Biomedical subjects

C Jenkinson

Publications and source records attributed to C Jenkinson.

100 records · Page 6Linked to original sources

PubMed1993

A comparison of the sensitivity to change of several health status instruments in rheumatoid arthritis.

We carried out a study to compare the sensitivity to change of disease specific compared with more generic health status instruments in relation to rheumatoid arthritis (RA). A sample of 102 patients was recruited and assessed by means of 4 health status instruments and standard rheumatological measures on 3 occasions separated by 3 monthly intervals. Sensitivity to change for mobility, activities of daily living, household, pain, emotions and social dimensions were calculated. For some dimensions disease specific health status instruments performed less well. However overall there was no evidence of consistent differences between the 2 approaches. We conclude that generic instruments have a role in the assessment of RA.

Adult↗

PubMed1992

A generic health status instrument in the assessment of rheumatoid arthritis.

Seventy-three patients with RA were assessed by means of the Nottingham Health Profile (NHP), the Arthritis Impact Measurement Scales (AIMS) and a number of clinical measures. Patients with RA scored higher than controls on the NHP scales for energy, pain, mobility and sleep. Energy, pain, mobility and emotions scales of the NHP correlate significantly with other measures such as clinical assessments, matching scales of the AIMS and the Beck Depression Inventory, indicating satisfactory validity for the instrument with RA. Five of the six scales of the NHP are stable on retesting. The social scale of the NHP on the other hand does not correlate with the matching instrument of the AIMS and is relatively unstable over time. Measurement properties of generic health status instruments such as the NHP will require serious attention as they are increasingly used in evaluation studies.

Adult↗

PubMed1992

Comparison of two approaches to measuring change in health status in rheumatoid arthritis: the Health Assessment Questionnaire (HAQ) and modified HAQ.

As an alternative to the calculation of change scores for health status questionnaires used in clinical trials or longitudinal studies, transitional questions have been developed for patients to assess changes directly themselves. Here the original Health Assessment Questionnaire (HAQ) is compared with a modified version of the HAQ (MHAQ) which contains transition questions used at follow up. These, together with a set of standard rheumatological tests, were all completed by 100 patients with rheumatoid arthritis on two occasions, three months apart. Change scores were calculated for the HAQ and for the clinical measures and compared with the MHAQ. The results were strikingly in favour of encouraging patients to assess their own degree of change through the use of transition questions in the MHAQ.

Activities of Daily Living↗

PubMed1992

Importance of sensitivity to change as a criterion for selecting health status measures.

OBJECTIVE: To assess the sensitivity to change over time of four health status instruments in relation to patients with rheumatoid arthritis. DESIGN: Observational three month study of four self assessed instruments (arthritis impact measurement scales (AIMS), health assessment questionnaire (HAQ), Nottingham health profile (NHP), functional limitations profile (FLP)). SETTING: One rheumatology unit. PATIENTS: 101 patients with definite or classic rheumatoid arthritis. MAIN MEASURES: Change scores for dimensions of instruments, as determined by effect size (mean change in score/baseline standard deviation of variable) and conventional rheumatological measures, at baseline and after three months. RESULTS: Change scores for comparable dimensions (mobility, activities of daily living, household, pain, mood or emotion, and social scales) of the instruments were compared among 30 patients who considered their health status to have improved over three months. For all dimensions of health status the magnitude of change varied considerably according to the instrument. Maximum range in effect size was for social scales (AIMS 0.06, NHP 0.24, FLP 0.60). No single instrument seemed consistently to show the most change over all dimensions. CONCLUSION: Selection of health status instruments for audit or evaluation may have a considerable impact on the pattern of results obtained, and the "responsiveness" of such scales should be as carefully examined as their reliability and acceptability when selecting outcome measures.

Activities of Daily Living↗

PubMed1991

Why are we weighting? A critical examination of the use of item weights in a health status measure.

There is currently much interest in the measurement of self reported health status. A number of health status measures have been designed. However, such questionnaires are often long and complicated, or are disease specific. The most famous generic British health status instrument is the Nottingham Health Profile (NHP) which is a short questionnaire designed for ease of completion. However, this paper addresses a number of related issues concerning the weights attached to particular items on this questionnaire. It is argued that the weighting of items by Thurstone's method of paired comparisons is inappropriate and can lead to logically inconsistent results.

Health Status Indicators↗

PubMed1990

Measurement of health status in patients with chronic illness: comparison of the Nottingham health profile and the general health questionnaire.

The results of two commonly used instruments for measuring health status were compared in patients with chronic illness. The Nottingham health profile (NHP) is a measure of perceived health, while the general health questionnaire (GHQ) is a measure of non-psychotic psychiatric disturbance. The questionnaires were completed by patients suffering either rheumatoid arthritis or migraine. The results provide evidence that, despite some specific problems in the measurement of pain and emotional reactions, the NHP and GHQ may be used to assess the impact of illness upon sufferers' lives, not only in severely disabling disorders such as rheumatoid arthritis, but in health problems such as migraine which have often been considered as relatively minor ailments.

Adult↗

PubMed1990

Health status and mood state in a migraine sample.

This paper is a report of the results gained from the administration of a health status questionnaire, the Nottingham Health Profile (NHP), on a sample of migraine sufferers. It is argued that chronic migraine suffering is an illness that has implications for perceived health status, and that the NHP is sufficiently sensitive to detect this. The results suggest that scores on the domains of Energy, Sleep and Social Relationships are associated with respondents' mood state as measured on an established psychiatric screening device, the General Health Questionnaire (GHQ-30). It is argued that the NHP has important uses as a survey measure of perceived ill-health in populations, and as an indicator of psychiatric morbidity.

Adaptation, Psychological↗

PubMed1988

The Nottingham Health Profile: an analysis of its sensitivity in differentiating illness groups.

A recent criticism of the Nottingham Health Profile (NHP) claimed it was an insensitive instrument for use in population surveys, because its modal response was zero, and domains measured by the instrument are insufficiently distinct. It is argued here that the NHP was designed specifically to uncover the chronically ill in populations and, further, research undertaken here indicates that the instrument is sufficiently sensitive to be successful in permitting variations within and between illness groups to be determined. However, the domains of mobility and pain, as measured by the instrument, are found to be confounded.

Adult↗

PubMedDate not supplied

The conceptual validity and appropriateness of using health-related quality of life measures with minority ethnic groups.

Health-related quality of life measures have become increasingly used in the evaluation of health care to provide a measure of patients' subjective health status. Although studies often include ethnically heterogeneous samples, it is not clear to what extent the use of quality of life measures in this context is valid, because culture can affect the perception and interpretation of health and illness and so may affect the responses to items in a questionnaire. Such use also assumes the appropriateness of using a questionnaire format with individuals from different cultural backgrounds. This paper questions the assumptions of universality of concept and method, and presents the findings of a study which explored the conceptual validity and appropriateness of using the one health-related quality of life measure, the Short Form-36 with a group of Indian cardiac patients. The study identified some differences between a matched control group and Indian patients. The implications of these results and the importance of considering culture in the measurement of health-related quality of life are discussed.

Adult↗

PubMedDate not supplied

The social dimension of health status measures in rheumatoid arthritis.

Fifty-six patients with rheumatoid arthritis (RA) were assessed on two occasions three months apart. They completed two health status instruments--the Arthritis Impact Measurement Scales (AIMS) and the Nottingham Health Profile (NHP)--and the Beck Depression Inventory. In addition, clinical and serological data were gathered in order to calculate severity of disease according to the Mallya and Mace index. Health status instruments and the severity of disease index showed agreement in the assessment of mobility; similar agreement was found for different assessments of emotions. However, the two instruments provided social interaction scores with little agreement either cross-sectionally or in terms of change over time. It is argued that the generic NHP may be a valid instrument as an outcome measure in RA but the NHP and AIMS assess different aspects of social interaction. Care is needed in the selection of outcome measures to evaluate interventions.

Adult↗