Abstract
BackgroundSelf-rated health status has been shown to be related to physical function. Therefore, changes in functional ability should be associated with changes in general health. However, functional needs may vary greatly between individuals. The purpose of this study was to propose and test a model of association between patient identified functional problems and responses to global measures of health in low back pain patients.MethodsParticipants in a low back pain clinical trial were followed up for 12 months. A series of analyses were undertaken using the Jonckheere-Terpstra test and chi-square for trends to determine the associations between two individualised items related to function, and measures of "overall improvement in condition", "general health status" and performance of "usual activities".ResultsSignificant associations between responses to the five items were found. Performance of usual activities is significantly associated with ratings of general health status (p < 0.001) and overall condition of the back (p < 0.001). The extent to which the patient identified problems influence an individual's perception on multi-task performance is dependent upon the degree of difficulty and level of importance attached to these problems.ConclusionThe relationship between patient identified problems and responses to global measures of health is complex. The explanatory model proposed here may improve our understanding of these interactions.Trial RegistrationISRCTN 32765488
Highlights
Self-rated health status has been shown to be related to physical function
Smith et al [5] explored a structural model of the determinants of health status and quality of life (QoL), suggesting that self-evaluation of these two constructs are "determined jointly by assessments of several domains"
Hypothesis 2 Patients were grouped according to their general health status (Q4) and to change in condition (Q5)
Summary
Self-rated health status has been shown to be related to physical function. changes in functional ability should be associated with changes in general health. Wilson and Cleary [4] described a five level classification scheme for different measures of health outcome, ranging from biological and physical factors, symptoms, functioning, general health perceptions, through to overall quality of life (QoL). They proposed a causal link between the levels, with each becoming "increasingly (page number not for citation purposes). Smith et al [5] explored a structural model of the determinants of health status and QoL, suggesting that self-evaluation of these two constructs are "determined jointly by assessments of several domains" They hypothesised a cognitive process that involved: 1) identifying the relevant domains comprising the construct
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