Todai Health Index Research Articles

２つの地域の男子勤務者とその妻の自覚症状に及ぼす喫煙と居住地の影響

Physical health levels of 95 married couples (group A), who live in the suburbs of big city, and 202 married couples (group B), who live in a local city of Kanto district, were measured using a health questionnaire, the Todai Health Index (THI). The male subject of both groups are workers of private company and the average age is early forties. This research was focused on the effect of smoking and place of residence on subjective complaints. Mean values of scale scores of couples' respiratory symptoms and husbands' digestive symptoms of group A were statistically higher than those of group B by the two-way analysis of variance. But no difference was recognized by the degree of smoking. Interactions existed on the effect of smoking and place of residence on the mean values of scale scores of wives' respiratory and digestive symptoms. These results indicate that respiratory symptoms and husbands' digestive symptoms increase by the modernization, but the effect of smoking habit on respiratory and digestive symptoms were relatively small.

地域の世話役女性集団の特徴 夫婦の質問紙ＴＨＩによる健康測定から

Physical and mental health level of 70 married couple, whose wives worked as volunteers of maternal and child health or diet improvement projects in a village of Gunma prefecture, was measured using a health questionnaire, the Todai Health Index (THI), consisting of 12 scales and 2 discriminant values. As controlled group, 68 men and 68 women randomly sampled from the neighboring village were set up. Mean values of scale scores of mental instability and depression of volunteer group were statistically smaller than those of control women, and that of aggressiveness of volunteer group was larger than that of control women. Scale scores of digestive organ and aggressiveness of husbands are higher than those of wives, and the reverse tendencies were found in the scores of mental instability and irregularity of life. Significant correlations were found between volunteers and their husbands in the scales: impulsiveness, lie scale, mental instability, depression, and irregularity of life, which were also found in the other married couples. These relation was not recognized in the control group. From these results, health level of wives who were volunteers of health promotion project of a village are mentally better or active compared with that of the control group, but there was little difference in the interaction of mental health between volunteer spouse and the other general one.

夫婦の加齢に伴う主観的健康レベルの変動とその関連性

The effect of married life on the health of the spouse was studied utilizing the Todai Health Index (THI) questionnaire, on 550 couples residing in an administrative district of Maebashi city, Gunma prefecture. The age of the wife of couples was 25 to 74 years, and the response rate of the complete survey was 75%. For 130 items relating to somatic symptoms and psychological complaints, 14 scales were derived as follows; SUSY: subjective symptoms, RESP: respiratory organs, EYSK: eye and skin, MOUT: mouth and anus, DIGE: digestive organ, IMPU: impulsiveness, LISC: lying scale, MENT: mental instability, DEPR: depression, AGGR: aggressiveness, NERV: nervousness, LIFE: irregularity of life, PSD: tendency for psychosomatic disease, and NEURO: tendency forneurosis. The 550 couples were divided into three groups by age of wife: young, middle aged (fifties), and old (65 years old or more). Scale scores of SUSY, IMPU, LISC, MENT, DEPR, AGGR, LIFE, PSD, and NEURO had significant correlations between husband and wife of the younger group. For middle aged couples, husband-wife correlations were found for SUSY, EYSK, MOUT, DIGE, IMPU, MENT, DEPR, LIFE, PSD, and NEURO; and for old couples SUSY, DIGE, and DEPR. Since little correlation was observed between scale scores of randomly matched men and women pairs, married life appears to demonstrate certain health interactions on spouses, which differ by age, being mainly psychological effects in the younger aged couples, psychosomatic in middle aged, and weak physical in the older aged group.

自記式健康調査標ＴＨＩを用いた嫁と姑の心身の主観的健康レベルとその関連性

In order to know the interaction of physical symptom and psychological health of daughter-in-law and those of mother-in-law living together in the same household, an attempt was made to apply a self-administered health questionnaire, the Todai Health Index (THI), to 36 daughters-in-law, who have twenty to twenty five-year-old daughters, and the paired mothers-in-law. Two female control groups were sampled of the same generation of mother-in-law (control A) and daughter-in-law (control B), who live in the suburbs of three big cities. Twelve scales and two discriminant function values (DF values) of THI are as follows: SUSY, subjective symptoms; RESP, respiratory; EYSK, eye and skin; MOUT, mouth and anus; DICE, digestion; IMPU, impulsiveness; LISC, lie; MENT, mental instability; DEPR, depression; AGGR, aggressiveness; NERV, nervousness; LIFE, irregularity of life; PSD, psychosomatic; NEURO, neurosis. The mean scores of SUSY, RESP, EYSK, DEPR, PSD and NEURO of daughter-in-law are significantly lower than those of mother-in-law, which are mainly on the decrease of those in daughter-in-law, and AGGR of daughter-in-law is significantly higher than that of mother-in-law. There are significant correlations of IMPU, DEPR, NERV, PSD and NEURO, which are on the psychological scales, between daughter-in-law and mother-inlaw. While there are no significant correlations of twelve scales and two DF values between control A and B. For daughter-in-law and mother-in-law, living together in the same household for a few decades gives a better influence on the health of the both.

自覚症状などの加齢による変化 ＴＨＩによる成人女性集団の断面調査から

Prevalence of subjective complaints by age was surveyed of 3389 adult women applied by a general health questionnaire-the Todai Health Index (THI). The women were sampled from the residents in the area around the Haneda, Osaka, and Fukuoka Airports excepted the noisy area of WECPNL being 90 or over. The recovery rate of the mail survey was 52%. Out of the recovered, 85.4% were married. All the subject were classified into 11 age groups at every five years of age. The positive response rate to each question, the mean values of 12 scale scores, and 3 discriminant values were compared among the age groups. And these data were also compared with male employee groups of a trading company and old gentlemen by the present coauthors. The results were as follows: 1) Women had higher scores in the scales and discriminant functions than men; Vague Complaints, Eye and Skin, Mouth and Anus, Psychosomatic disease, and Neurosis. 2) Women in their late twenties had lower scores in the scales; Vague Complaints, Respiratory Complaints, Eye and Skin, Mental Instabilty, Depressiveness, Psychosomatic disease, and Neurosis. These were different from those of men. 3) Women between their late forties and early fifties had highest scores in the same scales and seemed most unstable, which could be related with the climacteric and/or empty nest syndrome. 4) Women in their early seventies showed lower scale scores in most scales, which might be a result of the decreased sensitivity to the environmental stimuli. 5) The scale scores of Respiratory Complaints and the Lie increased according to the age, in contrast to the scale scores of Impulsiveness and Irregularity of Daily Life which decreased with aging. 6) For the middle aged women the scale scores of Aggressiveness were on the increase, but on the decrease for men. These results of a cross-sectional survery tells that the changes of THI scale scores by age could throw light on the characteristics of turning points of female life cycle.

A NEW QUESTIONNAIRE FOR ADOLESCENT MENTAL HEALTH CARE

A new self-administered questionnaire, named the THI (Todai Health Index) for juniors, was developed in order to assess the mental health of adolescents. The development process and some aspects of its validity and reliability evaluation are reported.Initially a preliminary questionnaire consisting of 195 items for assessing the physical and mental status of adolescents was prepared. It was then distributed to 1, 215 junior high school students in Gunma Prefecture.By factor analysis methods, 103 of the 195 items were used to construct 8 scales : Vague Complaints, Extraversion, Neuroticism, Deviation from Routine Life, Irritability, Lie Scale, Depression, and Psychoticism.The reliability of internal consistency was satisfactory, since Cronbach's alpha coefficient was over 0.8 in 6 of the scales.To confirm the content validity of the scales, interviews with the teachers in the subject school were carried out. Through cluster analysis (Ward) of the scale scores, some typical patterns between the scale-scored profiles and actual status of the students were found.For the assessment of predictive validity, discriminant analysis (Fisher) using all eight scale scores was applied to the results of the diagnostic interview by Rutter's method. Correct identification ratios were rather high at 83.33% (conduct disorder group vs. control), 62.86% (emotional disorder group vs. control), and 85.71% (mixed disorder group vs. control).

FACTORS AFFEHTING THE ATTENDANCE RATE OF MASS HEALTH EXAMINATION

The author has conducted a mass health examination for ten years, from 1971 to 1980, about a few thousands of adult farmers inhabiting in rural area of Gunma Prefecture, Japan. They were requested to attend the health examination once a year on indicated dates. Results on blood pressure, hemoglobin content, liver function test, and others, were notified individually to the attendants with advice after the examination. In addition, three specific surveys were carried out. Firstly, a self-administered questionnaire survey was for 289 male and 584 female attendants on motivation to the health examination, subjective symptom, and daily health behavior. Secondly, a household interview survey in 1985 was for 89 non-attendants and 64 attendants applying a psychodynamic theory on the behavior of attendance postulated by Baker and Shontz. Lastly, health questionnaires, simplified Cornell Medical Index and the Todai Health Index, were applied to the attendants.Subjective symptom and/or mental complaints had little relation to the attendance rate, unexpectedly. The attendance rate to the continuing mass health examination was rather related to cognizance and attitude to health examination and also to personal and family health practice than physical condition, subjective symptom, and perceived health. The attendant group had significantly higher level of promoting factors and lower level of inhibiting factors of Shontz for behavior of attendance than the levels observed in non-attendance group. Frequent attendants tended to have mormal blood pressure level and improved hemoglobin content as compared with less frequent ones.

Application of health questionnaires for health management in small- and medium-sized enterprises

Two kinds of health questionnaires, the Todai Health Index (THI) and Cumulative Fatigue Index (CFI), were applied as a screening device for health management of workers belonging to small-medium sized enterprises. A total of 495 workers composed of 452 male workers of a glass-bottle manufacturing factory and 43 male workers of a soft-drink bottling factory were the subjects of the present study. It was found that the two kinds of health questionnaires were different from each other and have their own characteristics. Twelve scales of THI were grouped into two, the first consisting of ten scales (SUSY, RESP, EYSK, MOUT, DIGE, IMPU, MENT, DEPR, NERV, and LIFE) and the second consisting of two scales (AGGR and LISC). Nine categories of CFI were grouped into one by using principal factor analysis. It was confirmed that the twelve scale scores of THI obtained at small-medium sized factories differed from those scale scores of a reference group investigated at a large-sized enterprise. It is on the basis of the scales of aggressiveness and lies and also of the scale of mental unstability which characterizes workers, locality, job (clerical or field work), and size of industry (large or small sized) that the difference could be evaluated. Urban life characterized by a life style of staying up late at night and waking up late in the morning has been reflected on the scale of life irregularity. Irregularity of life induced by transformation of working schedule, such as two or three shifts of work and overtime, was also reflected on this scale. Two scales of THI test, i.e., many subjective symptoms and digestive organ complaints, seemed to be the representative scales indicating a close relation between work load and health level. The discriminant score for diagnosis of psychosomatic diseases is considered to be one of the most useful assessments of the individual's health condition. As mentioned above, THI is recommended as a convenient assessment method for health management of workers and for screening individuals or groups requiring health management from the total respondents belonging to small-medium sized enterprises where health administrators or professionals for health services are not available. A combined use of THI and CFI is more effective in evaluating health status of field workers than the independent use of one of these two tests, because the causal relationship between work load and health status cannot be satisfactorily observed, only through THI.

An Improved Method of Tabulation of the Todai Health Index Questionnaire by a Personal Computer

An Improved Method of Tabulation of the Todai Health Index Questionnaire by a Personal Computer

Study on the validity of the health questionnaire, THI (I). The quantitative and qualitative difference of subjective complaints by sex and age (author's transl)

An attempt was made to make use of the results of a kind of health questionnaire in health administration or evaluation of health status of both a group of people and specific individuals.The Todai Health Index, THI, was developed by S. Aoki et al. in 1974 with the purpose of supplementing the widely-used Cornell Medical Index, CMI. It consists of 130 questions. Twelve scales and three discriminant scores are available for use in evaluation.In this paper, quantitative and qualitative differences of subjective complaints in five sex-age groups, and the relevance and usefulness of the THI in this problem were investigated.The survey was carried out using 5, 937 employees of a trading company. The five sex-age groups were as follows; females in their twenties (2, 190), males in their twenties (1, 217), males in their thirties (948), males in their forties (592) and males in their fifties (479).To determine quantitative differences, the proportion of responses to each question, the mean value of scale scores and discriminant scores were used. To determine qualitative differences, the factor-pattern of subjective complaints and scale scores were each checked by factor analysis.The results were as follows:1) Females in their twenties had many physical and psychological complaints, especially concerning their eyes. Two subjective complaint factors, the control of temper and the depression, were extracted by factor analysis. Twelve scales were divided into a physical scale group and two psychological scale groups.2) Males in their twenties had three factors; an irregular lifestyle, the complaints of the digestive organs and the self-aggrandizement.3) Males in their thirties seemed most stable, both physically and psychologically of the five groups.4) Males in their forties showed depression. This was assumed to be a result of a loss of self-confidence in their physical condition or their work ability.5) Males in their fifties had regular lives and were psychologically stable. On the other hand, this group showed somehow neurotic conditions and high scores on the “living scale”. Two factors, related to cardiovascular complaints and the self-aggrandizement, were extracted by factor analysis of subjective complaints.The author believes that these results have determined relevance of the THI in collecting information about the physical and psychological status of both groups and individual people.

Study on the validity of the health questionnaire, THI (II). The means of evaluation in the discriminative diagnosis of psychosomatic disease by THI.

The Todai Health Index, THI, was developed as a general health questionnaire by S. Aoki et al. in 1974. It consists of 130 questions. Twelve scale scores and three discriminant scores are available for use in evaluation.In this experiment, several methods for discrimination of psychosomatic diseases were investigated. Fifty psychosomatic disease patients (PSDs) and sex-age matched 250 controls were used as subjects.The results were as follows:1) Using discriminant analysis, seven scale scores were selected. With this function, the correct ratios were 82.0%, 81.6% and 81.7% for PSDs, controls and totals, respectively.2) Using the Quantification Theory, Type II, each three answer choices for nine of the questions were quantified. The relationship between psychosomatic diseases and subjective complaints was nonlinear. The correct ratios were 82.0%, 92.0% and 90.3% for PSDs, controls and totals, respectively.3) Using the Quantification Theory, Type III, and following the procedure for Type II, three choices for nine of the questions ranked in order of the seriousness of the subjective complaints were graphed on the first axis. A choice indicating a “medium degree” was assigned a negative value, and choices indicating a “high degree” or a “low degree” were assigned positive values on the second axis. Therefore, the graph of the three choices had a “V-shape”. The correct ratios were 72.0%, 92.0% and 88.7% for PSDs, controls and totals, respectively.4) The above three evaluation methods were applied to 94 other cases. Four out of five cases, where doctors gave their comments, and in 32 out of 36 cases, where there were no comments from doctors, were judged correctly using the above three methods of evaluation.

質問紙健康調査票THIによる神経症者,分裂病者などの判別診断のこころみ

One of the general health questionnaires, the Todai Health Index(THI), developed by S. Aoki et al. in 1974, is composed of 130 questions concerning subjective symptom, mental health, personality, health habit and the ones to check the reliability of the answered THI. Twelve scale scores are available from THI which tell the pattern of complaint and personality, and are able to identify psychosomatics from normals by Fisher's discriminant function. The authors applied THI to the several groups of psychiatric outpatient who had been definitely diagnosed by psychiatrists to be neurosis(52patients), schizophrenia(37), depression(16), epilepsia(15)and maina(3), and characteristic patterns were analysed of the 12 scale scores in the respective patient group. Two discriminant functions were obtained and they proved to identify 42 out of 52 clinical neurotics as it and 30 out of 37 clinical schizophrenics as it. The method of forward selection by means of Mahalanobis generalized distance was also applied for the identification of the two patient groups.