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: Patient satisfaction and improved quality of life are the predominant considerations determining success in cosmetic surgery. However, few studies have examined patients' perceptions of their appearance following cosmetic facial surgery and/or nonsurgical facial rejuvenation. This study identified patient-reported outcome measures developed and validated for use in patients undergoing surgical and/or nonsurgical cosmetic procedures. A systematic review of the English-language literature was performed. Patient-reported outcome measures designed to assess patient satisfaction and/or quality of life following surgical and/or nonsurgical cosmetic procedures were identified. Qualifying instruments were assessed for content and adherence to international guidelines for development and validation. From 442 articles, 47 patient-reported outcome measures assessing facial appearance after a cosmetic procedure were identified. Only nine questionnaires satisfied inclusion and exclusion criteria. These measures were subdivided into the following categories: rhinoplasty (Rhinoplasty Outcomes Evaluation, Glasgow Benefit Inventory, Facial Appearance Sorting Test), skin rejuvenation (Facial Lines Treatment Satisfaction Questionnaire, Skin Rejuvenation Outcomes Evaluation, Facial Lines Outcomes Questionnaire), face lift (Facelift Outcomes Evaluation), blepharoplasty (Rhinoplasty Outcomes Evaluation), and general appearance (Derriford Appearance Scale 59). None of these measures satisfied all guidelines. All measures were limited by either their development, their validation, or their content. Valid, reliable, and responsive instruments designed to measure patient-reported outcomes following surgical and nonsurgical facial rejuvenation are lacking. A patient-reported outcome measure that represents perceptions of facial cosmetic surgery patients and satisfies accepted health measurement criteria is needed. It would facilitate comparison of techniques and quantification of positive effects, and aid surgeons seeking to quantify outcomes in their own practices.Plastic and Reconstructive Surgery 07/2009; 123(6):1819-27. · 3.33 Impact Factor