РАЗРАБОТКА ПРОСТОГО ОПРОСНИКА ДЛЯ РАННЕГО ВЫЯВЛЕНИЯ ДОНОЗОЛОГИЧЕСКИХ ФУНКЦИОНАЛЬНЫХ НАРУШЕНИЙ ЗДОРОВЬЯ

Abstract

Introduction. Health systems and health status in developed economies demonstrate failure of chronic disease prevention, in part due to too late health interventions postponed until the patient has a medical diagnosis. Healthcare system can benefit from P4 medicine, which needs special questionnaires to collect person-centered data. The available questionnaires do not match the practical tasks of the P4-medicine paradigm. Aim. The aim is to develop a simple questionnaire for mass early screening of health status in the adults within the P4-medicine paradigm. Material and Methods. We transformed and adapted the Suboptimal health status questionnaire (SHSQ-25) to meet the requirements of mass screening in the P4 medicine paradigm. Information value, sensitivity and specificity of the new questionnaire were tested in several focus groups of respondents through matching with detailed clinical interview aimed at prevention of chronic health conditions. Results and discussion. The Functional impairment questionnaire “FIQ-15” includes 15 questions covering the most common warning symptoms seen in respondents of various health states. Two alternative scales, 5-point and 3-point, are proposed to rate the symptoms. Based on the rate of functional impairments, their impact on everyday functioning, and the need in detailed examination and/or help, respondents are divided into 4 risk groups. More than 400 respondents filled the FIQ-15 over 2 years, 300 of them underwent detailed clinical interviews for questionnaire development and validation. The system of data acquisition and interpretation based on FIQ-15 allows automated mass screening for early functional impairments, fast primary sorting into risk groups (‘traffic light’ system), semi-quantify the severity of functional impairments and their impact on life quality, propose effective routing of patients to further examination and diagnosing, and involve the respondent in active management of one’s health. Conclusion. The proposed FIQ-15 questionnaire can become a simple, affordable and informative tool in early mass screening for functional impairments in the P4-medicine paradigm, in sorting the respondents based on their need in detailed examination, and in real life decision support, including the respondent’s participatory decisions regarding one’s health management.