General Health Rating Index Research Articles

Role of Humor and Emotion Regulation towards Health of the Elderly

The population of the elderly is growing rapidly across the globe and is emerging as a serious area of concern for the government and policy makers. U.S. Census Bureau reported that India's older population is projected to quadruple by mid century, while that of the world is expected to triple. Due to increasing longevity and changing lifestyle factors, health of the elderly has become a matter of concern for every nation. Research suggests that the aged population suffer from a range of problems, among which health care demands are at the top. As a result, there is increasing focus on the psychological variables, viz., humor and emotion regulation that can promote health (mental as well as physical). The aim of the present study was to study the contribution of humor and emotion regulation towards health of the elderly. The sample comprised 150 elderly people (75 males and 75 females) in the age range of 55-70 years who had retired from government service and were residing with their families. They were administered Humor Styles Questionnaire, Emotion Regulation Questionnaire, Mental Health Inventory-18 and General Health Rating Index. Inter-correlations were computed and general regression model was applied. The results revealed that humor solely or alongwith reappraisal contributed towards health of the elderly. Both, humor and reappraisal were significantly contributing towards mental health outcomes of the elderly males, whereas, in case of their physical health, affiliative and self-enhancing humor were found to do so. Affiliative humor was found to be a positive predictor of physical health of elderly females, whereas, in case of their mental health, none of these variables were found to be potential predictors. It was further found that health was positively related with affiliative and self-enhancing humor, though its links with aggressive and self-defeating humor were relatively missing. Reappraisal was found to be with affiliative and self-enhancing humor particularly. The links of suppression with humour/health were, by and large, missing foerboth, elderly males as well as females. It was thought-provoking to find a positive relation between reappraisal and suppression.

The life situations of patients with primary antibody deficiency untreated or treated with subcutaneous gammaglobulin infusions.

The life situations of 25 patients with hypogammaglobulinaemia were studied before and after the initiation of subcutaneous replacement therapy by using medical records, data registers and questionnaires (a study and a disease-specific questionnaire, the Sickness Impact Profile and the General Health Rating Index). Before treatment, the patients perceived more dysfunctions with regard to ambulation, mobility, emotional behaviour, social interaction, sleep and rest, household management, work and recreation or pastime activities compared with a Swedish reference group (P = 0.0001). A significant increase in the perceived frequency of infections was also seen in untreated patients compared with a group of healthy individuals (P = 0.0001). After 18 months of weekly subcutaneous infusions of an intramuscular gammaglobulin preparation (100 mg/kg), the patients reported a significantly increased, health-related function and improved self-rated health. A significantly higher pre-infusion IgG level was also found.

Reliability and validity of functional health status and health-related quality of life questionnaires in children with recurrent acute otitis media

In this study the reliability and validity of generic and disease-specific questionnaires has been assessed focusing on responsiveness. This is part of a study on the effects of recurrent acute otitis media (rAOM) on functional health status (FHS) and health-related quality of life (HRQoL) in 383 children with rAOM participating in a randomized clinical trial. The following generic questionnaires were studied: 1. RAND general health rating index, 2. Functional Status Questionnaire (FSQ Generic and FSQ Specific), 3. TNO-AZL Infant Quality of Life (TAIQOL), and the following disease-specific questionnaires: 1. Otitis Media-6 (OM-6), 2. Numerical rating scales (NRS) for child and caregiver (NRS Child and NRS Caregiver), and 3. a new Family Functioning Questionnaire (FFQ). Reliability was good to excellent (Cronbach’s α range 0.80–0.90, intraclass correlation coefficient range 0.76–0.93). Moderate to strong correlations were found between the questionnaires as well as between questionnaires and relevant clinical indicators (r = 0.29–0.49), demonstrating construct validity. Discriminant validity for children with few versus frequent episodes of acute otitis media per year was good for most questionnaires (P < 0.004) but poor for the otitis media-related subscales of the TAIQOL (P = 0.10–0.97) and both NRS (P = 0.22 and 0.48). Except for the TAIQOL subscales, change scores were significant (P < 0.003) for generic and disease-specific questionnaires. Effect sizes were somewhat higher for disease-specific compared to generic questionnaires (0.55–0.95 versus 0.32–0.60) except for the TAIQOL subscales, which showed very poor sensitivity to change. Anchor-based methods resulted in a somewhat larger range of estimates of MCID than distribution-based methods. Combining distribution-based and anchor-based methods resulted in similar ranges for the minimally clinical important differences for generic and disease-specific questionnaires: 2–15 points on a 0–100 scale. Apart from the generic TAIQOL subscales, both generic and disease-specific questionnaires used in this study showed good psychometric qualities and responsiveness for use in clinical studies on children with rAOM.

Melatonin Improves Health Status and Sleep in Children With Idiopathic Chronic Sleep-Onset Insomnia: A Randomized Placebo-Controlled Trial

To investigate the effect of melatonin treatment on health status and sleep in children with idiopathic sleep-onset insomnia. A randomized, double-blind, placebo-controlled trial was conducted in a Dutch sleep center, involving 62 children, 6 to 12 years of age, who suffered more than 1 year from idiopathic chronic sleep-onset insomnia. Patients received either 5 mg melatonin or placebo at 7 pm. The study consisted of a 1-week baseline period, followed by a 4-week treatment. Health status was measured with the RAND General Health Rating Index (RAND-GHRI) and Functional Status II (FS-II) questionnaires. Lights-off time, sleep onset, and wake-up time were recorded in a diary, and endogenous dim light melatonin onset was measured in saliva. The total scores of the RAND-GHRI and FS-II improved significantly more during melatonin treatment compared to placebo. The magnitude of change was much higher in the melatonin group than in the placebo group, with standardized response means for the RAND-GHRI of 0.69 versus 0.07 and for the FS-II of 1.61 versus 0.64. Melatonin treatment also significantly advanced sleep onset by 57 minutes, sleep offset by 9 minutes, and melatonin onset by 82 minutes, and decreased sleep latency by 17 minutes. Lights-off time and total sleep time did not change. Melatonin improves health status and advances the sleep-wake rhythm in children with idiopathic chronic sleep-onset insomnia.

Symptom status and functional status outcomes: humanistic outcomes in obesity disease management.

Introduction Obesity is a complex, chronic health problem that is associated with increased mortality, morbidity, and health care costs, as well as decreased life quality (1–6). “The pathway to obesity is a complex journey,” involving biologic and genetic, emotional, social, and cultural factors (7). Changes in the U.S. health care delivery system, including managed care or disease management approaches, necessitate the development of systems that can be used to assess quality of care and demonstrate accountability in the health care of obese populations. Inherent in this is the identification of outcome, intermediate, and process measures (8,9). Disease management outcome measures must meet identified standards for scientific validity, relevance, and feasibility as outlined in the charge to the Team on Developing Obesity Outcomes and Learning Standards (TOOLS) Task Force of the North American Association for the Study of Obesity (NAASO) (10). The purpose of this paper is to recommend obesity disease management outcome measures to assess symptom status and functional status of populations in outcomes research evaluating the effectiveness of the management of obesity (grades I to III).

Loneliness and health-related variables in young adults.

In classrooms, 69 young adults responded to the Revised UCLA Loneliness Scale, the Symptom Pattern Scale, and the General Health Rating Index, a measure of perceived health status. A statistically significant positive correlation of .21 was found between scores for loneliness and ratings for symptom patterns. A statistically inverse correlation of -.35 was found between scores for loneliness and ratings for perceived health status. These findings replicated those found earlier with adolescents.

Ethnic differences in adolescents' perceived health status: preliminary findings

The purpose of this exploratory study was to identify ethnic differences in the perceived health status among three ethnic groups of adolescents. Significant differences were found for perceived health as measured by the General Health Rating Index (GHRI) [R2, 94) = 8.11, p = .0006]. Tukey's post hoc analysis showed that European American and Latino American subjects scored higher on the GHRI than African Americans. These preliminary findings have implications for further research on perceived health status among ethnically diverse populations of adolescents.

Well-being, general health and coping ability: 1-year follow-up of patients treated for colorectal and gastric cancer.

The aims of this paper were to describe the patients' perceived well-being, general health, symptoms and coping ability 1 year after surgery and to compare the results with the same as recorded before and 6 weeks after surgery and with those of healthy individuals. The investigation was carried out in a surgical unit at the Karolinska Hospital in Stockholm, Sweden during 1992 and 1993. Sixty-nine patients (34 men, 35 women) with diagnoses of colorectal or gastric cancer participated in the study. Two randomly selected samples of healthy individuals were available for comparisons and were used as reference subjects. Main measurements were the Health Index (HI) and the General Health Rating Index (GHRI). The HI measured the change in well-being before and after surgery. There were few and small differences in the patients' sense of well-being 1 year after surgery compared with before. There was no significant difference between the total HI scores before and 1 year after surgery but the HI subscale scores for energy, bowel function and mobility had improved. The patients living alone rated their well-being as inferior in comparison with those who lived with relatives. Furthermore, the cancer patients perceived their well-being as inferior to that of healthy individuals. One year after surgery the patients had not returned to a state of normal health. Social and marital status apparently affected the patients' sense of well-being.

Rogers's Pattern Manifestations and Health in Adolescents

The purpose of this exploratory study was to examine four manifestations of human-environmental field patterning--human field motion, human field rhythms, creativity, and sentience--in relation to perceived health status in 106 early, 111 middle, and 113 late adolescents. Participants responded to the Perceived Field Motion Instrument (a measure of human field motion), the Human Field Rhythms Scale, the Sentience Scale, the General Health Rating Index (a measure of perceived health status), and a brief demographic data sheet in classroom settings. Data were analyzed using Pearson correlations. Statistically significant positive correlations were found between perceived field motion and perceived health status in early, middle, and late adolescents, between human field rhythms and perceived health status in late adolescents only, and between creativity and perceived health status in late adolescents only. The inverse relationship found between sentience and perceived health status in early, middle, and late adolescents was not statistically significant. The findings are interpreted within a Rogerian framework.

The contributions of sleep to perceived health status during adolescence.

The purposes of this correlational study were to examine the relationships of three dimensions of sleep quality (sleep disturbance, sleep effectiveness, and sleep supplementation) and sleep quantity (the amount of sleep obtained per day) to perceived health status in early, middle, and late adolescents. The samples consisted of 106 early adolescents (aged 12 to 14), 111 middle adolescents (aged 15 to 17), and 113 late adolescents (aged 18 to 21). In classroom settings, all subjects completed the VSH Sleep Scale, which measures sleep disturbance, sleep effectiveness, and sleep supplementation (the amount of sleep per day was calculated from two items on the scale); the General Health Rating Index, which measures perceived health status; and a demographic data sheet. Pearson product moment correlation coefficients between the sleep variables and perceived health status were not statistically significant for early and late adolescents. For middle adolescents, however, the correlations between sleep disturbance and perceived health status, between sleep effectiveness and perceived health status, and between amount of sleep per day and perceived health status were statistically significant, but the correlation between sleep supplementation and perceived health status was not. A post hoc regression analysis indicated that the sleep variables explained a small, but statistically significant, amount of variance in perceived health status for middle adolescents. Findings are discussed in light of theories guiding the study, and implications for nursing practice are addressed.

Positive Health Practices and Perceived Health Status in Adolescents

The purpose of this study was to examine the relationships among the components of perceived health status and positive health practices in a sample of 211 adolescents, aged 15 to 21, using canonical variate analysis. All subjects completed the General Health Rating Index, which measures current health, prior health, health outlook, and resistance to illness; and the Personal Lifestyle Questionnaire, which measures exercise, nutrition, relaxation, safety, substance use, and health promotion. Four canonical variates emerged in the statistical analysis, two of which had statistically significant canonical correlations. Implications for nursing practice and research are discussed along with the findings.

Mediators of Daily Stress And Perceived Health Status In Adolescent Girls

A causal model based on the transactional cognitive theory of psychological stress and coping was tested in a middle adolescent female population to determine the effects of daily stress, introspectiveness, and coping efforts on perceived health status. Daily stress was hypothesized to affect perceived health status both directly and through the mediating variables of introspectiveness and coping efforts. A sample of 159 female adolescents completed the Hassles Scale, the Ways of Coping Checklist-Revised, the Introspectiveness Scale for Adolescents and the General Health Rating Index. The causal model was tested using the LISREL VI program. Findings indicated that the model fit the data, indicating a plausible representation of the relationships among the variables identified (x2 = 15.76, df = 12, p less than .203). Daily stress was significantly negatively related to perceived health status through the mediating variables of introspection and problem-focused coping but not emotion-focused coping. Introspectiveness had a significant direct effect on perceived health status. Problem-focused coping was found to have a direct positive effect on perceived health status.

Measuring overall health: An evaluation of three important approaches

There is growing recognition that meaningful measures of health-related quality of life must be used to evaluate health care interventions. We examined the practicality and validity of three promising measures of overall health: the General Health Rating Index (GHRI), the Quality of Well-being Scale (QWB), and the Sickness Impact Profile (SIP). Practicality was assessed in terms of interviewer training required, administration time, and respondent burden. Content validity, convergent construct validity, and tests of discriminant validity were also evaluated. Although differing in theory and application, we found that each instrument performed according to the claims of the developers and could provide useful, valid data on overall health. The GHRI may be preferred where brief, self-administered forms are required; the QWB has advantages when health assessments are used to calculate cost-effectiveness; and the SIP is a versatile, easy to understand measure dealing with a wide range of specific dysfunctions. It is worth the required effort to include well-studied measures such as these in any trial intended to provide definitive information on the effectiveness of health care interventions.

Measuring Components of Childrenʼs Health Status

Measures of physical, mental and social components of health status and general health ratings were studied for children ages 0-4 (N = 679) and 5-13 (N = 1473). Questionnaires were completed by adult proxies (usually mothers) in three generally healthy populations. Hypothesized multi-item scales were tested; reliability was estimated and preliminary attempts at validation were undertaken. Items in ten scales pertaining to mental health (Anxiety, Depression, Positive Well-Being, Mental Health Index), social health (Social Relations), general health ratings (Current Health, Prior Health, Resistance/Susceptibility to Illness, General Health Rating Index), as well as parental satisfaction with child development satisfied Likert-type and discriminant validity criteria. Because functional limitation items were endorsed for very few children, scales to measure physical health could not be tested. Almost all scales were sufficiently reliable for group comparisons; reliability coefficients were lower in the most disadvantaged population. Interrelationships among scales and validity variables generally supported their construct validity and supported a multi-component model of children's health status.