Self-rated Health Question Research Articles

Quantifying the relationship between gardening and health and well-being in the UK: a survey during the covid-19 pandemic

BackgroundRates of non-communicable diseases, including cardiovascular disease and type 2 diabetes, and mental health problems, such as anxiety and depression, are high and rising in the urbanising world. Gardening could improve both mental and physical health and help prevent a range of conditions by increasing fruit and vegetable (F&V) consumption, promoting physical activity, and reducing stress. However, good quality quantitative research in the area is scarce, and our understanding of the role of allotments and home gardens, and the effects of the level of engagement in gardening and involvement with food production has thus far been limited.MethodsWe quantitatively assess the relationship between home and allotment gardening and various indicators and predictors of health and well-being using an online survey of gardeners (n = 203) and non-gardeners (n = 71) in the UK. The survey was composed of multiple validated questionnaires (including the Short Form Food Frequency Questionnaire (SFFFQ), the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), the Physical Health Questionnaire (PHQ) and the Self-Rated Health question (SRH)) and self-defined questions relating to participants’ involvement with gardening and food production, and relevant demographic and lifestyle factors. Data were analysed using a series of hierarchical logistic and multiple linear regression models adjusting for socio-demographic variables.ResultsAfter adjusting for relevant socio-demographic factors, gardening related variables were associated with better self-rated health, higher mental well-being, increased F&V consumption. Higher F&V intake was in turn also associated with better self-rated health and decreased odds of obesity. Thus, gardening had a positive association with four different aspects of health and well-being, directly or indirectly via increased F&V consumption.ConclusionsOur results suggest that gardening in UK allotments and domestic gardens may promote different aspects of health and well-being via multiple mechanisms. Improving access to growing space and promoting regular gardening could provide a range of benefits to public health. More research on how socio-economic factors influence the health and well-being benefits of gardening will help policymakers devise strategies to maximise these benefits.

A machine learning approach to determine the influence of specific health conditions on self-rated health across education groups

BackgroundSelf-rated health, a subjective health outcome that summarizes an individual’s health conditions in one indicator, is widely used in population health studies. However, despite its demonstrated ability as a predictor of mortality, we still do not full understand the relative importance of the specific health conditions that lead respondents to answer the way they do when asked to rate their overall health. Here, education, because of its ability to identify different social strata, can be an important factor in this self-rating process.The aim of this article is to explore possible differences in association pattern between self-rated health and functional health conditions (IADLs, ADLs), chronic diseases, and mental health (depression) among European women and men between the ages of 65 and 79 according to educational attainment (low, medium, and high).MethodsClassification trees (J48 algorithm), an established machine learning technique that has only recently started to be used in social sciences, are used to predict self-rated health outcomes. The data about the aforementioned health conditions among European women and men aged between 65 and 79 comes from the sixth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) (n = 27,230).ResultsIt is confirmed the high ability to predict respondents’ self-rated health by their reports related to their chronic diseases, IADLs, ADLs, and depression. However, in the case of women, these patterns are much more heterogeneous when the level of educational attainment is considered, whereas among men the pattern remains largely the same.ConclusionsThe same response to the self-rated health question may, in the case of women, represent different health profiles in terms of the health conditions that define it. As such, gendered health inequalities defined by education appear to be evident even in the process of evaluating one’s own health status.

Can a Single General Self-Rated Health Question Mirror Social Determinant of Health?

Self-rated health (SRH) indicator is widely used and recommended in health research as a standard indicator for measuring health in different populations. This paper reports SRH of employees at Tehran University of Medical Sciences (TUMS), Tehran, Iran; and its related factors. We used the TUMS Employee's Cohort Study (TEC) data, collected from September 2017 to August 2019. SRH of 2158 employees were assessed using a single question. Univariate and multivariate logistic regression were performed to determine factors associated with sub-optimal SRH. Overall, 14.9% (n = 321) of respondents rated their health as sub-optimal. Differences were observed with subgroups. Women, lower socioeconomic status (SES), experiences of more economic fluctuation conditions and lower reading scores could predict sub-optimal SRH variations in crude and adjusted regression analyses. The age, social capital, work experience and employment status could predict sub-optimal SRH variations only in crude regression analyses (P<0.05). Differences in SRH report reflected differences in socioeconomic conditions. The biggest gap was observed between people of different SES (five times). Considering that SRH reflected socioeconomic characteristics of individuals, it may be considered as a quick, non-expensive, and simple way of identifying groups in need of addressing their social determinants of health.

Empowering pregnant women to improve diet quality: a RCT among pregnant women in the Netherlands

Abstract Objective A healthy diet during pregnancy is crucial for the health of both mother and child, but pregnant women often do not meet the nutritional requirements. Empowering pregnant women to improve their diet quality could play a significant role in improving maternal nutrition and health. However, empowerment has been rarely used in nutritional interventions. Based on research and input from stakeholders, we developed Power 4 a Healthy Pregnancy (P4HP). P4HP consists of four additional consults by the midwife or dietician to discuss nutrition with the pregnant women from an empowerment perspective. This study aims to evaluate the effectiveness of P4HP on diet quality, empowerment, and health of pregnant women. Methods A cluster randomized controlled trial started in January 2022 in 14 Dutch midwifery practices, with a total of 175 pregnant women in both the control and intervention groups (N = 350). Women in the intervention group follow P4HP in addition to their usual birth care. Measurements are carried out at the beginning and end of pregnancy. Diet quality is measured using the Dutch Healthy Diet index 2015, specifically adapted for pregnancy. Empowerment is assessed using the Pregnancy-Related Empowerment Scale, Sense of Coherence (SOC) using the SOC-3 scale, Self-Rated Health using a General Self-Rated Health question, and Quality of Life using a Visual Analogue Scale. Results will be analyzed using Linear Mixed Models to analyze the treatment effect of clustered data. Results Baseline results of 100 pregnant women indicate that they do not meet the Dutch dietary guidelines. We hypothesize that P4HP will lead to improvements in diet quality, empowerment, and health among the intervention group compared to the control group. Conclusions Our findings will show the effect of P4HP on pregnant women’s diet quality, empowerment, and health. We expect to present our preliminary results during the congress. Key messages • Our findings will show the effect of four additional nutritional consultations from an empowerment perspective on pregnant women’s diet quality, empowerment and health. • Empowering pregnant women to improve their diet quality could play a significant role in improving maternal nutrition and health.

Reliability and predictive validity of two scales of self-rated health in China: results from China Health and Retirement Longitudinal Study (CHARLS)

BackgroundDespite the widespread use of the single item self-rated health (SRH) question, its reliability has never been evaluated in Chinese population.MethodsWe used data from the China Health and Retirement Longitudinal Study, waves 1–4 (2011–2019). In wave 1, the same SRH question was asked twice, separated by other questions, on a subset of 4533 subjects, allowing us to examine the test–retest reliability of SRH. In addition, two versions of SRH questions (the WHO and US versions) were asked (n = 11,429). Kappa (κ), weighted kappa ({kappa}_{w}), and polychoric correlation coefficient (ρ) were used for reliability assessment. Cox proportional-hazards models were estimated to assess the predictive validity of SRH measurement for mortality over 7 years of follow up. To do so, relative index of inequality (RII) and slope index of inequality (SII) were estimated for each SRH scale.ResultsThere was moderate to substantial test–retest reliability (κ = 0.54, {kappa}_{w}=0.63) of SRH; 31% of respondents who used the same scale twice changed their ratings after answering other questions. There was strong positive association between the two SRH measured by the two scales (ρ > 0.8). Compared with excellent/very good SRH, adjusted hazard ratios (HR) of death are 2.30 (95% CI, 1.70–3.13) for the US version and 1.86 (95% CI, 1.33–2.60) for the WHO version. Using slope indices of inequality, the WHO version estimated slightly larger mortality differences (RII = 3.50, SII = 15.53) than the US version (RII = 3.25, SII = 14.80).ConclusionsIn Chinese middle-aged and older population, the reliability of SRH is generally good, although the two commonly used versions of SRH scales could not be compared directly. Both indices predict mortality, with similar predictive validity.

Cognitive Decline and Self Rated Health Among Older Adults in Lebanon

Several studies examined the factors associated with self-rated health (SRH), but few studied the relationship between cognitive decline and SRH. The aim of this study was to explore the association between cognitive decline and SRH of Lebanese older adults. This is a secondary analysis of data collected for a cross-sectional study conducted in 2013 to assess prevalence of dementia among a selected representative sample of community older adults aged 65 years and above living in two governorates, Beirut and Mount Lebanon. 419 older adults with no dementia who answered the SRH question and had data on cognitive decline were included in this study. Cognitive decline was measured using the Arabic validated Informant Questionnaire on Cognitive Decline in the elderly (IQCODE). Results show that around 43% reported moderate/bad SRH and 8.8% suffered from cognitive decline. Adjusting for nine confounders, our results showed that the odds of reporting moderate/bad SRH among older adults with cognitive decline was 2.91 times than that of those with no cognitive decline (p-value=0.016). As a conclusion, this study findings suggest that SRH is strongly correlated with cognitive decline. Health care providers in primary care centers, neurologists, and geriatricians can use the SRH question as a preliminary screen of older adults’ cognitive functions.

Comparison of the EQ-5D-Y-5L, EQ-5D-Y-3L and PedsQL in children and adolescents

BackgroundThere is an increased use of Patient-Reported Outcome Measures (PROMs) in children and adolescents. The aim of this study was to compare the feasibility, concurrent validity and known-group validity of the EQ-5D-Y-3L (Y-3L), EQ-5D-Y-5L (Y-5L) and PedsQL self-report PROMs.MethodsFive hundred and fifty children and adolescents, aged 8–15-years, with acute and chronic health conditions and a general population sample were recruited from schools and hospitals in Cape Town South Africa. All respondents self-completed the Y-5L, PedsQL, Self-Rated Health Question and Y-3L. Feasibility of the measures was determined by comparing the number of missing responses. Convergent validity was assessed by Spearman’s and Intra-class correlations on the corresponding items and summary scores respectively. Known-groups validity across health conditions was assessed across the summary scores of the measures with analysis of variance (ANOVA).ResultsThe Y-3L and Y-5L had a total of 1% and 3.5% missing responses compared to 19% on the PedsQL. Similar items on the PedsQL and Y-3L/Y-5L showed high correlations (> 0.5) and related items showed moderate correlations (0.3). PedsQL total score was moderately and significantly associated with Y-3L and Y-5L level sum and VAS scores. The Y-3L and Y-5L level sum and VAS scores showed significant differences between known health groups whereas the PedsQL only showed differences between those with acute and chronic illness.ConclusionThe results of this study show that the Y-3L and Y-5L showed comparable psychometric validity to the PedsQL. When considering the choice between the PedsQL, Y-5L and Y-3L these study results indicate that the EQ-5D-Y instruments (Y-3L and Y-5L) are recommended for studies assessing known-group validity or where missing data should be minimised. The PedsQL generic measure may be preferable in future studies including the general population where a ceiling effect is anticipated. When considering the choice between the Y-5L and the Y-3L there was no systematic difference in the validity between these instruments or between the Y-3L or Y-5L and the PedsQL. Thus, the selection of EQ-5D-Y measures to include in future studies should be guided by the characteristics of the population to be tested.

Assessment of self-rated health: The relative importance of physiological, mental, and socioeconomic factors.

The general self-rated health (SRH) question is the most common health measure employed in large population surveys. This study contributes to research on the concurrent validity of SRH using representative data with biomarkers from the Czech Republic, a population not previously used to assess the SRH measure. This work determines the relative contribution of biomedical and social characteristics to an individual's SRH assessment. Studies have already explored the associations between SRH and markers of physical health. However, according to a PubMed systematic literature search, the issue of the relative importance of physiological and psychosocial factors that affect individuals' assessments of their SRH has generally been neglected. Using data from a specialized epidemiological survey of the Czech population (N = 1021), this study adopted ordinary least squares regression to analyze the extent to which variance in SRH is explained by biomedical measures, mental health, health behavior, and socioeconomic characteristics. This analysis showed that SRH variance can be largely attributed to biomedical and psychological measures. Socioeconomic characteristics (i.e. marital status, education, economic activity, and household income) contributed to around 5% of the total variance. After controlling for age, sex, location, and socioeconomic status, biomarkers (i.e. C-reactive protein, blood glucose, triglyceride, low-density lipoprotein, and high-density lipoprotein), number of medical conditions, and current medications explained 11% of the total SRH variance. Mental health indicators contributed to an additional 9% of the variance. Body mass index and health behaviors (i.e. smoking and alcohol consumption) explained less than 2% of the variance. The results suggested that SRH was a valid measure of physiological and mental health in the Czech sample, and the observed differences were likely to have reflected inequalities in bodily and mental functions between social groups.

General and comparative self-rated health in chronic stroke: an important outcome measure for health professionals

BackgroundAfter a stroke, several aspects of health and function may influence how individuals perceive their own health. However, self-rated health (SRH), as well as its relationship with functioning, has been little explored in individuals with stroke. The aims of this study were to determine how individuals with chronic post-stroke disabilities evaluate their health, considering general, time- and age-comparative SRH questions and to investigate whether SRH measures would be influenced by the following health and functioning domains: mental/physical functions and personal factors.MethodsSixty-nine individuals with chronic post-stroke disabilities answered the three types of SRH questions and were assessed regarding depressive symptoms (emotional function domain), physical activity levels (physical function domain), and engagement in physical activity practice (personal factor domain). Subjects were divided into the following groups: good/poor for the general SRH question; better, similar, and "worse" for both time- and age-comparative questions. Between-group differences in the three domains for each SRH question were investigated (α = 5%).ResultsGeneral SRH was rated as good by 73% of the participants. Time- and age-comparative SRH was rated as better by 36% and 47% and as similar by 31% and 28% of the subjects, respectively. Significant between-group differences in emotional function were found for both the general and age-comparative questions. For the time-comparative question, significant differences were only observed for physical function.ConclusionSRH evaluation differed in individuals with chronic post-stroke disabilities according to the types of questions and health/functioning domains.

Self-Rated Health among General Population in the West of Iran: A Cross-Sectional Analysis of Socioeconomic Determinants

Background: Self-rated health (SRH), as a powerful independent predictor of mortality, has been used worldwide.However, there is currently lack of information about the SRH in Iran as a developing country. This study was conductedto investigate the relationship between SRH and socioeconomic factors in the general population in western Iran.Methods: A cross-sectional study was conducted in 2017 enrolling 1,444 subjects aged 18 years and over in fiveareas of Kermanshah City, Iran. A single question of SRH with five scales of excellent (coded as 1), very good, good,fair, or poor (coded as 5) was used. Univariate and multiple logistic regression models were performed to determinefactors associated with poor self-rated health.Results: The proportion of poor SRH was 14.7%. Multiple logistic regression showed that the most importantdeterminants of poor SRH were older age (adjusted odds ratio (AOR)31-50year=1.96, AOR≥51year=4.93, married status(AOR=2.53), divorced or widowed status (AOR=2.62), self-reported income level as middle (AOR=2.51) andlow (AOR=4.59), rural residency (AOR=1.5), low physical activity (AOR=11.97), and having chronic diseases(AOR=6.85). In addition, the educational level had a negative relationship with poor SRH (AOR academic=0.47).Conclusion: Our results revealed that both individual and social factors are directly associated with poor SRH.Therefore, these determinant factors should be considered in health policies and planning for promoting health andSRH in the west of Iran.

Measurement properties and responsiveness of the EQ-5D-Y-5L compared to the EQ-5D-Y-3L in children and adolescents receiving acute orthopaedic care

ObjectiveThe aim of this study is a head-to-head comparison of the instrument performance and responsiveness of the EQ-5D-Y-3L and the expanded English version of the EQ-5D-Y-5L in children/adolescents receiving acute orthopaedic management in South Africa.MethodsChildren/adolescents aged 8–15 years completed the EQ-5D-Y-5L, EQ-5D-Y-3L, self-rated health (SRH) question and PedsQL at baseline. The EQ-5D-Y-5L, EQ-5D-Y-3L and SRH question were repeated after 24 and 48 h. Performance of the EQ-5D-Y-5L and EQ-5D-Y-3L was determined by comparing feasibility (missing responses), redistribution of dimensions responses, discriminatory power, concurrent validity, and responsiveness.ResultsEighty-three children/adolescents completed baseline measures and seventy-one at all three time-points. Reporting of 11111 decreased by 20% from the EQ-5D-Y-3L to the EQ-5D-Y-5L. Informativity of dimensions improved on average by 0.267 on the EQ-5D-Y-5L with similar evenness. There was a range of 11–27% inconsistent responses when moving from the EQ-5D-Y-3L to the EQ-5D-Y-5L. There was a low to moderate and significant association on the EQ-5D-Y-3L and EQ-5D-Y-5L to similar items on the PedsQL and SRH scores. Percentage change over time was greater for the EQ-5D-Y-5L (range 0–182%) than EQ-5D-Y-3L (range 0–100%) with the largest reduction for both measures between 0 and 48 h. For those who respondents who showed an improved SRH the EQ-5D-Y-5L and EQ-5D-Y-3L showed significant paired differences.ConclusionThe English version of the EQ-5D-Y-5L appears to be a valid and responsive extension of the EQ-5D-Y-3L for children receiving acute orthopaedic management. The expanded levels notably reduce the ceiling effect and has greater discriminatory power. Concurrent validity of the EQ-5D-Y-3L and EQ-5D-Y-5L was low to moderate with similar PedsQL items and SRH. The EQ-5D-Y-5L generally showed greater change than the EQ-5D-Y-3L across all dimensions with the greatest change observed for 0–48 h. Responsiveness was comparable across the EQ-5D-Y-3L and EQ-5D-Y-5L for those with improved SRH. Greater sensitivity to change may be observed on comparison of utility scores, once preference-based value sets are available for the EQ-5D-Y-5L.

The single-item Self-Rated Mental Health Question in women with gestational diabetes mellitus.

This study aims to explore whether the single-item Self-Rated Mental Health Question (SRMHQ) may be an indicator of the need for further mental health assessment and investigation in women with gestational diabetes mellitus (GDM). Women with GDM (n = 159) were recruited from outpatient clinics in the Australian Capital Territory prior to a GDM information session (mean gestational age = 26, SD = 4.5). Participants were aged 20-45 (mean = 33, SD = 4.2) and completed a single-item Self-Rated Health Question (SRHQ), single-item Self-Rated Mental Health Question (SRMHQ), Kessler 10-item Psychological Distress Scale (K-10), and Edinburgh Depression Scale (EDS), as well as demographic, psychiatric, and general health items. Multiple regression was used to explore whether there was an association between SRMHQ responses and K-10 or EDS total scores. Regression analysis revealed that the SRMHQ was a statistically significant predictor of K-10 and EDS total scores, while controlling for key potential confounders. When mental health was rated as "poor" compared to "excellent," this was associated with an additional 12 and 9 points on K-10 and EDS total scores, respectively. The SRMHQ may have a role as an indicator of the need for further mental health assessment and investigation in women with gestational diabetes mellitus.

Exploring Personal Development Workshops' Effect on Well-Being and Interconnectedness.

Introduction: Personal development workshops are increasingly popular. This study evaluated the relationships between the measures of well-being, interconnectedness, and extended perception in various workshops and explored which kinds of workshops and individual characteristics predicted changes in these outcomes. Materials and Methods: In a prospective, uncontrolled, within-participant design study, adult participants completed questionnaires and online tasks before and after personal development workshops. Three analyses were conducted: (1) examining the relationships between measures by using only pre-workshop measures using Spearman correlations; (2) exploring change scores pre- to post-workshop and workshop using Wilcoxon signed-rank test; (3) assessing workshop format and content, and individual characteristics as predictors of those change scores multivariate nonparametric regression. The following outcomes were collected: Well-being-Arizona Integrative Outcomes Scale, positive and negative affect, Dispositional Positive Emotions Scale-Compassion subscale, Sleep Quality Scale, Numeric Pain Rating Scale; Interconnectedness-Cloninger Self-Transcendence Scale, Inclusion of Nature in Self and Inclusion of the Other in Self; and Extended perception tasks-Intuition Jar, Quick Remote Viewing, Psychokinesis Bubble, and Time Estimation. The following potential predictor variables were collected: demographic, mental health, psychiatric and meditation history, Single General Self-Rated Health Question, Brief Five-Factor Inventory-10, and the Noetic Experience and Belief Scale. Workshop leaders also selected which format and content characteristics applied to their workshop. Results: Interconnectedness measures were significantly and positively correlated with well-being (ρ: 0.27 to 0.33), positive affect (ρ: 0.20 to 0.27), and compassion (ρ: 0.21 to 0.32), and they were negatively correlated with sleep disturbance (ρ: -0.13 to -0.16) and pain (ρ: -0.11 to -0.16). Extended perception task performance was not correlated with interconnectedness or well-being. General personal development workshops improved subjective interconnectedness, well-being, positive emotion, and compassion, and they reduced sleep disturbances, negative emotion, and pain (all p's < 0.00005). The lecture (p = 0.03), small groups (p = 0.001), pairs (p = 0.01), and discussion (p = 0.03) workshop formats were significant predictors of well-being outcomes. The workshop content categories of meditation (p = 0.0002) and technology tools (p = 0.01) were also predictive of well-being outcomes, with meditation being the most consistent predictor of positive well-being changes. Conscientiousness was the only significant individual characteristic predictor (p = 0.002), although it was associated with increases in some well-being measures and decreases in others. Conclusions: This study provides preliminary evidence for the positive relationship between the subjective sense of interconnectedness and multiple well-being measures and the beneficial effects of some personal development workshops.

The Relationship Among Pain Location, Complications, and Quality of Life in Individuals With Fibromuscular Dysplasia

BackgroundFibromuscular dysplasia (FMD), a nonatherosclerotic arterial disease, can cause pain and vascular complications. The aim of this study was to examine the impact of FMD symptoms and complications on quality of life, depression, anxiety, and self-rated health. DesignThis was a cross-sectional, correlational study. MethodsParticipants were adults with a diagnosis of FMD. Quality of life (36-Item Short Form Health Survey), anxiety and depression (Patient-Reported Outcomes Measurement Information System [PROMIS®]), self-rated health question, and symptom/complication questionnaires were mailed to patients with FMD. Scores were compared with symptoms and complications. Multivariable linear models were fit for symptoms and survey scores. Ordinal regression was used for self-rated health. Backwards selection was run for each model. Alpha of 0.05 and 95% confidence intervals were used. ResultsOf the 162 (275 total; 47.8%) patients who returned surveys (156 female), 130 had carotid or vertebral artery involvement (80.2%). Migraine (p < .001), neck pain (p = .036), and flank pain (p = .025) were associated with decrease in Mental Component scores. Migraine (p = .002) and neck pain (p = .023) were associated with lower Physical Component scores. Patients reporting abdominal pain compared with those without had 4.88 points higher depression. Abdominal pain (p = .031) and pulsatile tinnitus (p = .011) were associated with greater anxiety. Migraine was associated with (p = .002) lower self-rated health. Participants with history of stroke/transient ischemic attack had 2.42 (1.08, 5.46; p = .033) times the odds of poor self-rated health compared with those without stroke/transient ischemic attack. ConclusionsAmong patients with FMD, presence of pain and history of vascular complications were related to lower quality of life and self-rated health.

Association of Self-Rated Health With Functional Limitations in Patients With CKD

Rationale & ObjectiveIn patients with chronic kidney disease (CKD), self-rated health (“In general, how do you rate your health?”) is associated with mortality. The association of self-rated health with functional status is unknown. We evaluated the association of limitations in activities of daily living (ADLs) with self-rated health and clinical correlates in a cohort of patients with CKD stages 1-5.Study DesignProspective cohort study.Setting & ParticipantsPatients with CKD at a nephrology outpatient clinic in western Pennsylvania.OutcomePatients participated in a survey assessing their self-rated health (5-point Likert scale) and physical (ambulation, dressing, shopping) and cognitive (executive and memory) ADLs. Adjusted analysis was performed using logistic regression models.Analytical ApproachLogistic regression was conducted to examine the adjusted association of 3 dependent variables (sum of total, physical, and cognitive ADL limitations) with self-rated health (independent variable of interest).ResultsThe survey was completed by 1,268 participants (mean age, 60 years; 49% females, and 74% CKD stages 3-5), of which 41% reported poor-to-fair health. Overall, 35.9% had at least 1 physical ADL limitation, 22.1% had at least 1 cognitive ADL limitation, and 12.5% had at least 3 ADL limitations. Ambulation was the most frequently reported limitation and was more common in patients reporting poor-to-fair self-rated health compared with those with good-to-excellent self-rated health (58.1% vs 17.4%, P < 0.001). In our fully adjusted model, poor-to-fair self-rated health was strongly associated with limitations in at least 3 ADLs (total ADL) [OR 8.29 (95% CI, 5.23-13.12)]. There was no significant association of eGFR with ADL limitations.LimitationsSelection bias due to optional survey completion, residual confounding, and use of abbreviated (as opposed to full) ADL questionnaires.ConclusionsPoor-to-fair self-rated health is strongly associated with physical ADL limitations in patients with CKD. Future studies should evaluate whether self-rated health questions may be useful for identifying patients who can benefit from additional evaluation and treatment of functional limitations to improve patient-centered outcomes.

Prevalence and determinants of mental distress during COVID-19 outbreak in Bangladesh: evidence from an online survey

Novel Coronavirus disease 2019 (COVID-19) is an ongoing pandemic and life-threatening highly infectious disease outbreak. The people of Bangladesh are at high risk of COVID-19 and have already experienced various socio-economic, Physical health, and psychological consequences. Particularly, mental health problems are dominantly reported in the literature and should be controlled. The main objective of this epidemiological study is to assess the mental distress and identify its determinants using an online-based survey. Such information is urgently needed to develop feasible strategies for Bangladesh. An online survey was conducted for this study from May 01 to May 05, 2020. A total of 240 respondents provided self-reported online responses. Respondent’s mental distress was measured by the General Health Questionnaire 12 (GHQ-12) and by the self-rated mental health (SRMH) questions. Various kinds of statistical analyses ranging from simple to multivariable logistic recession were performed using SPSS 23.0. About 31.3% and 48.3% of respondents were mentally distressed by GHQ-12 and SRMH questions, respectively. Logistic regression analysis revealed that mental distress was significantly higher among those respondents, whose usual activity was affected by the coronavirus (OR = 6.40, 95% CI: 1.87 - 21.90, p&lt;0.001) and whose financial stress was increased due to lockdown (OR = 2.12, 95% CI: 1.01 – 4.46, p&lt;0.05) on GHQ-12. Female sex (OR = 1.97, 95% CI: 1.03 – 3.75, p&lt;0.05) and respondents with poor mental health before the outbreak (OR = 3.38, 95% CI: 1.18 – 9.72, p&lt;0.05) were also significantly affected by mental distress on SRMH. At least thirty-one percent of the respondents were found to be mentally distressed. Some of the study findings, particularly significant determinants, should be considered while developing strategies to reduce the burden of mental distress among study respondents or similar groups.

Factors associated with self-rated health in a Norwegian population of older people participating in a preventive home visit program: a cross-sectional study

BackgroundAssessing self-rated health by preventive home visits of older people can provide information about the person’s well-being, quality of life and risk of developing illness. The aim of this study was to examine associations between self-rated health and factors related to demographics, lifestyle, health conditions and medical diagnoses by older people participating in a preventive home visit program.MethodsA cross-sectional study including 233 participants (age 75–79) from three municipalities of Western Norway was conducted. Data were collected through preventive home visits performed by six nurses, using a questionnaire including self-rated health assessment and questions and tests related to demographics (e.g. education and housing), lifestyle (e.g. social activities, alcohol and smoking), health conditions (e.g. sensory impairment, pain and limited by disease) and medical diagnoses. Descriptive and inferential statistics including linear block-wise regression model were applied.ResultsThe block-wise regression model showed that the variables Limited by disease and Pain were negatively associated with self-rated health and Use internet was positively associated. The model had a R2 0.432. The variable that contributed to largest change in the model was Limited by disease (R2 Change; 0.297, p-value< 0.001).ConclusionsIn the present study, being limited by disease and pain were strongly associated with poor self-rated health, indicating that these are important factors to assess during a preventive home visit. Also, digital competence (Use internet) was associated with a better self-rated health, suggesting that it could be useful to ask, inform and motivate for the use of digital tools that may compensate for or improve social support, social contact and access to health -related information.

Mental health status among male and female methamphetamine-dependent inmates in Japan

Abstract Background Although the prevalence of drug addiction in Japan is lower than that of in European and/or American countries, the number of methamphetamine-related arrests in this decade has exceeded 10,000 every year, with 66.2% of the arrests made in 2017 being of re-offenders. This study was performed to assess the mental health status among prison inmates whose sentences were related to methamphetamine use. Methods Face-to-face individual interviews using a questionnaire including self-rated health questions (answered on a 4-point Likert scale) and the Kessler 6-item psychological distress scale (K6, range: 0-24) was established by the authors and conducted with 30 methamphetamine-dependent inmates (15 male and 15 female inmates) in Japan. Results The age of inmates ranged from the 20s to the 70s. The median time served in adulthood was 5 (range: 2 - 12) among male inmates, and 4.5 (range: 2 - 12) among female inmates (Mann-Whitney U test, P = 0.202). The median K6 scores were 4 (0-8) for the male inmates and 6 (1-17) for the female inmates (Mann-Whitney U test, P = 0.074). The cut-off point for K6 exhibited variation, and the authors considered a participant psychologically distressed if K6 was 10 or higher. Six (40.0%) female inmates were found to be psychologically distressed, which was a higher proportion than among the male inmates (0.0%) (Fisher's exact test, P = 0.017). Regarding self-rated health, 13 (86.7%) of both male and female inmates reported being in “very good/good health” (Cochran-Armitage Test, P ¬= 1.000). There was no statistical correlation between the K6 scores and the self-rated health scores among the male inmates (ρ = 0.148, P = 0.599) or the female inmates (ρ = -0.499, P = 0.058). Conclusions Although the interviewees were not representative samples, the male inmates demonstrated better mental health status than the female inmates did; however, there was no difference in self-rated health between the two genders. Key messages The male inmates demonstrated better mental health status than the female inmates did; however, there was no difference in self-rated health between the two genders. Gender differences in mental health status among inmates, should be considered when a drug addiction recovery program is implemented to ensure the successful prevention of relapse.

Pilot prospective study of Frailty and Functionality in routine clinical assessment in allogeneic hematopoietic cell transplantation.

A Frailty and Functionality evaluation for alloHCT was implemented using existing resources. We describe the implementation of this evaluation across all ages and at first consultation, and correlate results with posttransplant outcomes in 168 patients. The evaluation consists of: Clinical Frailty Scale (CFS), Instrumental Activities of Daily Living (IADL), grip strength (GS), timed up and go test (TUGT), self-rated health question (SRH), Single question of Falls, albumin and C-Reactive Protein (CRP) levels. Median time to perform the evaluation was 5-6 min. Median age was 58 years (range: 19-77) and median follow-up was 5.3 months. TUGT > 10 s (HR 2.92; p = 0.003), raised CRP (HR 4.40; p < 0.001), and hypoalbuminemia (HR 2.10; p = 0.043) were significant risk factors for worse overal survival (OS). CFS ≥ 3 (HR 3.11; p = 0.009), TUGT > 10 s (HR 3.47; p = 0.003), GS (HR 2.56; p = 0.029), SRH (<excellent) (HR 3.8 × 106; p < 0.001), elevated CRP (HR 11.8; p < 0.001), and hypoalbuminemia (HR 4.6; p < 0.001), were significant predictors for worsenon relapse mortality (NRM). On multivariable analysis, TUGT > 10 s and raised CRP were significant predictors for worse OS and NRM. SRH (<excellent) was a significant predictor for higher NRM. Frailty and Functionality can be assessed in routine clinical practice in alloHCT and may be predictive of short-term outcomes.

EQ-5D-Y-5L as a patient-reported outcome measure in psychiatric inpatient care for children and adolescents \u2013 a cross-sectional study

BackgroundPsychiatric disorders have a major individual and societal impact. Until now, the association between health-related quality of life and physical disorders has been far more investigated than the association with psychiatric disorders. Patient-reported outcome measures makes it possible to capture the patient perspective to improve treatments and evaluate treatment outcomes. The aim of this study is to measure health-related quality of life with the EQ-5D-Y-5L among patients in child and adolescent psychiatric inpatient care and to test the instrument’s psychometric properties in terms of feasibility and construct validity.MethodsData were collected at the child and adolescent psychiatric inpatient facility in Region Stockholm. A questionnaire including the EQ-5D-Y-5L instrument, the Strengths and Difficulties Questionnaire with an impact supplement and a self-rated health question, was administered for self-completion using paper and pencil, with an interviewer present. The Chi-square test was used to investigate differences in proportion of reported problems in the EQ-5D-Y-5L dimensions and the Mann-Whitney U test was used for differences in mean EQ VAS scores. Feasibility was assessed by investigating proportion of missing and ambiguous answers and Spearman’s and Pearson’s correlation were used to examine construct validity.ResultsIn total 52 adolescents participated in the study and the majority were girls. The most common diagnosis at admission was depressive episode/recurrent depressive disorder. All participants reported problems on at least one dimension. Most problems were reported in the dimension ‘feeling worried, sad or unhappy’, where 64% reported severe or extreme problems. Mean EQ VAS score was 29.2. Feasibility was supported and construct validity indicated as some of the hypothesised correlations between the EQ-5D-Y-5 L and the Strengths and Difficulties Questionnaire were found, however, for ‘doing usual activities’ and ‘having pain or discomfort’ the correlations were weaker than hypothesised.ConclusionsThis is the first study where the newly developed EQ-5D-Y-5L instrument has been used in psychiatric inpatient care for youth. Participants reported problems in all severity levels in most of the EQ-5D-Y-5L dimensions; mean EQ VAS score was considerably low. Feasibility of the EQ-5D-Y-5L was supported, however other psychometric properties need to be further tested in a larger sample.