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Flynn MA, Eggerth DE, Jacobson CJ, Lyon SM. Heart Attacks, Bloody Noses, and Other "Emotional Problems": Cultural and Conceptual Issues With the Spanish Translation of Self-Report Emotional Health Items. FAMILY & COMMUNITY HEALTH 2021; 44:1-9. [PMID: 32842005 PMCID: PMC7869970 DOI: 10.1097/fch.0000000000000279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This article examines how respondents understood items in the Spanish versions of the Short-Form 36 (SF-36v2). Cognitive interviews of the SF-36 were conducted in 2 phases with 46 Spanish speakers living in the United States. Roughly one-third (17/46) of respondents had difficulty understanding the Role Emotional items upon their initial reading, and almost half (21/46) provided examples that were inconsistent with the intended meaning of the items. The findings of this study underscore the importance of conducting cognitive testing to ensure conceptual equivalence of any instrument regardless of how well validated it appears to be.
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Affiliation(s)
- Michael A Flynn
- Division of Science Integration, National Institute for Occupational Safety and Health, Cincinnati, Ohio (Mr Flynn and Dr Eggerth); Consortium for Multicultural Psychology Research, Michigan State University, East Lansing (Mr Flynn and Dr Eggerth); Departments of Anthropology (Dr Jacobson) and Family and Community Medicine (Dr Jacobson), University of Cincinnati, Cincinnati, Ohio; and Department of Anthropology, University of Kentucky, Lexington (Dr Lyon)
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Hendriks PM, van Thor MCJ, Wapenaar M, Chandoesing P, van den Toorn LM, van den Bosch AE, Post MC, Boomars KA. The longitudinal use of EmPHasis-10 and CAMPHOR questionnaire health-related quality of life scores in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Respir Med 2021; 186:106525. [PMID: 34218166 DOI: 10.1016/j.rmed.2021.106525] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/11/2021] [Accepted: 06/26/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Health-related quality of life (HRQoL) is impaired in patients with pulmonary hypertension (PH). The EmPHasis-10 and CAMPHOR questionnaires are developed to evaluate HRQoL specifically in patients with PH. Data on the longitudinal use of both questionnaires are still limited. We evaluated the longitudinal value of both questionnaires and established minimal clinically important differences (MCID). METHODS Sixty-one treatment naïve pulmonary arterial hypertension or chronic thromboembolic patients were prospectively included. Patients were treated according to the current ESC/ERS guidelines. We compared EmPHasis-10 and CAMPHOR scores between baseline, 6 and 12 months of follow-up and evaluated the correlation between these scores and a 5-scale symptom severity score, 5-scale overall health score, NYHA-classification, 6 min walk test distance (6MWD), NT-proBNP and echocardiographic parameters. RESULTS After one year of treatment a significant reduction in EmPHasis-10 score and CAMPHOR QoL and symptoms domain score was observed. Moderate to good correlations were observed between the questionnaires and the overall-health and symptom severity score and 6MWD. No relevant correlations were seen between the questionnaires and NT-pro-BNP and echocardiographic parameters. EmPHasis-10 scores showed strong correlations with all CAMPHOR domains. The MCID for the EmPHasis-10 questionnaire was -8. The MCIDs for the CAMPHOR domains were: activity -3, symptoms -4, QoL -3. CONCLUSION The EmPHasis-10 and CAMPHOR questionnaires are valid tools for the longitudinal measurement of HRQoL in patients with PH. The much shorter EmPHasis-10 correlates well with the CAMPHOR domain scores and with the clinical endpoints and it may be easier to use in daily practice.
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Affiliation(s)
- Paul M Hendriks
- Department of Respiratory Medicine, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands; Department of Cardiology, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Mitch C J van Thor
- Department of Cardiology, St. Antonius Hospital, Koekoekslaan 1, 3435CM Nieuwegein, the Netherlands
| | - Monique Wapenaar
- Department of Respiratory Medicine, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Prewesh Chandoesing
- Department of Respiratory Medicine, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Leon M van den Toorn
- Department of Respiratory Medicine, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Annemien E van den Bosch
- Department of Cardiology, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Marco C Post
- Department of Cardiology, St. Antonius Hospital, Koekoekslaan 1, 3435CM Nieuwegein, the Netherlands; Department of Cardiology, Utrecht University Medical Center, Heidelberglaan 100, 3584CX Utrecht, the Netherlands
| | - Karin A Boomars
- Department of Respiratory Medicine, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
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Alhajj MN, Halboub E, Amran AG, Alkheraif AA, Al-Sanabani FA, Al-Makramani BM, Al-Basmi AA, Al-Ghabri FA. Link between perceived oral and general health status among Yemeni adult dental patients. BMC Oral Health 2019; 19:93. [PMID: 31138198 PMCID: PMC6540451 DOI: 10.1186/s12903-019-0793-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/20/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Self-perceived health is an essential measure of health status and even a paramount predictor of mortality. So long as it is said that oral health (OH) and general health (GH) are mirrors to each other. This study sought to determine how Yemeni adults rate their OH and GH, whether such a self-rating influenced by some potential risk factors, and whether both ratings (OH and GH) are correlated. METHODS A sample of 587 Yemeni dental patients aged 20 years and over were consecutively recruited. A structured interview form was used covering the following variables: age, gender, marital status, educational level, presence of dental prosthesis (DP), smoking and Qat chewing habits as independent variables, along with questions on "perceived oral health (POH)" and "perceived general health (PGH)" as dependent variables. The bivariate and multiple ordinal regression analyses were applied at P-value < 0.05. RESULTS Most of participants were women (73.6%), and married (71.4%), and more than half of them were young adults (58.2%), with high educational levels (53.3%), and not having DP. Only 310 participants responded to the questions on smoking and Qat chewing habits. Of these, 88.5% were non-smokers and 62.1% were Qat non-chewers. Up to 50% of the participants reported their POH as poor or fair, while lower proportions of participants (17%) reported their PGH as such. Younger age (compared to elders), high education levels (compared to primary education) and being single (compared to married) significantly revealed better levels of POH, while high education levels and being females significantly revealed better levels of PGH. Smoking and Qat chewing habits were found to have no effect on the perception of POH or PGH. POH and PGH were found to be significantly correlated (r = 0.486; P < 0.001). CONCLUSION Higher levels of oral health problems can be anticipated among patients who perceive poor general health, and vice versa. The age, marital status and education were independent determinants of POH, while the gender and education were independent determinants of PGH.
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Affiliation(s)
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Abdullah G Amran
- Department of Periodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | - Abdulaziz A Alkheraif
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Fuad A Al-Sanabani
- Department of Prosthetic Dental Science, College of Dentistry, Jazan university, Jazan, Kingdom of Saudi Arabia
| | - Bandar M Al-Makramani
- Department of Prosthetic Dental Science, College of Dentistry, Jazan university, Jazan, Kingdom of Saudi Arabia
| | | | - Fawaz A Al-Ghabri
- Department of Periodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen
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Choi YJ, Kim HY. Analyzing Changes and Determinants of Self-rated Health during Adolescence: A Latent Growth Analysis. CHILD HEALTH NURSING RESEARCH 2018. [DOI: 10.4094/chnr.2018.24.4.496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Steel KC, Fernandez-Esquer ME, Atkinson JS, Taylor WC. Exploring relationships among social integration, social isolation, self-rated health, and demographics among Latino day laborers. ETHNICITY & HEALTH 2018; 23:425-441. [PMID: 28100070 DOI: 10.1080/13557858.2017.1280130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Research indicates social integration and social isolation are related to health, and Latino day laborers (LDLs) tend to be socially isolated and, thus, at high risk for adverse health consequences. relationships among social isolation, social integration, self-rated health (SRH), and demographics were examined in a sample of LDLs to contribute to the literature on social networks and health in this and other migrant populations. DESIGN We analyzed data from 324 LDLs who participated in Proyecto SHILOS (Salud del Hombre Inmigrante Latino), a Houston-based survey of Latino immigrant men's health. Based on the literature, we hypothesized SRH would be (1) positively associated with social integration and (2) negatively associated with social isolation. All proposed measures were first entered into a correlation matrix to identify significant bivariate relationships (p ≤ .05, two-tailed). Associations between variables that were directly correlated with SRH and variables that were, in turn, proximally associated with these variables were then used to develop a structural equation path model of SRH. Individual paths in the model were measured for significance, and goodness of fit was assessed by the model chi-square, the Comparative Fit Index, and the Root Mean Square Error of Approximation. RESULTS Inconsistent with the first hypothesis, SRH was negatively associated with social integration, as measured by the number of trusted friends. Consistent with the second hypothesis, SRH was negatively associated with social isolation, as measured by needing someone to talk to. More frequent contact with family was also negatively associated with social isolation. DISCUSSION Our findings suggest social integration may not always protect and promote health. Therefore, assessing the quality of LDLs' different relationships, not just the quantity, is vital. Future studies should further analyze the effects that social resources have on perceptions of social isolation and health in LDLs and other migrant populations.
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Affiliation(s)
- Kenneth C Steel
- a Maricopa County Department of Public Health , Office of Public Health Policy , Phoenix , AZ , USA
| | - Maria Eugenia Fernandez-Esquer
- b Department of Health Promotion and Behavioral Sciences , Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, School of Public Health , Houston , TX , USA
| | - John S Atkinson
- b Department of Health Promotion and Behavioral Sciences , Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, School of Public Health , Houston , TX , USA
| | - Wendell C Taylor
- b Department of Health Promotion and Behavioral Sciences , Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, School of Public Health , Houston , TX , USA
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Abstract
The purpose of this study is to develop and empirically evaluate a latent variable model that examines the relationships among role-specific control, personal meaning, and health in late life. It is hypothesized that older adults with high levels of role- specific control are likely to develop a deep sense of personal meaning. This conceptual scheme further specifies that elderly people who derive a sense of meaning will, in turn, enjoy better health than older adults who are unable to find meaning in life. Data from a nationwide survey of older people provide support for this theoretical rationale.
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Feng Q, Zhu H, Zhen Z, Gu D. Self-Rated Health, Interviewer-Rated Health, and Their Predictive Powers on Mortality in Old Age. J Gerontol B Psychol Sci Soc Sci 2016; 71:538-50. [PMID: 25617400 PMCID: PMC6366535 DOI: 10.1093/geronb/gbu186] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 12/08/2014] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study examines the potential use of interviewer-rated health (IRH) as a complementary measure of self-rated health (SRH) through a systematic comparison of their components and mortality-predictive powers in the Chinese elderly population. METHODS This study used a nationwide dataset with more than 12,000 adults aged 65 or older drawn from the 2005 and 2008 waves of the Chinese Longitudinal Health Longevity Survey (CLHLS). RESULTS Disability, cognitive function, chronic disease conditions, psychological well-being, and health behaviors influenced both the SRH and IRH of Chinese older adults; these factors, especially disabilities, explained a large portion of the association between SRH and mortality. However, the impact of these factors on the association between IRH and mortality was limited. Furthermore, when both SRH and IRH were included in the analytical models, the association between SRH and mortality disappeared, while the association between IRH and mortality still persisted. DISCUSSION Although there is some difference between IRH and SRH, IRH captures similar health information as SRH and is strongly predictive of mortality independent of SRH; thus, IRH could be a good supplementary measurement for well-adopted SRH.
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Affiliation(s)
- Qiushi Feng
- Department of Sociology, National University of Singapore, Singapore
| | - Haiyan Zhu
- Department of Sociology, Virginia Polytechnic Institute and State University, Blacksburg
| | - Zhihong Zhen
- Department of Sociology, Shanghai University, Shanghai, China
| | - Danan Gu
- United Nations Population Division, New York, New York. :
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Acculturation and Self-Rated Mental Health Among Latino and Asian Immigrants in the United States: A Latent Class Analysis. J Immigr Minor Health 2015; 18:836-849. [DOI: 10.1007/s10903-015-0258-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Pollard B, Johnston M, Dixon D. Exploring differential item functioning in the SF-36 by demographic, clinical, psychological and social factors in an osteoarthritis population. BMC Musculoskelet Disord 2013; 14:346. [PMID: 24330385 PMCID: PMC4029744 DOI: 10.1186/1471-2474-14-346] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 12/07/2013] [Indexed: 11/29/2022] Open
Abstract
Background The SF-36 is a very commonly used generic measure of health outcome in osteoarthritis (OA). An important, but frequently overlooked, aspect of validating health outcome measures is to establish if items work in the same way across subgroup of a population. That is, if respondents have the same ‘true’ level of outcome, does the item give the same score in different subgroups or is it biased towards one subgroup or another. Differential item functioning (DIF) can identify items that may be biased for one group or another and has been applied to measuring patient reported outcomes. Items may show DIF for different conditions and between cultures, however the SF-36 has not been specifically examined in an osteoarthritis population nor in a UK population. Hence, the aim of the study was to apply the DIF method to the SF-36 for a UK OA population. Methods The sample comprised a community sample of 763 people with OA who participated in the Somerset and Avon Survey of Health. The SF-36 was explored for DIF with respect to demographic, social, clinical and psychological factors. Well developed ordinal regression models were used to identify DIF items. Results DIF items were found by age (6 items), employment status (6 items), social class (2 items), mood (2 items), hip v knee (2 items), social deprivation (1 item) and body mass index (1 item). Although the impact of the DIF items rarely had a significant effect on the conclusions of group comparisons, in most cases there was a significant change in effect size. Conclusions Overall, the SF-36 performed well with only a small number of DIF items identified, a reassuring finding in view of the frequent use of the SF-36 in OA. Nevertheless, where DIF items were identified it would be advisable to analyse data taking account of DIF items, especially when age effects are the focus of interest.
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Affiliation(s)
- Beth Pollard
- Aberdeen Health Psychology Group, University of Aberdeen, 2nd Floor, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, UK.
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Lorenzo T, Millán-Calenti JC, Lorenzo-López L, Sánchez A, Maseda A. [Predictors of poor self-rated health in an elderly population]. Rev Esp Geriatr Gerontol 2013; 48:272-275. [PMID: 24042042 DOI: 10.1016/j.regg.2013.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 02/26/2013] [Accepted: 04/15/2013] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Self-Rated Health is part of the comprehensive concept of Quality of Life and is a valid measurement of health status. The main objective of this study was to test the predictive value of some different variables on the poor Self-Rated Health among elders. MATERIAL AND METHODS We performed a cross-sectional study on a sample consisting of 140 participants. MEASUREMENTS age, gender, level of education, environment, cognitive status, physical impairment, diseases, health perception and social support. The influence of the studied variables on the poor Self-Rated Health was performed with a logistic regression analysis and a ROC curve to establish the cut-off values for these variables with the best sensitivity and specificity to predict the poor Self-Rated Health. RESULTS A poor Self-Rated Health was significantly associated with age, comorbidity, and the perception of poor functional social support, whereas no association was found with gender, environment and educational level. CONCLUSIONS Old age, the number of diagnosed diseases, and functional social support are Self-Rated Health risk factors, while the characteristics and repercussions of the diseases should not be considered.
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Affiliation(s)
- Trinidad Lorenzo
- Grupo de Investigación en Gerontología, Departamento de Medicina, Facultad de Ciencias de la Salud, Universidad de A Coruña, A Coruña, España
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Pollard B, Dixon D, Johnston M. Does the impact of osteoarthritis vary by age, gender and social deprivation? A community study using the International Classification of Functioning, Disability and Health. Disabil Rehabil 2013; 36:1445-51. [PMID: 24164585 PMCID: PMC4196505 DOI: 10.3109/09638288.2013.847123] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 09/10/2013] [Accepted: 09/17/2013] [Indexed: 11/14/2022]
Abstract
UNLABELLED Abstract Purpose: The aim of the study was to explore if the impact of osteoarthritis varies with respect to age, gender and social deprivation. Impact was defined as impairment, activity limitations and participation restriction (International Classification of Functioning, Disability and Health (ICF)). Investigating the functioning of the ICF model for subgroups is important both practically and theoretically. METHOD The sample comprised a community sample of 763 people diagnosed with osteoarthritis. Uncontaminated measures of the ICF constructs were developed using discriminant content validity from a pool of 134 items, including the WOMAC and SF-36. Multigroup Structural Equation Modelling was used to explore if the same pathways exist for subgroups of gender, age and social deprivation. RESULTS Different significant paths were found for gender and social deprivation: impairment did not predict participation restriction for women and those most deprived, whereas these paths were significant for men and those less deprived. No difference in the paths was found for age. CONCLUSIONS The impact of osteoarthritis appears to vary with respect to gender and social deprivation but not age. This suggests both that osteoarthritis per se does not adequately explain the health outcomes observed and that different clinical approaches may be appropriate for people of different gender and levels of deprivation. Implications of Rehabilitation The ICF model appears to vary with respect to gender and social deprivation for people with osteoarthritis. The ICF model did not appear to vary with respect to age for people with osteoarthritis. Different treatments and interventions for osteoarthritis may need to be targeted for specific gender and social deprivation groups.
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Affiliation(s)
- Beth Pollard
- Aberdeen Health Psychology Group, University of AberdeenAberdeenUK
| | - Diane Dixon
- School of Psychological Sciences and Health, University of StrathclydeGlasgowUK
| | - Marie Johnston
- Aberdeen Health Psychology Group, University of AberdeenAberdeenUK
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Salomon JA, Nordhagen S, Oza S, Murray CJL. Are Americans feeling less healthy? The puzzle of trends in self-rated health. Am J Epidemiol 2009; 170:343-51. [PMID: 19564169 PMCID: PMC2714952 DOI: 10.1093/aje/kwp144] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Accepted: 05/06/2009] [Indexed: 01/12/2023] Open
Abstract
Although self-rated health is proposed for use in public health monitoring, previous reports on US levels and trends in self-rated health have shown ambiguous results. This study presents a comprehensive comparative analysis of responses to a common self-rated health question in 4 national surveys from 1971 to 2007: the National Health and Nutrition Examination Survey, Behavioral Risk Factor Surveillance System, National Health Interview Survey, and Current Population Survey. In addition to variation in the levels of self-rated health across surveys, striking discrepancies in time trends were observed. Whereas data from the Behavioral Risk Factor Surveillance System demonstrate that Americans were increasingly likely to report "fair" or "poor" health over the last decade, those from the Current Population Survey indicate the opposite trend. Subgroup analyses revealed that the greatest inconsistencies were among young respondents, Hispanics, and those without a high school education. Trends in "fair" or "poor" ratings were more inconsistent than trends in "excellent" ratings. The observed discrepancies elude simple explanations but suggest that self-rated health may be unsuitable for monitoring changes in population health over time. Analyses of socioeconomic disparities that use self-rated health may be particularly vulnerable to comparability problems, as inconsistencies are most pronounced among the lowest education group. More work is urgently needed on robust and comparable approaches to tracking population health.
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Affiliation(s)
- Joshua A Salomon
- Harvard University Initiative for Global Health, Cambridge, MA 02138, USA.
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Taga KA, Friedman HS, Martin LR. Early personality traits as predictors of mortality risk following conjugal bereavement. J Pers 2009; 77:669-90. [PMID: 20078734 DOI: 10.1111/j.1467-6494.2009.00561.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study explored pre-bereavement personality traits and gender as predictors of post-widowhood mortality risk, using newly derived life span data for participants originally recruited for Lewis Terman's classic study of the gifted. Personality traits measured in 1940 were used to predict mortality risk from 1940 through 2004 for married participants who were either widowed between 1940 and 1986 or who remained married. Results indicated that widowhood predicted a decrease in mortality risk for these (intelligent) individuals (relative hazard [rh]=0.68, N=843, p<.001) and neuroticism significantly moderated this effect. Specifically, neuroticism in young adulthood was significantly associated with decreased mortality risk among men who were later widowed (rh=0.50, N=66, p<.02) but not among women or consistently married men. Conclusions reveal the importance of personality-situation interactions and the adoption of a long-term perspective.
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Affiliation(s)
- Keiko A Taga
- University of California, Riverside, CA 92521, USA
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Ahmed S, Ernst P, Tamblyn R, Colman N. Evaluating asthma control: a comparison of measures using an item response theory approach. J Asthma 2007; 44:547-54. [PMID: 17885858 DOI: 10.1080/02770900701537024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Self-reported symptoms, FEV(1), and clinician judgment are all used to evaluate asthma control. The relative utility of each measure of control cannot be easily assessed. Item response theory (IRT) approaches allow for the direct comparison of the utility of different types of measures used to assess control. The objective of this study was to evaluate the validity and reliability of evaluating asthma control using symptom, clinical, and physiologic measures by applying an IRT approach. Subjects receiving care at an asthma clinic were evaluated on measures of asthma control. Based on 114 evaluations, IRT parameters were estimated to evaluate whether measures assessed a single underlying construct, the hierarchical relationship between the measures and the level of control each measure assessed, whether measures targeted all levels of asthma control, and whether the scoring categories distinguished between different levels of control. Infit statistics (0.74-1.5) for individual items showed that all items fit the underlying concept of asthma control. The reproducibility of the hierarchal scale was high (0.9). The results also demonstrated that items differentiated two strata (high, low) of control. The gaps in the hierarchal scale showed that for many subjects (37%) there were no items at their level of asthma control. The IRT approach identified gaps in current measurement that need to be addressed to provide more precise evaluations of control required to accurately monitor changes in patient status.
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Affiliation(s)
- Sara Ahmed
- Department of Medicine, McGill University, Montreal, Canada.
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Ruthig JC, Chipperfield JG, Perry RP, Newall NE, Swift A. Comparative risk and perceived control: implications for psychological and physical well-being among older adults. The Journal of Social Psychology 2007; 147:345-69. [PMID: 17955748 DOI: 10.3200/socp.147.4.345-369] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
As older adults become more susceptible to certain health crises, their preoccupation with their risk of suffering such events increases. Understanding the implications of risk perceptions is critical because they may have consequences for psychological and physical well-being in later life. In the present study of older adults living in the community, the authors examined participants' comparative risk estimates (CREs)--their perceptions of their own risk relative to a similar other's risk--of suffering a hip fracture. Using multiple regression analyses, the authors examined the role of CREs on psychological well-being (negative emotions, life satisfaction) and self-rated physical well-being (general physical health, recent physical health). The authors expected perceived control (PC) to moderate the relationship between CREs and well-being. The predicted interaction did occur: Among individuals with high PC, comparative optimism (perceiving a comparatively low risk) was associated with better psychological well-being (fewer negative emotions and greater life satisfaction) and better physical well-being (general and recent physical health) relative to comparative pessimism (perceiving a comparatively high risk). Among individuals with low PC, there were no differences in well-being between comparative optimists and comparative pessimists. These findings suggest that the protective effect of comparative optimism on well-being is limited to older adults who have a strong sense of control.
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Affiliation(s)
- Joelle C Ruthig
- Department of Psychology, University of North Dakota, Grand Forks, ND 58202, USA.
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Metz SM, Wyrwich KW, Babu AN, Kroenke K, Tierney WM, Wolinsky FD. Validity of patient-reported health-related quality of life global ratings of change using structural equation modeling. Qual Life Res 2007; 16:1193-202. [PMID: 17551850 DOI: 10.1007/s11136-007-9225-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2006] [Accepted: 05/10/2007] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patient-perceived global ratings of change are often used as anchors of health-related quality of life (HRQoL) since they are easy for clinicians to interpret and incorporate the patient's perception of change as a means to capture clinical significance. Although this approach may be preferred, the validity of the anchor-based approach is currently under scrutiny. OBJECTIVE To estimate the explained variation in single-item domain-specific global ratings of change (GRCs) that is accounted for by time 1 (T1) and time 2 (T2) domain-specific summary change scores from the Short-Form 36, V2 (SF-36) Health Survey in asthma primary care patients. METHODS The baseline and first follow-up enrollment data to be evaluated in this investigation were part of a larger longitudinal HRQoL study conducted from August 2000-December 2002, in which the 356 asthma patients from Midwestern primary care facilities completed telephone interviews for every two consecutive months for a year on multiple HRQoL measures, including the SF-36 and domain-specific GRCs. A structural equation modeling technique was employed to ascertain the explained variability in patient-reported GRCs for each SF-36 domain that is accounted for by the summary change scores at the two time-points for four SF-36 domains (bodily pain, general health perception, mental health, and physical functioning). The model was estimated by the maximum likelihood method with the Satorra-Bentler correction for ordinal variables using equal threshold asymptotic covariance matrices. RESULTS Multicollinearity between T1 and T2 latent constructs clouded interpretation of the standardized structural coefficients leading to GRCs. Correlations, however, revealed that all four domain-specific GRCs were more strongly related to T2- than T1-domain summary scores, indicating that patients were not equally relying on T1 and T2 to generate the GRCs. Furthermore, T1-domain summary scores were not of equal magnitude and opposite sign as compared to T2 scores. CONCLUSIONS In this study, there is insufficient evidence to establish SF-36 domain-specific GRC validity in asthma primary care patients. Therefore, it is recommended to reassess validity before using domain-specific SF-36 GRCs to classify clinically important change over time.
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Affiliation(s)
- Stacie M Metz
- Department of Health, West Chester University, West Chester, PA 19383, USA.
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Ruthig JC, Chipperfield JG, Newall NE, Perry RP, Hall NC. Detrimental effects of falling on health and well-being in later life: the mediating roles of perceived control and optimism. J Health Psychol 2007; 12:231-48. [PMID: 17284488 DOI: 10.1177/1359105307074250] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Falling is common among older adults, often resulting in decreased functional ability and quality of life. To understand processes underlying the fall/health and well-being relationship, it is important to identify psychosocial mediators. The current study examined the impact of falling on subsequent physical health, negative emotions and physical activity among 231 young-old (<85) and old-old (85+) community-dwelling adults, and the mediating effects of global perceived control (PC) and optimism. Regression results indicated that falling predicted poorer physical health, greater negative emotions and less physical activity among old-old but not young-old adults. Falling negatively predicted PC and optimism, which mediated the effects of falling on health and well-being among the old-old group. Findings have implications for enhancing recovery from falling via bolstering PC and optimism.
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Oxlad M, Wade TD. Application of a chronic illness model as a means of understanding pre-operative psychological adjustment in coronary artery bypass graft patients. Br J Health Psychol 2006; 11:401-19. [PMID: 16870052 DOI: 10.1348/135910705x37289] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To increase understanding of the factors associated with pre-operative psychological adjustment in coronary artery bypass graft (CABG) patients by assessing the utility of a chronic illness model developed by Scharloo, Kaptein, Weinman, Willems, and Rooijmans (2000). DESIGN A cross-sectional design was employed. METHOD Elective CABG patients (N=119) completed self-report measures of illness representation, self-rated health, social support, coping methods, and pre-operative adjustment (depression and post-traumatic stress disorder (PTSD) symptomatology) an average of 30 days prior to surgery. Hierarchical multiple regression was used to assess the mediational relationships proposed by the chronic illness model. RESULTS Five 3-variable mediational chains were assessed. In all instances, the results conformed to the relationships suggested by the chronic illness model where the strength of the relationship between the independent and dependent variables was reduced when the mediator variable was controlled. However, a significant reduction of this relationship was found in three of the five chains examined. The most rigorous support for the model occurred, where increased use of avoidance coping mediated the relationship between poorer self-rated health and increased PTSD symptomatology, and also where increased use of avoidance coping partially mediated the relationship between a more negative illness representation and increased PTSD symptomatology, and poorer self-rated health and increased depression. CONCLUSIONS The chronic illness model of Scharloo and colleagues shows potential in explaining pre-operative adjustment in CABG patients. Longitudinal examination of the model is recommended.
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Affiliation(s)
- Melissa Oxlad
- School of Psychology, Flinders University, South Australia, Australia.
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Perkins AJ, Stump TE, Monahan PO, McHorney CA. Assessment of differential item functioning for demographic comparisons in the MOS SF-36 health survey. Qual Life Res 2006; 15:331-48. [PMID: 16547771 DOI: 10.1007/s11136-005-1551-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2005] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate whether items of the Medical Outcomes Study (MOS) 36-Item Short-Form Health Status Survey (SF-36) exhibited differential item functioning (DIF) with respect to age, education, race, and gender. METHODS The data for this study come from two large national datasets, the MOS and the 1990 National Survey of Functional Health Status (NSFHS). We used logistic regression to identify items exhibiting DIF. RESULTS We found DIF to be most problematic for age comparisons. Items flagged for age DIF were vigorous activities, bend/kneel/stoop, bathing or dressing, limited in kind of work, health in general, get sick easier than others, expect health to get worse, felt calm and peaceful, and all four vitality items. Items flagged for education DIF include vigorous activities, health in general, health is excellent, felt calm and peaceful, and been a happy person. Vigorous activities, walk more than a mile, health in general, and expect health to get worse were identified as DIF when comparing African-Americans with whites. No items were identified for gender DIF. CONCLUSIONS We found several consistent patterns of DIF using two national datasets with different population characteristics. In the current study, the effect of DIF rarely transferred to the scale level. Further research is needed to corroborate these results and determine qualitatively why DIF may occur for these specific items.
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Affiliation(s)
- Anthony J Perkins
- Indiana University Center for Aging Research, 1050 Wishard Blvd, RG6, Indianapolis, IN 46202, USA.
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Franzini L, Caughy M, Spears W, Fernandez Esquer ME. Neighborhood economic conditions, social processes, and self-rated health in low-income neighborhoods in Texas: a multilevel latent variables model. Soc Sci Med 2005; 61:1135-50. [PMID: 15970226 DOI: 10.1016/j.socscimed.2005.02.010] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2004] [Accepted: 02/22/2005] [Indexed: 10/25/2022]
Abstract
This paper develops and tests a comprehensive model to explain the relationships of neighborhood economic indicators to multiple dimensions of neighborhood social and physical organization as well as the pathways through which neighborhood social and physical characteristics influence individual health outcomes. We hypothesized that neighborhood poverty would be associated with lower collective efficacy, lower social capital, higher degrees of social and physical disorder, worse social processes pertaining to children such as trust, and higher degrees of fear of crime and racism. Neighborhood social and physical characteristics were hypothesized to mediate the effect of neighborhood poverty on self-rated health, both directly and indirectly through their influence on neighborhood differences in social support and health behaviors, which in turn affect individual health. The results, based on data from low-income neighborhoods in Texas, USA generally supported the model and indicated that the effect of neighborhood impoverishment on health is mediated by social and physical neighborhood characteristics.
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Affiliation(s)
- Luisa Franzini
- University of Texas, School of Public Health, 1200 Herman Pressler Drive, Houston, TX 77030, USA.
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Franzini L, Fernandez-Esquer ME. Socioeconomic, cultural, and personal influences on health outcomes in low income Mexican-origin individuals in Texas. Soc Sci Med 2004; 59:1629-46. [PMID: 15279921 DOI: 10.1016/j.socscimed.2004.02.014] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Several studies have suggested that the health of Mexican-Americans is better than expected given their low socioeconomic status. The healthy migrant hypothesis and the acculturation hypothesis, stating that the foreign-born and the less acculturated enjoy better health, have been proposed as possible complementary explanations. However, it is not clear which are the socioeconomic, cultural, and personal characteristics that favor good health and that differentiate foreign-born from US-born and unacculturated from acculturated Mexicans. In this paper, we compare, by nativity and acculturation level, the socioeconomic, cultural, and personal characteristics in a sample of low income mostly female Mexican-origin individuals living in Texas and investigate their contribution to differences in self-reported physical health, mental health, and self-rated health (SRH) status. Using a multistage probability sample, we completed 1745 interviews with Mexican-origin individuals. The survey instrument included the SF-12, demographic and socioeconomic information, and questions on social support, religiosity, fear of victimization, trust, perceived racism, and perceived opportunity. Nativity and use of the Spanish language were combined into a nativity/acculturation variable. We estimated multivariate regressions and ordered logit regressions to investigate the association of health outcomes to nativity/acculturation and socioeconomic, cultural, and personal characteristics. Overall, the distribution of strengths (more social support, trust, perceived personal opportunities and less perceived victimization) reflected a nativity-based income gradient and an education gradient reflecting language use. Health outcomes varied by nativity/acculturation after controlling for socioeconomic, cultural, and personal characteristics. Physical health differed by nativity, supporting the healthy migrant hypothesis, while nativity-based differences in mental health were explained by socioeconomic and personal characteristics. SRH varied by language use, suggesting a culturally conditioned response. The socioeconomic, cultural, and personal factors affected health outcomes differently. These findings suggest a complicated interaction between nativity, acculturation, and economic factors in determining social and personal strengths and their influences on health.
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Affiliation(s)
- Luisa Franzini
- UT School of Public Health, University of Texas Health Science Center at Houston, 1200 Herman Pressler Drive, Houston, TX 77030, USA.
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Deeg DJH, Kriegsman DMW. Concepts of self-rated health: specifying the gender difference in mortality risk. THE GERONTOLOGIST 2003; 43:376-86; discussion 372-5. [PMID: 12810902 DOI: 10.1093/geront/43.3.376] [Citation(s) in RCA: 118] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE This study addresses the question of how the relation between self-rated health (SRH) and mortality differs between genders. In addition to the general question, four specific concepts of SRH are distinguished: SRH in comparison with age peers, SRH in comparison with one's own health 10 years ago, and current and future health perceptions. For these concepts, the gender-specific risks of mortality were evaluated for a short and a longer follow-up period. DESIGN AND METHODS Baseline and mortality data from the Longitudinal Aging Study Amsterdam (N = 1917, initial ages 55-85 years) were used. Mortality risks were evaluated in Cox regression models at 3 and 7.5 years of follow-up, both adjusted for age and for sociodemographic characteristics, indicators of functional and mental health, lifestyle, and social involvement. All SRH measures were scaled from 1 (positive) to 5 (negative). RESULTS Baseline correlations between SRH concepts were similar for men and women. After 3 years, 12% of the men and 7% of the women had died; after 7.5 years, these percentages were 27 and 15, respectively. In fully adjusted models, current health perceptions predicted 3-year mortality in men (risk ratio of 1.33). At 7.5 years, mortality in men was predicted by current health perceptions and by SRH compared with age peers (risk ratios of 1.25 and 1.23, respectively). In women, no SRH concept predicted either 3-year or 7.5-year mortality. IMPLICATIONS SRH was a predictor of mortality only in men, not in women. The gender difference showed most clearly at longer follow-up, in the SRH concept "comparison with age peers."
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Affiliation(s)
- Dorly J H Deeg
- Department of Psychiatry, Vrije Universiteit, Amsterdam, The Netherlands.
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Middel B, de Greef M, de Jongste MJL, Crijns HJGM, Stewart R, van den Heuvel WJA. Why don't we ask patients with coronary heart disease directly how much they have changed after treatment? JOURNAL OF CARDIOPULMONARY REHABILITATION 2002; 22:47-52. [PMID: 11839997 DOI: 10.1097/00008483-200201000-00007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Berrie Middel
- Department of Health Sciences, School of Medicine, University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands.
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Svedberg P, Lichtenstein P, Pedersen NL. Age and sex differences in genetic and environmental factors for self-rated health: a twin study. J Gerontol B Psychol Sci Soc Sci 2001; 56:S171-8. [PMID: 11316842 DOI: 10.1093/geronb/56.3.s171] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Self-rated health has been shown to be a predictor for future health status and mortality. The purpose of this study was to investigate age-group and sex differences in genetic and environmental sources of variation for self-rated health. METHODS A sample of twins from the Swedish Twin Registry participated in a computer-assisted telephone interview with assessment of self-rated health. Structural equation model analyses on 1,243 complete twin pairs provided estimates of genetic and environmental components of variance. RESULTS Individual differences primarily reflected individual specific environmental influences at all ages. The increase in total variance across age groups was primarily due to genetic influences in the age groups 45--74 years and greater environmental influences in the oldest age group (>74). No significant sex differences were found in variance components. DISCUSSION Genetic variance in the two middle age groups (45--74) could reflect genetic susceptibility to age-dependent illnesses not yet expressed in the youngest group. The findings suggest that it might be more fruitful to explore the origins of individual differences for self-rated health in the context of an individual's age and birth cohort rather than in the context of sex.
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Affiliation(s)
- P Svedberg
- Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
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