good mental health at baseline was correlated to improvement in self-efficacy for other symptoms, but only for patients with below average educational level. CONCLUSION: Baseline self-efficacy seems to influence future level of perceived pain and baseline mental health status seems to influence future self-efficacy. These associations seem to be affected by level of education.

Adult↗
PubMed2003

New options for health care policy and health status insurance: citizens as customers.

Health education and health literacy programs have implications on health care policy and health care status insurance. There are many benefits of a transition from disease management to a health care system, which includes priorities in prediction, prevention, and health education. Health care and disease management could best be implemented by multiple-tier, market-oriented models of universal coverage allowing for competition among health status insurers and educational, pharmaceutical, nursing, and other health service providers. Promotion of health literacy will allow citizens to become educated customers and consumers of health care services. Internationally, health literacy might narrow the gap between economically richer and poorer countries.

Delivery of Health Care↗
PubMedDate not supplied

Hispanic health status in Orange County, Florida.

PURPOSE: To assess the health status of the Hispanic population of Orange County, Florida. METHODS: The methodology utilized secondary data for 66 ethnically identified indicators in a comparative framework applied for a 5-year period (1997-2001). FINDINGS: Orange County Hispanics are younger with lower per capita income than their Florida peers, less likely to be White, and much more likely to be of Puerto Rican origin. Relative to the Hispanic populations in the selected peer counties and statewide, Orange County Hispanics have higher age-adjusted death rates for a majority of disease categories and conditions, such as breast, lung, and prostate cancers; chronic liver disease and cirrhosis; diabetes mellitus; pneumonia and influenza; stroke; acquired immunodeficiency syndrome; motor vehicle accidents; and infant, neonatal, and child mortality. Orange County Hispanics did better in comparison to Orange non-Hispanics, with lower age-adjusted death rates for major causes of death such as heart disease, cancer, and stroke. However, for many indicators, the 5-year trends for Orange County Hispanics are moving in an unfavorable direction in contrast to the trends for non-Hispanics, which are either stable or improving. CONCLUSION: Comparative assessments of Hispanic populations using secondary data enable the development of a comprehensive health status profile. However, this approach is currently constrained by the limited number of ethnically identified indicators and, especially for Hispanics, problems in the accuracy and consistency of the assignment to racial categories and subsequent reporting.

Adolescent↗
PubMed2006

Physical activity and quality of life in older adults: influence of health status and self-efficacy.

BACKGROUND: Physical activity has been positively linked to quality of life (QOL) in older adults. Measures of health status and global well-being represent common methods of assessing QOL outcomes, yet little has been done to determine the nature of the relationship of these outcomes with physical activity. PURPOSE: We examined the roles played by physical activity, health status, and self-efficacy in global QOL (satisfaction with life) in a sample of older Black and White women. METHOD: Participants (N = 249, M age = 68.12 years) completed multiple indicators of physical activity, self-efficacy, health status, and QOL at baseline of a 24-month prospective trial. Structural equation modeling examined the fit of 3 models of the physical activity and QOL relationship. RESULTS: Analyses indicated that relationships between physical activity and QOL, self-efficacy and QOL were all indirect. Specifically, physical activity influenced self-efficacy and QOL through physical and mental health status, which in turn influenced global QOL. CONCLUSIONS: Our findings support a social cognitive model of physical activity's relationship with QOL. Subsequent tests of hypothesized relationships across time are recommended.

Aged↗
PubMed1997

Functional health status as a predictor of mortality in men and women over 65.

This study evaluated the effect of functional health status on mortality in a sample of community-dwelling older people. White and African-American self-respondents to the 1986 National Health Interview Survey Functional Health Supplement (n = 5, 320) were included in the study. Functional health status was measured by a ten-item unidimensional activities of daily living-instrumental activities of daily living (ADL-IADL) scale and a three-item cognitive ADL scale. Proportional hazards regression was used to evaluate the effect of increasing score on the ten-item ADL-IADL scale on risk of mortality over a 5-year period while controlling for demographic, social, and health status covariates. In both men and women, increasing score on the ADL-IADL scale was predictive of mortality, adjusting for increasing age, poor self-rated health, low body mass index in women, and being an unmarried man. These findings indicate that a unidimensional scale consisting of both ADL and IADL items is useful in predicting mortality, controlling for the effect of covariates in sex-specific models.

Activities of Daily Living↗
PubMed2000

Oral health status and treatment needs of 35-44-year old adults in Lebanon.

OBJECTIVES: The purpose of this study was to assess the oral health status and treatment needs of a Lebanese adult population. DESIGN: An epidemiological survey of 401 Lebanese adults aged 35-44 years was carried out in 1996. It followed the WHO methodology in assessing the oral health status and treatment needs of adult populations. A structured questionnaire and a standardised oral health exam were used for the investigation. RESULTS: Showed that the Decayed, Missing and Filled Teeth (DMFT) index was 16.3 and that 1.5 per cent of the sample had a DMFT score of zero, whereas, 55 per cent had a score of less than 4. Of the 401 subjects, 24 per cent had at least one bridge and 16 per cent had a removable prosthesis. Compared to other neighbouring countries, Lebanon ranked the highest in the DMFT index and its separate components. Close to 60 per cent of the sample was in need of operative treatment, 31 per cent needed tooth extraction and 60 per cent were in need of a crown or a bridge. Significant variations were observed in the oral health status as well as treatment needs of the sample when examining gender, socio-economic status, and place of residence differences. CONCLUSION: This study can be used as a stepping stone in the direction of building the base of knowledge on oral health in Lebanon. The planning and implementation of any strategy for oral health status improvement is crucial, alongside the country's infrastructure development.

Adult↗
PubMed2002

The influence of chronic respiratory conditions on health status and work disability.

OBJECTIVES: This study examined the impact of asthma and chronic obstructive pulmonary disease (COPD) on health status and work disability. METHODS: We used data from a population-based sample of 3805 California adults. RESULTS: Compared with adults with no chronic health conditions, adults with COPD or asthma had a greater risk of self-reported diminished general health (odds ratio [OR] = 10.95; 95% confidence interval [CI] = 6.31, 19.0 and OR = 3.92; 95% CI = 2.31, 6.65, respectively). Respondents with COPD or asthma also had worse mental health status, as indicated by a greater risk of depressive symptoms (OR = 10.05; 95% CI = 5.29, 19.08 and OR = 2.59; 95% CI = 1.33, 5.04). COPD was associated with reduced current employment (OR = 0.41; 95% CI = 0.24, 0.71). CONCLUSIONS: Asthma and COPD are associated with poor health status and greater work disability.

Adolescent↗
PubMedDate not supplied

Medical inpatients at risk of extended hospital stay and poor discharge health status: detection with COMPRI and INTERMED.

OBJECTIVE: To detect the patients in medical wards at risk of extended LOS and poor discharge health status with the use of complexity prediction instrument (COMPRI) and interdisciplinary medicine (INTERMED) instruments. METHODS: STUDY 1: In a sample of 275 consecutively admitted medical inpatients, a hierarchical cluster analysis on INTERMED variables was performed. The clusters were compared on length of hospital stay (LOS) and Short Form 36 (SF-36) at discharge. STUDY 2: Receiver operating characteristic (ROC) analysis was used to optimal cut-off points for the COMPRI and INTERMED. Patients detected with COMPRI and INTERMED were then compared with undetected patients on LOS and SF-36. RESULTS: STUDY 1: In concordance with previous findings, a cluster of patients with high biopsychosocial vulnerability was identified with significantly higher scores on LOS (p <.05) and lower scores on SF-36 (p <.001) than patients in other clusters. STUDY 2: A cut-off point for the COMPRI of 5/6 was found to detect patients at risk of long LOS. A cut off score for the INTERMED of 20/21 was found to detect patients at risk of poor discharge health status. Patients detected with COMPRI and INTERMED had a significantly longer LOS (p <.001) and a poorer discharge health status (SF-36 MCS: p <.001; SF-36 PCS: p =.05) than nondetected patients. Of the detected patients, 37% had an extended hospital stay and poor discharge health status; of the nondetected patients, this was only 7%. CONCLUSIONS: The COMPRI-INTERMED can help to detect complex patients admitted to medical wards within the first days of admission, and rule out those with a small chance of poor outcomes.

Case Management↗
PubMed1997

Health status gender differences of newly admitted black nursing home residents.

OBJECTIVES: To investigate gender differences in health status of newly admitted black nursing home residents on the day following admission. DESIGN: Descriptive and comparative cross-sectional study of black residents drawn from a larger prospective longitudinal study on health and functional status of new nursing home residents interviewed on the first full day after admission. SETTING: Eight southern nursing homes: three not-for-profit, three for-profit, one county government-operated, and one federal government-operated. Homes ranged in size from 110 to 575 beds and were licensed for skilled and intermediate care. PARTICIPANTS: Black nursing home residents (N = 224) aged 60 years and older as admitted sequentially to nursing homes. MEASUREMENTS: Health status was assessed by the Short Portable Mental Status Questionnaire, as a measure of mental status, and the Scaled Outcome Criteria, as a measure of ability to perform activities of daily living (ADLs). Morbidity was assessed by the number of medical diagnoses, number of prescribed medications, and the medical diagnoses of hip fracture, dementia, and cancer. Resident classification data assessed the source of entry to the nursing home, payer source, and level of care required. Demographic data assessed included age, education, marital status, and number of living children. RESULTS: Both black men (n = 126) and women (n = 98) newly admitted to the nursing home had health and social deficits. Moreover, women, although not significantly different from men in average age, were more impaired in six of eight ADLs, including grooming, dressing, feeding, ambulating, transferring, and defecating. Women were also less likely to be married. No gender differences were found for five other health status variables, four other demographic variables, five resident classification variables, or five measures of morbidity. CONCLUSION: These data on southern black nursing home residents provide evidence that among older black nursing home residents, women have greater care needs than men. Findings illustrate the need to consider gender in planning nursing home care of black older residents, black women may be at greater risk for health status alterations and require more frequent health status monitoring and intervention.

Activities of Daily Living↗
PubMed2006

Identification of diagnostic subtypes of chronic pelvic pain and how subtypes differ in health status and trauma history.

OBJECTIVE: Our primary aim was to identify subtypes of chronic pelvic pain and to compare the cases of women with the identified subtypes on health status and trauma history. We hypothesized that women with diffuse abdominal/pelvic pain would have greater health impairment and report more lifetime trauma than women with vulvovaginal pain or cyclic pain. STUDY DESIGN: We collected questionnaire data on 289 consecutive women patients from a university chronic pelvic pain clinic. From patient records, 1 gynecologist identified chronic pelvic pain subtypes on the basis of reported symptoms and the localization of pain during examination. We used analysis of covariance with pairwise contrasts. RESULTS: Seven diagnostic subtypes were identified. Patients with diffuse abdominal/pelvic pain had more trauma and worse mental and physical health status compared with patients with vulvovaginal pain and cyclic pain. Those patients with abdominal/pelvic pain also had poorer health than patients with neuropathic and fibroid pain. Endometriosis was unrelated to health status. CONCLUSION: There is immense need for further research to define subtypes of chronic pelvic pain.

Adolescent↗
PubMed1987

Longitudinal study on the health status of children in a rural Tanzanian community: comparison of community-based clinical examinations, the diseases seen at village health posts and the perception of health problems by the population.

Standardised household interviews among adults and children, open-ended questionnaires, and clinical examinations administered during cross-sectional health status surveys, as well as the registers of village health posts (VHP), were used to assess the pattern of health problems of a rural community in southeastern Tanzania, and their results compared. All four approaches gave very similar results for the two major health problems (fever/malaria and abdominal pain or discomfort) which were mentioned by both children and adults. The parasitological data from the cross-sectional surveys also revealed hyperendemic P. falciparum malaria and a high prevalence and incidence for infections with hookworm (N. americanus), Strongyloides, and G. lamblia. However besides consistently revealing the two major health problems, each approach showed a distinct pattern for the additional health problems: household interviews and open-ended questionnaires resulted in a higher ranking of problems that had not yet been solved by the health care facilities available in the community at the time of the interview. This view was further biased by the fact that the interviews were done by people representing the health professionals. The statistics from the registers of VHP clearly reflected the types of treatment provided by this service. Malnutrition and various eye problems only became evident during the clinical examination of the population. However, the clinical examination did not identify the importance of the abdominal problems in the community. The cross-sectional survey (questionnaires, clinical examination) chiefly showed the health problems affecting the population around the time of the surveys (end of the dry season). Interestingly, the registers of the VHP did not show marked seasonal variations in the morbidity statistics for this community. Both questionnaire approaches and the registers of VHP showed a change in both the morbidity and the disease perception pattern that may reflect the effects of interventions launched at community level (activities of village health workers, mass-treatment against hookworm and G. lamblia). The study indicated that the individual ranking of the major health problems matched with data from health status surveys. It also pointed to the possibility that disease perception patterns could become a tool for community diagnosis and for the monitoring of health care programs.

Abdomen↗
PubMed1976

Predicting self-assessed health status: a multivariate approach.

Two-stage multivariate analysis was used to examine factors affecting personal perception of health status. In the first stage, sociodemographic variables were used as independent variables in Automatic Interaction Detector (AID) analysis in order to partition the study sample (11,153 civilian noninstitutionalized adults aged 58-63) into subgroups. In the second stage, binary multiple regression analysis was performed on each AID subgroup and on the total sample. Predictors used were indicators of psychological, socioeconomic, and sociomedical well-being. Finally the applicability of these indicators in classifying persons in one of the two categories of perceived health status was examined by discriminant function analysis. Sociomedical health indicators were better explanatory variables of self-assessed health status than socioeconomic or psychological indicators of well-being.

Activities of Daily Living↗
PubMed1983

[Work environment and health status of agricultural aviation personnel].

The morbidity rate and present health status of flying agricultural aviation personnel under health care of the Main Military Medical Committee for aviation workers were analysed and compared with another group of helicopter pilots. A detailed clinical examination of 77 "Agro" pilots indicated more trauma cases than idiopathic diseases cases, some of those trauma cases were due to professional work. Analysis of the present health status indicated the predominance of pilots with just one health disturbance, pilots with no health disturbances taking the second position in the comparison. The health deviations did not differ from those in other populations, as classified by pilots' age. On the other hand, their percentage was higher than in helicopters pilots control group. Average age of "Agro" pilots was relatively high and number of hours spent in air considerable, too.

Accidents, Aviation↗
PubMed2001

Family pain history predicts child health status in children with chronic rheumatic disease.

OBJECTIVES: To examine the relationships of parental and family pain history on the pain experience of children with chronic rheumatic disease. The aims of the study were as follows: 1) to describe the pain history of parents and families of children with rheumatic disease, 2) to examine relationships between parental and family pain history and the pain report and physician-rated health status of children with chronic rheumatic disease, and 3) to determine whether child coping mediates the relationship between family pain history and the child's pain and physician-rated health status. METHOD: Parents of 100 children were recruited from a pediatric rheumatology clinic during routine visits. Parents completed questionnaires assessing parental pain history and family characteristics. Children in the study completed a series of questionnaires to assess pain and pain coping strategies, including the Coping Strategies Questionnaire and parts of the Pediatric Pain Questionnaire. A pediatric rheumatologist provided a global assessment of disease severity on a 100-mm visual analog scale as an index of child health status. RESULTS: A high number of parents of children seen in a pediatric rheumatology clinic described a personal pain history. More than 90% of parents reported having at least 1 chronic pain condition, with an equal proportion reporting an episode of pain in the past month. The most commonly reported pain conditions were lower back pain, shoulder/neck pain, and migraine headache pain. On average, this group of parents reported a history of 3.5 chronic pain conditions (standard deviation: 2.3) and reported having sought treatment for 1.7 (standard deviation: 2.3) of these conditions. Additionally, 93% of all parents reported extended family members experiencing at least 1 chronic pain condition. Correlational analyses indicated that parents reporting higher levels of current pain and higher mean levels of pain during the past month were more likely to have children reporting higher levels of current pain (r = 0.23 and r = 0.27). In addition, parents who sought more treatment for their own pain were more likely to have children reporting higher levels of pain (r = 0.22) and presenting with poorer health status (r = 0.22). Similarly, parents reporting higher levels of pain-related interference with activity were more likely to have children reporting higher levels of current pain (r = 0.23). Correlational analyses also indicated that children whose extended families reported a history of multiple pain conditions were more likely to report higher levels of current pain (r = 0.24) and more pain locations (r = 0.23). Finally, a series of mediational statistical models confirmed that child use of the pain coping strategy, catastrophizing, partially accounted for the relationship between several parent and family pain history variables and the child's own current pain ratings and physician global assessment. Specifically, child catastrophizing mediated the relationships between the total number of treated pain conditions and children's current pain ratings and physician global assessment. In addition, child catastrophizing was shown to mediate the relationship between parental mean level of pain in the past month and children's current pain rating and the relationship between total number of family pain conditions and children's current pain rating. Taken together, our results suggest that parental and familial pain experiences predict children's use of catastrophizing to cope with pain, which in turn predicts physician global assessment and children's current pain. CONCLUSIONS: The results from the present study indicate that many of the parents of children seen in a pediatric rheumatology clinic have a personal pain history and highlight the potential impact of parental pain history on children's pain experiences. Specifically, parents who were more likely to seek treatment for their own pain or more likely to report interference with recreational activities because of pain had children with higher pain ratings and poorer health status as measured by the physician global assessment. Additionally, a series of mediational models showed that child catastrophizing serves as a specific mechanism through which parental and familial pain history variables influence child ratings of current pain and physician ratings of health status. Future studies are needed to determine exactly how children living in families with painful conditions become more reliant on catastrophizing to cope with their pain. In addition, more research is needed to identify other potential mediators, such as positive ways parents may influence children's pain coping. There are several important clinical implications of our findings. First, our results suggest that by gathering information from parents about their own pain histories, health care providers may be able to identify children at risk for developing maladaptive pain coping strategies and higher levels of disease-related pain and disability. Second, our results indicate that intervention programs should focus specifically on reducing children's use of catastrophizing to cope with their pain. Perhaps most importantly, our results highlight the need to include parents in interventions aimed at reducing children's pain and improving children's abilities to cope with pain.

Adaptation, Psychological↗
PubMed2004

The health and health status of older Korean Americans at the 100-year anniversary of Korean immigration.

There are 28 subgroups in the Asian American Pacific Islander (AAPI) ethnic population. They accounted for 12.5 million persons in the year 2002 or 4.4% of the non-institutionalized US population (Reeves&Bennett, 2003). It is a rapidly growing population in the United States, particularly in Southern California. The Korean American population is the fifth largest ethnic group in the heterogeneous AAPI population. Despite their increasing numbers there lacks data regarding the health status and healthcare utilization of the AAPI population. The aim of this study is to characterize the health status and healthcare utilization of an Asian American ethnic group, the Korean Americans. The data are from the 2000 Korean American Health Survey (KAHS). This survey of 1,660 Korean Americans living in Los Angeles County assessed their health status and medical needs and composed the largest sample recruited for a health study on Korean Americans to date. For the study 208 Koreans Americans aged 65 and over were reported. Descriptive statistics were performed to illustrate the health status and needs of the Korean American older persons. Over one-half of the sample, 69% of the Korean American older persons in the study reported a fair or poor health status. This is in stark contrast to a survey conducted by the Commonwealth Fund, which found that 17% of the minorities and 30% of the Korean Americans rated their health as fair or poor (Commonwealth Fund, 2002). With regards to access to healthcare 21% of the Korean American older adults in the sample lacked health insurance and 31% had never visited a medical doctor within the last 12 months for a check up or consultation. It is felt that an individual's chance of being uninsured varies across the life span and that people 65 years and older have a minimal likelihood of being uninsured due to Medicare (IOM, 2001). However when looking at certain subgroups higher percentages of uninsured are revealed. One out of every three Koreans Americans in the US is uninsured compared to 21% of all AAPI and 14% non-Latino whites. In California the proportion is even higher with almost half of all Koreans being uninsured (Brown et al. 2001). This type of discrepancy compounds the "Model Minority Myth" that AAPI population is a successful minority group and do not have barriers to health care (Chen et al. 1995). One study examining health services research status in the AAPI found that Korean Americans were one of the most understudied populations relative to their size (Andersen et al. 1995). Since the AAPI population and subgroups are often not included in health services research this results in "myths" or inaccuracies regarding their health. Studies of AAPI populations are needed to provide information regarding the health of the population, educate health care providers to assist them in the care of ethnic populations and seek interventions to remove health disparities in minority populations.

Aged↗
PubMedDate not supplied

The impact of the Iowa S-SCHIP program on access, health status, and the family environment.

OBJECTIVES: To determine the effect of the Iowa Separate State Child Health Insurance Program (S-SCHIP) on need for services, utilization and access to care, child health status, and the family environment. METHODOLOGY: A longitudinal pretest-posttest panel survey was used to evaluate differences in children's access to health care, health status, and family environment at the beginning of the program and after 1 year. Written surveys with telephone follow-up calls were used to collect the data. Pre- and postquestionnaire results for 463 children were matched and compared using the McNemar test for correlated proportions and the Wilcoxon signed rank test. Approximately 71% of families responded to both surveys. PRINCIPAL FINDINGS: Similar rates of perceived need for each of 6 service areas were found after being in the program for a year as before. Unmet need was significantly reduced among those needing services: medical care (27% before, 6% after), specialty care (40% before, 13% after), dental care (30% before, 10% after), vision care (46% before, 12% after), behavioral and emotional care (42% before, 18% after), and prescription medications (21% before, 13% after). Overall health status was rated significantly better (ie, excellent: 37% before, 42% after). Ninety-five percent of families reported a reduction in family stress, and there was significantly less worry about the ability to pay for their child's health care (92% before, 57% after). The activities of fewer children were limited because of potential health care costs. CONCLUSIONS: The Iowa S-SCHIP program improved access to care and the family environment for children enrolled during the first year without a change in perceived need for services.

Adolescent↗
PubMed2004

Examining discharge outcomes and health status of critically ill patients: some practical considerations.

This prospective observational study examined the outcomes of 200 consecutive admissions to an adult tertiary level Intensive Care Unit (ICU). Eligible and consenting participants were also involved in a sub-study that examined health status at four measurement points from pre-illness to 6 months post-discharge. Of the 189 individual patients admitted, 23% died in ICU and 57% were discharged home. The health status sub-study enrolled 34 participants (39% of eligible patients) who were representative of the ICU population for demographic and clinical variables. Surviving participants returned to a similar, though not identical state of health at 6 months post-discharge, when compared to their pre-ICU health-state using the 15D and SF-36 instruments. Health status at ICU discharge was significantly impaired when compared to other measurement points, particularly for mobility, breathing, eating, usual activities and vitality. A number of methodological challenges were evident, particularly for the health status sub-study, including prospective subject recruitment and retention, losses to follow-up and instrument responsiveness. Despite the limitations noted, the study provided useful findings and recommendations for the continued development of methods to examine the health status of critically ill patients.

APACHE↗