PubMed Health⌕ Search

Biomedical subjects

H K McNaughton

Publications and source records attributed to H K McNaughton.

7 recordsLinked to original sources
PubMed2001

Living with arthritis--what is important?

PURPOSE: Demonstrating the effectiveness of health care interventions requires valid measurement of the impact of those interventions. However, outlining precisely what constitutes a 'good outcome' in the field of rehabilitation is no easy task and tends to rely on models proposed by 'experts' rather than people with the disabling conditions. This paper describes a study exploring outcomes that those people with a disabling condition (arthritis) consider important. METHOD: A qualitative study, interviewing 10 women with rheumatoid arthritis was carried out. The narratives were explored for categories and themes that encapsulated the perspective of the participants. RESULTS: A range of categories was identified and collated into five themes (personal/intrinsic factors, external/extrinsic factors, future issues, perceptions of normality and taking charge). CONCLUSIONS: The research supports in part, but also challenges more commonly used models of understanding the important consequences of disease and disability. The findings of the study may assist health professionals to reflect on current practice and reconsider processes used, and outcomes aimed for, in light of what patients/clients consider important.

Activities of Daily Living↗
PubMed2001

EuroQol EQ-5D may not adequately describe the health of people with disabilities.

PURPOSE: To assess whether life-circumstances and factors other than those described in the EuroQol EQ-5D instrument have a systematic influence on how the same EuroQol health-state is valued. METHOD: A simulation exercise whereby health professionals were asked to rate the health-state of 16 case-scenarios. Each case-scenario was designed to describe the same EuroQol health-state but was varied systematically using a 4 by 2 factorial design, in terms of ability to work, ability to perform usual leisure activity, age and type of disability. A convenience sample of 41 health professionals studying towards a postgraduate Diploma in Rehabilitation formed the study group. RESULTS: The average valuation was significantly higher than that derived from a social tariff model. The following factors contributed to a model which explained 10% of the variability in valuation scores: characteristics of the assessor--years of experience, experience with musculoskeletal disorders, and characteristics of the scenario--disability type, ability to work and ability to perform usual leisure activities (beta weights ranged from 0.093 to 0.253). Ability to perform usual leisure activities was associated with the greatest influence on the valuation rating. Additionally, professional type had a significant influence on rating with general practitioners giving significantly lower valuations. CONCLUSIONS: The same health-state, as defined by EuroQol EQ-5D cannot be regarded as describing similar life-circumstances, sufficient to be valued in the same way. Factors specific to the 'valuer' (experience and professional type) and specific to the 'valuee' (disability type, ability to work or perform usual leisure activities) that are not included in the EQ-5D description are significantly associated with different valuation scores. Caution should be used in applying valuations obtained from social tariff models to a disabled population.

Adult↗
PubMed2000

Brain injury - the perceived health of carers.

PURPOSE: This paper explores the perceived health and reported level of strain in the primary carers of severely brain injured individuals, 15 - 18 months after discharge from inpatient rehabilitation. METHOD: Seventy carers took part in a prospective descriptive study utilizing a semistructured interview and standardized measures including the SF36, The Carer Strain Index and the Relative Questionnaire. Functional consequences for the injured person were also assessed. RESULTS: The SF36 demonstrated a trend towards lower perceived health for carers than that reported in the general population. Neither perceived health status nor level of strain differed significantly according to the type of injury sustained (haemorrhagic or traumatic) nor initial severity of injury. Factors that contributed to carers having worse health status included the injured person's level of disability and interpersonal factors such as the nature of the relationship, with spouses having lower perceived health status than parents. CONCLUSIONS: Irrespective of cause of injury, generalised health consequences result for the carers of those with disabling consequences of brain injury. Factors independent of the injured individual themselves (such as the nature of the relationship to the carer) need to be taken into consideration when exploring wellbeing of carers and planning services.

Adolescent↗
PubMed2000

Prognosis for people with back pain under a No-fault 24-hour-cover compensation scheme.

STUDY DESIGN: A retrospective descriptive casenote review of consecutive back pain claimants assessing claim outcome at 12 months from onset. OBJECTIVE: To assess prognosis for back pain claimants in a no-fault 24-hour-cover accident compensation system. BACKGROUND: New Zealand has a unique accident compensation system that may provide incentives for health professionals to classify people with backache as having a back injury and incentives for back pain claimants to continue claims longer than would be the case in other compensation systems. METHODS: One hundred consecutive back pain claimants were identified from a single office of New Zealand's sole accident compensation insurer (Accident Rehabilitation and Compensation Insurance Corporation; ACC), who were still receiving compensation payments 4 weeks after the initial date of the claim. The study end point was case closure in the subsequent 12 months. Case closure rate was analyzed in relation to several potential prognostic variables. RESULTS: Of the 100 cases identified in which the claimant was receiving compensation 4 weeks from the initial date of the claim, 43 cases were not closed by 6 months, and 30 cases were not closed at 12 months. The variable most strongly associated with case nonclosure was whether the claimant was receiving earnings-related compensation (equal to 80% of previous income), with 41% of this group still receiving compensation at 12 months versus 16% of the group not receiving earnings-related compensation (chi2 = 8.55, P = 0.003). These results compare unfavorably with those from previous published studies from The Netherlands and Jersey in the United Kingdom. CONCLUSION: New Zealand's unique accident compensation environment may discourage return to work for people with back pain. New Zealand legislators should assess the impact of the ACC scheme on people with back pain, particularly in light of the recent recommendations of the International Association for the Study of Pain Task Force on Back Pain in the Workplace, that compensation cover for workers with back pain be limited to 6 weeks.

Adolescent↗