PubMed · 9483146
Getting people to take care of their health care by mending unhealthy ways makes cost-saving sense--until you hear about the small percentage that actually manages to kick bad habits for good.
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J Greene. 1998-02-05. Bound & nagged.. https://pubmed.ncbi.nlm.nih.gov/9483146/
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BACKGROUND: The measurement of health, the effects of disease, and the impact of health care include not only an indication of changes in disease frequency and severity but also an estimate of patients' perception of health status before and after treatment. One of the more important developments in health care in the past decade may be the recognition that the patient's perspective is as legitimate and valid as the clinician's in monitoring health care outcomes. This has lead to the development of instruments to quantify the patients' perception of their health status before and after treatment. METHODS: We review evidence supporting the measurement properties of the MacNew Heart Disease Health-related Quality of Life [MacNew] Questionnaire which was designed to evaluate how daily activities and physical, emotional, and social functioning are affected by coronary heart disease and its treatment. RESULTS: Reliability was demonstrated by using internal consistency and the intraclass correlation coefficients for the three domains in the Dutch, English, Farsi, German, and Spanish versions of the MacNew. With internal consistency and intraclass correlation coefficients =>0.73, reliability is high. Validity of the MacNew was examined with factor analysis and three core underlying factors, physical, emotional, and social, were identified, explaining 63.0 - 66.5% of the observed variance and replicated in the translations with psychometric data. Construct validity of the MacNew was further demonstrated by extensive substantiation of the logical relationships, defined a priori, between items and other comparison tools. The MacNew is responsive and sensitive to changes in HRQL following various interventions for patients with heart disease with 11 of 13 effect size statistics >0.80. Taking an average of 10 minutes or less to complete, the respondent-burden for the MacNew is low and its acceptability is demonstrated by response rates of over 90%. Normative data are available for patients with myocardial infarction, angina, and heart failure in the English version. CONCLUSION: The MacNew may be a valuable tool for assessing and evaluating health related quality of life in patients with heart disease.
Contingent valuation question formats that will be used to elicit willingness to pay for goods and services need to be relevant to the area they will be used in order for responses to be valid. A novel contingent valuation question format called the "structured haggling technique" (SH) that resembles the bargaining system in Nigerian markets was designed and its criterion and content validity compared with those of the bidding game (BG) and binary-with-follow-up (BWFU) technique. This was achieved by determining the willingness to pay (WTP) for insecticide-treated nets (ITNs) in Southeast Nigeria. Content validity was determined through observation of actual trading of untreated nets together with interviews with sellers and consumers. Criterion validity was determined by comparing stated and actual WTP. Stated WTP was determined using a questionnaire administered to 810 household heads and actual WTP was determined by offering the nets for sale to all respondents one month later. The phi (correlation) coefficient was used to compare criterion validity across question formats. The phi coefficients were SH (0.60: 95% C.I. 0.50-0.71), BG (0.42: 95% C.I. 0.29-0.54) and the BWFU (0.32: 95% C.I. 0.20-0.44), implying that the BG and SH had similar levels of criterion-validity while the BWFU was the least criterion-valid. However, the SH was the most content-valid. It is necessary to validate the findings in other areas where haggling is common. Future studies should establish the content validity of question formats in the contexts in which they will be used before administering questionnaires.
This study examines how Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants have played a contributing role in expanding categories of women's "mental illness" in relation to categories of "normal" behavior. We hypothesized that between 1985 and 2000, as Premenopausal Dysphoric Disorder (PMDD), postpartum depression, and perimenopausal depression were increasingly treated with SSRIs, popular categories of depressive illness expanded to encompass what were previously considered normative women's life events such as motherhood, menstruation, or child birth. We quantified and qualified this expansion through an in-depth analysis of popular representations of depressive illness during the time period when SSRIs were introduced. Using established coding methods, we analyzed popular articles about depression from a mix of American magazines and newspapers spanning the years 1985-2000. Through this approach, we uncovered a widening set of gender-specific criteria outside of the Diagnostic and Statistical Manual criteria for dysthymic or depressive disorders that have, over time, been conceived as indicative of treatment with SSRIs. Our results suggest that SSRI discourse may have helped shift popular categories of "normal/acceptable" and "pathological/treatable" womanhood, in much the same way that the popularity of Ritalin has shifted these categories for childhood.