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PubMed2003

[The health status and health care use of elderly living in sheltered residences. A comparison with independently living elderly].

A sheltered residence for older persons is a living arrangement in between independent living and a residential institution. There is little knowledge about the health of elderly living in these residences. We studied the physical, functional and psychosocial health of 401 persons living in a sheltered residence for elderly in Zwolle through a standardised interview. We compared the health of these elderly to the health of independently living elderly in the same region studied in the Longitudinal Aging Study Amsterdam and adjusted for sex, age and married state. We found an impaired functional health and more chronic illnesses among elderly living in a sheltered residence. In addition, more medication was used (OR = 2.4). The studied elderly felt more often depressed (OR = 1.9) or lonely (OR = 1.7). Their mental state was more frequently impaired (OR = 1.7), they visited health professionals more often and received more help for personal care (OR = 2.0) and housekeeping (OR = 1.6). We conclude that people living in sheltered residences form a distinct group of elderly, characterised by impaired physical, functional and psychosocial health. Planners of future care must be aware of this vulnerable group.

Aged↗
PubMed2006

Oral health status and health-related quality of life: a systematic review.

This study was conducted in order to identify the literature on oral health status and health-related QOL, review the findings systematically, and assess the association between them. We performed a literature search of reports published between January 1973 and June 2004, using five databases including MEDLINE. Only studies that used validated generic health-related QOL instruments were selected. The reviewers evaluated selected articles independently and resolved disagreements by consensus. A total of 1,726 articles were retrieved and seven were selected for the review; five observational studies and two intervention studies. Four studies showed significant associations between oral health status and health-related QOL. Temporomandibular disorders were highly associated with reduced health-related QOL. Poor oral status linked to both craniomandibular and cervical spinal pain was associated with increased impairment of health-related QOL. Dissatisfaction with the teeth and mouth, and a sensation of dry mouth contributed to reduce health-related QOL. Providing edentulous patients with implant-supported full dentures contributed to improve health-related QOL. Assessment of health-related QOL in relation to oral health with validated instruments remains insufficient. The present findings suggest that oral health status could affect health-related QOL in some settings; however, further evidence is needed to support this interpretation.

Craniomandibular Disorders↗
PubMed1995

Multi-attribute health status classification systems. Health Utilities Index.

In this article, multi-attribute approaches to the assessment of health status are reviewed with a special focus on 2 recently developed systems, the Health Utilities Index (HUI) Mark II and Mark III systems. The Mark II system consists of 7 attributes: sensation, mobility, emotion, cognition, self-care, pain and fertility. The Mark III system contains 8 attributes: vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain. Each attribute consists of multiple levels of functioning. A combination of levels across the attributes constitutes a health state. The HUI systems are deliberately focused on the fundamental core attributes of health status, and on the capacity of individuals to function with respect to these attributes. Thus, the measure obtained constitutes a pure description of health status, uncontaminated by differential opportunity or preference. Multi-attribute systems provide a compact but comprehensive framework for describing health status for use in population health and programme evaluation studies. An important advantage of such systems is their ability to simultaneously provide detail on an attribute-by-attribute basis and to capture combinations of deficits among attributes. An additional advantage is their compatibility with multi-attribute preference functions, which provide a method for computing a summary health-related quality-of-life score for each health state.

Canada↗
PubMed2000

Parental perspectives of the health status and health-related quality of life of teen-aged children who were extremely low birth weight and term controls.

OBJECTIVES: To compare the health status and health-related quality of life of teen-aged children who were extremely low birth weight (ELBW) with matched controls from the perspective of their parents. STUDY DESIGN: Geographically defined cohort; longitudinal follow-up; cross-sectional interviews. PARTICIPANTS: parents of 149/169 (88%) ELBW children between 12 and 16 years of age (including 41 children with neurosensory impairments) and 126/145 (87%) parents of term controls. Health status of the teenagers was classified according to the 6 attributes of the Health Utilities Index Mark 2, based on information obtained during parent interviews. Parents were asked to imagine themselves living in their own child's health state and 4 preselected hypothetical health states when providing directly measured standard gamble utility scores. RESULTS: Parents of ELBW children reported a higher frequency and more complex functional limitations than parents of controls for their own children's health status. Also, the mean utilities were lower (ELBW =.91 vs controls =. 97) and the variability in their scores was greater. There were no differences in the valuation of the hypothetical health states provided by parents of ELBW and control children. CONCLUSIONS: ELBW children were reported to have a greater burden of disability than were control children based on parental descriptions. Nonetheless, parents of ELBW children, on average, rated the health-related quality of life of their children fairly high. Thus, differences in reported functional status are not necessarily associated with lower utility scores.

Activities of Daily Living↗
PubMed1995

Health status and occupation: use of a health status index to measure the health of occupations.

A total of 4466 employed persons completed the short Auckland University Health Status Index (AUHSI) questionnaire and a health score was assigned to each individual on the basis of their responses. This health score was found to have statistically significant associations with a number of health-related measures, including socio-economic status (P < 0.001), and with occupational group: administrative, clerical/sales/service, skilled trades and unskilled labour (P < 0.001). Within the occupational groups, 3361 employees could be assigned to 42 specific occupations having 19 or more members each. After controlling for age and gender, significant differences in mean health score for specific occupation were found in the clerical/sales/service (P < 0.05), skilled trades (P = 0.002) and unskilled manual (P < 0.05) groups. It is postulated that these differences may be due to the nature of the specific occupation. Some possible reasons are listed. It is concluded that a global measure of health status such as this may be useful in the planning and evaluation of occupational health services.

Female↗
PubMedDate not supplied

Behavior, lifestyle, and socioeconomic variables as determinants of health status: implications for health policy development.

Health promotion has become an official health policy of this country, and it is being pursued through efforts to change individuals' health-related behavior. This approach is based on the assumption that it is in fact an individual's behavior that most directly determines his or her health status. But how good is the evidence that supports this assumption? Specifically, is the evidence sufficient for this assumption to outweigh the long-standing finding that social and economic conditions have a strong relationship to health status? The major support for the behavior approach derives from the coronary heart disease risk-factor studies and the Alameda County Study. In a series of reports over time, the relationship between individuals' health practices and their health status generally, as well as that between heart disease and cancer specifically, have been established by these studies. These observations, however, have not been confirmed when deliberate efforts have been made to change those practices. The evidence in support of the importance of social and economic conditions to health status has been documented through a long series of studies in this country, which have found a direct relationship between individuals' socioeconomic status and their health status. This relationship, however, has not in this country been tested by intervention. Only a few studies have examined the interrelationship between these two approaches to health promotion, but the evidence to date has failed to suggest that either one is the mediator of the other. We must, therefore, conclude that pursuing a policy of health promotion based on either approach to the exclusion of the other would indeed be short-sighted health policy.

Cardiovascular Diseases↗
PubMed2000

Functional health literacy is associated with health status and health-related knowledge in people living with HIV-AIDS.

BACKGROUND: Poor health literacy is a prevalent barrier to medical care and people with lower health literacy experience greater illness severity than people with higher health literacy. Health literacy may therefore be an important factor in the health and treatment of people living with HIV-AIDS. METHODS: A community-recruited sample of 339 HIV-infected men and women completed surveys and interviews that assessed functional health literacy, health status, AIDS-related disease and treatment knowledge, and health care perceptions and experiences. Medical records were available for chart abstraction of health status for a subsample of participants. RESULTS: About 1 of 4 people living with HIV-AIDS demonstrated difficulty comprehending simple medical instructions and therefore lower health literacy. HIV-infected people with lower health literacy had lower CD4 cell counts, higher viral loads, were less likely to be taking antiretroviral medications, reported a greater number of hospitalizations, and reported poorer health than those with higher health literacy. In addition, after adjusting for years of formal education, lower health literacy was associated with poorer knowledge of one's HIV-related health status, poorer AIDS-related disease and treatment knowledge, and more negative health care perceptions and experiences. CONCLUSIONS: Health literacy is a significant factor in the health and treatment of persons living with HIV-AIDS. Interventions are needed to improve medical care and the health status of people with lower health literacy that are living with HIV-AIDS.

Adult↗
PubMed2004

Health status and health-related quality of life of children with haemophilia from six West European countries.

A multicentre, international, cross-sectional study was carried out in the frame of field testing of the first haemophilia-specific quality-of-life (QoL) questionnaire (Haemo-QoL). The aim of this paper is to describe health status and health care and their impact on QoL in haemophilic children in Western Europe. Children aged 4-16 years with severe haemophilia without inhibitors were enrolled by 20 centres in France, Germany, Italy, the Netherlands, Spain and the United Kingdom. Clinical information was collected by the physicians with a medical documentation form. Health-related QoL (HRQoL) of children was assessed with Haemo-QoL, available for three age groups. Clinical data were available in 318 patients, 85.5% with haemophilia A. The mean age at first bleeding was 11 months, at first joint bleed 25 months. Functional joint impairments were found in 11.3%. Prophylaxis treatment was given to 66.7% of children in whom breakthrough bleeds occurred 0.4 times a month compared to 1.1 bleeds in children receiving on-demand treatment. A significantly higher factor consumption was found only in the two younger age groups of prophylaxis patients compared to on-demand patients. HRQoL was satisfactory in this cohort: young children were impaired mainly in the dimension 'family' and 'treatment', whereas older children had higher impairments in the so-called 'social' dimensions, such as 'perceived support' and 'friends'. Health care of children in Western Europe is progressively improving with a large diffusion of home treatment and prophylaxis. This provides a high level of health status and HRQoL, being better in haemophilic adolescents on prophylaxis.

Adolescent↗
PubMed1993

Health status, adherence with health recommendations, self-efficacy and social support in patients with rheumatoid arthritis.

A study was performed in 86 patients with rheumatoid arthritis (RA) to assess their health problems, the problems they experience in adhering to health recommendations and the relationships of these problems with self-efficacy and social support. Feeling dependent, disability and pain were the most important health related problems. The results showed self-efficacy to be related to the subjective experience of health status as measured by DUTCH-AIMS. Social emotional support was not related to health status, and contrary to what we expected social instrumental support was positively related to health status. The majority of the patients (55%) experienced adherence problems with health recommendations. These problems were not related to functional incapacity, pain or other aspects of health status but to the patient's self-efficacy expectations about coping with arthritis. Our conclusion is that to improve the self-management of disability and pain and adherence to health recommendations, patient education should be aimed at strengthening self-efficacy expectations in which social emotional support might be a motivating factor.

Activities of Daily Living↗
PubMed2004

Health status and health-related quality of life in a population-based sample of neonatal intensive care unit graduates.

OBJECTIVE: To measure the health status (HS) and health-related quality of life (HRQL) of preschoolers who were admitted to a neonatal intensive care unit (NICU) at birth and their family caregivers and to investigate differences in HS and HRQL in relation to gestational age and major morbidity experienced during the NICU stay. METHODS: Retrospective cross-sectional survey was conducted in the province of British Columbia, Canada. A total of 1140 of 2221 children who were admitted at birth to the 3 tertiary care NICUs in the province and 393 of 718 healthy full-term children recruited from 2 of these hospitals were studied. The main outcome measures were Infant and Toddler Quality of Life Questionnaire (ITQOL), Health Status Classification System Preschool Version (HSCS-PS), and Child Behavior Checklist/1.5-5 (CBCL) RESULTS: The overall response rate was 55%; the response rate for families that we located was 67.1%. NICU children differed from healthy children on the ITQOL in physical abilities, growth and development, temperament/moods, behavior, and general health perceptions, and caregivers differed on both parent-impact scales. On the HSCS-PS, proportionally more NICU children had a health problem in the following areas: sight, speech, getting around, using hands and fingers, taking care of self, learning and remembering, thinking and solving problems, pain and discomfort, general health, and behavior. The NICU sample reported more behavioral problems on the CBCL/1.5-5. Poorer HS and HRQL were reported for infants who were born at <27 weeks' gestation and for children who experienced > or =1 major morbidities during their NICU stay. CONCLUSIONS: Preschool-aged children with conditions that require NICU care and their family caregivers had poorer HS and HRQL in a range of domains compared with healthy children. There were also differences within the sample by gestational age and major morbidity. The differences in health were small using the ITQOL and CBCL/1.5-5 but larger using the HSCS-PS.

British Columbia↗