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At least 19 recordsLinked to original sources
PubMed1989

Effect sizes for interpreting changes in health status.

Health status measures are being used with increasing frequency in clinical research. Up to now the emphasis has been on the reliability and validity of these measures. Less attention has been given to the sensitivity of these measures for detecting clinical change. As health status measures are applied more frequently in the clinical setting, we need a useful way to estimate and communicate whether particular changes in health status are clinically relevant. This report considers effect sizes as a useful way to interpret changes in health status. Effect sizes are defined as the mean change found in a variable divided by the standard deviation of that variable. Effect sizes are used to translate "the before and after changes" in a "one group" situation into a standard unit of measurement that will provide a clearer understanding of health status results. The utility of effect sizes is demonstrated from four different perspectives using three health status data sets derived from arthritis populations administered the Arthritis Impact Measurement Scales (AIMS). The first perspective shows how general and instrument-specific benchmarks can be developed and how they can be used to translate the meaning of clinical change. The second perspective shows how effect sizes can be used to compare traditional clinical measures with health status measures in a standard clinical drug trial. The third application demonstrates the use of effect sizes when comparing two drugs tested in separate drug trials and shows how they can facilitate this type of comparison. Finally, our health status results show how effect sizes can supplement standard statistical testing to give a more complete and clinically relevant picture of health status change. We conclude that effect sizes are an important tool that will facilitate the use and interpretation of health status measures in clinical research in arthritis and other chronic diseases.

Activities of Daily Living↗
PubMed1988

Socioeconomic status and health status: a study of males in the Canada Health Survey.

The relationships between education/occupation/income and health status have been well documented in the international epidemiological and sociological literature for many years, however, specific studies on the subject are scarce in Canada. Even when relationships have been demonstrated, the reasons for these relationships are much debated. This study presents an analysis of the relationship between socioeconomic status (SES) and health status. The study is based on analysis of data from a sample of nearly 2000 male principal income earners from the 1978 Canada Health Survey. Firstly, is there a relationship between an individual's SES and health status in Canada? Secondly, what aspects of SES--education, occupational status, and/or income--are most important? Thirdly, what are the possible explanations of the observed relationship? That is, is it possible to disaggregate the relationship and thereby infer possible causal mechanisms? The findings indicated a direct positive relationship between SES and health status, i.e. the higher an individual's SES, the better that person's health. The major exception to this was the SES/fitness relationship. In this instance, the higher the SES, the lower the level of fitness. Though age was an important control variable as SES, fitness and illness are age related, the findings relating SES to the health measures remained even when age was controlled for. Of the three SES measures, income was consistently the best correlate of health status. Occupational status showed the most inconsistent relationships with health status. The findings supported both the social causation and social selection hypotheses. That is, social position can have an effect on health status (social causation), while health status can affect one's social position (social selection).

Adolescent↗
PubMed1985

The independent contributions of socioeconomic status and health practices to health status.

The objective of this study was to determine whether the much-repeated finding of a relationship between socioeconomic status and health status is explained by individuals' health practices. The investigation was carried out using data tapes from the 1977 Health Interview Survey in which a one-third subsample of adults was asked a series of questions related to the seven nonmedical health practices identified in the Alameda County Study. The group selected for analysis comprised 15,892 white, responding adults. With age controlled statistically, perceived health status was found to be associated with socioeconomic status, whether the indicator was educational level, family income, or occupation, and to number of positive health practices. When number of health practices, in addition to age and other socioeconomic indicators was controlled for, the association was still positive and significant. The finding of an independent contribution by socioeconomic status to health status emphasizes that individual health habits are not the only influence on health status.

Adult↗
PubMedDate not supplied

Benign and malignant breast disease: the relationship between women's health status and health values.

The study purpose was to determine whether differences in the weights assigned to various dimensions of health by 90 women in three subgroups (benign breast disease, breast cancer receiving chemotherapy, and breast cancer receiving other therapies) were associated with differences in self-reported health status in these dimensions. Two methods, one direct and the other indirect, were used to elicit values for mobility, depression, and social support. Two different scales also provided self-reports of health status in each of these dimensions. These measures, in conjunction with sociodemographic variables, were used to test for status-value relationships. No statistically significant association between health values and health status was observed. The absence of any detectable association may have been a result of methodologic difficulties in assessing broadly defined dimensions of health. A possible solution would be to use "individualized" dimensions that are uniquely important to the individual, and to take into account such factors as possible influences of past health status and values, and possible gaps between expected health status and health status actually experienced.

Activities of Daily Living↗
PubMedDate not supplied

The rating form of IBD patient concerns: a new measure of health status.

Health status assessment for persons with chronic illness includes not only symptoms, but also an appraisal of the psychosocial concomitants of illness. In this national study of persons with inflammatory bowel disease (IBD), we standardized a disease-specific 25-item measure of perceived health status: the Rating Form of IBD Patient Concerns (RFIPC). Factor analysis yielded four indices: a) impact of disease (e.g., being a burden, loss of energy, loss of bowel control); b) sexual intimacy; c) complications of disease (e.g., developing cancer, having surgery, dying early); and d) body stigma (e.g., feeling dirty or smelly). A higher level of IBD concerns was associated with greater disease severity, female gender, and lower educational status. When controlling for these factors, as well as disease type and age, we found that concerns about: a) impact of disease was positively associated with poorer perception of health and well-being, greater psychological distress (SCL-90), and poorer daily function (Sickness Impact Profile) (p less than 0.0001); b) sexual intimacy was related to poorer psychologic function (p less than 0.01); and c) complications of disease was related to several measures of poorer daily function (p less than 0.0001 to 0.01). This standardized measure of the worries and concerns of persons with IBD may be used in clinical care and research to evaluate the effects of interventions on IBD patient outcomes.

Activities of Daily Living↗
PubMed1992

Health status and health care utilization among New York City home attendants: an illustration of the needs of working poor, immigrant women.

In this paper, the health needs and health care utilization patterns of home attendants and their families have been studied as an illustration of those likely to be found among working poor, immigrant women and their children. Despite tremendous growth in the number of immigrants, studies to date provide only limited information regarding the specific health needs and patterns of health care utilization among such women and their children. As part of a longitudinal study on the impact of insurance on health status and health care utilization, 387 female, immigrant home attendants were interviewed. Data were also gathered on 355 of their minor children. These women and children were found to be less likely than other Americans to make use of basic health services, despite the fact that they are more likely to indicate fair or poor health status. This is true even in comparison to poor or uninsured Americans. Immigrant attendants in fair or poor health report an average annual visit rate of 4.1 ambulatory care visits for themselves and 2.2 for their children, as compared to 8.4 for poor adults and 4.4 for poor children in national samples. These findings illustrate the likelihood that poor, immigrant women make limited use of American medical care, and face barriers to health care that appear even greater than those faced by the uninsured and the poor.

Adult↗
PubMed1988

Medical conditions, health status, and health services utilization.

Using data from the 1980 National Medical Care Utilization and Expenditure Survey (N = 11,530), four commonly used health status indicators are interpreted in terms of the underlying medical conditions they reflect. It is found that self-rated health status, role limitations, restricted activity days, and functional limitations measure similar conditions. These conditions tend to be chronic and severe; heart and cerebrovascular disease are especially associated with poor health as measured by all of the variables. Disability days is most likely to reflect acute, transitory morbidity. Practical suggestions for the appropriate use of the four variables are made. In addition, the conditions associated with the most ambulatory utilization of health services are identified. Among these conditions, those which are and are not measured adequately by the health status indicators are disclosed. It is concluded that the health status variables, either individually or as a group, do not measure many variations in health that are strongly related to utilization.

Activities of Daily Living↗
PubMed1991

Health status and health practices--Alameda and beyond.

Using the population of St John's, Newfoundland, we did a constructive replication of previous studies testing the association between health practices and health status. A telephone questionnaire was applied to all adults in a probabilistic sample of households (3300 subjects, 85% response rate). Several health practices and preventive behaviours indexes were developed and tested. An additive index of six practices (breakfast, sleeping, drinking, smoking, weight and exercise) using the Alameda County definitions, and an additive score of five practices (excluding breakfast and with revised definitions for smoking, drinking and exercise) were analysed using log-linear models; there was association between the indexes and self-assessed health status when controlling for sex, age and education, with the exception of the six-practice index in males. The association between these two indexes and several variables and constructs of health status showed that the best relationships were with self-assessed health status and with a construct including variables measuring subjective health.

Adult↗
PubMed1992

[Effect of seasonal and intermittent work at high altitude on health status].

Health status of 7 men was examined in order to study the effect of duty work cycle of 3-d stay at the altitude of 2,000 m and one-day holiday at 600 m for a period of 6 months from May to October. Their usual works were desk work and road patrol. Total hemoglobin concentration in blood increased significantly after work at high altitude, which was considered to be a compensatory response to the hypoxic state. Subjective symptoms were obtained by a self-administered questionnaire before (April), during (June and October) and after (November) work at high altitude. Fatigue was observed in three out of the seven subjects in June, which subsequently disappeared in October. Dyspnea was observed also in June in three of the subjects, which disappeared in two, persisted in one, and newly appeared in another subject in November. In contrast, a tendency of favorable effects of the work environment on nausea and lumbago was observed. Blood pressure and pulse rate were measured for 24 h. The mean systolic blood pressure during 24 h decreased in two of five subjects in October and November, and the mean values during the working hours decreased in two in October from 145 to 131 mmHg and from 147 to 129 mmHg, respectively. The blood pressure measured at health examination correlated well with the mean blood pressure during 24 h and working hours. The mean pulse rate during 24 h and working hours increased in one in June, October and November. These results indicate that adaptive responses to low barometric pressure environment developed during a work period of 5 months at high altitude.(ABSTRACT TRUNCATED AT 250 WORDS)

Altitude↗
PubMed1978

Measures of community health status for health planning.

The National Health Planning and Resources Development Act of 1974 (P.L. 93-641) requires health systems agencies (HSAs) to assess the health status of their area populations but limits their data-collecting activity. Numerous measures of health status have been devised, but many of these require data that are not yet available or are available only on the national level. Proposed measures are reviewed, and the problems of applying them to the measurement of health status in small areas, under current technical and practical constraints, are discussed. Several measures have promise for giving reasonable results, but only with further development of data sources, estimation techniques, and social indicator models; under present constraints, HSAs will have to work with less precise and less useful methods.

Health Status Indicators↗
PubMed1989

Health status and health care in rural Australia: a case study.

Knowledge of the health status of, and patterns of health care service utilization by rural Australian communities, is scant. This deficiency limits attempts to formulate policies designed to bring about efficient, effective and equitable delivery of health care services. This article reports the results of a health interview survey conducted in the Wimmera region of Victoria during spring 1984. The results demonstrate not only that patterns of morbidity in rural areas differ from the Australian average, but also that the health status of rural dwellers is worse than that of most Australians. Evidence suggests that while accessibility is not the most significant determinant of utilization of health care services, distance from services does affect propensity to use them.

Adolescent↗
PubMed1988

A comparison of two survey measures of health status.

Health service planning requires information on levels of health and illness in the population. Surveys, such as the British General Household Survey (GHS) rely on self-reports of health, illness and restriction, but interpretation of results is problematic. Multi-item measures such as the Nottingham Health Profile (NHP) tap different aspects of health and allow respondents less freedom to define health and illness. In a survey of 1862 adults, health questions from the GHS and the NHP were used, and the results compared. Responses to GHS questions were associated with NHP scores, but the strength of the associations between the four GHS questions and the six NHP items varied considerably. Reporting a recent restriction was only weakly associated with NHP scores. Associations between GHS questions and NHP scores were weakest for the NHP items measuring emotional reactions, sleep and feelings of social isolation. Reporting good health or no illness in response to GHS questions was no guarantee that respondents experienced no health problems. Those who use health data from the GHS, NHP or similar surveys should look closely at whether such data provide appropriate information for their purposes.

Adolescent↗
PubMed1991

Health status and health care use in persons with inflammatory bowel disease. A national sample.

We randomly surveyed 997 members of the Crohn's and Colitis Foundation of America with inflammatory bowel disease (320 ulcerative colitis and 671 Crohn's disease) in order to: (1) assess their health status, (2) compare members with ulcerative colitis and Crohn's disease, and (3) determine the correlates of health care use. Data collection included variables relating to physical and psychological symptoms, medication use, daily functional status, perceptions of health, and coping styles. The findings indicate that: (1) despite a number of symptoms and complications related to inflammatory bowel disease, the health status of this population is generally good and may be a result of effective coping styles; (2) those with Crohn's disease have more psychosocial difficulties, which appear related to greater symptom severity; (3) both psychosocial and physical health variables are related to number of physician visits, while primarily physical health variables are related to number of hospitalizations and surgeries. Further studies are needed to determine the representativeness of this self-selected sample with others having IBD. In this study, we have provided the basis for developing a more sensitive measure of health status than currently exists, and one which may have implications for future clinical studies.

Adaptation, Psychological↗
PubMed1991

Educational differences in health status and health care.

Includes estimates by years of education for limitation of activity, restricted-activity days, assessed health status, physician contacts, hospital discharges and days, incidence of acute conditions, and prevalence of chronic conditions. Level of education is cross-classified by age, sex, race, poverty status, Hispanic origin, geographic region, place of residence, major activity, marital status, and employment status. All estimates are shown as unadjusted and age adjusted and are based on data collected in household interviews by the U.S. Bureau of the Census for the National Health Interview Survey during 1989.

Activities of Daily Living↗