The Relationship between Self-Rated Health and Health Status among Coronary Artery Patients
Health Services Research and Development, Durham. Journal of Aging and Health
(Impact Factor: 1.56).
12/1999; 11(4):565-84. DOI: 10.1177/089826439901100405
This study examined the descriptive relationship of self-rated health (SRH) with various psychosocial measures, sociodemographic variables, coronary artery disease (CAD) diagnostic/clinical measures, and medically abstracted comorbidities.
The sample was 2,855 individuals from the Mediators of Social Support (MOSS) study who had at least 75% narrowing in more than one vessel, as indicated by a cardiac catheterization.
After adjusting for sociodemographic factors, individuals who rated their health as poor/fair had significantly worse performance on all psychosocial measures and were more likely to be female, non-White, and of a lower socioeconomic status than those who rated their health as being good or better. There were few differences on SRH across various diagnostic/clinical measures of health.
A single item measure of SRH may be useful; the generalizability of the item must be considered. In this sample of CAD patients, SRH was related more to psychosocial factors than to clinical and disease indicators.
Available from: PubMed Central
- "Some health-related factors, including underweight, weight loss, marital status, education, low income, early menopause, physical activities, life stress, work strain, spiritual status, and quality of interpersonal relationships, were significantly associated with SRH. This suggests that individuals may use these factors to evaluate their overall health [23,24]. "
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Self-rated health (SRH), a subjective assessment of health status, is extensively used in the public health field. However, whether SRH can reflect the objective health status is still debatable. We aim to reveal the relationship between SRH and objective health status in the general population.
We assessed the relationship between SRH and objective health status by examining the prevalence of diseases, laboratory parameters, and some health-related factors in different SRH groups. Data were collected from 18,000 residents randomly sampled from the general population in five cities of China (3,600 in each city). SRH was assessed by a single-item health measure with five options: “very good,” “good,” “fair,” “bad,” and “very bad.” The differences in prevalence of diseases, laboratory parameters, and health-related factors between the “healthy” (very good plus good), “relatively healthy” (fair), and “unhealthy” (bad plus very bad) groups were examined. The odds ratios (ORs) referenced by the healthy group were calculated using logistic regression analysis.
The prevalence of all diseases was associated with poorer SRH. The tendency was more prominent in cardio-cerebral vascular diseases, visual impairment, and mental illnesses with larger ORs. Residents with abnormalities in laboratory parameters tended to have poorer SRH, with ORs ranging from 1.62 (for triglyceride) to 3.48 (for hemoglobin among men) in a comparison of the unhealthy and healthy groups. Most of the health-related factors regarded as risks were associated with poorer SRH. Among them, life and work pressure, poor spiritual status, and poor quality of interpersonal relationships were the most significant factors.
SRH is consistent with objective health status and can serve as a global measure of health status in the general population.
Available from: Peter Johansson
- "Havranek et al., however, discussed that the disadvantage of this method was that it obscures the impact of disease on perceived HR-QoL . In contrast, one study found that as reports on such a single question about perceived health declined from excellent to very good, good, fair and poor health, there were significantly lower levels of HR-QoL in all eight domains of the SF-36 . However, the study included patients with coronary artery disease (CAD) with a mean age of 60 years and cannot be generalized to patients with HF. "
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ABSTRACT: The aim was to examine whether a single question about global perceived health (GPH) is associated with the domains of health-related quality of life (HR-QoL) as assessed by the SF-36, and whether the scores in these domains differ from the different scores of the GPH in relation to left ventricular ejection fraction (LVEF).
The study included 412 elderly outpatients with symptoms of heart failure (HF). Echocardiography was used to determine their LVEF, and GPH was assessed by the first question on the SF-36.
The correlations between GPH and the different domains in SF-36 ranged from 0.33 to 0.64 in patients with LVEF>or=50% and was between 0.29 and 0.59 in patients with LVEF<40%. Regression analyses revealed GPH to be the strongest predictor of HR-QoL. Patients with LVEF<40% rating poor GPH differed significantly (p<0.05) from those with good or moderate GPH in six of the eight HR-QoL domains.
One question about GPH gives a good general description of HR-QoL and may therefore be used as a simple tool to assess HR-QoL in elderly outpatients with clinical symptoms of HF.
Available from: Virginia Carrieri-Kohlman
- "This association persists even with multivariate adjustments for potential confounders such as major medical, behavioral, and psychological risk factors (Idler & Benyamini, 1997; Idler & Kasl, 1991; Idler, Kasl, & Lemke, 1990; Kaplan & Camacho, 1983; Mossey & Shapiro, 1982; Wolinsky & Johnson, 1992). Patients with coronary disease with poor global health ratings have almost four times the risk of coronary-related mortality compared to those with good health ratings even after controlling for other relevant factors (Bosworth et al., 1999). The prognostic power of global self-rated health (GSRH) has also been reported in patients with various cancers (Osoba, 1999; Shadbolt, Barresi, & Craft, 2002) and a large primary care clinical population (DeSalvo, Fan, McDonell, & Fihn, 2005). "
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ABSTRACT: 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).
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.
Cross-sectional analysis of data from a longitudinal clinical trial.
University medical center in the United States.
115 patients with moderate to severe COPD.
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.
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)].
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.
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