The HMQ: measuring health status in the community
ABSTRACT The measurement of health outcome is central to the evaluation of medical treatment and intervention. In the past, such measurement has been based on data relating to survival and life expectancy. There is now general acknowledgment that a through assessment of the benefits of health care must examine the quality of life, as well as its quantity. The Health Measurement Questionnaire (HMQ) has been developed as a way of collecting self-report information from which a disability/distress rating could be derived on the Rosser Classification of Illness States. This discussion paper provides a fuller review of the data collected as part of a general population survey in which the HMQ was used as a self-report measure of health status alongside the GHQ and the NHP. The HMQ appears to have both construct and convergent validity. It has also discriminated between groups of the population which differ in terms of health status or in the degree of psychiatric morbidity. Several factors have been shown to contribute to overall distress, particularly pain, sadness/depression and dependence on others. It is evident that there is considerable morbidity in the community. These data reinforce the need for continued measurement of health status within the general population, with the dual aim of identifying areas of need, and then monitoring improvement as services are adjusted to meet that need.
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ABSTRACT: To evaluate the quality of life of patients following surgery for colorectal cancer, and to compare the quality of life between patients whose cancer was detected as a result of faecal occult blood screening with that of patients whose cancer presented symptomatically, an analysis was conducted within the context of the randomized controlled trial of colorectal cancer screening, University Hospital, Nottingham, UK. A total of 418 survivors of the trial's test and control groups and 33 randomly selected cancer patients completed quality of life questionnaires (Nottingham Health Profile and Health Measurement Questionnaire). The mode of entry to diagnosis and treatment (screening vs. non-screening) appeared to exert no major impact on post-intervention quality of life. The stage of cancer progression was not closely related to outcome life quality. A quality of life coefficient for surviving patients based on the Rosser classification was estimated to lie within the range 0.948-0.981. This figure accords well with the estimates of other studies of interventions in populations of similar age. Overall, there are no grounds for believing that faecal occult blood screening for colorectal cancer per se significantly influences patients' post-intervention quality of life.Quality of Life Research 07/1994; 3(3):191-8. DOI:10.1007/BF00435384 · 2.86 Impact Factor
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ABSTRACT: Evidence suggests that magnetic resonance imaging (MRI) allows accurate diagnosis of meniscal and ligamentous injuries of the knee. However the link between improved diagnosis through MRI and improved patient quality of life (QOL) has yet to be shown. Previous studies aimed at establishing this link have found no significant improvements in health related quality of life (HRQOL) as measured by the Rosser classification and index. This paper presents the results of three HRQOL questionnaires (SF-36, Rosser and EuroQol) used to measure health change in 332 patients referred for MRI of the knee. Before imaging, patients reported poorer HRQOL than the general population on two of the three questionnaires (SF-36 and EuroQol). The same two questionnaires recorded significant improvements in patient health at six months, although patients' health had not yet reached that experienced in the general population. There was evidence to suggest that the index values attached to the Rosser classification made it unresponsive in this group of patients, which may have predisposed the null results of previous studies of the influence of MRI on HRQOL. Some evidence is provided to suggest that the EurolQol may be less responsive in assessing change in health status than the SF-36.Quality of Life Research 09/1995; 4(4):325-34. DOI:10.1007/BF01593885 · 2.86 Impact Factor
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ABSTRACT: The request for cosmetic surgery is of a psychological nature. Very few studies have quantitatively assessed whether or not this psychological need was actually satisfied, and more precisely, which psychic components were satisfied. This is a multicentric, prospective cohort study. One hundred and three patients scheduled for facial cosmetic surgery from three different hospitals were examined before and after surgery using four assessment scales validated using European populations. The Montgomery and Asberg depression rating scale (MADRS) measured the existence and intensity of depression, the self-assessment test of thoughts in social interaction (SISST) measured the positive or inhibitory thoughts in the context of social relationships, and the European quality of life 5 dimensions (EQ-5D) (generic test) measured the quality of life. In addition, a semi-directive interview was specially created by our team. For statistical analysis, ANOVA and Student's t test were applied. Twenty-four patients were lost to follow-up. Although the initial MADRS index was high (p<0.05), it did not change after surgery (p>0.1). SISST+ (positive thoughts): the social anxiety of the individual examined was significantly greater than that of the control group (p<0.005) and improved after surgery (p<0.01). The SISST- (inhibitory thoughts) did not change (p>0.1). The EQ-5D visual analogue scale (VAS) did not reveal any difference (p>0.1) while the descriptive EQ-5D demonstrated over-representation of anxiety/depression (p<0.01), and an improvement of this (p<0.05) postoperatively. The mean subjective satisfaction index was 8.1 (scale of 1-10) without sharing any influence of the complications suffered (65% of the patients made self-assessments). The best indications for facial cosmetic surgery seem to be a lack of self-confidence associated with a desire for social interaction, and a request focused on a specific physical feature. The results presented add documentary confirmation to the impression shared by the majority of cosmetic surgeons. However, it was also confirmed that cosmetic surgery is not limited to its technical components, but remains a medical act which must consider the overall effect on the whole patient.Journal of Cranio-Maxillofacial Surgery 02/2003; 31(1):46-50. DOI:10.1016/S1010-5182(02)00159-2 · 2.60 Impact Factor