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Buchholz I, Feng YS, Buchholz M, Kazis LE, Kohlmann T. Translation and adaptation of the German version of the Veterans Rand-36/12 Item Health Survey. Health Qual Life Outcomes 2021; 19:137. [PMID: 33947411 PMCID: PMC8097879 DOI: 10.1186/s12955-021-01722-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The translated and culturally adapted German version of the Veterans Rand 36 Items Health Survey (VR-36), and its short form, the VR-12 counterpart, were validated in a German sample of orthopedic (n = 399) and psychosomatic (n = 292) inpatient rehabilitation patients. METHODS The instruments were analyzed regarding their acceptance, distributional properties, validity, responsiveness and ability to discriminate between groups by age, sex and clinically specific groups. Eligible study participants completed the VR-36 (n = 169) and the VR-12 (n = 177). They also completed validated patient-reported outcome measures (PROs) including the Euroqol-5 Dimensions 5 Level (EQ-5D-5L); Depression, Anxiety and Stress Scale (DASS); Hannover Functional Abilities Questionnaire (HFAQ); and CDC Healthy Days. The VR-12 and the VR-36 were compared to the reference instruments MOS Short Form-12 Items Health Survey (SF-12) version 1.0 and MOS Short Form-36 Items Health Survey (SF-36) version 1.0, using percent of completed items, distributional properties, correlation patterns, distribution measures of known groups validity, and effect size measures. RESULTS Item non-response varied between 1.8%/1.1% (SFVR-36/RESF-36) and 6.5%/8.6% (GHVR-36/GHSF-36). PCS was normally distributed (Kolmogorov-Smirnov tests: p > 0.05) with means, standard deviations and ranges very similar between SF-36 (37.5 ± 11.7 [13.8-66.1]) and VR-36 (38.5 ± 10.1 [11.7-67.8]), SF-12 (36.9 ± 10.9 [15.5-61.6]) and VR-12 (36.2 ± 11.5 [12.7-59.3]). MCS was not normally distributed with slightly differing means and ranges between the instruments (MCSVR-36: 36.2 ± 14.2 [12.9-66.6], MCSSF-36: 39.0 ± 15.6 [2.0-73.2], MCSVR-12: 37.2 ± 13.8 [8.4-70.2], MCSSF-12: 39.0 ± 12.3 [17.6-65.4]). Construct validity was established by comparing correlation patterns of the MCSVR and PCSVR with measures of physical and mental health. For both PCSVR and MCSVR there were moderate (≥ 0.3) to high (≥ 0.5) correlations with convergent (PCSVR: 0.55-0.76, MCSVR: 0.60-0.78) and small correlations (< 0.1) with divergent (PCSVR: < 0.12, MCSVR: < 0.16) self-report measures. Known-groups validity was demonstrated for both VR-12 and VR-36 (MCS and PCS) via comparisons of distribution parameters with significant higher mean PCS and MCS scores in both VR instruments found in younger patients with fewer sick days in the last year and a shorter duration of rehabilitation. CONCLUSIONS The psychometric analysis confirmed that the German VR is a valid and reliable instrument for use in orthopedic and psychosomatic rehabilitation. Yet further research is needed to evaluate its usefulness in other populations.
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Affiliation(s)
- Ines Buchholz
- University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475 Greifswald, Germany
| | - You-Shan Feng
- University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475 Greifswald, Germany
- Institute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Tübingen, Germany
| | - Maresa Buchholz
- University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475 Greifswald, Germany
| | - Lewis E. Kazis
- Department of Health Law, Policy and Management, School of Public Health, Boston University, 715 Albany St Talbot Building, Boston, MA 02118 USA
| | - Thomas Kohlmann
- University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475 Greifswald, Germany
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Danan ER, Krebs EE, Ensrud K, Koeller E, MacDonald R, Velasquez T, Greer N, Wilt TJ. An Evidence Map of the Women Veterans' Health Research Literature (2008-2015). J Gen Intern Med 2017; 32:1359-1376. [PMID: 28913683 PMCID: PMC5698220 DOI: 10.1007/s11606-017-4152-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 06/08/2017] [Accepted: 07/27/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Women comprise a growing proportion of Veterans seeking care at Veterans Affairs (VA) healthcare facilities. VA initiatives have accelerated changes in services for female Veterans, yet the corresponding literature has not been systematically reviewed since 2008. In 2015, VA Women's Health Services and the VA Women's Health Research Network requested an updated literature review to facilitate policy and research planning. METHODS The Minneapolis VA Evidence-based Synthesis Program performed a systematic search of research related to female Veterans' health published from 2008 through 2015. We extracted study characteristics including healthcare topic, design, sample size and proportion female, research setting, and funding source. We created an evidence map by organizing and presenting results within and across healthcare topics, and describing patterns, strengths, and gaps. RESULTS We identified 2276 abstracts and assessed each for relevance. We excluded 1092 abstracts and reviewed 1184 full-text articles; 750 were excluded. Of 440 included articles, 208 (47%) were related to mental health, particularly post-traumatic stress disorder (71 articles), military sexual trauma (37 articles), and substance abuse (20 articles). The number of articles addressing VA priority topic areas increased over time, including reproductive health, healthcare organization and delivery, access and utilization, and post-deployment health. Three or fewer articles addressed each of the common chronic diseases: diabetes, hypertension, depression, or anxiety. Nearly 400 articles (90%) used an observational design. Eight articles (2%) described randomized trials. CONCLUSIONS Our evidence map summarizes patterns, progress, and growth in the female Veterans' health and healthcare literature. Observational studies in mental health make up the majority of research. A focus on primary care delivery over clinical topics in primary care and a lack of sex-specific results for studies that include men and women have contributed to research gaps in addressing common chronic diseases. Interventional research using randomized trials is needed.
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Affiliation(s)
- Elisheva R Danan
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA. .,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Erin E Krebs
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA.,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Kristine Ensrud
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA.,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Eva Koeller
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA
| | - Roderick MacDonald
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA
| | - Tina Velasquez
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA
| | - Nancy Greer
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA
| | - Timothy J Wilt
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA.,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
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Gilson KM, Bryant C, Judd F. Understanding older problem drinkers: The role of drinking to cope. Addict Behav 2017; 64:101-106. [PMID: 27597130 DOI: 10.1016/j.addbeh.2016.08.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 08/24/2016] [Accepted: 08/24/2016] [Indexed: 12/13/2022]
Abstract
INTRODUCTION AND AIMS Despite a common perception that older adults drink less than younger adults, drinking frequency increases with age. The aim of this study was to examine the types of coping motives associated with problem drinkers in addition to the types of specific drinking problems most commonly endorsed by older drinkers. The study also sought to investigate the role of individual drinking to cope motives in problem drinking. METHOD Participants were 288 community dwelling older adults aged who consumed alcohol, and were drawn from a larger study of health and aging in rural areas of Australia. Participants completed a postal questionnaire comprising the Drinking Problems Index, Drinking Motives Questionnaire, The AUDIT-C, and the Centre for Epidemiological Studies Depression Scale. RESULTS Overall, 22.2% of the sample were problem drinkers, with a higher prevalence for men (30.4%) than women (15.6%). Problem drinkers were significantly more likely to consume alcohol according to several indices of risky drinking. The most common drinking problems experienced were becoming intoxicated, spending too much money on drinking, feeling confused after drinking, and skipping meals. Drinking to cope motives to relax, to manage physical symptoms and to feel more self-confident increased the odds of problem drinking. CONCLUSIONS Problem drinking is highly prevalent in older adults. Given the potential adverse consequences of problem drinking on the health of older adults it is imperative that health professionals pay attention to drinking behaviours as part of routine practice.
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Affiliation(s)
- Kim-Michelle Gilson
- Centre for Health Equity, Melbourne, School of Population and Global Health, Victoria, 3010, Australia
| | - Christina Bryant
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia; Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria, Australia.
| | - Fiona Judd
- Department of Psychiatry, University of Melbourne, Victoria, Australia
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Hoggatt KJ, Jamison AL, Lehavot K, Cucciare MA, Timko C, Simpson TL. Alcohol and drug misuse, abuse, and dependence in women veterans. Epidemiol Rev 2015; 37:23-37. [PMID: 25608962 DOI: 10.1093/epirev/mxu010] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
We conducted a systematic literature review on substance misuse, abuse, and dependence in women veterans, including National Guard/reserve members. We identified 837 articles published between 1980 and 2013. Of 56 included studies, 32 reported rates of alcohol misuse, binge drinking, or other unhealthy alcohol use not meeting diagnostic criteria for abuse or dependence, and 33 reported rates of drug misuse or diagnosed alcohol or drug use disorders. Rates ranged from 4% to 37% for alcohol misuse and from 7% to 25% for binge drinking; among Veterans Health Administration (VA) health-care system outpatients, rates ranged from 3% to 16% for substance use disorder. Studies comparing women veterans and civilians reported no clear differences in binge or heavy drinking. Substance misuse rates were generally lower among women veterans than men veterans. Substance misuse was associated with higher rates of trauma, psychiatric and medical conditions, and increased mortality and suicide rates. Most studies included only VA patients, and many used only VA medical record data; therefore, the reported substance misuse rates likely do not reflect true prevalence. Rates also varied by assessment method, source of data, and the subgroups studied. Further efforts to develop epidemiologically valid prevalence estimates are needed to capture the true health burden of substance misuse in women veterans, particularly those not using VA care.
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Hoggatt KJ, Williams EC, Der-Martirosian C, Yano EM, Washington DL. National prevalence and correlates of alcohol misuse in women veterans. J Subst Abuse Treat 2014; 52:10-6. [PMID: 25661517 DOI: 10.1016/j.jsat.2014.12.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 12/05/2014] [Accepted: 12/14/2014] [Indexed: 11/28/2022]
Abstract
Our goal was to estimate the prevalence and correlates of alcohol misuse in women veterans and to assess the associations between alcohol misuse and mental health (MH) care utilization in a group comprising both Veterans Health Administration (VA) healthcare system users and non-users. We assessed alcohol misuse using survey-based AUDIT-C scores. The prevalence of alcohol misuse was 27% in VA users and 32% in non-users. Prevalence rates were higher for VA users who were younger, served in OEF/OIF, or had combat exposure and for VA non-users who screened positive for posttraumatic stress disorder or sexual assault in the military. In contrast to VA users, VA non-users with alcohol misuse had a low prevalence of past-year MH care despite having indications of MH care need. Our results on alcohol misuse prevalence, its correlates, and its association with MH care may aid program planning and resource allocation in VA and non-VA settings.
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Affiliation(s)
- Katherine J Hoggatt
- VA Greater Los Angeles Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), Sepulveda, CA, USA; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
| | - Emily C Williams
- Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, HSR&D, VA Puget Sound, Seattle, WA, USA; Department of Health Services, University of Washington, Seattle, WA, USA
| | | | - Elizabeth M Yano
- VA Greater Los Angeles Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), Sepulveda, CA, USA; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Donna L Washington
- VA Greater Los Angeles Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), Sepulveda, CA, USA; Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
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