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PubMedDate not supplied

[Psychological, social and medical items used to assess health status of patient with osteoarthritis].

One of the characteristic of the modern world is the continuum increase of the elderly people, and subsequently the increase of pathology related to ageing. Among the most common health problems, related to age increase, is joint related pathology, mainly arthritis. Assessing life quality of the patients with arthritis is using the hypothesis that their health status, depends on the patients ability to take decisions and to implement the decisions taken. The new concept, introduced by the World Health Organization (W.H.O.), in order to evaluate life quality of the patients with arthritis, is that of the "healthy ill person". This concept reconsiders "health" and "illness" as opposites, and does appreciate that "health" and "illness" are both part of a continuum. The standardized tool used to appreciate the life quality of the patients with chronic illnesses is the Nottingham Health Profile (NHP). The authors did apply the Romanian version of the NHP to 50 patients with arthritis registered in the Rheumatology Out-Patients Clinic, no. 1, Iasi. The results analysis demonstrated that the NHP questionnaire is a valuable tool able to assess health status of patients with arthritis. The NHP is worthy to use also for clinical monitoring of the patients with arthritis. An interesting analysis result is that the duration of the illness does not correlate with the self-perception of the degree of severity of the arthritis. The most specific scales are those related to Pain and Mobility.

Algorithms↗
PubMed2006

A comparison of the health and mental health status of homeless mothers in Worcester, Mass: 1993 and 2003.

OBJECTIVES: We assessed background characteristics, health status, and prevalence rates of mental health disorders in 2 studies of homeless mothers conducted in Worcester, Mass, one in 1993 and the other in 2003. METHODS: We compared the women taking part in the 2 studies, which involved similar methodologies, on the key variables of interest over time. RESULTS: Homeless families taking part in the 2003 study were poorer than those taking part in the 1993 study, and female heads of household in that study reported more physical health limitations, major depressive illness, and posttraumatic stress disorder. CONCLUSION: Data from 2003 suggest that the characteristics of homeless mothers changed over the 10-year period assessed. Service providers and shelter staff may need to refine services so that they are responsive to these changing needs.

Adult↗
PubMed1995

Acute health status and its relationship to falls in the nursing home.

1. Falls represent a major health threat to the elderly, often resulting in injury, disability and/or death. 2. A significant association between acute changes in health status and falling was revealed in this study over 1-month, 2-month and alternating time periods. 3. Nurses' fall prevention efforts should be more attuned to the more relevant predictor of changing health status and functioning capability of residents.

Accidental Falls↗
PubMed2007

The effects of Taiwan's National Health Insurance on access and health status of the elderly.

The primary objective of this paper is to evaluate the impact of Taiwan's National Health Insurance program (NHI), established in 1995, on improving elderly access to care and health status. Further, we estimate the extent to which NHI reduces gaps in access and health across income groups. Using data from a longitudinal survey, we adopt a difference-in-difference methodology to estimate the causal effect of Taiwan's NHI. Our results show that Taiwan's NHI has significantly increased utilization of both outpatient and inpatient care among the elderly, and such effects were more salient for people in the low- or middle-income groups. Our findings also reveal that although Taiwan's NHI greatly increased the utilization of both outpatient and inpatient services, this increased utilization of health services did not reduce mortality or lead to better self-perceived general health status for Taiwanese elderly. Measures more sensitive than mortality and self-perceived general health may be necessary for discerning the health effects of NHI. Alternatively, the lack of NHI effects on health may reflect other quality and efficiency problems inherent in the system not yet addressed by NHI.

Aged↗
PubMed2000

Occlusal and oral health status of a group of 3-8-year-old South African black children.

This study determined the oral health status of a group of 3-8-year-old South African black children, comprising a total of 214 children from the townships of Garankuwa, Shosanguwe, Mabopane, Hebron and Erasmus who attended a school in Akasia, Greater Pretoria Metropolitan Substructure. The decayed, missing and filled teeth (dmft), oral hygiene status, dental IQ and malocclusion status were determined. The study found that the children's oral health status and occlusal status were unacceptable. The level of their dental IQ scores was low, their oral hygiene poor, and they were in urgent need of primary and secondary dental care. In addition they were in need of both preventive and interceptive orthodontic care. A national strategy to address primary dental health care is recommended.

Ankylosis↗
PubMed1995

The Short Form-36 is preferable to the SIP as a generic health status measure in patients undergoing elective total hip arthroplasty.

OBJECTIVE: To assess the comparative usefulness of the Short Form-36 (SF-36) and the Sickness Impact Profile, (SIP) as generic health status measures in total hip arthroplasty. METHODS: Analysis of preoperative and 3-month data of 54 consecutive patients undergoing total hip replacement for osteoarthritis or rheumatoid arthritis. Instruments were mailed to patients preoperatively and 3 months postoperatively. RESULTS: In 10 of the 12 SIP subscales, but just 1 of the 8 SF-36 subscales, more than 40% of the patients had scores of zero. On a 100-point scale, the median global SIP was 12 (range 0-40) whereas the median global SF-36 was 50 (range 10-85). This indicates that many items of the SIP were not germane to patients undergoing joint arthroplasty. The global and, particularly, the physical dimensions of the SF-36 were more responsive than their SIP counterparts, as measured both by the standardized response mean (1.26 and 0.88, respectively) and the correlation with self-perceived improvement in quality of life (r = 0.37 and 0.26, respectively). The SF-36, but not the SIP, discriminated between patients with relatively good physical performance at 3 months with respect to their ability to work, to play sports, or to garden. CONCLUSION: The SF-36 is briefer, more relevant, and more responsive than the SIP and is preferable as a generic health status measure in patients undergoing elective hip arthroplasty. The SF-36 should be tested in other populations as well as other conditions to determine whether it is a superior generic health status instrument for evaluative research in orthopedic surgery.

Aged↗
PubMed2001

The health status of obese individuals in Canada.

OBJECTIVE: To determine whether there is a clinically relevant difference in the health state utilities of obese and non-obese individuals as measured by the Health Utility Index Mark III. METHODS: Secondary analysis of the population-based, cross-sectional, interviewer-administered National Population Health Survey (NPHS), 1996-1997. A probability sample of house-dwelling Canadians, excluding populations on First Nations Reserves, Canadian Armed Forces Bases, the Yukon and Northwest Territories, and long-term residents of hospitals or residential care facilities. The sub-sample used in this analysis consisted of 38 151 respondents (52.4% male) between the ages of 20 and 64 y, excluding pregnant women. Health Utilities Index-Mark III (HUI3) scores were used to define normal weight (body mass index (BMI) 19-24.9 kg/m(2)), overweight (BMI 25-29.9 kg/m(2)), obese (BMI 30-34.9 kg/m(2)), and morbidly obese (BMI> or =35 kg/m(2)) individuals. HUI3 scores were age- and gender-standardized. RESULTS: The overall prevalence of obesity (BMI> or =30 kg/m(2)) in this Canadian population was 13.3%. The average difference in HUI3 scores between normal weight and morbidly obese respondents was 0.04 (P<0.001). Statistically significant (P<0.05) differences across BMI categories were found in each of the eight component attributes of the HUI3. The attributes with the most substantial difference between normal and obese patients were cognition, mobility and pain. All demonstrated a > or =2-fold increase in the proportion of individuals in poorer classifications of health when normal weight respondents were compared with the morbidly obese. The magnitude of the decrement in utility ratings associated with obesity was comparable with other chronic non-cardiovascular conditions such as migraine or colitis. CONCLUSION: The results indicate that changes in self-rated health status appear to be due to significant changes across several relevant domain attributes. Obesity has a significant impact on both quality of life and health.

Adult↗
PubMed1987

Social ties, social support, and perceived health status among chronically disabled people.

Social ties can be particularly useful to disabled people, but little is known about the nature of social support in this population. This study investigated social ties, perceived support, received support, and perceived health status in a sample of 332 disabled persons living in a southeastern metropolitan area of the U.S. Major disability groups represented were musculoskeletal, neuromuscular, cardiac, and end-stage renal disease. Size of kin networks was inversely related to respondents' socioeconomic status. Disabled women were less likely than disabled men to be married, more likely to be single-parent heads of household, and more likely to be socioeconomically disadvantaged. Perceived support from family was high for all respondents. Perceived health status did not vary with amount of perceived support, but within disability groups, perceived health status tended to vary with amount of received help.

Adolescent↗
PubMed2000

[Does health status improve after re-assumption of ABM employment?].

UNLABELLED: Due to structural problems of the East German economy the level of unemployment will probably remain high for the next ten years. Thus, thousands of health-employment-schemes are established to reduce negative social and financial consequences of unemployment for those groups that are most affected. In this study the effects of temporary re-employment on health within the bounds of a job-creating measure are examined. By questionnaire employees of two firms in Magdeburg that exclusively occupies former unemployed men and women were asked about their subjective health status and changes in health status since re-employment. 217 employees filled the questionnaire (response rate: 50%; mean age: 45 years, mean duration of former unemployment: 18 months). About one half of the employees (48%) report positive effects on health after re-employment. This percentage is highest in the age group 50 years and older. The frequency of health impairments remained unchanged for half of the workers, the rest mainly stated fewer impairments. Poor working conditions or physical overtaxing decreases the positive effects of re-employment. Employees who had a positive attitude towards their work report on positive effects on health and other aspects of life more than average. CONCLUSIONS: Negative consequences of unemployment on physical and psychological health are well understood. On the other hand, our study demonstrates positive effects on health and a reduction of health impairments by temporary job-creating measures. This is influenced by the working conditions and the social environment of the employees. Further investigation are needed for detailed medical evaluation of job-creating schemes.

Adult↗
PubMed2005

[Mental health status and coping strategies of dementia patients' caregivers of diverse ethnicities: a cross-cultural study].

OBJECTIVE: To explore the relationship between the mental health status and coping strategies among the dementia patients' caregivers of diverse ethnicities. METHODS: A survey of questionnaire, including sub-questionnaires related to the perceived living ability and cognitive damage, activities of daily living, instrumental activities of daily living, of the patients, and the mental health, coping strategies, and depression status of the CGs, was conducted among 121 caregivers (CGs) of dementia patients in the US, including 4 ethnicities: Chinese-Americans (CN, n = 29), African-Americans (BK, n = 29), Caucasians (WT, n = 32), and Latinos (LT, n = 31). RESULTS: The primary CGs were daughters in the BK, WT, and LT groups, while the spouses, sons, and daughters shared the caregiving role in the CN group. No significant difference in depression status and health status and physical and mental health were detected among the 4 groups (all P < 0.05). The CGs of different ethnicities origins presented different coping strategies. The subtotal scores of accepting the current situation and seeking for positive profiles were significantly different among the 4 ethnic groups with BK > WT > LT > CN (all P < 0.05). Regression analysis suggested that the CGs' depression status was associated with the background characteristics of the CGs and the care receivers and the coping strategies of the CGs were cross-ethnic differences of coping patterns relevant to the CGs' depressive experiences. CONCLUSION: Mental health status is associated with the coping strategies among the dementia patients' CGs, and there is cross-ethnic difference of coping strategies relevant to the CGs' depressive experience. Culturally appropriate training on coping strategies and care service is needed to improve the quality of care and quality of life for the dementia patients and their caregivers.

Activities of Daily Living↗
PubMed2004

[Predictors of mental health status and working ability of blue-collar workers].

BACKGROUND: From the 1980s, the research focused on factors influencing work ability among older workers has been developed. In Poland, these issues were not in the field of interest until 2001, when the Polish government established a new research project on work activity and ageing. One of its main topics was the relationship between psychosocial factors at work and work ability. The aim of the presented study was to find out psychosocial work characteristics that influence the level of work ability and mental health status. The attention was also paid to the role of coping with occupational stress and life style perceived as factors protecting against the decrease in work ability and mental health problems. MATERIALS AND METHODS: The cross-sectional study was performed in the group of 400 blue-collar male workers employed in large industrial plants. RESULTS: Several predictors of work ability were found. There were: age, stress experienced due to lack of rewards at work, and mental health status. A properly composed diet was the only factor that positively correlated with work ability. Taking into account mental health status, it was found that stress experienced due to organizational uncertainty, expression of negative emotion at work and amount of alcohol drunk negatively correlates with good mental health status. CONCLUSIONS: A high level of physical activity performed after work and a wide range of different coping strategies in use positively correlate with good mental health.

Adult↗
PubMed2004

Prognostic value of health status in patients with heart failure after acute myocardial infarction.

BACKGROUND: Disease-specific health status instruments such as the Kansas City Cardiomyopathy Questionnaire (KCCQ) can quantify symptoms, functional limitations, and quality of life in patients with heart failure. Understanding the relationship between KCCQ scores and prognosis may assist clinicians in both interpreting KCCQ scores and stratifying risk in patients. METHODS AND RESULTS: We examined the prognostic value of the KCCQ in a prospective, international cohort of 1516 patients with heart failure after a recent acute myocardial infarction. We focused on the relationship between the KCCQ overall score (KCCQ-os), measured at the first outpatient visit (4 weeks after enrollment), and subsequent 1-year cardiovascular mortality or hospitalization (n=258, 20.3%). KCCQ-os was strongly associated with subsequent cardiovascular events in that those with a score > or =75 had an 84% 1-year event-free survival compared with 59% for those with a score <25 (P<0.001). After demographic and other clinical characteristics were controlled for in multivariable models, KCCQ-os remained strongly associated with outcome (hazard ratio, 2.02; 95% CI, 1.24 to 3.27 for KCCQ-os <25; P<0.001). CONCLUSIONS: In outpatients with heart failure complicating an acute myocardial infarction, KCCQ-os is strongly associated with subsequent 1-year cardiovascular mortality and hospitalization. Use of the KCCQ in outpatient clinical practice can both quantify patients' health status and provide insight into their prognosis.

Adult↗
PubMed1989

Role of support networks in maintenance of improved cardiovascular health status.

This study was undertaken to clarify the relationship between maintaining an improved cardiovascular health status and social support networks. Two hundred and ninety participants from a national trial that was carried out to specify the impact of reducing risk for cardiovascular disease were rescreened 3 years after completion of the trial. Original risk status of the participants was compared to risk status at the end to identify who had an improved risk status (n = 204). Risk status of 204 improvers was calculated from the rescreening data to identify maintainers (n = 63) and nonmaintainers (n = 143). No significant differences were found between maintainers and nonmaintainers in sociodemographic status, or in level of general support. Highly significant differences were found for four types of support provided specifically for risk reduction: information/advice (P = 0.002), appraisal (P = 0.004), emotional support (P = 0.01) and availability (P = 0.019). Most of these differences in support were accounted for by the larger support network identified by the maintainers. In addition, compared to nonmaintainers, maintainers' networks were more family-centered (P = 0.012), and were correspondingly more dense (P = 0.021). A discriminant function analysis using the significant variables was able to predict maintenance in 72% of the cases. The significant variables also accounted for 10% of the variance between maintainers and nonmaintainers. The implications of this study are: (1) assessment of support should be specific to the health outcome being studied: (2) research on the impact of social environment on health status will benefit from clearly specifying individual components of social support and social networks; (3) amount of social support provided is related to size of the network and relationship of supporter to the at-risk individual; (4) because social support and social networks account for a small but significant amount of the variance between maintainers and nonmaintainers, these concepts should be included in patient assessments prior to developing a treatment or maintenance plan.

Conflict, Psychological↗
PubMed1988

Self-rated health among the elderly. A comparative analysis of health status measures, leisure activities and social contacts in age/sex groups.

A comparative analysis of self-rated health (SRH) by demographic characteristics, health status measures, leisure activities and social contacts was performed in four age/sex groups of elderly. The relative contribution of each group of variables to the explained variation in SRH was assessed using multiple regression analyses. A stratified sample drawn in an Israeli city led to 606 structured home interviews. The results show that: 1) for all groups the strongest correlates with SRH are health status measures, 2) for all groups the weakest correlates with SRH are demographic variables, 3) a significant relationship is found between SRH and age at immigration only for younger males, and 4) the explanatory power of social contacts and leisure activity variables varies significantly among the different groups. These factors explain relatively more of SRH in the younger age groups, and especially among younger males. Such findings suggest careful analyses of concepts in different socio-demographic groups for theoretical reasons and for purposes of planning health promotion community programs.

Aged↗
PubMed1990

Health status, retirement plans, and retirement. The Kaiser Permanente retirement study.

The purpose of this study was to assess the stability of short-term plans to retire and to evaluate the role of self-reported health status in predicting both plans to retire and actual retirement from a sample of 1,165 older members of a prepayment, group practice model, health maintenance organization. The study sample was derived from a random sample of members 60 to 66 years of age. Mailed questionnaires were completed that obtained data on the following variables: self-reported health status, work status, demographic variables, and plans to retire in the next year. Telephone interviews were conducted throughout the study period to determine dates of retirement from both those who planned to retire and those who had not. Results indicated that retirement plans were relatively stable for this population. Logistic regression analyses revealed that poorer health status was related to both retirement plans and actual retirement for women but not for men.

Data Collection↗
PubMed1996

The relationship between meeting patients' information needs and their satisfaction with hospital care and general health status outcomes.

OBJECTIVE: The objective of this study was to determine if there is an association between meeting patients' information needs and their overall satisfaction with care and their general health status outcomes. STUDY DESIGN: This non-experimental study used data from hospital medical records as well as patient-completed surveys conducted two and eight weeks post discharge. The setting involved three community hospitals in the southeastern section of the US that provided care to a series of 167 acute myocardial infarction (Acute MI) patients. MEASURES: The independent variable was an index measuring how well patients' information needs were met. The dependent variables were patient satisfaction (ratings of satisfaction with care process, global satisfaction, and health benefit) and general health status outcomes (physical function, psychosocial function and quality of life). Covariates used as control variables to hold patient characteristics constant, included demographics (age, gender) and clinical measures of acute MI severity, comorbidity, angina (at eight weeks), and dyspnea (at eight weeks). ANALYSIS: Univariate analyses were employed to: (1) describe patients' characteristics; (2) determine the relative importance of meeting different types of information needs; and (3) identify information need areas most likely not to be met. Multivariate linear regression and logistic regression was used to evaluate the association between patients' ratings of meeting information needs with satisfaction and health outcomes, respectively, after controlling for covariates. RESULTS: The multivariate regression results show that meeting information needs are positively and significantly associated with both patient satisfaction measures (i.e., Ratings of Care Processes, p < 0.01; Global Satisfaction, p < 0.05, Perceived Health Benefit, p < 0.01) and one general health status measure (i.e. Quality of Life, p < 0.01). CONCLUSION: The results suggest that providers of care should ensure that they meet the information needs of patients with specific conditions because patients' perceptions of both quality of care and quality of life are associated with the clinicians' ability to transfer key information to their patients.

Aged↗
PubMed1984

Toward clinical applications of health status measures: sensitivity of scales to clinically important changes.

While the validity and reliability of many newer health status instruments have been reported, few data are available regarding the sensitivity of these instruments to clinically discernible changes in patient status. We studied this feature of the Sickness Impact Profile (SIP) in a group of patients with rheumatoid arthritis, comparing it with more traditional measures of functional status (the American Rheumatism Association (ARA) functional classification and a patient self-rating scale). Four different approaches were devised to measure "sensitivity to clinical change." These involved comparisons of functional score changes with clinical changes in patient status which were independently agreed upon by both clinician and patient, and also comparisons with several clinical disease severity indicators. When applied to groups of patients, the SIP and the patient self-rating scale were modestly superior to the ARA scale, but neither the SIP nor the self-rating scale was clearly superior to the other. For considering individual patients, all of the scales were relatively insensitive, and predictive accuracy for clinically estimated change was low. New strategies for assessing sensitivity to small changes should be developed and applied to health status and functional scales. Attention to this characteristic should allow refinement of existing scales and may enhance their clinical usefulness.

Adult↗