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PubMed2006

Age group and health status effects on health behavior change.

The authors explored health behavior change during 5 years, considering age/cohort, health status, and gender effects. The authors divided the sample (n = 1,064) into 4 age/cohort groups: young adults (n = 139; 19-42 years), middle-aged adults (n = 386; 43-62 years), young-old adults (n = 296; 63-72 years), and old-old adults (n = 243; 73+ years) and health status: cardiovascular disease and physical disability. Smoking and seat belt behaviors remained stable, whereas alcohol, food consumption, food preparation, physical activity, dental, and medical behaviors showed change. Change in health behaviors differed by age/cohort group and health status for food consumption, food preparation, and medical care, primarily showing negative change for old-old adults and positive change for individuals with cardiovascular disease. Health behavior interventions need to focus on the old-old, individuals with physical disability, and on smoking and seat belt use. These specific populations and behaviors need to be targeted to promote positive health behavior change, to limit future onsets of disability and morbidity, and to prevent the occurrence of premature death.

Adult↗
PubMed1996

Multiattribute utility function for a comprehensive health status classification system. Health Utilities Index Mark 2.

The Health Utilities Index Mark 2 (HUI:2) is a generic multiattribute, preference-based system for assessing health-related quality of life. Health Utilities Index Mark 2 consists of two components: a seven-attribute health status classification system and a scoring formula. The seven attributes are sensation, mobility, emotion, cognition, self-care, pain, and fertility. A random sample of general population parents were interviewed to determine cardinal preferences for the health states in the system. The health states were defined as lasting for a 60-year lifetime, starting at age 10. Values were measured using visual analogue scaling. Utilities were measured using a standard gamble technique. A scoring formula is provided, based on a multiplicative multiattribute utility function from the responses of 194 subjects. The utility scores are death-anchored (death = 0.0) and form an interval scale. Health Utilities Index Mark 2 and its utility scores can be useful to other researchers in a wide variety of settings who wish to document health status and assign preference scores.

Adolescent↗
PubMed2005

Patient-focused measures of functional health status and health-related quality of life in pediatric orthopedics: a case study in measurement selection.

The objectives of this report are to review the assessment of patient-focused outcomes in pediatric orthopedic surgery, to describe a framework for identifying appropriate sets of measures, and to illustrate an application of the framework to a challenging orthopedic problem.A detailed framework of study design and measurement factors is described. The factors are important for selecting appropriate instruments to measure health status and health-related quality of life (HRQL) in a particular context. A study to evaluate treatment alternatives for patients with neurofibromatosis type 1 and congenital tibial dysplasia (NF1-CTD) provides a rich illustration of the application of the framework. The application involves great variability in the instrument selection factors. Furthermore, these patients and their supportive caregivers face numerous complex health challenges with long-term implications for HRQL. Detailed summaries of important generic preference-based multi-attribute measurement systems, pediatric health profile instruments, and pediatric orthopedic-specific instruments are presented. Age-appropriate generic and specific measures are identified for study of NF1-CTD patients. Selected measures include the Activities Scale for Children, Gillette Functional Assessment Questionnaire Walking Scale, Health Utilities Index, and Pediatric Inventory of Quality of Life. Reliable and valid measures for application to pediatric orthopedics are available. There are important differences among measures. The selected measures complement each other. The framework in this report provides a guide for selecting appropriate measures. Application of appropriate sets of measures will enhance the ability to describe the morbidity of pediatric orthopedic patients and to assess the effectiveness of alternative clinical interventions. The framework for measurement of health status and HRQL from a patient perspective has relevance to many other areas of orthopedic practice.

Activities of Daily Living↗
PubMed1997

Evaluating changes in health status: reliability and responsiveness of five generic health status measures in workers with musculoskeletal disorders.

OBJECTIVES: To compare the measurement properties over time of five generic health status assessment techniques. METHODS: Five health status measures were completed on two occasions by a sample of workers with musculoskeletal disorders. They included the SF-36, Nottingham Health Profile, Health Status Section of the Ontario Health Survey (OHS), Duke Health Profile, the Sickness Impact Profile and a self-report of change in health between tests. SETTING: Subjects were accrued from a work site (within one week of injury) (n = 53), physiotherapy clinics (four weeks after injury), (n = 34), and a tertiary level rehabilitation center (more than four weeks after injury) (n = 40). ANALYSIS: Intraclass correlation coefficients (ICC) derived from nonparametric one-way analysis of variance were used for test-retest reliability in those who had not changed (n = 49). Various responsiveness statistics were used to evaluate responsiveness in those who claimed they had a positive change in health (n = 45) and in those who would have been expected to have a positive change (n = 79). RESULTS: Of the 127 subjects recruited, 114 completed both questionnaires (89.8%). In the subjects who reported no change in health, analysis of targeted dimensions (overall scores, physical function, and pain) demonstrated acceptable to excellent test-retest reliability in all but the Duke Health Profile. In subjects with change in health, the SF-36 was the most responsive measure (moderate to large effect sizes [0.55-0.97] and standardized response means ranging between 0.81 and 1.13). CONCLUSIONS: The results suggest that the SF-36 was the most appropriate questionnaire to measure health changes in the population studied. The selection of a health status measure must be context-specific, taking into account the purpose and population of the planned research.

Confidence Intervals↗
PubMed1988

The relationship of socioeconomic status to subsequent health status in systemic lupus erythematosus.

We examined the relationship of socioeconomic status to health status, as determined by the Arthritis Impact Measurement Scales, in 78 systemic lupus erythematosus patients who had been entered into a prospective study. After controlling for age, disease duration, and disease severity, a significant relationship between socioeconomic status and outcome was not demonstrated. All study subjects had health insurance for medical services. The results have potential implications for health care policy.

Depression↗
PubMed1996

A comparison of two multidimensional measures of health status: the Nottingham Health Profile and the RAND 36-Item Health Survey 1.0.

In this study the applicability of two multidimensional instruments, the NHP and the RAND 36-item Health Survey 1.0, for measuring health status in population surveys was examined. A population sample of 1,063 persons aged over 17 years participated in the study. It was shown that, as compared with the NHP, the RAND 36-Item Health Survey 1.0 is a more reliable measure of health status. Second, within a group of subjects who scored 'zero' on the NHP, considerable dispersion in RAND 36-Item Health Survey 1.0 scores was found. For the whole group, no significant differences were found in the amount of variance explained by the corresponding scales from both instruments in the prevalence of chronic diseases. However, among subjects with a zero score on the NHP, the RAND 36-Item Health Survey 1.0 scores were still predictive of the occurrence of chronic diseases. It was concluded that, compared with the NHP, the RAND 36-Item Health Survey 1.0 seems to be a more sensitive instrument for the use in population samples.

Adult↗
PubMed1994

Measuring change over time: a comparison of results from a global single item of health status and the multi-dimensional SF-36 health status survey questionnaire in patients presenting with menorrhagia.

This paper compares the sensitivity to change of a multi-item, multi-dimensional health status measure with a single global health status question, in the assessment of treatment for menorrhagia. A cohort study of patients recruited by general practitioners, was carried out, with a follow up at eighteen months. Questionnaires were administered postally at base-line and follow up. General practices in Berkshire, Buckinghamshire, Northamptonshire and Oxfordshire supplied three hundred and nine women who reported heavy menstrual bleeding, and received either drug treatment alone or both drug and surgical treatment (endometrial resection or hysterectomy) during the eighteen months between the two administrations of the questionnaires. A single global question was given to patients asking them to rate their overall health status as 'excellent', 'very good', 'good', 'fair' or 'poor'. The eight dimensions of the SF-36 health survey questionnaire were also given to patients to complete. The dimensions of the SF-36 indicated only small levels of improvement for patients who received drug treatment. However, on many dimensions of the SF-36, a moderate to large improvement was detected for the surgical group. However, small changes were reported in overall health status, as indicated by the single global question, for both groups. Single item measures of health status may not provide a sufficiently accurate indication of health status to be appropriate for use in longitudinal studies.

Adult↗
PubMed1984

Outcome assessment in clinical trials. Evidence for the sensitivity of a health status measure.

Health status measures are conceptually relevant to the assessment of clinical outcome in the rheumatic diseases, but their ability to detect meaningful changes in health has not been clearly demonstrated. This report describes the performance of a self-administered health status questionnaire in a randomized, double-blind, 21-week comparison of placebo, oral gold, and injectable gold in rheumatoid arthritis patients. Outcome was assessed by standard clinical measures, including joint count, grip strength, and laboratory tests, and by the Arthritis Impact Measurement Scales, a reliable and valid health status measure that assesses physical disability, psychological status, and pain. Data from the clinical and health status measures produced highly similar conclusions: injectable and oral gold are more effective than placebo for rheumatoid arthritis, and injections are slightly more effective than oral gold. The health status measure was thus quite sensitive to clinically meaningful drug-induced improvements. These findings provide justification for the further application of health status measures to clinical trials of chronic disease.

Chronic Disease↗
PubMed2006

Adequate sleep among adolescents is positively associated with health status and health-related behaviors.

BACKGROUND: Amount of sleep is an important indicator of health and well-being in children and adolescents. Adequate sleep (AS: adequate sleep is defined as 6-8 hours per night regularly) is a critical factor in adolescent health and health-related behaviors. The present study was based on a health promotion project previously conducted on adolescents in Tao-Yuan County, Taiwan. The aim was to examine the relationship between AS during schooldays and excessive body weight, frequency of visiting doctors and health-related behaviors among Taiwanese adolescents. METHODS: A cross-sectional study design, categorical and multivariate data analyses were used. The hypotheses investigated were: high frequency of AS is positively associated with lack of obesity and less frequent visits to doctors; and high frequency AS is positively associated with health-related behavior. RESULTS: A total of 656 boys (53.2%) and girls (46.8%), ranging in age from 13-18 years were studied between January and June 2004. Three hundred and fifty seven subjects (54%) reported that they slept less than the suggested 6-8 hours on schooldays. A significant negative association was found between low sleep and of the following health-related behaviors: (1) life appreciation; (2) taking responsibility for health; (3) adopting healthy diet; (4) effective stress management; (5) regular exercise; and (6) total AHP score. High frequency AS was associated with low frequencies of obesity after potential confounding factors were controlled. Junior high school adolescents reported significantly higher frequencies of AS than high school participants. Gender, family structure, home location and frequency of television watching or computer use were not significantly associated with AS. CONCLUSION: These findings support the proposition that AS is associated with good health status and high-frequency adoption of health-related behavior. Furthermore, these findings suggest that inadequate sleep may be a screening indicator for an unhealthy lifestyle and poor health status. The results might be useful for future research into the development of intervention strategies to assist adolescents who are not receiving enough hours of sleep.

Activities of Daily Living↗
PubMed1978

[Nutritional status and health status of under-fives of the Mentawai island Sipora (Indonesia) (author's transl)].

Weight, Height, head circumference, chest circumference, arm circumference and triceps skinfold of 223 children under 5 years from the small Mentawai island Sipora/Indonesia have been measured and related to international standards. Beginning from standard values, the anthropometric data decrease during the first 2-3 years, rising again in the following years. Weight for age is 72% of standard at 24 months and 83% at 5 years, height for age 89% at 30 months and 92% at 5 years, weight for height of the boys 82% at 12 months, of the girls 79% at 24 months and 94% for both at 4-5 years, chest/head ratio 95% at 12 months and 100% at 3-5 years. Arm circumference is 83% at 18 months 100% and above already at 3 years. Therefore, fold regains after the minimum of 90% at 18 months and above already at 3 years. Therefore, muscle growth would predominantly be reduced. The weight gain follows approximately the 3rd centile of english girls with a clear depression between 9 and 30 months. The birth weights of 476 children are 3230 g (boys) and 3120 g (girls). Perinatal mortality is low (2.9%), mortality during the first 5 years between 15 and 24%. In the health centre charts of 126 children under 5 years of a selected village (93% of that age group) 463 treatments in 5 years are recorded. The most frequent diagnoses are diseases of the respiratory tract (38% of all treatments), followed by malaria (23%), diarrhoea (19%), ascaris and hookworm infections (7.6%) and skin conditions (6%). Tuberculosis was the cause of treatment in 1.3%. In spite of the temporary growth retardation, as indicated by the anthropometric values, no cases of clinical Protein-Energy-Malnutrition have been observed. Malaria seems to be holoendemic, since all 223 children had a palpable spleen.

Anthropometry↗
PubMed1995

Canada's health status: a public health perspective.

Health status assessment and disease surveillance are essential to identify and priorize health issues, to evaluate intervention programs and to plan to meet future needs for health services. Canadians currently benefit by having among the highest life expectancies at birth in the world (81 for females, 74 for males). Disability-free life expectancies for females and males, respectively, were 10.1 and 11.3 years lower for the lowest income quintile compared to the highest. Canada's infant mortality rate in 1990 (7/1000 live births) was one of the lowest in the world but within Canada, the rate in the lowest income quintile (10.5/1000 live births) was almost double that in the highest income quintile (5.8/1000 live births). Fair or poor health was reported by 36% of adult Canadians in the lowest income category in 1990 compared to only 5% in the highest income group. The leading causes of premature death for females in 1991 were breast cancer, coronary heart disease, lung cancer, car crashes, birth defects and suicide; those for males were coronary heart disease, suicide, car crashes, lung cancer, birth defects, and AIDS. Lowest income quintile males had mortality rates at least double those for the highest income quintile for alcohol-related conditions, violence, injuries and emphysema. Cardiovascular diseases, cancer, musculoskeletal diseases, injuries and respiratory diseases imposed the highest direct and indirect economic costs in Canada in 1986. For all of these conditions, improved prevention is possible. For example, the forecasted tobacco-related deaths before age 70 among current male smokers age 15 will far exceed those due to car crashes, suicide, murder, AIDS, and drug abuse combined. Population aging will aggravate trends for many chronic conditions especially those with increasing incidence rates; there will be large increases in the numbers of persons with aging-related cancers, dementias and other conditions. There is an urgent need for Canadian health jurisdictions to ensure that rational priorities, goals/objectives, strategies, and programs are in place to enhance prevention and disease control.

Adolescent↗
PubMed2002

[Birth weight and gestational age in relation to risk factors of social conditions and health status].

BACKGROUND: The participants of European Longitudinal Study of Pregnancy and Childhood (ELSPAC) are women permanently resident in Brno, whose expected term of delivery corresponded with the prelimited period. In midpregnancy, 3327 of them filled in two research questionnaires with data concerning their marital status, health, education, dwelling, their up-bringing and stress in childhood as the essential information for the study of birth weight and gestational age variations of expected newborns. METHODS AND RESULTS: Sharing the flat with the parental generation, heating with solid fuel or gas and more smokers at home meant the risk for antenatal development of foetus. A certain influence seemed to have the number of rooms, too. Education of the mother-to-be as well as that of her partner and partly of her mother, too, determined the birth weight. To a certain degree, partner's position in employment and his health status played also a role. An important factor predetermining the birth weight and gestational age was the marital status of the mother: in the best situation were children born in complete families and greatly handicapped were offsprings of single mothers not living with their partners. CONCLUSIONS: Small influence on the prenatal development had the medical history of mothers, character of the upbringing in their original families and presence stressogenic events occurring in their girlhood up to 18 years of age.

Birth Weight↗