PubMed HealthSearch

PubMed · 9720127

Assessing functional outcomes: an overview.

Abstract

Assessment of functional outcomes requires, first, a good working definition and, second, sufficiently reliable and valid measures from which to choose. With the advent of new or refined conceptualizations of patient outcomes, the functional domain has expanded to address not only routine activities of daily life but also the richly diverse aspects believed to constitute quality of life. This article defines and places the concept of functional outcomes within a context of various published and proposed classification schemes, and supports an expanded definition on the basis of these schemes, emerging models of health care that combine biomedical with social science approaches, and the visionary contributions of respected colleagues in the field.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

C M Frattali. 1998. Assessing functional outcomes: an overview.. https://doi.org/10.1055/s-2008-1064045

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Evaluation of an instrument to assess the needs of patients with cancer. Supportive Care Review Group.

BACKGROUND: This study aimed to assess the face, content, and construct validity and the internal reliability of a tool for assessing the generic needs of patients with cancer (the Supportive Care Needs Survey). METHODS: A total of 1,492 consecutive patients attending the surgical, radiation, or medical oncology departments of 9 cancer treatment centers in New South Wales, Australia, were asked to participate. Of the 1,370 eligible patients, 1,354 (99%) consented to participate and 888 (65%) completed the survey. Eligible consenting patients were given a Supportive Care Needs Survey to complete at home and return by mail within 7 days. RESULTS: In the assessment of construct validity, the principal components method of factor analysis identified 5 factors with eigenvalues greater than 1, which together accounted for 64% of the total variance (patients' needs in the domains of psychologic, health system and information, physical and daily living, patient care and support, and sexuality). Face and content validity were found to be high following pilot tests and tests of reading ease. Internal reliability coefficients (Cronbach alpha) of all 5 factor-based scales were found to be substantial, ranging from 0.87 to 0.97. CONCLUSIONS: These findings suggest that the Supportive Care Needs Survey provides a reliable and valid index of the global needs of oncology patients. The standardized and widespread application of this instrument is recommended following further refinement and evaluation.

Activities of Daily Living

Assessing head and neck cancer patient outcome domains.

BACKGROUND: The purpose of this study was to assess the relative importance on patients' lives of multiple outcomes resulting from the management of head and neck cancer (HNC). METHODS: HNC patients filled out a disease-specific quality of life (QOL) survey covering 5 domains (speech, eating, aesthetics, pain/discomfort, and social/role functioning). Logistic regression was used to determine which of these domains best predicted the patients' response to a single, overall QOL assessment. RESULTS: In univariate analyses, all 5 domains were significantly correlated to QOL (p<.0001), with correlation coefficients ranging from.48 for eating to.64 for social/role functioning. Logistic regression indicated that speech and eating best predicted QOL (R(2) =.4647), with odds-ratios of 2. 96 for speech and 2.49 for eating. CONCLUSIONS: These data demonstrated that, for this group of patients, speech has the most impact on well-being, whereas eating has a substantial, unrelated influence. This is important information in counseling patients about treatment plans that have different levels of impairment.

Activities of Daily Living

Caregiving as a risk factor for mortality: the Caregiver Health Effects Study.

CONTEXT: There is strong consensus that caring for an elderly individual with disability is burdensome and stressful to many family members and contributes to psychiatric morbidity. Researchers have also suggested that the combination of loss, prolonged distress, the physical demands of caregiving, and biological vulnerabilities of older caregivers may compromise their physiological functioning and increase their risk for physical health problems, leading to increased mortality. OBJECTIVE: To examine the relationship between caregiving demands among older spousal caregivers and 4-year all-cause mortality, controlling for sociodemographic factors, prevalent clinical disease, and subclinical disease at baseline. DESIGN: Prospective population-based cohort study, from 1993 through 1998 with an average of 4.5 years of follow-up. SETTING: Four US communities. PARTICIPANTS: A total of 392 caregivers and 427 noncaregivers aged 66 to 96 years who were living with their spouses. MAIN OUTCOME MEASURE: Four-year mortality, based on level of caregiving: (1) spouse not disabled; (2) spouse disabled and not helping; (3) spouse disabled and helping with no strain reported; or(4) spouse disabled and helping with mental or emotional strain reported. RESULTS: After 4 years of follow-up, 103 participants (12.6%) died. After adjusting for sociodemographic factors, prevalent disease, and subclinical cardiovascular disease, participants who were providing care and experiencing caregiver strain had mortality risks that were 63% higher than noncaregiving controls (relative risk [RR], 1.63; 95% confidence interval [CI], 1.00-2.65). Participants who were providing care but not experiencing strain (RR, 1.08; 95 % CI, 0.61-1.90) and those with a disabled spouse who were not providing care (RR, 1.37; 95% CI, 0.73-2.58) did not have elevated adjusted mortality rates relative to the noncaregiving controls. CONCLUSIONS: Our study suggests that being a caregiver who is experiencing mental or emotional strain is an independent risk factor for mortality among elderly spousal caregivers. Caregivers who report strain associated with caregiving are more likely to die than noncaregiving controls.

Activities of Daily Living