Self-rated Health In Patients Research Articles

Association between Psychological Resilience and Self-Rated Health in Patients with Knee Osteoarthritis.

This study aimed to evaluate whether psychological resilience is an independent factor of self-rated health (SRH) among patients with knee osteoarthritis (KOA). A cross-sectional study with convenience sampling was designed. Patients with doctor-diagnosed KOA were recruited from the orthopedic outpatient departments of a hospital in southern Taiwan. Psychological resilience was measured by the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and SRH was measured by three items, including the current SRH, the preceding year-related SRH, and age-related SRH. The three-item SRH scale was categorized as "high" and "low-moderate" groups by terciles. Covariates included KOA history, site of knee pain, joint-specific symptoms measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), comorbidity measured by Charlson Comorbidity Index, and demographic variables (i.e., age, sex, education attainment, and living arrangements). A multiple logistic regression was used to detect the independent variables with significant odds ratios that can predict "high" SRH among participants. Results: In total, 98 patients with KOA (66 women and 32 men) with a mean age (±SD) of 68.3 ± 8.5 years were enrolled and were analyzed. A total of 38.8% (n = 38) of participants were categorized as "high SRH", while 61.2% (n = 60) were categorized as "low-moderate SRH". Multiple logistic regression showed that CD-RISC-10 had an increased odds ratio (OR) for high SRH (OR [95% CI] = 1.061 [1.003-1.122]; p = 0.038), whereas bilateral pain (vs. unilateral pain), WOMAC stiffness, and WOMAC physical limitation showed a decreased OR for high SRH (0.268 [0.098-0.732], 0.670 [0.450-0.998], and 0.943 [0.891-0.997], respectively). Our findings provide evidence indicating that psychological resilience plays a significant positive role in the SRH in our study sample. Further research is required to extend the growing knowledge regarding the application of psychological resilience on KOA.

Determining the Cut-Off Points of the Self-Rated Health Visual Analogue Scale for Patients with Depression in Greece

Introduction: Depressed individuals usually rate their health more poorly than non-depressed ones. Aim: Because little is known regarding the correspondence between the scales used to measure self-rated health in patients with depression, the objective of this study is to determine the cut-off points of the Visual Analogue scale that indicate bad, moderate and good health for patients with depression. Methods: For the purpose of this study, data from a Panhellenic cross-sectional survey were used. The survey was conducted in 2017 and used stratified random sampling. The study focused on 71 patients with depression. The respondents were asked to rate their health on a 5-point Likert scale and in a Visual Analogue scale. In order to determine the cut-off points of the Visual Analogue scale, an ordinal logistic model was applied. The dependent variable was the Likert scale and the independent variable was the Visual Analogue scale. In addition, a multinomial logistic model was applied and the 33.3rd and 66.6th percentiles of the Visual Analogue scale were calculated. Results: According to the ordinal logistic regression model, the cut-off points of the Visual Analogue scale are 24 and 76. In addition, according to the multinomial logistic regression model, the cut-off points are 21 and 77. The cut-off points that correspond to the 33.3rd and 66.6th percentiles of the Visual Analogue scale are 50 and 70, respectively. Finally, the Gwet’s AC2s of the regression methods were found to be significantly higher than the percentiles’ method. Conclusions: The results of this study confirm international bibliography in the sense that depression is positively related to poor perception of health. Because the cut-off point of poor health, which is based on the percentiles method, is relatively high, we argue that the percentiles method is inappropriate. This conclusion is also derived from the Gwet’s AC2s’ comparison.

SELF-RATED HEALTH IN INFLAMMATORY BOWEL DISEASE CORRELATES WITH ANXIETY, DEPRESSION, CATASTROPHIC THINKING, AND DISEASE SEVERITY

Abstract BACKGROUND The construct of self-rated health (SRH) has been found to be strongly associated with objective markers of health status (e.g., disease progression, healthcare utilization, mortality) in both general and disease-specific populations. For individuals with inflammatory bowel disease (IBD), SRH correlates with symptom severity and health-related quality of life. SRH is typically influenced by one’s disease activity, functional status, and coping style, but there is scant research investigating how specific psychological constructs are related to SRH in patients with IBD. This study aimed to examine how SRH correlates with anxiety, depression, and catastrophic thinking patterns. If clarified, results can inform assessment and intervention efforts to improve quality of life in IBD. METHODS Participants were recruited from a gastroenterology clinic in a midwestern academic medical center. Questionnaires included: Hospital Anxiety and Depression Scale (HADS), GI-Cognitions Questionnaire, and the 36-Item Short Form Survey (SF-36). SRH was measured from SF-36 item 1, which asked participants to rate their health on a five-point scale ranging from excellent to poor. Physicians also completed a clinician rating of IBD activity (Partial Mayo Index [PMI] for ulcerative colitis and Harvey Bradshaw Index [HBI] for Crohn’s disease). Pearson correlation analyses were conducted comparing SRH ratings to psychological variables and IBD activity. RESULTS A total of 117 adults participated (mean age = 38.5 years, 59% female; see Table 1 for demographics). Higher ratings of anxiety, depression, somatization, and catastrophic thinking patterns about GI symptoms were significantly correlated with poorer SRH. There was a significant negative correlation between SRH and IBD activity for patients with Crohn’s disease, but not ulcerative colitis. This is likely due to a restricted range of possible scores on the PMI. Table 2 displays correlation analyses. DISCUSSION Results highlight the potential utility of SRH to identify other patient concerns (e.g., anxiety, depression) and allow an additional avenue for medical providers to consider when assessing patients’ illness experience. Assessing SRH could be part of a step-wise screening and referral process in GI clinics. For example, it may be fruitful to assess SRH in a standardized manner such as using the SF-36 item 1, and when poor SRH is detected, additional screening may be warranted such as using the PHQ-9 or GAD-7. If scores are elevated, a referral to a mental health provider with training in psychogastroenterology may help identify psychological factors that could be targeted via behavioral interventions to improve quality of life and coping with illness. Additional clinical recommendations will be discussed.

SELF-RATED HEALTH IN INFLAMMATORY BOWEL DISEASE CORRELATES WITH ANXIETY, DEPRESSION, CATASTROPHIC THINKING, AND DISEASE SEVERITY

The construct of self-rated health (SRH) has been found to be strongly associated with objective markers of health status (e.g., disease progression, healthcare utilization, mortality) in both general and disease-specific populations. For individuals with inflammatory bowel disease (IBD), SRH correlates with symptom severity and health-related quality of life. SRH is typically influenced by one’s disease activity, functional status, and coping style, but there is scant research investigating how specific psychological constructs are related to SRH in patients with IBD.

Relationship between patient activation measurement and self-rated health in patients with chronic diseases

BackgroundIn the aging population, chronic diseases and multimorbidity are common. Therefore, it is important to engage patients in their self-care. The aim of this study was to analyze the relationship between activity in self-care and self-rated health among primary care patients with chronic diseases.MethodsThe data of the present study were derived from a research project on the Participatory Patient Care Planning in Primary Care (4PHC). A total of 605 patients were recruited in the Siilinjärvi Health Center from those patients who were being monitored due to the treatment of hypertension, ischemic heart disease or diabetes.We evaluated the level of patient’s activity in self-care with the Patient Activation Measurement (PAM). Self-rated health (SRH) was measured with the 5-item Likert scale. An adjusted hypothesis of linearity across categories of PAM and self-rated health was estimated using analysis of covariance (ANCOVA).ResultsIt was found that 76 patients had low activity, 185 had moderate while 336 patients had high activity as measured with PAM. Patients with the highest activity were younger, less depressed, had a lower body mass index and a higher level of physical activity than those with the lower activity. Correspondingly, good SRH was perceived by 29, 45 and 67% of the patients in these three PAM groups adjusted with sex, age, depressive symptoms (BDI) and number of diseases. There was a significant linear trend (adjusted with age, number of diseases and depressive symptoms) between SRH and PAM, p < 0.001.ConclusionsActivity in self-care had an independent, linear relationship with the self-rated health. The present findings suggest that Patient Activation Measurement has the potential to categorize the patients according to their perceived health and their needs related to their disease management and self-care. The present results warrant longitudinal studies on the impact of promoting patient activation levels.Trial registrationClinicalTrials.gov Identifier: NCT02992431. Registered 14 December 2016 https://clinicaltrials.gov/ct2/show/NCT02992431

Abstract # 1814 Systemic levels of IgE as a determinant of self-rated health in patients with asthma

Allergic asthma is a chronic inflammatory disorder with both local and systemic inflammation and is associated with elevated levels of IgE. Poor self-rated health has repeatedly been associated to inflammatory markers, but the nature of this relationship in states of chronic inflammatory disease in not known. Likewise, such findings largely rely on cross-sectional investigations. Here, we investigated the associations between self-rated health and levels of IgE over time in patients with asthma. Self-rated health and levels of IgE were assessed in 181 (87 women) non-smoking patients with allergic asthma aged 18–64 years in a one-year longitudinal study with two repeated measurements. All patients had a confirmed IgE sensitization to at least one airborne perennial allergen. Analyses of associations between repeated measurements were performed using mixed regression models and spearman’s correlations. Poor self-rated health was associated with higher levels of seasonal IgE ( p p p = 0.04). In conclusion, systemic levels of IgE in response to seasonal-, food and perennial allergens is a possible determinant of self-rated health in individuals with asthma.

Clinical characteristics of asymptomatic left ventricular diastolic dysfunction and its association with self-rated health and N-terminal B-type natriuretic peptide: a cross-sectional study.

AimsLeft ventricular hypertrophy, obesity, hypertension, and N‐terminal B‐type natriuretic peptide (Nt‐proBNP) predict left ventricular diastolic dysfunction with preserved systolic function (DD‐PSF). Self‐rated health (SRH) is shown to be associated with chronic diseases, but the association of SRH with DD‐PSF is unclear. In light of the clinical implications of DD‐PSF, the following goals are of considerable importance: (1) to determine the role of SRH in patients with DD‐PSF in the general population and (2) to study the association between Nt‐proBNP and DD‐PSF.Methods and resultsThe current study is a cross‐sectional study conducted on a random sampling of a rural population. Individuals 30–75 years of age were consecutively subjected to conventional echocardiography and tissue velocity imaging. Data were collected on 500 (48%) men and 538 (52%) women (n = 1038). DD‐PSF was the main outcome, and SRH and Nt‐proBNP were the primary indicators. Diabetes mellitus, hypertension, and obesity were accounted for as major confounders of the association with SRH. DD‐PSF was identified in 137 individuals, namely, 79 men (15.8%) and 58 women (10.8%). In a multivariate regression model, SRH (OR 2.95; 95% CI 1.02–8.57) and Nt‐proBNP (quartile 4 vs. quartile 1 OR 4.23; 95% CI 1.74–10.26) were both independently associated with DD‐PSF.ConclusionsSRH, evaluated based on a descriptive question on general health, should be included in the diagnostic process of DD‐PSF. In agreement with previous studies, our study confirms that Nt‐proBNP is a major indicator of DD‐PSF.

Self-rated health in patients with rheumatoid arthritis is associated with health-related quality of life but not with clinical variables

Objectives: Self-rated health (SRH) is a well-known overall health status measure used in the general population but it is rarely examined in a clinical setting. We assessed SRH-related factors in clinic-based patients with rheumatoid arthritis (RA).Method: The study included 123 consecutive outpatients treated in 1998–1999. Patient questionnaires, including a single SRH item, sociodemographics, the Health Assessment Questionnaire (HAQ) for functional ability, and the Nottingham Health Profile (NHP) for health-related quality of life (QoL), were collected at baseline. Comorbidities were measured by the Charlson Comorbidity Index (CCI) and data on the use of drugs and surgery for RA were verified from medical records and by querying patients. Factors associated with SRH were examined using regression models with the propensity score as the covariate. Mortality rates were collected up to 31 December 2014. Hazard ratios (HRs) were used to estimate SRH-associated mortality.Results: In univariate analysis, poor SRH was associated with higher age and poorer patient-reported outcomes (PROs) but not with gender and clinical variables. After adjustment for the propensity score, the NHP dimensions for pain, energy, emotional reactions, and mobility remained significantly associated with SRH. The age- and sex-adjusted HR for death was 2.38 [95% confidence interval (CI) 1.13–5.04, p = 0.034] for the patients with poor vs. good SRH. The propensity score-adjusted HR for death was 1.69 (95% CI 0.74–3.86, p = 0.21).Conclusions In patients with RA, SRH was associated with health-related QoL dimensions, reflecting patients’ well-being rather than clinical factors. During the 16 years of follow-up, SRH had no independent association with mortality.

Can contact to a physician specialized in social medicine reduce long-term sick leave and increase self-rated health in patients with musculoskeletal disorder?

Background Musculoskeletal pain is frequently occurring. In a recent Danish survey, about 50% of responders reported symptoms from neck or back during the last 14 days. Musculoskeletal pain can lead to increased absenteeism and exclusion from the labor market. This study reports the effect of contact to a physician specialized in social medicine parallel to treatment of suspected spinal disc herniation on long term sick leave, self-rated health and mental resources. Methods In a two-year time period (2011 …

Modification in self-rated health in patients discharged by a geriatric rehabilitation ward

Self-rated health is a valuable outcome in geriatric rehabilitation besides objective results. The present work aims at measuring and analyzing overall health as it is perceived at admission into and at discharge from a geriatric rehabilitation ward. Overall health was self-appraised through a visual-analogue scale (VAS), spanning from 0 (worst) to 10 (best). We studied 1997 patients (70% females), aged 79 (standard deviation, s.d. 8.7) years; most were frail, either functionally, clinically and cognitively. 80% of patients were discharged to home after a length of stay lasting 47.5 (s.d. 22.7) days. At admission, 3/5 patients appraised favorably their overall health (VAS ≥ 6/10): at discharge, the proportion rose to 3/4, with a mean (s.d.) gain = 2 (2) points. The improvement in self-perceived health score positively correlates with the grade expressing clients’ overall satisfaction for the stay (p 0.001), and with discharge versus admission differences in: Barthel Index (BI) total score (p items GDS), pain (VAS 0 to 10). A Linear regression model predicting the changes in self-perceived health included changes in BI, MMSE, GDS, pain, dropping Tinetti test. Changes in self-rated health were positively correlated to functional gain adjusted for pre-morbid level, and to relative functional gain. By analysis of variance, health self-appraisal changed more favorably in patients discharged to home than for other social outcomes (all p

Beyond the P Value

Ischemic heart disease is highly prevalent in the United States, affecting 17.6 million patients (≈7.9% of the adult population), and is associated with increased mortality, hospitalizations, and an estimated annual cost of $177 billion.1 Diabetes mellitus is a coexistent complication for many of the patients living with ischemic heart disease with similar short-term outcomes whether it predates or is diagnosed at the time of the initial acute coronary syndrome.2 Targets of therapy for these ischemic heart disease patients are focused on improved mortality and reduced major adverse nonfatal cardiovascular events, including myocardial infarction, unstable angina, stroke, and need for repeat revascularization. As a result in part of research advances in the management of acute coronary syndromes and implementation of primary and secondary prevention efforts, overall mortality rates attributable to ischemic heart disease in the United States have decreased dramatically since 1970 with an additional 36% decrement between 1996 and 2006.1,3 Because more patients are living with ischemic heart disease, improving quality of life or health status has emerged as an important additional target of therapy. Article see p 1690 Health status is a concept that measures the impact of a patient's illness on various parts of his or her daily life related to symptom burden, functional limitations, and quality of life.4 Although some tools such as the New York Heart Association functional classification have traditionally been assessed by physicians, more recent trends allow patients to report their health status directly, grouped as patient-reported outcomes. Quality of life is a complex measure resulting from the patient's integration of biological variables related to the disease process, symptom burden, disconnect between the desired and actual functional status, perceived prognosis, and general health perceptions.5 These concepts can be quantified with tools that have established psychometric properties and …

Self-rated health in patients with mild Alzheimer's disease: Baseline data from the Danish Alzheimer Intervention Study

In both epidemiological studies and in clinical trials the patients’ own health perception, self-rated health (SRH), measured by a single question, is frequently used as an overall health assessment. Researchers have been encouraged to examine ways of assessing SRH in cognitively impaired persons, but the validity and the influence on other factors on SRH among cognitively impaired persons remain unknown. This study reports how patients with mild Alzheimer's disease (AD) report SRH and which factors influence SRH. The study was based on baseline data from 321 home living patients with mild AD who participated in the Danish Alzheimer Intervention Study (DAISY). Analysis using the generalized estimating equation (GEE) models revealed that good/excellent SRH among patients with mild AD were associated with longer education, lack of other chronic conditions, higher scores of quality of life (QOL), lower scores of mini mental state examination (MMSE), and loss of insight in own cognitive deficits. The present results indicate that SRH reported by patients with mild AD may differ from SRH among cognitively intact persons. Further research is needed in order to establish the validity and implication of SRH in this group of patients.

P4-055: Self-rated health in patients with mild Alzheimer's disease: Baseline data from the Danish Alzheimer Intervention Study

P4-055: Self-rated health in patients with mild Alzheimer's disease: Baseline data from the Danish Alzheimer Intervention Study

Self-rated health in patients with chronic heart failure: distribution and association with mortality

Self-rated health in patients with chronic heart failure: distribution and association with mortality

Associations between symptoms, functioning, and perceptions of mastery with global self-rated health in patients with COPD: A cross-sectional study

Background Self-rated health has been shown to be a significant predictor of mortality. However, there is limited knowledge on what factors contribute to the global perception of self-rated health in patients with chronic obstructive pulmonary disease (COPD). Objective To describe the associations between physical and psychological symptoms, physical and mental health functioning, and perceptions of mastery with concurrent and longitudinal global self-rated health (GSRH) in patients with COPD and to determine if gender modifies these relationships. Design Cross-sectional analysis of data from a longitudinal clinical trial. Setting University medical center in the United States. Participants 115 patients with moderate to severe COPD. Methods GSRH was measured using one question from the Medical Outcomes Study, SF-36 which states, “In general, would you say your health is: excellent, very good, good, fair, or poor”. Physical and psychological symptoms were measured with the Shortness of Breath Questionnaire, Chronic Respiratory Questionnaire (CRQ), and Center for Epidemiologic Studies Depression Scale (CESD); the SF-36 was used to measure physical and mental health functioning; mastery was measured by a sub-scale of the CRQ. The BODE index, a multidimensional disease severity grading system, was also included. Stepwise logistic regression analyses were performed. Results In cross-sectional analyses, only disease severity as measured by the BODE index was associated with GSRH [odds ratio, 1.52; 95% confidence interval, CI (1.08, 2.15)]. Stratified analyses by gender showed that the association between the BODE index and the GSRH held up for men, but not for women. Higher perception of symptom control was associated with positive health ratings in women. Subjects with less fatigue at baseline had a lower risk of reporting poor health 12 months later [OR 0.84; 95% CI (0.72, 0.98)]. Conclusions For patients with COPD, ratings of global health were mostly influenced by measures that reflect their physical state, e.g. disease severity and fatigue. While additional work is needed to better understand gender differences in factors that contribute to GSRH, therapeutic nursing interventions might place greater focus on symptom management if the goal is to improve patients’ perceptions of their global health.

Predictors of Self-Rated Health in Patients with Chronic Nonmalignant Pain

Self-rated health (SRH) is an important outcome measure that has been found to accurately predict mortality, morbidity, function, and psychologic well-being. Chronic nonmalignant pain presents with a pattern that includes low levels of power and high levels of pain, depression, and disability. Differences in SRH may be related to variations within this pattern. The purpose of this analysis was to identify determinants of SRH and test their ability to predict SRH in patients with chronic nonmalignant pain. SRH was measured by response to a single three-option age-comparative question. The Power as Knowing Participation in Change Tool, McGill Pain Questionnaire Short Form, Center for Epidemiological Studies Depression Scale, and Pain Disability Index were used to measure independent variables. Multivariate analysis of variance revealed significant differences ( p = .001) between SRH categories on the combined dependent variable. Analysis of variance conducted as a follow-up identified significant differences for power ( p < .001) and depression ( p = .003), but not for pain or pain-related disability; and discriminant analysis found that power and depression correctly classified patients with 75% accuracy. Findings suggest pain interventions designed to improve mood and provide opportunities for knowing participation may have a greater impact on overall health than those that target only pain and disability.

Sociodemographic predictors of self-rated health in patients with diabetes of short duration

Sociodemographic predictors of self-rated health in patients with diabetes of short duration

Sociodemographic predictors of self-rated health in patients with diabetes of short duration

To examine the impact of gender and socioeconomic factors on health-related quality of life (HRQoL) one year and eight years after diabetes diagnosis. Two national incidence cohorts who contracted diabetes between the ages of 15 and 34 years (n=554) and matched control groups from the general population of Sweden (n=1,029) were surveyed. Data on HRQoL, diabetes treatment, marital status, education, social class, and employment were collected via a questionnaire mailed to the younger cohort (aged 16-35) one year after diagnosis and to the older cohort (aged 23-42) eight years after diagnosis. Response rates were 73% among people with diabetes and 68% among the controls. Multivariable linear regression models were used to analyse the impact of gender and socioeconomic factors on HRQoL in the diabetic and control groups. The dependent variable was the "general health perceptions" score of the SWED-QUAL instrument, which corresponds to the "global self-rated health" concept. A model including all the sociodemographic variables explained 6% of the variance in self-rated health one year after diabetes diagnosis and 13% of the variance eight years after diagnosis. In the control groups, the level of explanation was 2-3%. Female gender was an independent predictor of poor self-rated health in the older diabetic cohort, but not in the younger cohort. Gender and socioeconomic factors were more closely associated with self-rated health eight years after diabetes diagnosis than one year after diagnosis, indicating early sociodemographic stratification in the health of the diabetic populations studied.