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PubMed2002

Health status predicts long-term outcome in outpatients with coronary disease.

BACKGROUND: Although patient-reported health status measures have been used as end points in clinical trials, they are rarely used in other settings. Demonstrating that they independently predict mortality and hospitalizations among outpatients with coronary disease could emphasize their clinical value. METHODS AND RESULTS: This study evaluated the prognostic utility of the Seattle Angina Questionnaire (SAQ), a disease-specific health status measure for patients with coronary artery disease. Patients were enrolled in a prospective cohort study from 6 Veterans Affairs General Internal Medicine Clinics. All patients reporting coronary artery disease who completed a SAQ and had 1 year of follow-up were analyzed (n=5558). SAQ predictor variables were the physical limitation, angina stability, angina frequency, and quality-of-life scores. The primary outcome was 1-year all-cause mortality, and a secondary outcome was hospitalization for acute coronary syndrome (ACS). Lower SAQ scores were associated with increased risks of mortality and ACS admissions. Prognostic models controlling for demographic and clinical characteristics demonstrated significant independent mortality risk with lower SAQ physical limitation scores; odds ratios for mild, moderate, and severe limitation were 1.5, 2.0, and 4.0 versus minimal limitation (P<0.001). Odds ratios for mild, moderate, and severe angina frequency were 0.8, 1.2, and 1.6 (P=0.078). The odds ratios for ACS admission among those with mild, moderate, and severe angina frequency were 1.4, 2.0, and 2.2, respectively (P=0.016). CONCLUSIONS: SAQ scores are independently associated with 1-year mortality and ACS among outpatients with coronary disease and may serve a valuable role in the risk stratification of such patients.

Aged↗
PubMed2005

Quantification of relationship between health status and physical fitness in middle-aged and elderly males and females.

AIM: The purpose of this study was to quantify the degree of the relationship between health status and physical fitness level in middle-aged and elderly people using multiple discriminant analysis. METHODS: The participants were 3114 males and females aged 30 to 69 years. Ten physical fitness tests and medical checkups were performed. The participants were divided into 2 groups according to health status; the healthy group and the unhealthy group. Multiple discriminant analysis was applied to the multivariate data. RESULTS: Correct discriminant probabilities of multiple discriminant functions to discriminate the healthy group and unhealthy group were 72.3% for males and 71.7% for females. For all age groups, a gender difference was not found (P>0.05). For aging, as a result of the test of proportion, it was found that the correct discriminant probabilities decreased with age for both genders (P<0.05). CONCLUSIONS: These results suggest that there is a relatively strong relationship between health status and the level of physical fitness in both males and females. These findings support daily physical activities and exercise to maintain or improve physical fitness could be useful for the health status of middle-aged and elderly people. From the result that the correct discriminant probability decreased with age, the changes in probability for males and females were calculated and described with correct discriminant probabilities by moving averages with 5 point smoothing.

Adult↗
PubMedDate not supplied

Indoor air pollution in rural China: cooking fuels, stoves, and health status.

Solid fuels are a major source of indoor air pollution, but in less developed countries the short-term health effects of indoor air pollution are poorly understood. The authors conducted a large cross-sectional study of rural Chinese households to determine associations between individual health status and domestic cooking as a source of indoor air pollution. The study included measures of health status as well as measures of indoor air-pollution sources, such as solid cooking fuels and cooking stoves. Compared with other fuel types, coal was associated with a lower health status, including negative impacts on exhaled carbon monoxide level, forced vital capacity, lifetime prevalence of chronic obstructive pulmonary disease and asthma, and health care utilization. Decreasing household coal use, increasing use of improved stove technology, and increasing kitchen ventilation may decrease the short-term health effects of indoor air pollution.

Adolescent↗
PubMed1979

A study of the health status of radar workers.

The health status was examined of 322 radar workers with a history of occupational exposure in a microwave field from 5-10 years. The clinical findings were compared with a control group of 220 persons. There were no statistically significant differences in clinical and laboratory findings between exposed and control group. Only some subjective complaints were found more frequently in the exposed group than in the control. The authors' feeling is that subjective complaints in radar workers could not be ascribed only to the influence of microwaves because they could be due to other nonspecific harmful occupational factors. On the basis of the results of this work, the authors concluded that it is unlikely to expect marked harmful effects from microwaves in radar workers in normal working conditions.

Aerospace Medicine↗
PubMed1991

[Health status of physicians].

According to the results of a comprehensive socio-hygienic survey, a characteristic of the health status of physicians in Tatarstan is provided. The health status was studied by computation using the specially designed statistical cards of primary sick lists, death certificates, primary disability. The materials were processed on AT personal computers according to the programme developed by us. The findings would permit one to scientifically substantiate measures aimed at promoting health of physicians.

Adult↗
PubMed2004

Health status of patients with ankylosing spondylitis: a comparison with the general population.

OBJECTIVE: To examine the subjective health in patients with ankylosing spondylitis (AS) compared with the general population, and to explore the associations between health status and age, sex of the patients, and educational level in AS. METHODS: Health status was assessed with a generic instrument (SF-36) in 314 patients with AS and in 2323 people from the general population. Subgroup analyses were performed according to age, sex, and educational level. Standard difference scores (s-scores) were calculated to ensure the clinical meaningfulness of the norm based comparisons. RESULTS: Both men and women with AS reported significantly impaired health on all scales of the SF-36. Women reported significantly worse health on physical health domains. However, when calculating differences from the general population, numerically larger s-scores were found for men (except for physical role and vitality). The relative impact of AS seems to diminish with increasing age. In AS, better health was significantly associated with higher education across all scales. Deviations from the general population on the non-physical health aspects were especially pronounced in patients with low education. CONCLUSIONS: All key dimensions of health are affected by AS. The physical aspects seem to be most severely affected, but in the less educated group of patients, the disease impact on the mental health aspects was also considerable. Evaluation and management planning should take the complexity of AS into consideration. The focus on physical function should be maintained, and additional attention should be paid to the mental and social consequences of AS.

Adult↗
PubMed1983

Health status and social factors in nonprescribed drug use.

This article examines the relationship between a set of demographic, socioeconomic, sociopsychologic, and health status characteristics of a heterogeneous adult population and their use of nonprescribed drugs. The objective is to determine whether nonprescribed drug use is best accounted for by demographic and socioeconomic factors, by health and medical beliefs, by health status, or by some combination of these. The data are derived from a personal interview survey of 2603 adult members of the Kaiser-Permanente Medical Care Program, Oregon Region. The results indicated that a combination of characteristics from among these three sets were the best predictors. Sex, income, education, mental health status, tendency toward self-treatment, and level of concern with health matters were the most important variables, although they account for only a small amount of the variation in nonprescribed drug use. A portrait of the most frequent users of nonprescribed drugs raised the question as to whether these are the classic neurotics, the "worried-well," or persons whose medical care needs have not been adequately recognized or met.

Attitude to Health↗
PubMed1982

The arthritis impact measurement scales. Further investigations of a health status measure.

The Arthritis Impact Measurement Scales (AIMS) have been developed to assess the health status of arthritis patients. In this study, the self-administered AIMS questionnaire, which includes scales designed to measure the physical, psychologic, and social aspects of health status, was completed by 625 patients with various forms of arthritis. A comprehensive battery of analytic techniques was used to investigate the performance of these scales in this large sample. The results confirmed the reliability and validity of the AIMS instrument. They also showed that AIMS performs well in at least 4 major types of arthritis, in a range of sociodemographic groups, and across time. These findings emphasize the strengths of the AIMS approach and suggest that the instrument will prove useful as a tool to assess arthritis outcome in a wide variety of clinical settings.

Aged↗
PubMed1999

[The relationships between the elderly loneliness and its factors of personal attributes, perceived health status and social support].

The purpose of this study were to investigate the level of loneliness in elderly people and to explore relationships between loneliness and personal attributes, perceived health status and social support. Purposive sampling was used to recruit clients over 65 years of age from an outpatient department of the Municipal hospital and a senior citizen center in Kaohsiung city, and totaled 120 elderly people had participated in this study. Data were collected by a structured questionnaire which included the UCLA Loneliness Scale, Perceived Health Status Scale, and Social Support Scale. The results revealed the following: 1. The mean score was 38.4 (SD 9.6); level of loneliness in elderly people was moderate, and people who were male, uneducated, unsatisfied with living circumstance, unsatisfied with economic situation, and not attending social groups were more likely to have higher scores of loneliness. 2. There was a significantly negative correlation between perceived health status, mental health, health satisfaction, social support, supportive satisfaction and loneliness. 3. The results of multiple regression found that family interactions, attending social groups and supportive satisfaction were the significant predicting variables of loneliness, and "supportive satisfaction" was the most powerful predictor. Results generated from this study may act as references for mental health care for elderly people.

Aged↗
PubMed2003

[Survey of self-rated health status of troop members stationing in the South China Sea islands].

OBJECTIVE: To conduct a survey of the self-rated health status of the troops stationing in the islands of the South China Sea. METHODS: Altogether 290 members of the selected troops were investigated by means of self-rated health evaluation sale (SRHMS 1.0), and the factors affecting the health status were analyzed. RESULTS: No significant difference was noted in the physical and psychosocial health between the troops in the isolated islands, but the social health and self-rated health significantly differed (P<0.05). The individual identity, dwelling place or education background did not significantly affect self-rated health status as the marital status did (P<0.05). CONCLUSIONS: The self-rated health of the troop members differ to some degree, especially the social health condition, and is affected by marital status in stead of the individual identity, dwelling place, and education background.

Adult↗
PubMed1998

How should we evaluate health status? A comparison of three methods in patients presenting with obstructive sleep apnoea.

The purpose of this paper is to compare three approaches to the measurement of patient-reported health status which produce summary scales of health status: the Patient-generated Index (PGI) is a measure of individual quality of life (QoL), the EuroQol is a measure of QoL the results of which are weighted by utility values gained from community surveys and the SF-36 which produces two summary scales of health status (the physical component summary (PCS) and the mental component summary (MCS) scores). A follow-up interview survey of patients with obstructive sleep apnoea (OSA) was conducted. The patients received continuous positive airways pressure therapy (CPAP) between the two administrations of the questionnaires. One hundred patients presenting with OSA and who were suitable for CPAP therapy were asked if they would take part in the study. The results on the PGI, EuroQol EQ-5D utility weighted scores and 'thermometer' scores and SF-36 physical and mental summary scores were measured. Eighty-nine respondents provided sufficient data to calculate PGI and EuroQol scores and 86 patients provided sufficient data to calculate SF-36 summary scores. The PGI indicated substantial improvement after CPAP treatment whereas the EuroQol indicated little or no improvement on either utility weighted or thermometer scores. The SF-36 PCS and MCS scores were lower than those of the general population at baseline, but had improved to the normative levels after treatment. The EuroQol provided a substantially different picture of change to either of the ones gained from the SF-36 or PGI. It is suggested that the EuroQol does not contain questions which relate to important aspects of health and well-being and may not accurately reflect the health state of individuals. Consequently, caution must be exercised to assure that an appropriate instrument has been employed when using health outcomes data to assess or prioritize available health care treatments.

Adult↗
PubMedDate not supplied

Institutionalized older adults in a health district in the United Arab Emirates: health status and utilization rate.

BACKGROUND: Little is known about the rate of institutionalization and health status of nursing home (NH) type patients living in the Middle East. This study was set in the Al-Ain Medical District, a geographically discrete region of the United Arab Emirates, a country with a developing economy located on the shores of the Arabian Gulf. NH-type patients were defined as people aged 60 years and older who were admitted to a hospital or a long-term institutionalized setting for at least 6 weeks and with no evidence of an expectation of discharge at the time of the evaluation. OBJECTIVE: To determine the clinical, functional, cognitive, and nutritional status of NH-type patients living in a defined community within a developing country. METHOD: Cross-sectional survey. RESULTS: All NH-type patients were identified, and all were included in this study (n = 47, 100% participation rate). All were located within three public institutions, none of which was a dedicated NH facility. The rate of institutionalization was 7.0-14.0 per 1,000 people aged 65 or older. The age distribution was 30% (60-74 years), 49% (75-84 years), and 21% (85+ years). The length of stay was 3.8 years. The female:male ratio was 1.6. All except 1 had a neurological disorder, and 89% had dementia. The cognitive deficits were severe with only 61% alert, 41% able to speak, 17% orientated in place, and 15% orientated in time. The functional status was also poor: 98% received assistance with all instrumental activities of daily living, 85% received assistance with five activities of daily living, and 94% were bed bound. The nutritional status was also impaired with a mean body weight of 45 +/- 14 kg and a mean albumin level of 3.1 +/- 0.6 g/dl. When compared with the USA data from the National Center for Health Statistics, the study population was younger, had a longer length of stay, a lower female:male ratio, a higher rate of neurological diseases and dementia, and were far more dependent and disoriented. The rate of institutionalization was one sixth to one third of that in the USA. CONCLUSION: From these data we concluded that this region has a distinctly different population of institutionalized older people who demonstrate greater impairments in all domains of health status.

Activities of Daily Living↗
PubMed1996

Racial and ethnic disparities in self-assessed health status: evidence from the National Survey of Families and Households.

We examined racial and ethnic disparities in global health assessment and functional limitations of daily activities among whites, blacks and Hispanics, and within the Hispanic origin among Mexicans, Puerto Ricans, Cubans, and 'Others'. Logistic regression were employed to estimate the log odds of reporting 'poor health' and 'having functional limitations' among 12,814 respondents from the 1987-1988 National Survey of Families and Households. Compared with whites, blacks had an increased risk of reporting poor health and functional limitations. Hispanics had even a higher risk of reporting poor health, but did not have an increased risk of reporting functional limitations. Among Hispanics, Mexicans were more likely than whites to report poor health, whereas Puerto Ricans were more likely than whites to experience functional limitations. Both race and ethnicity remain important factors in explaining the disparities in self-assessed health status independent of socioeconomic status (SES). Meanwhile, the way self-assessed health status varies with ethnicity is importantly stratified by SES as measured by income and education. These results suggest that future research should analyze the interplay between ethnicity and SES rather than assuming measuring either captures all the important variation.

Activities of Daily Living↗
PubMed1990

[Mortality and mean life span as an indicator of population health status].

The main source of data for the evaluation of the health status of the population are mortality statistics. The paper contains data on the standardized mortality and mean life span from the Annual World Health Report. The graphic presentation of data makes it possible to compare 15 selected European countries. In addition to the general mortality the cardiovascular mortality and the mortality from neoplasm is given. In the conclusion the author points out that the adverse health status of the Czechoslovak population must be improved not only by ensuring healthy living conditions but also by creating prerequisites for a change of the present lifestyle.

Czechoslovakia↗
PubMed2004

Mental health status and leisure-time physical activity contribute to fatigue intensity in patients with spondylarthropathy.

OBJECTIVE: To examine the relationship between disease-related variables, leisure-time physical activity (LTPA), and mental health status with fatigue severity in patients with spondylarthropathy (SpA). METHODS: Sixty-six SpA patients completed questionnaires assessing disease activity (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), functional ability (Bath Ankylosing Spondylitis Functional Index), and health-related quality of life (Short Form 36). LTPA patterns, demographics, and disease-related data were obtained by interview. A clinical examination determined tender point count. Fatigue was assessed with the BASDAI fatigue item. RESULTS: The mean BASDAI fatigue score was 5.5 (SD=2.7) with 59% of the sample obtaining a score > or =5. Disease activity, functional disability, and worse mental health contributed to greater fatigue (R2=0.56). The relationship between exercise duration and fatigue intensity was moderated by mental health status. For patients with poorer mental health scores, exercise did not influence fatigue severity. However, for patients reporting better mental health status, engaging in more LTPA decreased fatigue severity. CONCLUSION: In addition to increased disease activity and functional disability, greater fatigue severity in SpA is associated with poorer mental health status. Integrating regular leisure physical activity into the comprehensive treatment of SpA may be useful for modulating fatigue.

Fatigue↗
PubMed2006

Health status identifies heart failure outpatients at risk for hospitalization or death.

OBJECTIVES: We tested the hypothesis that one health status measure, the Kansas City Cardiomyopathy Questionnaire (KCCQ), provides prognostic information independent of other clinical data in outpatients with heart failure (HF). BACKGROUND: Health status measures are used to describe a patient's clinical condition and have been shown to predict mortality in some populations. Their prognostic value may be particularly useful among patients with HF for identifying candidates for disease management in whom increased care may reduce hospitalizations and prevent death. METHODS: We evaluated 505 HF patients from 13 outpatient clinics who had an ejection fraction <40% using the KCCQ summary score. Proportional hazards regression was used to evaluate the association between the KCCQ summary score (range, 0 to 100; higher scores indicate better health status) and the primary outcome of death or HF admission, adjusting for baseline patient characteristics, 6-min walk distance, and B-type natriuretic peptide (BNP). RESULTS: The mean age was 61 years, 76% of patients were male, 51% had an ischemic HF etiology, and 5% were New York Heart Association functional class IV. At 12 months, among the 9% of patients with a KCCQ score <25, 37% had been admitted for HF and 20% had died, compared with 7% (HF admissions) and 5% (death) of those with a KCCQ score > or =75 (33% of patients, p < 0.0001 for both comparisons). In sequential multivariable models adjusting for clinical variables, 6-min walk, and BNP levels, the KCCQ score remained significantly associated with survival free of HF hospitalization. CONCLUSIONS: A low KCCQ score is an independent predictor of poor prognosis in outpatients with HF.

Ambulatory Care↗
PubMed2004

Minimally supervised home rehabilitation improves exercise capacity and health status in patients with COPD.

OBJECTIVE: The purpose of this study was to investigate the effects on exercise tolerance and quality of life of an outpatient rehabilitation program implemented at home without a physiotherapist's direct supervision in patients with chronic obstructive lung disease. DESIGN: Patients with moderate chronic obstructive pulmonary disease were studied. The rehabilitation program included lower limb exercise on a stationary bicycle and upper limb exercise and stretching, together with education, and it lasted for 12 wks. Every 2 wks, a physiotherapist contacted patients by phone to evaluate their compliance with the rehabilitation program and any adverse effects. The main measures of outcome were the Health Status Index, cycle ergometer test, forced expiratory volume in 1 sec, and forced vital capacity. Patients were evaluated at the baseline and at 12 wks. RESULTS: A total of 32 patients were recruited and 28 (mean age, 70.4 yrs) completed the trial. After pulmonary rehabilitation, a significant improvement was found in seven of the nine Health Status Index quality-of-life subscales. Exercise tolerance also improved significantly, whereas no variation was observed in pulmonary function tests. There was no correlation between the improvement in quality of life and the improvement in exercise tolerance. The improvements in the Health Status Index physical function and general health subscales correlated negatively with forced expiratory volume in 1 sec (percentage of predicted value) and positively with residual volume/total lung capacity ratio. The improvement in exercise tolerance (expressed in watts or as maximum oxygen uptake), but not in quality-of-life indexes, was associated negatively with age and positively with weight, cognitive function, and forced expiratory volume in 1 sec/forced vital capacity ratio. CONCLUSIONS: We conclude that an inexpensive home rehabilitation program can improve quality of life and exercise tolerance in patients with moderate chronic obstructive pulmonary disease. Furthermore, our results indicate that exercise tolerance evaluated by cycloergometry and quality of life evaluated by the mean of the Health Status Index questionnaire are independent outcome measures of pulmonary rehabilitation.

Aged↗
PubMed1983

Aging and perceived health status.

Using a probability sample of 660 adults in Illinois, this study focuses on the relationship between age and perceived health status. According to age stratification theory, age groups need to be analyzed as age-specific entities that exist in relation to other sets of age groups. Following this perspective these data examine differences across the spectrum of adult age groups in this sample in regard to self-assessments of health. Number of symptoms was the strongest predictor of perceived health status employed in this analysis, followed by age, education, and race. It was found that those persons belonging to age groups over the age of 60 tend to perceive their own health in a significantly more positive fashion than members of younger adult age groups. The more educated elderly persons and those with the fewest symptoms, however, were most likely to hold this perception. One important area in which people appear to adjust their perception in later life is in their evaluation of personal health status.

Adolescent↗