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PubMedDate not supplied

Health status, resource consumption, and costs of dysthymic patients in Italian primary care.

AIMS: To describe the health status, resource consumption and costs of patients with dysthymic disorder in the Italian primary care setting. METHODS: A total of 79 general practitioners (GPs) participated the study. Diagnosis was based on each GP's clinical assessment. At entry the Mini-International Neuropsychiatric Interview (MINI) was used as a supporting diagnostic aid. Health status was measured with the SF-36 questionnaire. Resource consumption and costs regarded the six months before enrolment. RESULTS: Out of 598 patients enrolled by GPs according to their clinical assessment, 503 fulfilled the MINI criteria and 95 did not. The latter had a better perception of their health than the former. Resource consumption was similar in the two groups; and the total per patient six-month costs did not differ significantly. CONCLUSIONS: The study confirms there may be a gap between standardised criteria for defining dysthymia and everyday clinical practice. All dysthymic patients diagnosed by GPs might be considered together from a health policy perspective.

Adolescent↗
PubMed2006

Association of body size with health status in patients beginning dialysis.

BACKGROUND: Greater weight-for-height has been associated with prolonged survival in patients with end-stage renal disease (ESRD) but not in the general population. The association between body size and health status has not been carefully evaluated. OBJECTIVES: We compared the self-reported health status of 2467 participants in the Dialysis Morbidity and Mortality Study Wave 2 by using body mass index (BMI; in kg/m2) to approximate body size and composition. DESIGN: BMI was categorized into 4 groups (<19, 19 to <25, 25 to <30, and > or = 30) corresponding to World Health Organization criteria for underweight, normal-weight, overweight, and obese status. We adjusted for demographic, clinical, and laboratory factors that may have confounded the association between body size and health status. RESULTS: Scores on the physical component summary and the physical functioning scale were significantly lower for obese subjects than for those with normal weight or moderately high BMI after adjustment for demographic factors, comorbidity, and laboratory markers of nutritional status. Mental component summary and symptom scores were unrelated to BMI. The underweight group scored lower on many Medical Outcomes Study 36-Item Short Form scales than did the normal-weight group. CONCLUSIONS: Whereas higher BMI has consistently been associated with enhanced dialysis-related survival, health status-particularly physical function-may be impaired by obesity. Additional longitudinal studies of body weight and composition are needed for a better understanding of the complex effects of obesity and undernutrition in persons with ESRD and advanced chronic kidney disease.

Body Composition↗
PubMed1999

Consideration of the use of health status, functional outcome, and quality-of-life to monitor neonatal intensive care practice.

Measures of health status, functional abilities, and quality-of-life are being used increasingly to evaluate health care practice, and to measure outcomes from the patient's perspective. There is thus a need to reassess the use of growth and neurodevelopmental status that have traditionally been used as measures of outcome after neonatal intensive care. The quality of neonatal intensive care constitutes only one factor among many that determine the functional health and quality-of-life of survivors of neonatal intensive care. These include genetic disposition, intrauterine events, the effects of sociodemographic factors on the health and development of the child, and on the parents' assessment of their child's functioning. To obtain health status, functional and quality-of-life measures, parents need to act as proxy for the child during infancy and childhood. The parents' cultural, social, and educational background and the specific experience of the parent with children may influence their responses. Furthermore, their perspective may differ from that of the child. Measures that have been used or have the potential to measure health status, functioning, and quality-of-life include the National Health Interview Survey, the National Health Insurance Study, the Functional Status II, the Multi-Attribute Health System, the Functional Independence Measure for Children, the Vineland Adaptive Behavior Scales, the Adolescent Child Health and Illness Profile, and the Child Health Questionnaire for children, infants, and toddlers. Knowledge of the validity of the use of these measures among survivors of neonatal intensive care is, however, sparse. Studies have shown that the collection of a standard core of data from various national sources with specific criteria for defining severe disability at 2 years of age is feasible in Great Britain. However, questionnaires or available national databases provide global and epidemiologic information on outcomes rather than identifying the specific pathogenesis or rates of impairments. To determine the possible deleterious effects of new therapies, specific diseases or impairments will need to be identified rather than the global effect on functioning or health related quality-of-life. Examination of the proximal neonatal impairments that predispose to later disability, such as rates of periventricular hemorrhage or retinopathy of prematurity, are probably better measures for evaluating quality of neonatal care rather than distal impairments such as cerebral palsy, growth impairments, or reactive airway disease. The ultimate goal of neonatal intensive care is to provide survival without impairment. Objective measures of specific impairments and their residual disability are thus better measures of the quality of neonatal intensive care than subjective assessments of children and their families.

Child↗
PubMed2006

Improved perceived health status persists three months after a special sports camp for children with congenital heart disease.

INTRODUCTION: Although summer and sports camps for children with congenital heart disease are organized in many countries and regions, empirical data on the effects of such camps is limited. OBJECTIVES: The aim of the present study was to investigate changes in the perceived health status and habitual physical activities in children attending a special sports camp. MATERIALS AND METHODS: In this longitudinal study, 25 children with congenital heart disease who participated in a three-day multi-sports camp were included. The perceived health status was measured using the Child Health Questionnaire-Child Form, CHQ-CF87, completed by the child at the start of the camp (T1), at the end of the camp (T2), and 3 months after the camp concluded (T3). Habitual physical activities were assessed by means of a modified version of the Baecke questionnaire, which was completed by one of the parents at T1 and T3. RESULTS: During the sports camp, we observed significant improvements in the children's perception of their physical functioning, role-physical functioning, general health, role-emotional functioning, self-esteem, mental health, and general behavior. For physical functioning, role-emotional functioning, and family activities, high scores persisted three months after the sports camp concluded. The habitual physical activities (sport and leisure time) of the children remained unchanged. DISCUSSION AND CONCLUSION: In conclusion, we propose that a special sports camp for children with congenital heart disease may improve specific dimensions of subjective health status. Our study confirms a previous report on the benefits of such camps for afflicted children. If these findings can be further corroborated in other settings, participation in sport camps should be advocated as a simple, noninvasive means to promote healthier children.

Adolescent↗
PubMed1989

Psoriatics in Norway. A questionnaire study on health status, contact with paramedical professions, and alcohol and tobacco consumption.

Information on health status, use of prescription-drugs, contact with paramedical professionals and alcohol and tobacco consumption was obtained from a health interview survey, conducted by the Central Bureau of Statistics of Norway in 1985, of a representative sample of the Norwegian population. A total of 149 cases of psoriasis were registered in the study population of 10,576 persons, giving an overall prevalence of 1.4%. Among psoriatics, 75% felt that they suffered from chronic disease, while 66% suffered from one or more diseases in addition, indicating an increased susceptibility to diseases other than psoriasis, in psoriatics. 46% of the psoriatics used prescription-drugs, indicating that in many cases both the psoriasis as well as the other disease(s) were mild or moderate, not requiring therapy. Psoriatics had few contacts with rep-resentatives of the paramedical professions. Rather, there was a tendency to turn to alcoholic drinks and in larger amounts, among psoriatics. Fewer were total abstainers, and males with psoriasis drank more frequently. Among psoriatics, daily cigarette smoking was more frequent (48%) than among non-psoriatics (36%), the difference being greatest among females.

Adolescent↗
PubMed1992

Do self-reported arthritis symptom (RADAR) and health status (AIMS2) data provide duplicative or complementary information?

This study assessed whether self-report measures of symptoms and functional health status provide unique outcome information, or whether functional status assessments primarily serve as a proxy for self-reported arthritis symptoms. Symptom scores of 138 individuals with rheumatoid arthritis (RA) collected with the Rapid Assessment of Disease Activity in Rheumatology (RADAR) measure were compared with same-day functional health scores collected with the recently revised Arthritis Impact Measurement Scales (AIMS2). Correlational and factor analyses revealed that self-assessed arthritis symptoms, physical function and work impact, psychological status, and social health each made independent contributions to outcome. Satisfaction with health status was shown not to be independent of symptoms, functional capacity, or psychological status. It is important to document that self-reported symptom and health status information, when collected concurrently, provides complementary rather than duplicative information.

Activities of Daily Living↗
PubMed2005

Instruments used in measuring symptoms, health status and quality of life in hypothyroidism: a systematic qualitative review.

BACKGROUND: Symptoms of hypothyroidism are varied and nonspecific, thereby making clinical diagnosis impossible. Some patients report ongoing symptoms despite treatment. Measuring symptoms, health status and quality of life by using appropriate instruments, in addition to biochemical tests, is therefore vital to quantify disease severity and assess response to treatment. A number of instruments have been used in hypothyroidism, leading to lack of clarity about what exactly is being measured, and the rationale for the inclusion of particular measures is often uncertain. OBJECTIVES: To evaluate and compare instruments used in hypothyroidism in assessing patient-reported outcomes. DATA SOURCES AND STUDY SELECTION: All published literature on MEDLINE until March 2005 was searched using the keywords 'hypothyroidism', 'symptoms', 'quality of life' and 'health status'. Articles reporting controlled trials or instrument design and development were analysed to assess the instruments used and to ascertain whether they were measuring the stated outcome. DATA SYNTHESIS: Available tools to measure symptoms, health status and quality of life in diagnosis and management of hypothyroidism are discussed. We also describe how these tools have been described in published clinical trials along with the advantages and possible pitfalls of each of the commonly used tools. CONCLUSIONS: Some instruments reviewed have not been suited to the outcome being studied, thereby giving rise to questionable results. This review should be useful for clinicians, researchers and patient-support groups in understanding the principles behind these tools and the results obtained from their use in clinical practice, and in selecting measures for their own use.

Biomarkers↗
PubMed1997

Female life expectancy, gender stratification, health status, and level of economic development: a cross-national study of less developed countries.

A number of studies have attempted to account for cross-national differences in life expectancy, but relatively few have focused on female life expectancy, and even fewer on the relevance of predictors linked to gender stratification theory. The present study seeks to assess the utility of gender stratification theory in accounting for cross-national differences in female life expectancy in less developed countries. An incremental model building strategy is used to develop a final model that combines predictors linked to both industrialism theory and gender stratification theory. The analysis is based on multiple regression and cross-sectional samples that vary in size from 40 to 97 countries. Evidence is presented that several aspects of women's status have a positive effect on female life expectancy. Indicators of women's educational status, women's economic status, and women's reproductive autonomy all prove to be important predictors of female life expectancy. Analysis of interaction effects suggests that the strength of the effects of some aspects of women's economic status and the effect of some aspects of health status on female life expectancy vary with the level of economic development. A comprehensive assessment of the relative strength of alternative measures of women's education is carried out, and evidence is presented that it does make a difference how the level of women's education is measured.

Adolescent↗
PubMedDate not supplied

Dilemmas in assessing the health status of children with learning disabilities.

There has been little research directed at the evaluation of the general health status of children in mainstream settings with learning disabilities. The purpose of this study was to describe the effectiveness of a teacher-referral instrument in comparing the health status of children with learning disabilities and nondisabled children. Health records were reviewed to validate the findings of the teacher assessments. Students with learning disabilities were found to have increased frequency of health problems on the teacher-referral instrument. The health records did not serve to validate the teacher assessments, however, as a result of missing information and format inconsistencies. Policy implications are identified and discussed.

Child↗
PubMedDate not supplied

SF-36 health status of workers compensation cases with spinal disorders.

BACKGROUND CONTEXT: Poorer outcomes of treatment are reported in patients with spinal disorders who receive workers compensation. The reason for their suboptimal outcomes is unclear. No study has examined the relationship between workers compensation and the Short Form Health Survey (SF-36) health status of patients with spinal disorders. PURPOSE: To compare the self-perceived health status of spinal disorder patients receiving workers compensation with those not receiving workers compensation. STUDY DESIGN/SETTING: A cross-sectional study on 18,389 patients who were evaluated in the 28 centers comprising the National Spine Network. PATIENT SAMPLE: The study data were derived from patients when first evaluated for back or neck pain between January 1998 and April 2000. OUTCOME MEASURES: The outcome measures used were the eight individual and two component scores of the SF-36. METHODS: All first-visit patients enrolled in the National Spine Network from January 1998 to April 2000 were reviewed. Eight individual scores and two component scores of the SF-36 were compared. RESULTS: Of the 18,389 patients, 1,535 (8%) were receiving workers compensation. Bivariate analyses showed all eight individual scores, and two summary scores of the SF-36 were significantly lower (p<.0001) in patients receiving workers compensation. After controlling for confounding covariates, workers compensation status was a significant predictor of lower SF-36 scores for General Health (p<.0001), Physical Functioning (p<.0001), Role Physical (p<.01), Social Functioning (p<.05), and Mental Health (p<.05). CONCLUSIONS: Workers compensation status is associated with poorer physical and mental health of patients with spinal disorders. Because the workers compensation group is younger, has a shorter duration of symptoms, and fewer comorbid medical problems, the lower SF-36 scores most likely reflect psychological factors and not ill health per se. The lower SF-36 scores may also reflect premorbid personality differences in the workers compensation patients, compared with those not receiving workers compensation. SF-36 is a validated tool that can be used to objectively identify the patient at risk for delayed recovery. Future treatment protocols should pay special attention to improve the health-related quality of life, especially general health and physical functioning of spinal patients receiving workers compensation.

Adult↗
PubMed2002

Health behaviors and health status of older women with schizophrenia.

The authors interviewed 43 women with schizophrenia who were 40 to 70 years of age about their health status, preventive health care, addictive behaviors, and comorbid medical conditions. Data were compared with those for age-matched samples from the general population. Thirty women in the study sample (71 percent) were overweight or obese, compared with 38 percent in the general population. Twenty-seven (63 percent) smoked cigarettes. Twenty-six women (62 percent) had received a mammogram in the past two years, compared with 86 percent in the general population. Rates of routine physical examinations and Pap tests did not differ markedly between the study sample and the general population. These results highlight the health impairments of older women who have schizophrenia.

Adult↗
PubMed1995

Functional health status of older women.

By the year 2000 in the United States, there will be 32 million adults age 65 or over, representing 12% of the population, with the majority being women. Older women are experiencing greater longevity but worse overall health than men. The assessment of functional health status in older women is often neglected yet is the major contributor to independent living. Functional health status includes the dimensions of physical health, independent health, and psychosocial health. Studies of two different groups of non-institutionalized older women who reside in the same Southwestern state are discussed in relation to national study samples and implications for nurse practitioners.

Activities of Daily Living↗
PubMed2005

Preoperative cerebral ischemic lesions predict physical health status after on-pump coronary artery bypass surgery.

BACKGROUND: Risk assessment is integral to patient selection and counseling before coronary artery revascularization. We studied the predictive ability of cerebral magnetic resonance imaging of preoperative and postoperative cerebral ischemic injury on self-reported physical and mental health at 3 months after coronary artery bypass surgery with or without use of cardiopulmonary bypass. METHODS: In a prospective clinical trial comparing on-pump and off-pump surgery, 120 patients responded to a questionnaire for self-report of angina (Canadian Cardiovascular Society scale) and physical and mental health status (Short Form 36) at baseline before preoperative cerebral magnetic resonance imaging. Preoperative sets of both magnetic resonance imaging and self-assessments were available for 103 (85.8%) patients. These patients were grouped according to classification of preoperative cerebral magnetic resonance imaging findings. Analysis of covariance determined the association of (1) preoperative magnetic resonance imaging status, (2) new postoperative cerebral lesions, and (3) actual use of cardiopulmonary bypass to physical and mental health. RESULTS: At 3 months after surgical intervention, 98 of 103 patients completed follow-up. The analysis revealed an interaction effect of preoperative cerebral ischemic injury and use of cardiopulmonary bypass on physical health (F = 9.07, P = .003) independent of age. No independent effects on health status were found of baseline magnetic resonance imaging or new cerebral lesions at 3 months. CONCLUSIONS: This study strongly suggests that the combination of preoperative cerebral ischemic injury and use of cardiopulmonary bypass can predict postoperative health status at 3 months. Cerebral magnetic resonance imaging might be a more specific indicator than age for preoperative assessment of vulnerability or resilience during rehabilitation after on-pump cardiac surgery.

Adult↗
PubMed2004

Effect of udder health status and lactation phase on the characteristics of Sardinian ewe milk.

Mammary involution and inflammation are known to negatively affect milk quality. A trial was carried out to elucidate the mechanism by which udder health status and lactational phase determine compositional modifications in ovine milk. A total of 60 individual milk samples was collected from a group of 20 pluriparous Sardinian ewes from mid to late lactation. Each sample was assessed for its chemical characteristics, quantitative distribution of casein fractions, lactodynamographic characteristics, and enzymatic activity. Udders were classed as healthy, doubtful, or infected on the basis of repeated somatic cell counts, and samples were grouped in 3 classes of days in milk. Results indicated that both udder inflammation and mammary involution can increase plasmin (PL) activity (15.6 vs. 18.4 U/mL in healthy vs. infected udders; 14.0 vs. 20.2 U/mL in phase 1 vs. 3), which is responsible for an evident protein breakdown in milk. Significant differences between groups were observed for several characteristics. With regard to udder heath status, casein index was lower in the infected vs. healthy udders (74.8 vs. 76.6%), and beta(tot)-casein showed a similar trend (43.9 vs. 46.6%). As a consequence of protein degradation, gamma-casein (5.78 vs. 2.82%) and proteolysis index (7.60 vs. 3.82) increased in the infected group with respect to the healthy group. Udder health status also affected milk technological traits. Udder inflammation resulted in longer clotting time (20.7 vs. 16.5 min for infected vs. healthy, respectively) and in poorer curd firmness (35.6 vs. 47.6 mm for infected vs. healthy, respectively). Frequency of samples reactive to rennet was 100, 93, and 67%, respectively, for healthy, doubtful, and infected groups. With regard to lactational phase, a decrease in alpha(s1)-casein (39.13 vs. 29.36%) and beta(1)-casein (23.41 vs. 19.36%) occurred during phase 1 vs. 3, whereas kappa + alpha(s2)-casein increased (12.30 vs. 21.56%, phase 1 vs. 3). Correlation coefficients confirmed the role of PL in protein degradation. It was concluded that PL activity was strongly affected by both lactational phase and udder health status and, in turn, could be an important agent enhancing milk quality detriment.

Animals↗
PubMed2000

Relationships between perception of engagement with health care provider and demographic characteristics, health status, and adherence to therapeutic regimen in persons with HIV/AIDS.

The purpose of this descriptive, correlational study was to examine the relationships between perception of engagement with health care provider and demographic characteristics, health status, and adherence to therapeutic regimen in persons with HIV/AIDS. The convenience sample of 707 non-hospitalized persons receiving health care for HIV/AIDS was recruited from seven U.S. sites. All measures were self-report. Perception of engagement with health care provider was measured by the newly developed Engagement with Health Care Provider scale. Adherence to therapeutic regimen included adherence to medications, provider advice, and appointments. Health status was measured by the Medical Outcomes Study Short Form 36 (MOS SF-36), Living with HIV scale, CD4 count, and length of time known to be HIV-positive. There were no significant relationships between engagement with health care provider and age, gender, ethnicity, and type of health care provider. Subscales of the MOS SF-36 and Living with HIV explained a significant, but modest amount of the variance in engagement. Clients who were more engaged with their health care provider reported greater adherence to medication regimen and provider advice. Clients who missed at least one appointment in the last month or who reported current or past injection drug use were significantly less engaged.

Acquired Immunodeficiency Syndrome↗
PubMed1998

[The study of healthy life-style risk factors and health status for cardiovascular diseases for employees in Kaohsiung area].

To understand the healthy life style, health status and risk factors of employees, institutional employees in Kaohsiung area were studied by using questionnaire investigation and blood specimen examination. One-thousand-four hundred-fifty subjects were used, but 1147 questionnaires were completed. The complete rate was 79.1%. The reliability and validity of the healthy life style scale achieved an acceptable level. The results are as follows: 1. The mean total score of healthy life-style scale was 63.9. Four healthy behavior scored lowest: "consulted health professional about health information", "monitored self of blood pressure and blood sugar", did moderate exercise at least three times per week", "took leisure activities". 2. The severity of risk factor was as follows: (1) 32.2% of employees had abnormal value for blood cholesterol (> or = 200 mg/dl); (2) 22.9% of employees had abnormal blood pressure value; (3) 22.6% of employees were overweight or obese; (4) 16.7% of employees often smoked; (5) 13.6% of employees had abnormal values for blood triglyceride. (6) 2.1% of employees had abnormal blood sugar values. 3. 10.8% of subjects were perceieved to have a worsing health status; 14.5% of the subjects had chronic disease with physicians diagnosis and most of their (71%) were hypertersion. 4. The findings of demographic data showed that people who were male, aged over forty, had education below junior high school and those of blue collar class should be screened and monitored, for the risk factors at regular intervals. Similarly, People who are male, age below forty and blue-collar class should be encouraged to develop the healthy life-styles.

Adult↗
PubMed2005

The impact of epilepsy on health status among younger and older adults.

PURPOSE: The incidence of epilepsy is highest among the elderly, yet our understanding of the impact of epilepsy is based predominantly on inferences from studies of younger adults. This study examines the impact of epilepsy on patients' subjective health status in a population that includes both younger and older adults. METHODS: We used national administrative and survey databases from the Veterans Health Administration to examine health status as measured by a modification of the SF-36 (RV-36) in patients from three age cohorts: young adults (18-40 years), middle-aged adults (41-64 years), and older adults (65 years and older). Because chronicity of epilepsy may influence these outcomes, we compared scores for patients with new-onset epilepsy, chronic epilepsy, and no epilepsy by using analysis of covariance, controlling for patient demographic and clinical characteristics that may also affect health status. RESULTS: With the exception of physical status measures, older adults appeared to cope better with their epilepsy than did middle-aged patients. Young adults with new-onset epilepsy reported poor general health and worse mental health, but high levels of physical function and physical activity. Middle-aged patients with new-onset epilepsy scored lowest in all domains, and their peers with chronic epilepsy also reported poor general physical health and emotional functioning. CONCLUSIONS: Although having fewer physiologic reserves, older adults appeared most resilient in facing this chronic illness, and middle-aged adults fared the worst. Interventions to improve quality of life among patients with epilepsy should be tailored to age and epilepsy chronicity.

Adolescent↗