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PubMed2001

Measuring health status of people who are wheelchair-dependent: validity of the Sickness Impact Profile 68 and the Nottingham Health Profile.

PURPOSE: Several questionnaires measuring health status are available, but their validity and correspondence between them in people with severe physical disabilities is not well known. In this study, the equivalence of the Nottingham Health Profile (NHP) and the Sickness Impact Profile 68 (SIP68) was examined. METHODS: Patients were 111 people who were wheelchair-bound due to spinal cord injuries (45%), rheumatic diseases (27%) or other causes (28%). Internal consistency, associations between scales of both questionnaires and with criterion variables (reflecting upper and lower extremity function, perceived health, social functioning and well-being) were examined. RESULTS: Both the NHP and the SIP68 were of acceptable clinimetric quality (Cronbach's alpha 0.53-0.85). Agreement between scales of both questionnaires was moderate for scales reflecting emotional health (0.56) and for scales reflecting physical (0.22-0.68) and social functioning (0.28-0.35). CONCLUSION: The NHP reflects perceived health, whereas the SIP68 reflects functional health status. In rehabilitation research, a careful choice between available health status measures must be made.

Persons with Disabilities↗

PubMed1993

Health status assessment in rheumatoid arthritis. II. Evaluation of a modified Shorter Sickness Impact Profile.

OBJECTIVE: To develop a shortened form of the Sickness Impact Profile (SIP) for routine practice. METHODS: We used data from a study of health status in 99 women with rheumatoid arthritis (RA). A stepwise analysis model used physical discomfort (global rating), self-assessed pain (Body Symptom Scale), mental well-being (Mood Adjective Check List) and joint function (Keitel Index) to define important aspects of health. RESULTS: Short forms of the SIP for discrimination (53 items), evaluation (25 items) and prediction (28 items) compared well in validity to the original 136-item SIP. The discriminative short form showed excellent reliability (internal consistency), matching the level of the generic SIP. The evaluative and predictive short forms had acceptable but lower internal consistency than the original Profile. CONCLUSION: We suggest a 64-item core health status questionnaire (SIP-RA) to be included and further tested in the arsenal of routine measurements in outpatients with RA. The questionnaire should include physical (Body care and movement, Mobility), psychosocial (Emotional behavior, Social interaction, Alertness behavior, Communication) and free-standing (Sleep and rest, Home management, Recreation and past-times, Eating) SIP categories, and it will improve the description of patients with RA.

Adult↗

PubMed1999

Screening for mobility disorders by the Mobility Control subscale of the short version of the Sickness Impact Profile.

OBJECTIVE: To test the usefulness of the Mobility Control subscale (MC scale) of the short version of the Sickness Impact Profile (SIP68) as a simple self-administered questionnaire for screening mobility disorders in a population of independent living elderly. DESIGN: The SIP68-MC scale was compared with the results of one functional test as independent criteria. SUBJECTS AND SETTING: A group of 81 people of 70 years and older was selected from a potential population of over 200 people. All were independent living elderly persons selected from a general practice. INTERVENTIONS: The short version of the Sickness Impact Profile and questions about falling last year were applied. Three functional tests were carried out: walking 10 metres, get up and sit down in a chair five times and a test for standing balance. A trained observer rated all tests. RESULTS: It is shown that the sensitivity of the MC scale (cut-off point: 1) with the total functional score is 91%, with a relative low specificity (59%). The relationship between the SIP-MC score and falling frequency is significant when there is a falling frequency equal to or more than two times a year. CONCLUSION: It is concluded that the MC scale is a useful test for screening mobility disorders in the elderly.

Activities of Daily Living↗

PubMed1995

Re-scaling the Spanish version of the Sickness Impact Profile: an opportunity for the assessment of cross-cultural equivalence.

The Sickness Impact Profile (SIP), a behaviour-based measure of health status developed in the US, was adapted into Spanish. The aim of this study was to obtain the item weights of the Spanish version, to compare these weights with those of the original instrument, and to assess cross-cultural differences that may affect scale equivalence. Following the original work, weights for the Spanish items were obtained using the equal appearing intervals methodology in two groups of judges: 25 health professionals and 120 consumers. Correlation between professionals' and consumers' item weights was 0.93, thus data were combined for further analysis. Correlations between Spanish and American item weights was 0.89 (p < 0.001). Among each SIP category, correlations ranged from 0.61 to 0.99. Cultural differences were found among social items belonging to the social interaction category. While specific cultural differences exist when specific item weights were compared, overall cultural differences were not relevant. For practical purposes, the American and Spanish versions of the SIP should be considered cross-culturally equivalent.

Adult↗

PubMed1994

A comparison of three quality of life instruments in subjects with angina pectoris: the Sickness Impact Profile, the Nottingham Health Profile, and the Quality of Well Being Scale.

Three instruments for the assessment of quality of life, the Quality of Well Being index (QWB), the Nottingham Health Profile (NHP) and the Sickness Impact Profile (SIP) were assessed in 59 patients with angina pectoris. The NHP showed increased statistically significant impairment with higher New York Heart Association (NYHA) class in 4 out of 6 subscales but not in single responses to questions on daily life. In the SIP 9 out of 11 dimensions increased with NYHA grade as did the physical and psychosocial subscores and the total score. There were statistically significant increases in six of the eleven dimensions. In the QWB an increase was observed only for two out of four categories employed in this instrument. The QWB was the most difficult to administer and thought likely to be insensitive to changes in anginal pain. There was a high level of agreement in similar dimensions of NHP and SIP. A psychological distress score was evaluated using the Symptom Rating Test and correlated with all summary dimensions of both instruments. The coefficients of variation were lower in SIP than in NHP categories. In conclusion quality of life instruments like NHP and SIP may be able to identify treatment effects in angina patients and so yield a useful addition to the traditional measures employed for the assessment of their condition.

Adult↗

PubMed1989

General versus disease-specific measures. Further work on the Sickness Impact Profile for head injury.

Three modifications devised to make the Sickness Impact Profile more sensitive to head injury are evaluated in 202 head-injured and 132 general trauma patients 1 month and 12 months after injury. The modifications consist of adding items, deleting nonapplicable items, and reweighting areas of function. Each of the modifications, and especially all three combined, slightly but significantly improve discrimination of head-injured and comparison subjects and increase correlations with neurologic and neuropsychologic severity indexes. These slight improvements occur more often at 12 months than at 1 month and among those without rather than with pre-existing conditions. No improvements are found in the ability to classify patients into subgroups. The modifications fail to make improvements sufficiently large or consistent to provide a practical advantage over the SIP. The standard SIP provides a reasonable measure of psychosocial functioning following head injury. It relates to head injury and other system injury severity and reflects recovery with time. The SIP score relates to emotional functioning even after injury severity has been taken into account. Until other factors, such as emotional status and responses style, are better controlled, little benefit is likely to be obtained from creating disease-specific psychosocial measures.

Activities of Daily Living↗

PubMed1998

Translation and calibration of a Chinese version of the Sickness Impact Profile for use in Hong Kong.

Because of the lack of suitable generic health status measures in Hong Kong that reflect the value structure and culture of the society, we have translated and calibrated the Sickness Impact Profile, which was originally developed in the United States. Translation consisted of a sequence of forward translations into Chinese, back translations into English and, when there was a loss of meaning or conceptual equivalence, retranslation into Chinese. Sixty Hong Kong Chinese people, including health professionals, patients, and members of the public were then recruited to determine item and dimension weights for the Hong Kong population. Individual ratings were averaged to obtain a consensus value for each item. Within-category reliability analysis for scores varied from 0.70 to 0.92 (Cronbach's alpha values) and overall internal consistency was 0.98. There were only small differences between this version and the original American English version in the ratings given to individual questions (Pearson's product moment correlation coefficient, r=0.8). We have developed a Chinese translation of the Sickness Impact Profile, which can now be used to evaluate health outcomes in Hong Kong and to compare outcomes with studies in other populations where the Sickness Impact Profile was used.

Journal Article↗

PubMed1997

Item re-scaling of an Italian version of the sickness impact profile: effect of age and profession of the observers.

An Italian version of the Sickness Impact Profile (SIP) obtained by professional and nonprofessional translators was checked for cross-cultural equivalence using a back-translation method followed by two scaling studies. The first scaling study involved 30 health professionals who ranked the items within each category for severity of dysfunction. By comparing Italian and US average ranks, 14 highly discordant items were identified. A revised translation was evaluated in a new study involving 120 observers stratified by age (< 65 versus > or = 65 years) and profession (health versus non health professionals) into 4 groups of the same size. The Italian and American item rank orders were almost equivalent, independently of the age and profession of the observers (93% of the ranks showing differences < 2), suggesting that this Italian version of SIP is cross-culturally unbiased. However, older age was associated with higher variability in the rank orders, and some caution is required for use in the geriatric population.

Adult↗

PubMed1996

Validity and reproducibility of the Spanish Version of the Sickness Impact Profile.

The Perfil de las Consecuencias de la Enfermedad (PCE), the Spanish version of the Sickness Impact Profile (SIP), was administered to 352 individuals who were grouped into 4 subsamples according to type and severity of illness. Differences among scores in the subsamples were used for assessing the discriminating ability of the PCE and correlation of PCE scores with theoretically comparable measures for convergent validity. Test-retest reliability was studied in a subgroup of 129 patients. The PCE scores correlated well with self-perceived overall health (0.53), self-assessment of sickness (0.51), self-assessment of dysfunction (0.63), the Index of Restricted Activity (0.54), and the Index of Activities of Daily Living (0.45). A poor correlation with clinicians' assessment of dysfunction (0.29) and speech therapists' assessment of speech pathology (0.23) was found. Reproducibility across illnesses (0.95-0.98), types of administration (0.96-0.98), and interviewers (0.93-0.99) was very high. The PCE is equivalent to the original instrument in terms of validity and reliability, which allows its use in international studies.

Activities of Daily Living↗

PubMed2001

Problems with the sickness impact profile: a theoretically based analysis and a proposal for a new method of implementation and scoring.

The Sickness Impact Profile (SIP) is one of the most widely used health status measures, but there are problems with the measure that lead to inconsistent and illogical scores. There are many desirable features to the SIP development methodology in that it is based on a good range of items and the item weightings are valuable. The current method of scoring the SIP is the use of a summated total and was selected based on limited empirical evidence. However, in this paper we argue that there are problems with the SIP because the current empirically derived method of scoring is incompatible with both the underlying theoretical scaling framework (Thurstone scaling) and the nature of the items in the SIP. In addition, the items do not have properties consistent with the scaling methodology. We suggest that it is crucial to take both a theoretical and empirical approach to selecting a scoring method. To examine problems associated with the SIP we explored the underlying scaling methodology and identified the types of items in the SIP. A new method of scoring is proposed that is consistent with the items and scaling in the SIP, namely using the maximum individual weighting from the items that were checked as a category score. This new method of scoring resolves many of the previously observed problems in the SIP. The new method of scoring also presented the opportunity for a new implementation of the SIP that reduces the number of items that most respondents, especially those with severe limitations, would be asked. Without taking a theoretical approach to scoring we suggest that subsequent, empirically based, scale amendments are unlikely to solve the problems. It is proposed that this new method of scoring justifies a thorough empirical investigation.

Activities of Daily Living↗

PubMed1992

Sickness Impact Profile: the state of the art of a generic functional status measure.

The Sickness Impact Profile (SIP) is a widely used health status measure, known to be valid and reliable. After the final development and testing in 1978, however, in which several methodological aspects were investigated, no descriptions of research projects that systematically evaluate the methodological and theoretical aspects of the instrument were found. In this article a review is presented of literature on the SIP. This review is the first step taken in a project that evaluates the SIP. The instrument appears to be a reliable instrument with sufficient content validity. It shows good correlations with other health status and functional status measures. Yet a number of questions about the SIP remain unanswered. Theoretical implications of the construct of sickness, the effect of age and gender on SIP scores, the construct validity judged by factor analysis, the responsiveness of the instrument, and the possibilities to use proxy-respondents or to shorten the list and to simplify the scoring procedure still have to be studied. If the instrument is to be used as an international standard measure of functional status, these topics should be thoroughly examined.

Activities of Daily Living↗

PubMed1987

The functional status of ESRD patients as measured by the Sickness Impact Profile.

This study describes and compares the perceived sickness-related behavioral dysfunction of 859 end-stage renal disease (ESRD) patients from 11 centers according to treatment modality via the Sickness Impact Profile (SIP). The unadjusted functional status of ESRD patients differed significantly by treatment modality. Transplantation patients were least functionally limited followed in order by home dialysis, continuous peritoneal dialysis, and in-center dialysis patients. The largest overall differences were for the sleep and rest, work, recreation and pastimes, and home management SIP categories. Regression analysis revealed that many of the large observed intermodality differences in functional status may have resulted from casemix variations (e.g. age and comorbidity differences). Only SIP score differences between transplantation and other treatment modality patients remained significant following the introduction of casemix controls. Results do not justify choosing one dialysis modality over another because of differences in perceived dysfunction.

Adult↗

PubMed1990

[The sickness impact profile; results of an evaluation study of the Dutch version].

The U.S. clinimetric instrument, the sickness impact profile (SIP), was validated for The Netherlands. The SIP is a standardized list of 136 statements aimed at measuring changes of conduct in everyday activities due to sickness, and may be used as a measure of outcome in clinical studies. Three necessary stages of a validation study were performed: translation, assignment of weighing factors to the statements and comparison of SIP measurements in a Dutch and an U.S. open population. The findings were that a good Dutch version of the SIP is available, that there is a strong correlation between the weighing factors assigned to the statements of the Dutch and of the U.S. version, and that the SIP scores of open populations of the two countries are in agreement. The findings for the Dutch open population may be used as reference values in other studies.

Activities of Daily Living↗

PubMed1994

The Sickness Impact Profile for nursing homes (SIP-NH)

BACKGROUND: Valid, feasible measures of functional status are needed to evaluate the expanding nursing home population. This study attempts to increase relevance and reduce respondent burden of the Sickness Impact Profile (SIP) for nursing home residents while maintaining internal consistency and validity. METHODS: 231 residents from one academic and four community nursing homes, aged > or = 60 with a Mini-Mental State Exam score > or = 11, were study participants. Nominal group process was used to identify items and/or categories for removal. Candidate items were those that: represented restrictions of the nursing home environment, had weak item-total score correlations, and/or made minimal contribution to category internal consistency. Reduction was constrained by: minimum correlation of r = .90 between SIP and Sickness Impact Profile for Nursing Homes (SIP-NH) scores, coefficients alpha that fell within 95% confidence regions about predicted alpha. Convergent and discriminant validity were evaluated with the Katz Activities of Daily Living, Physical Disability Index, Geriatric Depression Scale, and Folstein Mini-Mental State Exam. RESULTS: The SIP-NH contains 66 items, a 51.5% reduction. Correlations between the SIP-NH and SIP were: total score r = .98, Physical dimension r = .97, and Psychosocial dimension r = .97. Alpha coefficients all fell within the 95% confidence regions. The SIP and the SIP-NH did not differ in correlations with validating instruments. CONCLUSIONS: The SIP-NH reduces respondent burden and has acceptable internal consistency and external validity. Potentially useful for discriminatory and predictive purposes, responsiveness to change will require longitudinal evaluation.

Activities of Daily Living↗

PubMed1994

The sickness impact profile: SIP68, a short generic version. First evaluation of the reliability and reproducibility.

In previous research a short version of the Sickness Impact Profile (SIP136) was developed, containing 68 items. This SIP68 is intended as a short generic alternative to the original SIP. High reliability of the SIP68 was reported when it was extracted from the SIP136. This paper is a report on the first reliability testing of the SIP68 administered as an independent instrument without the context of the SIP136. To establish the test-retest reliability and the internal consistency of the new instrument, 51 patients of an outpatient department of rheumatology completed the SIP68 twice, with an interval of 48 hours. To compare the performance of the independent SIP68 with the SIP68 extracted from the SIP136, the SIP136 also was completed two times by the same 51 respondents. Test-retest reliability for both administration types was assessed by means of the intraclass correlation coefficient and the Jaccard's similarity ratio. Internal consistency was assessed by means of Cronbach's alpha. The reliability appears to be high in both the independent SIP68 as well as the extracted SIP68. Moreover, the reliability of the independent SIP68 appears to be as high as for the SIP136. These findings were very encouraging, indicating that the SIP68 may very well serve as a generic alternative to the SIP136.

Activities of Daily Living↗

PubMed1981

The Sickness Impact Profile: development and final revision of a health status measure.

The final development of the Sickness Impact Profile (SIP), a behaviorally based measure of health status, is presented. A large field trial on a random sample of prepaid group practice enrollees and smaller trials on samples of patients with hyperthyroidism, rheumatoid arthritis and hip replacements were undertaken to assess reliability and validity of the SIP and provide data for category and item analyses. Test-retest reliability (r = 0.92) and internal consistency (r - 0.94) were high. Convergent and discriminant validity was evaluated using the multitrait--multimethod technique. Clinical validity was assessed by determining the relationship between clinical measures of disease and the SIP scores. The relationship between the SIP and criterion measures were moderate to high and in the direction hypothesized. A technique for describing and assessing similarities and differences among groups was developed using profile and pattern analysis. The final SIP contains 136 items in 12 categories. Overall, category, and dimension scores may be calculated.

Activities of Daily Living↗

PubMed1989

The Sickness Impact Profile as a measure of the health status of noncognitively impaired nursing home residents.

The Sickness Impact Profile (SIP) is a multidimensional, behaviorally based measure of the health status that has been successfully used in a wide range of applications. The characteristics of this measure have not been assessed with nursing home residents. The purpose of this study was to assess the feasibility, reliability (internal consistency), validity, and comprehensiveness of the SIP as a measure of the health status of a selected group of nursing home residents. One hundred sixty-eight veterans residing in community and VA nursing homes responded to a questionnaire consisting of the SIP, Index of Activities of Daily Living, Barthel Index, Life Satisfaction Index Z, and the Philadelphia Geriatric Center Morale Scale. In general, the respondents correctly interpreted instructions; reliability and validity were supported; and the SIP was found to provide a comprehensive assessment of physical function. Adding a measure of psychologic well-being to a study protocol involving this population may, however, provide additional useful information regarding this construct.

Activities of Daily Living↗

PubMed1994

The development of a short generic version of the Sickness Impact Profile.

This study concerns the development of a short version of a well-known and much used clinimetric instrument called the Sickness Impact Profile (SIP). The SIP is a generic measure of functional status. Based on findings of a principal components analysis of over 800 SIPs from a multi-diagnostic population, a selection of 68 items divided over 6 dimensions was made and initially tested. As no support was found for the statistical validity of the categorical structure of the original SIP, a new structure, discovered through principal components analysis, was used as the basis for selecting items. Comparison of the scores on the selection with information provided by the original SIP showed very promising results: the 68 item selection may serve as a valid short SIP-version.

Female↗