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The SF-36 Health Survey: Development and use in mental health research and the IQOLA Project

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Abstract

Data from general population surveys (n 1483 to 9151) in nine European countries (Denmark, France, Germany, Italy, the Netherlands, Norway, Spain, Sweden, and the United Kingdom) were analyzed to cross-validate the selection of questionnaire items for the SF-12 Health Survey and scoring algorithms for 12-item physical and mental component summary measures. In each country, multiple regression methods were used to select 12 SF-36 items that best reproduced the physical and mental health summary scores for the SF-36 Health Survey. Summary scores then were estimated with 12 items in three ways: using standard (U.S.-derived) SF-12 items and scoring algorithms; standard items and country-specific scoring; and country-specific sets of 12 items and scoring. Replication of the 36-item summary measures by the 12-item summary measures was then evaluated through comparison of mean scores and the strength of product-moment correlations. Product-moment correlations between SF-36 summary measures and SF-12 summary measures (standard and country-specific) were very high, ranging from 0.94–0.96 and 0.94–0.97 for the physical and mental summary measures, respectively. Mean 36-item summary measures and comparable 12-item summary measures were within 0.0 to 1.5 points (median 0.5 points) in each country and were comparable across age groups. Because of the high degree of correspondence between summary physical and mental health measures estimated using the SF-12 and SF-36, it appears that the SF-12 will prove to be a practical alternative to the SF-36 in these countries, for purposes of large group comparisons in which the focus is on overall physical and mental health outcomes.

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... SF-36 is widely used to assess HRQoL using a self-report approach [13]. In this study, we used the Italian version of SF-36 [14]. ...
... In this study, we used the Italian version of SF-36 [14]. SF-36 encompasses 36 items to assess physical functioning, role limitations due to physical problems, bodily pain, general health perceptions, vitality, social functioning, role limitations due to emotional problems, and perceived mental health [13,14]. Each item has response categories which vary from two-to six-point scales; accordingly, raw scores for items range from 1 to 6, which require to be linearly transformed into two 0-100 components, named as physical component summary (PCS36) and the mental component summary (MCS36) [13]: a higher scores indicating a better health perception. ...
... SF-36 encompasses 36 items to assess physical functioning, role limitations due to physical problems, bodily pain, general health perceptions, vitality, social functioning, role limitations due to emotional problems, and perceived mental health [13,14]. Each item has response categories which vary from two-to six-point scales; accordingly, raw scores for items range from 1 to 6, which require to be linearly transformed into two 0-100 components, named as physical component summary (PCS36) and the mental component summary (MCS36) [13]: a higher scores indicating a better health perception. Several studies reported that SF-36 has adequate internal consistency (the extent to which items within the scale's components are correlated with each other) and adequate construct validity (SF-36 scores varied in relation to predefined hypotheses, such as it can discriminate different levels of HRQoL in patients who theoretically have different levels of HRQoL) [12]. ...
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Introduction The structural validity and reliability of the Short-Form Health Survey 12 (SF-12) has not yet been tested in adults with the Marfan syndrome (MFS). This gap could undermine an evidence-grounded practice and research, especially considering that the need to assess health-related quality of life in patients with MFS has increased due to the improved life expectancy of these patients and the need to identify their determinants of quality of life. For this reason, this study aimed to confirm the dimensionality (structural validity) of the SF-12, its concurrent validity, and its reliability (internal consistency). Methods We performed a cross-sectional study in a convenience sample of 111 Italian adults with MFS, collecting anamnestic and socio-demographic information, the SF-12, and short-form Health Survey 36 (SF-36). A confirmatory factor analysis was performed to verify whether the items of SF-12 related to physical restrictions, physical functioning, and bodily pain were retained by the physical summary component of the SF-12. The items referred to the role limitations due to emotional issues, social functioning, and mental health were retained by the mental summary component (MCS12). SF-36 was used to assess the concurrent validity of SF-12, hypothesizing positive correlations among the equivalent summary scores. Results The two-factor structural solution resulted in fitting the sample statistics adequately. The internal consistency was adequate for the two factors. Furthermore, the physical and mental summary scores of the SF-36 were positively correlated with their equivalent summary scores derived from the SF-12. Conclusions This study confirmed the factor structure of the SF-12. Therefore, the use of SF-12 in clinical practice and research for assessing the health-related quality of life among adults with MFS is evidence-grounded. Future research is recommended to determine whether the SF-12 shows measurement invariance in different national contexts and determine eventual demographic variation in the SF-12 scores among patients with MFS.
... While these are important domains contributing to QoL, they are less relevant to PTSD specifically or to psychotherapy outcomes (in the short-term, though some clients may use skills learned in therapy to be successful in higher-paying jobs that may support abilities to more effectively change surroundings, etc.). Similarly, the SF and VR scales (which are similar scales, with the VR scales adapted from the SF versions, both with 12-and 36-item forms; Kazis et al., 2004Kazis et al., , 2006Ware Jr et al., 1996;Ware Jr & Gandek, 1994) ask specifically about physical functioning; indeed, on 36-item forms, items assessing physical functioning compose nearly a third of the total item pool and form the largest subscale (Ware Jr & Gandek, 1994). Versions of these scales were the most common measures in our meta-analysis, used in 15 independent samples. ...
... While these are important domains contributing to QoL, they are less relevant to PTSD specifically or to psychotherapy outcomes (in the short-term, though some clients may use skills learned in therapy to be successful in higher-paying jobs that may support abilities to more effectively change surroundings, etc.). Similarly, the SF and VR scales (which are similar scales, with the VR scales adapted from the SF versions, both with 12-and 36-item forms; Kazis et al., 2004Kazis et al., , 2006Ware Jr et al., 1996;Ware Jr & Gandek, 1994) ask specifically about physical functioning; indeed, on 36-item forms, items assessing physical functioning compose nearly a third of the total item pool and form the largest subscale (Ware Jr & Gandek, 1994). Versions of these scales were the most common measures in our meta-analysis, used in 15 independent samples. ...
Article
People with posttraumatic stress disorder (PTSD) experience a wide array of symptoms, often accompanied by significant functional and quality of life impairments. Evidence-based psychotherapies are effective for alleviating symptoms in this group, but functional outcomes following psychotherapy are understudied. This study aimed to synthesize existing work on functional outcomes of psychotherapy to conduct a meta-analytic investigation examining whether people with PTSD experience significant improvements in functioning and quality of life following a course of psychotherapy. A literature search was conducted for studies reporting results of randomized clinical trials of psychotherapies for people diagnosed with PTSD that included a functional or quality of life outcome measured at pre- and post-intervention. Both between-groups and within-groups analyses were conducted using a random effects model. Fifty-six independent samples were included. Results suggest that, on average, people with PTSD experience significant, moderate improvement in functional outcomes after a course of psychotherapy. Taken together, this meta-analysis represents a substantial advance in our understanding of functional outcomes of psychotherapy for people with PTSD. Findings suggest that psychotherapy is one vehicle through which functional outcomes may be improved for this group, though notably to a lesser degree than symptom improvement.
... Physical health perception was self-reported through the Italian version [25] of the subscale "General Health (GH)" from the SF-36 Health Survey [26]. The subscale is composed of four items on a 5-level Likert scale, ranging from "poor" to "excellent" for the first item (i.e., "In general, would you say your health is ... ") and from "completely untrue" to "completely true" for the remaining three items (e.g., "My health is excellent"). ...
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The aim of this study was to explore the potentially different associations between two common aspects of adolescents’ life, namely social jetlag and weekend catch-up sleep, with well-being and physical health, according to the actual sleep duration, i.e., <7 h and ≥7 h. To this end, 504 participants (42.1% males), with a mean age of 16.17 (standard deviation = 1.39), were examined in the current study. Participants were asked to wear the Micro Motionlogger Watch actigraph (Ambulatory Monitoring, Inc., Ardlsey, NY, USA) around their non-dominant wrist for seven consecutive days in order to objectively assess social jetlag and weekend catch-up sleep. Participants were also asked to fill in the Mental Health Continuum—Short Form for the assessment of subjective, social, and psychological well-being, as well as the SF-36 Health Survey for the perception of physical health. In adolescents sleeping less than 7 h, those experiencing weekend catch-up sleep longer than 120 min reported significantly lower subjective well-being compared to those with a weekend catch-up sleep duration between 0 and 59 min. These data pointed out the detrimental effect of long weekend catch-up sleep on self-reported well-being only in adolescents getting less than the recommended amount of sleep.
... Mental distress. Mental distress was assessed as a composite score computed by summing up six indicators of the mental/psychological functioning of the respondents 40 . The items were evaluated with widely used selfrated and cross-culturally validated items: "Over the past four weeks, have you been (1) happy, (2) sad/depressed, Covariates. ...
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Poor sleep is a long-term public health issue that has become increasingly prevalent among socially isolated older adults. However, research on the mechanisms explaining the link between social isolation and impaired sleep (IS) remains limited, particularly in low- and middle-income countries. This study explored the serial mediating effects of loneliness and mental distress on the association of social isolation with IS among Ghanaian older adults. We analyzed data from 1201 adults aged ≥ 50 from Ghana's AgeHeaPsyWel–HeaSeeB study (mean age = 66.14, SD = 11.85, age range = 50–111; women = 63.28%). Measures included the UCLA 3-item Loneliness Scale, modified Berkman–Syme Social Network Index, Sleep Quality Scale, and Mental Distress Questionnaire. We used bootstrapping techniques from Hayes’ PROCESS macro program to estimate the hypothesized serial mediation. Social isolation was significantly associated with IS (β = 0.242, p < 0.001). Crucially, social isolation indirectly predicted IS via three significant mediating pathways. Loneliness accounted for 17.6% (β = 0.054, CI = 0.096, 0.016), mental distress accounted for 6.5% (β = 0.020, 95% CI = 0.004, 0.040), and loneliness and mental distress accounted for 32.2% (β = 0.099, 95% CI = 0.065, 0.138) of the overall effect. The total mediating effect was 56.4%. These findings suggest that the social isolation-sleep link is respectively and serially explained by loneliness and mental distress. Social integrative interventions for sleep quality in old age should target mental and emotional well-being.
... The 36-Item Short Form Health Survey (SF-36) [18,19] is a widely used non-specific measure of HRQoL. The measure meets high psychometric standards [20,21]. The 36 items represent eight scales: Physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional and mental health. ...
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Purpose Sleep disturbance after cancer treatment could compromise recovery. This paper examined the associations between post-treatment sleep problems and health-related quality of life (HRQoL), and the effectiveness of an e-enabled lifestyle intervention on sleep outcomes. Methods The Women’s Wellness after Cancer Program (WWACP) was examined in a single blinded, multi-centre randomised controlled trial. Data were collected from 351 women (Mage = 53.2, SD = 8.8; intervention n = 175, control group n = 176) who had completed surgery, chemotherapy and/or radiotherapy for breast, gynaecological or blood cancers within the previous 24 months. Participants completed the Pittsburgh Sleep Quality Index (PSQI) at baseline (prior to intervention randomisation), and at 12 and 24 weeks later. Sociodemographic information, menopausal symptoms (Greene Climacteric Scale) and HRQoL (36-Item Short Form Health Survey; SF-36) were also collected. Linear panel regression was used to examine the association between sleep variables and SF36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. A difference-in-difference regression model approach was used to examine the intervention effect on the sleep outcomes. Results After adjustment for potential confounders, the sleep variables (except sleep duration) significantly predicted physical, but not mental, HRQoL. There was no statistically significant effect of the intervention on sleep outcomes at 12 or 24 weeks. Conclusion Women who have completed treatment for cancer experience sleep problems that are associated with decreased physical HRQoL. Improving sleep through targeted interventions should improve their physical HRQoL. Improved targeting of the sleep components of the WWACP should be explored.
... A higher score indicates better mental health. Studies have indicated reasonable validity for the SF-36 scale (Butterworth and Crosier 2004;Ware et al. 1994). ...
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Psychosocial job quality has been proven to be linked to workers’ mental health. Drawing on a life course perspective, this study sought to identify, compare, and contrast the psychosocial characteristics of job quality that are related to mental health in three age groups of manual/nonmanagerial construction workers, i.e., young workers, middle-aged workers, and older workers. Data were extracted from the national and longitudinal Household, Income, and Labour Dynamics in Australia (HILDA) Survey data set. The study used 15 waves of data from the HILDA survey with 6,352 responses from 1,768 participants. Longitudinal random-intercept regression models were used to examine the association between each of five aspects of job quality (i.e., job demands and complexity, job control, perceived job security, effort-reward fairness, and job intensity) and mental health. Overall, the research results showed that construction workers’ mental health declined when experiencing adverse job conditions and the magnitude of decline increased as the number of job adversities increased. Specifically, workers of the mid-age group experienced more accelerated decline in mental health compared with the other two groups when experiencing two adverse job conditions. Age-related differences were also identified in the way that individual job quality aspects are related to mental health. Although low job security and perceived unfairness of effort and reward were significant predictors of mental ill-health in all age groups, job demand and complexity and high job intensity were predictors of mental ill-health in mid-age and older construction workers but were not significant contributors to mental ill-health among younger workers. The findings highlight the need to develop targeted approaches to protecting and promoting the mental health of construction workers in different age groups.
... In Study 3, the physical functioning checklist was unintentionally left out of the survey. Due to this missingness, factor loadings from Study 1 were used to calculate the SF36 physical and mental composites in Study 3.4 The original manual for the SF36 recommended orthogonal rotation(Ware & Gandek, 1994). However, physical and mental health are correlated and later work recommended an oblique rotation to allow the factors to correlate(Farivar et al., 2007).Content courtesy of Springer Nature, terms of use apply. ...
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Objective Social status has been extensively linked to stress and health outcomes. However, two routes by which status can be earned – dominance and prestige – may not uniformly relate to lower stress and better health because of inherent behavioral and stress-exposure differences in these two routes.Methods In one exploratory and two preregistered studies, participants (total N = 978) self-reported their trait dominance and prestige and self-reported several stress and health outcomes.ResultsThe meta-effects evident across the three studies indicate that higher trait dominance was associated with worse outcomes – higher stress, poorer physical and mental health, poorer behavioral health, poorer life satisfaction, higher negative affect (range of absolute values of non-zero correlations, |r| = [0.074, 0.315], ps < 0.021) – and higher trait prestige was associated with better outcomes – lower stress, better physical and mental health, better behavioral health, better life satisfaction, higher positive and lower negative mood (|r| = [0.134, 0.478], ps < 0.001). These effects remained evident (with few exceptions) after controlling for socioeconomic status, other status-relevant traits, or self-enhancing motives; associations with behavior relevant to the COVID19 pandemic generally were not robust.Conclusions This work indicates that evolved traits related to the preferred route by which status is earned likely impact self-reported stress and health outcomes. Future research is necessary to examine physiological and other objective indicators of stress and health in more diverse populations.
... A disease specific PROM is the best instrument for measuring the HRQOL in this patient population as the specific physical and psychosocial complaints that form a burden to these patients are not incorporated in generic PROMs like the 36-item short form health survey (SF-36) (25) or the EuroQol 5 dimensions 5 levels instrument (EQ-5D-5L) (26). ...
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Background: Pectus excavatum often imposes significant burden on the patients' quality of life. However, despite the known biopsychosocial effects, the deformity remains underappreciated. Patient reported outcome measures can be used to measure and appreciate results from a patient's perspective. The pectus excavatum evaluation questionnaire (PEEQ) is the most employed disease specific instrument to measure patient-reported outcome measures (PROMs). A translation and linguistic validation of this questionnaire is presented for its use in the Dutch pediatric pectus excavatum population. By providing an insight in our translation process, we want to encourage other researchers to perform translations to other languages to make the questionnaire available to clinicians and researchers worldwide. Methods: The 22-item PEEQ was translated and adapted according to the leading guidelines for the translation of patient reported outcome measures. Conceptual equivalence and cultural adaptation were emphasized. Results: One forward translation was produced through reconciliation of two forward translations. Back translation resulted in 15 identical items, as well as 6 literal, and 1 conceptual discrepancy. The latter was expected as during the forward translation a more culturally appropriate translation was chosen. Ten patients were involved during the cognitive debriefing process, following which one item was revised and the final Dutch version was established. Conclusions: We provide a culturally appropriate and linguistically validated Dutch version of the PEEQ.
... Fizeram parte dos instrumentos de coleta de dados: 1) entrevista sociodemográfica personalizada, com informações sobre dados pessoais, de alimentação e consumo, práticas de atividade física, estigmas e discriminação devido ao peso, uso do SUS, dentre outras informações; 2) escala para avaliar a QV, Short Form Health Survey SF-36 (15) traduzida para o Brasil (16) -de modo que a interpretação dos escores obtidos no SF-36 podem ser normalizados para uma distribuição em que valores médios variam em torno de 50, com um fator de escala de dispersão de 10 [assim, pontuações superiores a 50 e mais próximos a 100 indicam melhores QV ou estado de saúde (17) ] -; 3) questionário para averiguação do nível de percepção da imagem corporal, identificado como Body Shape Questionnaire (BSQ) e validado na população brasileira (18) ; 4) dois inventários psicológicos, traduzidos e adaptados à população brasileira (19) , um para mensurar ansiedade, chamado Inventário Beck de Ansiedade (BAI) e um outro para mensurar depressão, chamado de Inventário Beck de Depressão (BDI); e 5) Escala de Compulsão Alimentar Periódica, Binge Eating Scale (BES) para mensurar os aspectos do comportamento alimentar, especialmente a compulsão alimentar, traduzida e adaptada para o português brasileiro (20) . Contudo, antes mesmo da aplicação dos instrumentos, o participante consentia e autorizava mediante a assinatura a sua inserção na pesquisa, através do Termo de Consentimento Livre e Esclarecido (TCLE). ...
... The overall score ranged from 0 to 20 with a higher score reflecting higher social connectedness. Self-rated health was assessed with a single-item measure of the Short Form Health Survey 36 Questionnaire (very good, good, fair, and poor) 60 . Mental health was measured by the Kessler Psychological Distress Scale (K-10) (none of the time, a little of the time, some of the time, most of the time, all of the time) 20 with a sum score ranging from 0 to 40 with higher scores reflecting higher psychological distress outcomes. ...
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Females on average live longer but with higher rates of functional impairment and lower physical and economic activities than men. However, research linking retirement to functional impairment and the modifying role of gender and physical activity (PA) is limited especially in low- and middle-income countries. This paper examines the association between retirement and functional impairment in Ghana and evaluates the effect modification of the association by gender and PA. The sample included 1201 adults aged ≥ 50 years from a population-based study. Functional impairment was assessed with the activities of daily living scale. Ordinary least squares regression models adjusted for confounding variables and estimated gender-wise and PA heterogeneity effect of retirement on functional impairment. Regressions showed that retirement predicted an increase in functional impairment score in the full sample (β = .76, p < .001) and in men (β = 1.96, p < .001), but not in women. Interestingly, retirement significantly increased functional impairment in ≥ 65 age cohort (full sample: β = .71, p < .005; men: β = 1.86, p < .001) although not in women. However, the effect was significantly moderated by PA such that retirement × PA predicted a decrease in functional impairment in the full sample (β = −.81, p < .005) and the ≥ 65 age group (β = −.43, p < .005). Functional impairment risk of retirement is gender-specific, but PA buffers the relationship. Retirement is generally commonplace, but these findings imply that promoting PA may hold promise for addressing functional impairment in old age. Attending to the physical health needs of men during retirement should be a social policy priority.
... Pain severity and pain interference were assessed with the bodily pain subscale of the Medical Outcomes Study Short Form-36 (MOS SF-36) [32]. Pain severity was based on selfrated and a cross-culturally validated single-item question eliciting information on how much pain an individual has felt over the past four weeks, "How much bodily pain have you had during the past 4 weeks?" ...
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Objectives : Pain is prevalent among older adults and may result in impairment in physical function. However, little is known about the effect-modification of this relationship by physical activity (PA) participation. This large and representative study sought to estimate the effect of pain on physical function among older adults in Ghana and evaluate whether PA modifies this association. Methods : Data came from 1201 adults aged ≥50 years participating in the AgeHeaPsyWel–HeaSeeB Study in Ghana. Pain constructs were defined using the Medical Outcomes Study Short Form-36 (MOS SF-36). PA was assessed using the International Physical Activity Questionnaire short form (IPAQ-SF) and physical function impairment was measured by seven-item domains based on the activities of daily living (ADL) and instrumental ADL (IADL). Adjusted hierarchical OLS regressions were fitted to estimate the direct and moderating relationships between pain facets, PA, and impaired physical function. Results : The relationships of pain severity (β = 0.348, p < .001), and pain interference (β = 0.424, p < .001) with impaired physical function were robust after full adjustment for confounding variables. Persons with pain experiences had significantly increased impaired physical function risks. PA significantly modified the association between pain severity (β = -0.232, p < .001) and pain interference (β = -0.143, p < .001) with impaired physical function. Conclusions : Our data indicate that the relationships of pain with physical function impairment are modified by PA intensity. Future studies are warranted to understand the indirect effect of pain on functional limitations and how PA promotion could manage pain and improve functional ability in aging adults.
... McDonald's ωt (internal consistency) were bootstrapped 1000 iterations. Unless otherwise indicated, we used discrete visual analogue responses (e.g., 1 = very unlikely, 2, 3, 4, 5 = very likely), as typical Likert-type responses may be more likely to violate monotonicity assumptions (Ware & Gandek, 1994). S1 included the Satisfaction With Life Scale (Diener et al., 1985), a five-item measure of global satisfaction with life. ...
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Clinicians are expected to provide accurate and useful mental health assessments, but existing instruments often fail to meet expectations. We used a multi-model approach to address one urgent psychiatric concern, developing a highly valid, ‘free culture’ license, instrument – the Suicidality Scale (SS). Study 1 survey participants (N=5,115, aged 13-82) completed an item pool and psychosocial measures. Study 2 (N=814, aged 14-80) included SS modifications and a follow-up (two weeks) assessment (n=190). Study 3 (N=626, aged 14-83) included further modifications. SS psychometric properties were high (loadings > .77; a > 2.2; test-retest r = .87; internal consistency, ωt = .96). Invariance checks were satisfied for demographics, self-reported psychiatric diagnosis, and suicide attempt history. The SS showed stronger psychometrics and significant differences in bivariate associations compared with available suicide measures. The ‘open source’ Suicidality Scale represents a step forward in accurate suicide risk assessment for adolescents, adults, and diverse populations.
... Each item is scored from 0 to 100, where a higher score indicates a better health state. This survey has good psychometric properties in adults [83], has been used successfully in research on adolescents [84,85], and normative data on randomly sampled adolescents [16][17][18][19] are available from the local BC CaMos database [86]. ...
Article
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Background The incidence of depression in human females rises steadily throughout adolescence, a critical period of pubertal maturation marked by increasing levels of gonadal hormones including estrogens and progesterone. These gonadal hormones play a central role in social and emotional development and may also contribute to the increased occurrence of depression in females that begins in early adolescence. In this study, we examine whether and how introducing synthetic estrogen and progestin derivatives through the use of combined hormonal contraceptives (CHC), affects adolescent females’ risk for developing depression. We further assess potential links between CHC use and alterations in stress responses and social-emotional functioning. Methods Using a longitudinal cohort design, we will follow a sample of adolescent females over the span of three years. Participants will be assessed at three time points: once when they are between 13 and 15 years of age, and at approximately 18 and 36 months after their initial assessment. Each time point will consist of two online sessions during which participants will complete a clinical interview that screens for key symptoms of mental health disorders, along with a series of questionnaires assessing their level of depressive symptoms and history of contraceptive use. They will also complete a standardized social-evaluative stress test and an emotion recognition task, as well as provide saliva samples to allow for assessment of their circulating free cortisol levels. Discussion In this study we will assess the effect of CHC use during adolescence on development of Major Depressive Disorder (MDD). We will control for variables previously found to or proposed to partially account for the observed relationship between CHC use and MDD, including socioeconomic status, age of sexual debut, and CHC-related variables including age of first use, reasons for use, and its duration. In particular, we will discover whether CHC use increases depressive symptoms and/or MDD, whether elevated depressive symptoms and/or MDD predict a higher likelihood of starting CHC, or both. Furthermore, this study will allow us to clarify whether alterations in stress reactivity and social-emotional functioning serve as pathways through which CHC use may result in increased risk of depressive symptoms and/or MDD.
... Each item is scored from 0 to 100, where a higher score indicates a better health state. This survey has good psychometric properties in adults [83], has been used successfully in research on adolescents [84,85], and normative data on randomly sampled adolescents [16][17][18][19] are available from the local BC CaMos database [86]. ...
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Introduction Previously reported associations between oral contraceptives (OCs) use and depression have been conflicting. Insight into the impact of analytical choices on the association may help to reconcile previous heterogeneous findings. Objectives We aimed to examine the association between adolescent OC use and subsequent depression risk in early adulthood analyzing all theoretically justifiable models. Methods Women from the prospective cohort study Tracking Adolescents’ Individual Lives Survey (TRAILS) were included in this study. All justifiable associations between adolescent OC use (ages 16-19 years) and major depressive disorder (MDD) in early adulthood (ages 20-25 years) as assessed by the Diagnostic and Statistical Manual of Mental Disorders-IV oriented Lifetime Depression Assessment Self-Report and the Composite International Diagnostic Interview were tested. Results A total of 818 analytical models were analyzed in 534 adolescent OC users and 191 nonusers. Overall, there was a tentative association of adolescent OC use and an episode of MDD in early adulthood (median odds ratio [OR] median =1.41; OR min =1.08; OR max =2.18, permutation testing p-value 1 = .052, and p-value 2 = .046), which was primarily driven by the group of young women with no history of MDD (OR median =1.72; OR min =1.21; OR max =2.18, both permutation testing p-values = .02). Conclusions Adolescent OC use was associated with an increased risk for experiencing an episode of MDD, but only among women with no history of MDD in adolescence. Understanding the potential side effects of OCs will help women and their doctors make informed choices when deciding among possible methods of birth control. Disclosure No significant relationships.
... Para as pesquisas conseguintes, de acordo com a perspectiva da Organização Mundial de Saúde (WHOQOL GROUP, 1994) acerca da prospecção de uma qualidade de vida considerada 'saudável', este estudo indicou que há a necessidade de identificação e descrição dos fatores ligados à saúde física, ao estado psicológico, ao nível de independência e às relações sociais do indivíduo e suas interfaces com o meio onde está inserido, e se estes estão correlacionados à baixa saúde mental experimentada pelos gestoresde acordo com o resultado do nível MCS,54). Além disso, há a urgência de verificar, conformeWare et al. (1994), quais fatores negativos (síndromes ou doenças) estão concomitantes a uma saúde mental não saudável. ...
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Este artigo se propôs a identificar e descrever os componentes de saúde física e mental sob os processos de saúde e suas relações ao burnout para avaliar a qualidade de vida da equipe gestora socioeducativa do Distrito Federal. Como método, utilizou-se, o SF-36 Health Survey e o MBI- HSS. Nos resultados, enquanto os índices de saúde física foram elevados, a baixa qualidade de vida foi evidenciada sob o aspecto de saúde mental. Sobre a qualidade de vida relacionada ao desenvolvimento de burnout, quanto maior o esgotamento emocional, mais as relações com a equipe de trabalho foram afetadas. Com relação à saúde mental, quanto maior a 'vitalidade', melhor a saúde mental e quanto menor o esgotamento emocional, maior a qualidade de saúde mental do gestor. Este estudo intencionou apresentar o “retrato de saúde" dos gestores, de forma a propiciar reflexões sobre a escolha de gerenciar um sistema complexo, conciliando e/ou privilegiando ou 'desconsiderando' a "vivacidade" de sua própria saúde.
... All patients' chief complaint was chronic widespread pain. Diagnosis of MSD was supported by means of a modified interview of the somatoform disorders section of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorder IV (DSM-IV) (SCID) as well as the German version of the 36-item Short Form 36 (SF-36) questionnaire, i.e., the Physical Component Summary score needed to be ≤ 40 as sign of strong psychophysiological strain [1,2,[6][7][8]47]. The presence of chronic widespread pain fulfilling the strict criteria of pain present in three out of four body quadrants in addition to axial pain [15] was systematically assessed by a 34-item pain localization questionnaire. ...
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Background Different functional somatic syndromes (FSS), fibromyalgia (FMS) and other unexplained painful conditions share many common clinical traits and are characterized by troubling and functionally disabling somatic symptoms. Chronic pain is most frequently reported and at the center of patients’ level of disease burden. The construct of multisomatoform disorder (MSD) allows to subsume severely impaired patients suffering from FSS, FMS and other unexplained painful conditions to be examined for common underlying processes. Altered leptin levels and a pathological response of the HPA-axis as a result of chronic stress and childhood trauma have been suggested as one of the driving factors of disease development and severity. Previous studies have demonstrated that methylation of the leptin promoter can play a regulatory role in addiction. In this study, we hypothesized that methylation of the leptin promoter is influenced by the degree of childhood traumatization and differs between patients with MSD and controls. A cohort of 151 patients with MSD and 149 matched healthy volunteers were evaluated using clinical and psychometric assessment while methylation level analysis of the leptin promoter was performed using DNA isolated from whole blood. Results In female controls, we found CpG C-167 to be negatively correlated with leptin levels, whereas in female patients CpG C-289, C-255, C-193, C-167 and methylation cluster (C-291 to C-167) at putative bindings sites for transcription factors Sp1 and c/EBPalpha were negatively correlated with leptin levels. Methylation levels were significantly lower in female patients CpG C-289 compared with controls. When looking at female patients with chronic widespread pain methylation levels were significantly lower at CpG C-289, C-255 and methylation cluster (C-291 to C-167). Conclusion Our findings support the hypothesis that epigenetic regulation of leptin plays a role in the regulation of leptin levels in patients with MSD. This effect is more pronounced in patients with chronic widespread pain.
... SF-36 and the SF-12 are among the most used multi-item health-related quality of life scales. These scales were developed by Ware et al. and Ware and Gandek (1996;1994) in order to evaluate the quality of life, and it is a scale that reviews the quality of life in the last 4 weeks. ...
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Introduction: The absence of a scale adapted to Turkish to determine the level of insufficiency in the physical activities of athletes sometimes causes difficulties in our clinical practices. Our study aims to adapt the Short Form‑10 (SF‑10) of the Disablement in the Physically Active Scale (DPA) to Turkish. Materials and Methods: Athletes who are healthy or have any musculoskeletal injuries participated in the study. DPA‑TR SF‑10, which consists of ten items, and the SF‑12 scale used in the analysis of concurrent validity were applied to 106 athletes. Results: As a result of confirmatory factor analysis (CFA), no item was required to be removed from the scale. A high level of correlation was found between DPA‑TR SF‑10 and physical component summary sub‑score of the SF‑12 scale (r = 0.61; p< 0.01). The reliability coefficient obtained as a result of the reliability analysis was estimated to be 0.91. All items in the scale were determined to be distinctive. In order to facilitate the calculation of the DPA‑TR SF‑10 score, the sum of the answers given to the 5‑point Likert Scale was evaluated. Thus, the lowest score of the DPA‑TR SF‑10 is 10, and 50 is the highest score. Conclusion: DPA‑TR SF‑10 has been provided in Turkish to evaluate physically active individuals/athletes as a valid and reliable measurement tool.
... PASQ Parental Alienation Syndrome Questionnaire (Machuca, 2005), BSQ Baker Strategy Questionnaire (Baker & Chambers, 2011), PDS Parental Denigration Scale (Rowen & Emery, 2014), SA−45 Symptom Assesment−45 Questionnaire (Davison et al., 1997), SCL−90 Symptom Checklist−90 (Derogatis et al., 1973), SCL−90−R Symptom Checklist−90 Revise (Derogatis, 1977), STAI State−Trait Anxiety Inventory (Spielberger et al., 1970), IDDL Inventory to Diagnose Depression Lifetime Version (Zimmerman & Coryell, 1987), BDI−II Beck Depression Inventory -II (Beck et al., 1996), CESD Center of Epidemiologic Studies Depression Scale for Adults (Radloff, 1977), RSE Rosengerg Self−Esteem Scale (Rosenberg, 1965), DSSQ Daily Sufficiency Skills Questionnaire (Baker & Ben-Ami, 2011), CAGE Questionnaire (Ewing, 1984), RQThe Relationships Questionnaire (Bartholomew & Horowitz, 1991), PMM Psychological Maltreatment Measurement (Baker & Festinger, 2011), TCI−125 Temperament and Character Inventory-125 (Cloninger et al., 1994), PBI Parental Bonding Instrument (Parker et al., 1979), IPPA Inventory of Parent and Peer Attachment (Armsden & Greenberg, 1987) WHO−3 (Bech, 2003), SF−36 The Short Form (36) Health Survey (Ware et al., 1994), NRI The Networks of Relationships Inventory (Furman and Burhmester, 1985), PSI The Parenting Styles Index (Steinberg et al., 1992), CPIC The Children's Perception of Interparental Conflict Scale (Grych et al., 1992), The Satisfaction With Life Scale (Diener et al., 1985), PFAD The Painful Feelings About Divorce Scale (Laumann-Billings & Emery, 2000) years; therefore, we face a problem in an emerging area of study. There are variations in sample size among studies, between 6 and 739 participants. ...
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Although the emotional consequences of childhood exposure to parental alienation behaviors in children and adolescents of divorced parents are known, there is scarce evidence on their long-term consequences in adulthood. Therefore, this work aims to conduct a systematic review of the state of research in this area and its main conclusions and identify gaps and limitations to guide future research. A search of the literature was performed in electronic databases PsycInfo, MEDLINE, SCOPUS, Web of Science, PubMed, Cochrane Library, DART-Europe, ProQuest, Wiley, TESEO and Dialnet, and a secondary review of the bibliography; in February 2019 updated in December of the same year. Thirteen pieces of research were selected after applying inclusion and exclusion criteria; twelve published articles from journals and one doctoral thesis, both with qualitative and quantitative methodology. Children exposed to parental interference and alienation show in adulthood depression and anxiety symptoms, a higher risk of psychopathology, lower self-esteem and self-sufficiency. As well as, higher alcohol and drug use rates, parental relationship difficulties, insecure attachment, lower life quality, higher divorce rates, feelings of loss, abandonment and guilt. They also report repetition of these alienating behaviors on their children by their partner or their own children's grandparents. Some limitations of the study are described, and proposals are made for future research.
... The 12-Item Short Form Health Survey (SF-12) is a self-report measure of health-related quality of life (QoL). The SF-12 consists of two subscales: the physical component summary score and the mental component summary score (range for each subscale is 0-100, and higher scores indicate better functioning [Ware et al., 1994]). The test-retest reliability is 0.80 for the physical health component score and 0.76 for the mental health component score (Ware Jr, Kosinski, & Keller, 1996). ...
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Objective This study compared the benefits of cognitive–behavioral therapy for insomnia for sleep, mental health symptoms, and quality of life (QoL) in a sample of women veterans with and without probable post-traumatic stress disorder (PTSD) comorbid with insomnia disorder. Methods Seventy-three women veterans (30 with probable PTSD) received a manual-based 5-week cognitive–behavioral therapy for insomnia treatment as part of a behavioral sleep intervention study. Measures were completed at baseline, posttreatment, and 3-month follow-up. Sleep measures included the Insomnia Severity Index, Pittsburgh Sleep Quality Index, sleep efficiency measured by actigraphy, and sleep efficiency and total sleep time measured by sleep diary. Mental health measures included the PTSD Checklist-5, nightmares per week, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 scale. QoL was measured with the Short Form-12. Linear mixed models compared changes over time across groups. Independent t tests examined PTSD symptom changes in women veterans with probable PTSD. Results Both groups demonstrated improvements across sleep (ps < .001–.040), mental health symptoms (ps < .001), and QoL measures (ps < .001). The probable PTSD group reported greater improvements in diary sleep efficiency (p = .046) and nightmares per week (p = .001) at post-treatment and in total sleep time (p = .029) and nightmares per week (p = .006) at follow-up. Most participants with probable PTSD experienced clinically significant reductions in PTSD symptoms at post-treatment (66.7%) and follow-up (60.0%). Significant reductions in intrusive and arousal/reactivity symptoms were maintained at follow-up. Conclusions Cognitive–behavioral therapy for insomnia improves insomnia, mental health symptoms and QoL among women veterans, with greater improvement in those with probable PTSD.
... Ein weiteres Unterscheidungsmerkmal bildet die Fokussierung auf die durch die Erkrankung bedingte Beeinträchtigung körperlicher Funktionen wie z.B. im SF36 (Ware et al. 1994) oder auf die Zufriedenheit mit bzw. die Bewertung von Lebensbedingungen wie z.B. in den WHOQOL Instrumenten (Angermeyer et al. 2000;The WHOQOL Group 1998a;The WHOQOL Group 1998b). ...
... Finally, information about mental health was included in the Mental Health Index (MHI, see e.g. Ware & Gandek, 1994). Possible scores on the MHI vary between 0 and 100, with a higher score indicating better mental health. ...
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The role of health has never entered the debate about migrant fertility. The main goal of this work was to explore, for the first time, the relationship between health and fertility intentions among migrants by gender, duration of stay and parity. Three health measures were considered: self-rated health, the presence of chronic illnesses and mental health. We compiled data from the Italian survey "Social Condition and Integration of Foreign Citizens" and employed generalized ordered logistic models to test the relationship between health and fertility intentions among migrants. Our findings show that poor health negatively affects migrants’ fertility intentions, net of a wide array of control variables (including employment and reason for migration). This is especially true among long-term migrant women, and, among the latter, the effect is strongest when chronic illnesses and mental health are considered. We encourage future research to consider health in the demographic debate about migrant fertility.
... Patients completed QOL (SF-36 [11] and Faecal Incontinence Quality of Life Score FIQOLS [12]) pre, immediately postoperatively, and 6 and 12 months after surgery. ...
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Background The length of sphincter which can be divided during fistulotomy for perianal fistula is unclear. The aim was to quantify sphincter damage during fistulotomy and determine the relationship between such damage with symptoms and severity of faecal incontinence and long-term quality of life (QOL). Methods A prospective cohort study was performed over a 2-year period. Patients with intersphincteric and mid to low transsphincteric perianal fistulas without risk factors for faecal incontinence were scheduled for fistulotomy. All patients underwent 3D endoanal ultrasound (3D-EAUS) pre-operatively and 8 weeks postoperatively. Measurements were taken of pre- and postoperative anal sphincter involvement and division. Anal continence was assessed using the Jorge-Wexner scale and QOL scores pre, 6 and 12 months postoperatively. Results Forty-nine patients were selected. A strong correlation between pre- and postoperative measurements was found p < 0.001. A median length of 41% of the external anal sphincter and 32% of the internal anal sphincter was divided during fistulotomy. Significant differences in mild symptoms of anal continence were found with increasing length of external anal sphincter division. But there was no significant deterioration in continence, soiling, or quality of life scores at the 1-year follow-up. Division of over two-thirds of the external anal sphincter was associated with the highest incontinence rates. Conclusions 3D-EAUS is a valuable tool for quantifying the extent of sphincter involvement pre- and postoperatively. Post-fistulotomy faecal incontinence is mild and increases with increasing length of sphincter division but does not affect long-term quality of life.
... Age-and sex-matched control groups are available for comparison. 41 SF-36 scores may be summarized by aggregating the physical and mental domain subscales into two constructs: physical component summary (PCS) and mental component summary (MCS) scores. The relative weight of each subscale is determined by factor analysis. ...
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Health‐related quality of life (HRQOL) is reduced in Fabry disease (FD) and associated with clinical disease manifestations, but few have used Fabry‐specific severity scores to study how disease burden interferes with quality of life. We investigated how the Fabry DS3, consisting of four somatic domains and one patient‐reported item, associates with HRQOL, while also evaluating fatigue, pain and psychological distress as possible predictors. Thirty‐six adults with FD completed the Short‐form Health Survey (SF‐36), the hospital anxiety and depression scale (HADS), the brief pain inventory (BPI) and reported fatigue on a visual analog scale. Clinical data were collected from the last multidisciplinary hospital visit. Using correlation and hierarchical linear regression analyses, we examined associations between demographic, clinical and self‐reported predictors and the SF‐36 physical (PCS) and mental (MCS) component summary scores. Males scored lower than the general population in all SF‐36 domains (P < .05). General health and social functioning were reduced in females. Before including self‐reported symptom scores, DS3 showed associations with PCS (P = .009). Our fully adjusted model explained 66% of the variation in PCS, where education (P = .040) and fatigue (P = .002) retained significance. With HADS depression score (P = .001) as the sole significant factor, our regression model explained 56% of the variation in MCS. The DS3 score has implications for HRQOL in FD. Low education and fatigue represent major barriers to physical well‐being, while depression strongly influences mental quality of life. Fatigue should be recognized as an important endpoint in future FD trials. Increased efforts to diagnose and treat affective disorders are warranted.
... The Short Form 36 Version 2 (SF-36v2) is a validated, reliable and non-specific QoL measure that explores different aspects of mental and physical health and allows for comparisons with a general standard population (Ware and Sherbourne, 1992;Ware et al., 1994). The measure is composed of nine individual subscales, with higher scores indicating better QoL. ...
Article
STUDY QUESTION What is the relationship between specific quality of life domains and depression, anxiety and stress in the endometriosis population? SUMMARY ANSWER Psychosocial domains of quality of life, such as a perception of social support and self-image, are more strongly associated with depression, anxiety and stress than pain and medical factors. WHAT IS KNOWN ALREADY Prior research indicates a high prevalence of anxiety and depression in individuals with endometriosis. Pain is thought to be critical in the development of psychological distress, however prior research has investigated this association without consideration of psychosocial quality of life domains such as social functioning, perceived social support and self-image. STUDY DESIGN, SIZE, DURATION This study is a cross-sectional analysis of baseline data collected in a longitudinal study exploring psychological distress in endometriosis (n = 584). PARTICIPANTS/MATERIALS, SETTING, METHODS Individuals living with endometriosis participated in this study and were recruited via online platforms of community organizations and support groups. Demographic and medical information concerning endometriosis treatment and diagnosis was self-reported. Psychological distress and quality of life was measured using the Depression, Anxiety and Stress Scale (DASS-21), Endometriosis Health Profile-30 (EHP-30) and the Short Form Survey (SF-36v2). A series of linear regression analyses explored the relationship between specific quality of life domains and the primary outcomes of depression, anxiety and stress. MAIN RESULTS AND THE ROLE OF CHANCE Approximately half of the participants in this sample reported moderate to severe anxiety, depression and stress. Quality of life domains, particularly perceived social support, social functioning and self-image, were more strongly associated with psychological distress than medical or demographic factors. Pain was associated with anxiety, but not depression or stress. A greater number of endometriosis symptoms was only associated with depression. LIMITATIONS, REASONS FOR CAUTION These data are cross-sectional and, therefore, causality cannot be inferred from this analysis. Information about endometriosis diagnosis and treatment was self-reported, and not verified against medical records. WIDER IMPLICATIONS OF THE FINDINGS This study indicates that psychosocial factors may be more salient factors underlying depression, anxiety and stress in the endometriosis population than pain and medical factors. There is a need for interventions that target psychological distress in this population with a focus on the broader impact of endometriosis beyond pain and physical symptomatology. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by the Research Training Program (RTP) Scholarship awarded to C.S.M. by Macquarie University. The remaining authors have nothing to declare. TRIAL REGISTRATION NUMBER ACTRN12619001508167.
... Já para a avaliação da qualidade de vida, foi utilizado o SF-36, que possui 36 questões, englobando a capacidade funcional, aspectos físicos, dor, estado geral da saúde, vitalidade, aspectos sociais, aspectos emocionais e saúde mental, além de uma questão comparativa entre a saúde atual e a de um ano atrás saúde (Ware & Sherbourne, 1992;Ware & Gandek, 1994). Apresenta uma versão validada para o português, sua aplicação resulta em um valor específico para cada questão, que posteriormente levará a uma escala que representa desde uma menor qualidade de vida, quando obtém-se valores próximos de 0, até uma melhor Os dados descritivos e as características das participantes estão apresentadas na Tabela 1. ...
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Introdução:A pandemia de SARS-CoV-2 gerou um impacto na saúde sexual e reprodutiva principalmente por ser uma doença com alta transmissibilidade entre indivíduos que mantém contato próximo. Objetivo: Avaliar o impacto do isolamento social na função sexual, qualidade de vida, e autoimagem de mulheres nulíparas, antes e durante a pandemia de SARS-CoV-2. Métodos: Estudo analítico observacional longitudinal, com mulheres de 18 a 35 anos, nulíparas, com ensino médio completo, que não realizaram tratamento fisioterapêutico prévio. A coleta de dados contemplava dados antroposociodemográficos e os questionários Female Sexual Function Index (FSFI), Short Form Health Survey 36 (SF-36), e a Escala de Silhuetas de Stunkard, Sorensen e Schlusinger (avaliação da autoimagem), aplicados antes e durante o isolamento social. A análise estatística foi realizada no GraphPad Prisma 6.0, e foi utilizado o teste de Shapiro Wilk, para analisar a distribuição da amostra, que foi não paramétrica, em seguida aplicou-se o Teste de Wilcoxon e a Correlação de Spearman. O nível de significância adotado foi p≤0,05. Resultados: Foram avaliadas 37 voluntárias, as variáveis sociodemográficas e o índice de massa corporal não apresentaram diferença entre as avaliações, durante o isolamento social o número de mulheres sedentárias aumentou (p<0.0001), a função orgástica melhorou (p=0,0081), a dor piorou significativamente no SF-36 (<0.0001), e quanto melhor foi o Estado Geral de Saúde do SF36 melhor foi a função sexual [p=0,04; r=0,37], na correlação da atividade física, o tipo de isolamento social e o escore total obtido no questionário FSFI, não foi verificado correlações significativas. Conclusão: O isolamento social, favoreceu a melhora da função orgástica, a piora da dor no SF-36, e não interferiu na insatisfação da imagem corporal, que permaneceu semelhante.
... A five-point discrete visual analogue response set was developed for all items. Only anchor points were verbally labelled, as research has shown verbally labelled responses do not form equal response points (Ware & Gandek, 1994). Only labelling anchor points helps obtain near-interval level data via equidistant response options. ...
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Research into problematic smartphone use is growing as people are increasingly dependent on technological connections – a situation highlighted during the COVID-19 pandemic. However, current research has been limited by measurement validity issues and a lack of construct clarity. In response, this study developed and validated the Smartphone Connectivity Stress Scale (SCSS) for adolescents and adults. An online survey included an item pool, based on previous research and existing scales, as well as several psychosocial measures (N = 814; aged 14–80 years; 59% female). Iterative exploratory factor analyses, classical test theory and item response theory (IRT) analyses produced a unidimensional six-item scale of smartphone connectivity stress – from a perceived obligation to be constantly connected with others. Two-week test-retest reliability was assessed through a follow up survey (n = 190). SCSS factor structure and reliability were strong for adolescents (aged 14–18) and adults (aged 19–80). The SCSS demonstrated good internal consistency (α = 0.87, ωt = 0.91); test-retest reliability, r = 0.82; and all items captured significant information across the latent trait. The SCSS demonstrated no differential item functioning by sex, age, ethnicity or urban/rural residence. The SCSS was positively correlated (ps < .001) with anxious attachment style and psychopathology symptoms (stress, anxiety, depression, suicidality). This is the first measure of smartphone connectivity stress and included valuable IRT analyses. The brief public domain SCSS provides reliable measurement, with reduced error, of a validated construct, and is suitable for use with adolescents and adults.
... Kvalitet života u vezi sa zdravljem (HRQOL) treba da obuhvati fizičko, psihičko i društveno (socijalno) funkcionisanje. Komponente kvaliteta života su: fizička, psihološka i socijalna individualna percepcija položaja u porodici i društvu, kao i ostvarenje društvenih kontakata [7,8]. ...
Article
Introduction. The aim of the study was to examine the correlation between subjective well-being and quality of life of the elderly in relation to their demographic characteristics, health, social and financial status. Methods. The study sample was comprised of 159 subjects of both sexes and of older age. The respondents underwent research in Banja Luka in the premises of the Association of Pensioners of the Republic of Srpska, senior citizens' clubs when coming to some of financial institutions to get help, to open bank accounts etc., as well as in the premises where pensioners gather to socialize and communicate. The survey questionnaire developed for the purpose of the paper and adapted to this population was used in the study. The survey questionnaire consisted of the following elements: sociodemographic data, self-assessment concerning the quality of life and Quality of Life Scale for the Elderly. Results. The study included a total of 159 subjects, 56.6% males and 43.4% females, of whom the majority were 65-75 years old (67.3%). The average health status (M = 2.17; SD = 0.68) was higher than the expected value, while the social status (M = 1.93; SD = 0.60) and the social needs (M = 1.91; SD = 0.72) were slightly lower compared to theoretical mean. Furthermore, the financial status had an average value (M = 2.08; SD = 0.59). The distribution of social needs was unsatisfactory. The obtained value of the Self-Perceived Quality of Life Scale was within the range of the theoretical mean values (M = 5.54, SD = 2.47), indicating that the distribution of the obtained quality of life values was symmetrical. Conclusion. Financial status significantly affects the quality of life of the elderly. The distribution of social needs is unsatisfactory. The level of education significantly affects the quality of life: highly educated respondents have a better health, social and financial status compared to the elderly with a lower level of education.
... In agreement with the SF-36 manual (Ware et al., 1994), the two aggregated health measures (physical component score [PCS] and mental component score [MCS]) had no significant linear correlation (Pearson's r(178) = 0.126, p = .094). Furthermore, the PCS was significantly correlated with PF, RP, and BP subscales. ...
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Purpose: To explore the relationship between shame, ageing, physical disease, and quality of life in Greek older people. Design and methods: A cross-sectional design using a stratified random cluster sample of older adults from Open Care Centers for the Elderly in the region of Epirus, Greece. Data were collected using (a) the Short Form-36 Health Survey, (b) the Other As Shamer Scale, and (c) the Experience of Shame Scale. Data were analyzed using SPSS software. Results: Internal shame was positively correlated with external shame (Pearson's r(177) =, p < .01), with negative effect on the mental component in both men and women (effect on women bW = -0.173, pW = .004, effect on men bM = -0.138, p M = .047), b = path analysis beta coefficient and with a significant negative effect on the physical health component for men. External shame was found to have a significant negative effect on women's mental health (b = -0.266, p = .002) and a nonsignificant effect on the physical health component. Age was negatively related with the physical health component in both groups (bW = -0.392, pW = .002 and bM = -0.384, pM = .003), while the presence of a bodily disease corresponded with a lower physical health component score for men (b = -4.267, p = .033). Conclusion: Shame in older individuals is present in both sexes. Older males suffering from a physical disease displayed a greater decline of the health-related quality of life on physical health components, leading to greater internal shame. Older females suffering from a physical disease displayed a greater decline of health-related quality of life on mental health components, leading to greater external shame. Clinical relevance: These results indicate the need for developing assessment and care plans for older individuals that incorporate in them the concept of shame as a factor in dealing with and adapting to physical disease.
... 24 Health status was assessed by the Short Form general health questionnaire. 25 Self-efficacy with subscales for pain (five items) and symptoms (six items) was measured with the Arthritis Self-Efficacy Scales. 26 This instrument measures whether patients have confidence in coping with pain, function and other symptoms due to arthritis (numeric rating scales 10-100, 100=highest). ...
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Objectives Gout is often not adequately treated, and we aimed to apply urate lowering treatment (ULT) combined with individual information to achieve target serum urate (sUA) in clinical practice, and to identify predictors of achievement of this sUA target. Methods Patients with a recent gout flare and sUA >360 µmol/L (>6 mg/dL) were consecutively included in a single-centre study and managed with a treat-to-target approach combining nurse-led information about gout with ULT. All patients were assessed with tight controls at baseline, 1, 2, 3, 6, 9 and 12 months including clinical examination, information on demographics, lifestyle, self-efficacy and beliefs about medicines. The treatment target was sUA <360 µmol/L and multivariable logistic regression was used to identify predictors of target attainment with ORs and 95% CIs. Results Of 211 patients (mean age 56.4 years, disease duration 7.8 years, 95% males), 186 completed the 12-month study. Mean sUA levels decreased from baseline mean 500 to 311 µmol/L at 12 months with 85.5% achieving the treatment target. Alcohol consumption at least weekly versus less frequently (OR 0.14; 95% CI 0.04 to 0.55) as well as beliefs in overuse of medicines (OR per unit 0.77; 95 CI 0.62 to 0.94) decreased the chance of reaching the treatment target, while higher self-efficacy for arthritis symptoms (OR 1.49 per 10 units; 95% CI 1.09 to 2.05) increased the likelihood. Conclusions This study shows that target sUA can be achieved with ULT in most patients. Less self-reported alcohol consumption, low beliefs in overuse of medicines and higher self-efficacy are associated with treatment success.
... The prompt reads: "Currently, to what degree do the following reasons for dying apply to you?" Followed by each of the eight RFD themes: Responses can be scored: "1 = not at all," "5 = very much." Midpoints (2, 3, 4) labeled by number or not at all [71]. The RFD-I would provide data from all participants on each theme, allowing for more extensive analyses. ...
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Reasons for dying (RFD) are one of the most authentic factors illustrating the lived experience of suicidal individuals. However, the field has been criticized for inadequate evaluation of risk factors and suicidal symptoms, such as RFD, to develop more robust theoretical models and risk assessments. In this study, we aimed to critically examine RFD themes as predictors of suicidal symptoms to improve our understanding of the suicidal mind, test suicide theory validity and improve risk assessment. This cross-sectional mixed-method study included anonymous survey data (N = 713) with a subsample (n = 474; 77% female; age M = 31.48, SD = 13.53) who provided RFD. Participants were asked to write down five RFD (ranked 1 st to 5 th most important) and completed the Suicidal Affect-Behavior-Cognition Scale (SABCS). Thematic analysis revealed eight valid RFD themes—Negative Self-appraisal, Hopelessness, Desire to Escape, Escape Pain, Relationships, Loneliness, Financial Hardship, and Physical Health. Themes were quantified by rank and total endorsements of the theme. Hierarchical regression modelling, statistically controlling for demographics, showed all RFD themes, except Physical Health, were positive predictors of suicidality, accounting for 26% of variance in suicidal symptoms. Negative Self-appraisal was the strongest predictor. RFD differences were also found by gender, age and education. From these findings, we determined current suicide theories do not fully account for suicidal persons’ RFD. There is a pressing need for more critical review of current theories, as current theories only partially represent this key attribute of the suicidal mind, and none of the reviewed theories accurately reflected suicidal participants’ RFD. Clinical implications include integrating financial therapies into suicide prevention treatments and incorporating RFD into assessments and treatments. To aid research and risk assessment efforts, we propose a new RFD Index, with eight five-point response items.
... 10 It is a broad concept incorporating in a complex way subjective assessment of his or her physical health, psychological state, level of independence, social relationships, personal beliefs and their relationships to their environment. 11 The scope of quality of life extends beyond traditional symptom reduction and includes the patient's subjective feeling of wellbeing, satisfaction, functioning and impairment. 12 Epilepsy affects many aspects of quality of life, including social functioning, the ability to concentrate on things, the ability to work with full potential, psychological aspect, and other daily activity. ...
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Background: Epilepsy is strongly associated with an impaired quality of life. Patients suffering from epilepsy have a poorer quality of life than both the general population and many other chronic disease sufferers. However, attention is not given on the quality of life of people with epilepsy other than focusing on symptom reduction. This increases the frequency of seizures, impacts on the ability to perform and increases health-related costs. The aim of this study was to assess quality of life and associated factors among patients with epilepsy attending the outpatient department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Methods: An institution-based cross-sectional study design was conducted between May and June 2019 at Amanuel Mental Specialized Hospital. A systematic random sampling technique was used to get a total number of 447 samples. Data on quality of life was assessed through interviews using the World Health Organization Quality of Life-Brief (WHOQOL-BREF) Version. The collected data were coded, entered into EpiData 3.1, and analyzed by using SPSS version 20. Simple and multiple linear regression analysis models were fitted and the unstandardized β coefficient at 95% confidence interval was employed. The statistical significance was accepted at p-value <0.05. Results: The mean score of quality of life was 61.1±11.6 (95%CI: 59.05, 61.23). Perceived stigma (β=-2.13, 95%CI:-2.96, -1.30), frequent seizure (β=-3.16, 95%CI: -4.27, -2.04), AED adherence (β=1.24, 95%CI: 1.10, 1.30), antiepileptic drug side effect (β=-0.32, 95%CI: -0.38, -0.26), anxiety (β-1.91, 95%CI: -2.95, -0.86), depression (β=-3.59, 95%CI: -4.67, -2.52), poor social support (β=-2.51, 95%CI: -3.62, -1.40) and moderate social support (β=-1.60, 95%CI: -2.58, -0.62) were significantly associated factors with quality of life. Conclusion: The finding from this study indicated that quality of life of patients with epilepsy were moderate. Perceived stigma, frequent seizure, comorbid depression and anxiety, antiepileptic drug nonadherence, antiepileptic drug side effect and poor social support were the predictors of quality of life.
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Background: A strength-based approach in the rehabilitation after traumatic brain injury (TBI) is recommended for patients and their families. However, further exploration of the complexity of individual and family factors is needed. Objective: To explore the associations between individual protective resources in patients and family members and the overall family functioning using a strength-based approach. Methods: Secondary data collected at baseline in a randomized controlled trial were analyzed. A structural equation modeling with two latent constructs and six observed variables was performed. Outcome measures included the Resilience Scale for Adults, the Mental Component Summary (SF-36), the General Self-Efficacy Scale, and the Family Adaptability and Cohesion Evaluation Scale-IV. Results: Hundred-and-twenty-two participants (60 patients, 62 family members) with a mean age of 43 years were included at a median of 11 months post-injury. The final model demonstrated a strong covariance (coefficient = 0.61) between the latent Protective construct and Family functioning. Model-fit statistics indicated an acceptable fit to the data. Conclusion: Higher levels of protective resources (resilience, self-efficacy, and mental HRQL) were positively associated with Family functioning. These resources should be further assessed in patients and their families, to identify factors that can be further strengthened through TBI rehabilitation interventions.
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Föräldraalienation och dess följder för barnet-en systematisk litteraturöversikt Föräldraalienation (parental alienation, PA) är ett beteendemönster genom vilken den ena föräldern för-söker försämra relationen mellan barnet och den andra föräldern. Syftet med denna litteraturöversikt är att sammanställa empirisk forskning som publicerats mellan åren 2015 och 2019 med fokus på fenomenet PA och på vilka följder PA kan ha för det utsatta barnet. Litteratursökningen gjordes i databaserna PsycINFO (Ebsco), PubMed samt de finska databaserna Finna, Helda, Melinda, Tampub och Utupub. Åtta studier och en avhandling pro gradu inkluderades. Resultaten tyder på att PA oftare förekommer i familjer med från-skilda föräldrar och att PA som börjat tidigt i barndomen tenderar att fortsätta. Resultaten visar på ett negativt samband mellan att i barndomen ha blivit utsatt för PA och senare psykisk hälsa. Därtill tyder resultaten på att PA har en negativ inverkan på barn-förälder-relationen. Därmed kan man dra slutsatsen om att PA är ett allvarligt övergrepp mot barnets rätt till psykisk hälsa och trygga relationer. Mer empirisk forskning inom området behövs till exempel om att känna igen PA, om följderna för det utsatta barnet både på kort och lång sikt samt om, ifall PA-beteenden hos föräldrar kan förebyggas. Nyckelord: föräldraalienation, PA, skilsmässa, barns psykiska hälsa, barn-förälder-relation INLEDNING Föräldraalienation och dess bakgrund Föräldraalienation (parental alienation, PA) defi-nieras som ett beteende som den ena föräldern utövar, medvetet eller omedvetet, för att försämra relationen mellan den andra föräldern och bar-net (Häkkänen-Nyholm, 2010; Rowen & Emery , 2014) och/eller för att direkt göra den andra föräldern illa (Harman, Leder-Elder & Biringen, 2016). Den alienerande föräldern (AF) utövar ett förödmjukande och svartmålande beteende mot den andra, alienerade, utsatta föräldern (UF), ge-nom att till exempel hindra eller försvåra kommu-nikationen mellan UF och barnet eller kräva att barnet väljer mellan föräldrarna (Harman m.fl., 2016; Häkkänen-Nyholm, 2010). PA är inte en-skilda beteenden utan utövas upprepade gånger över tid (Harman m.fl., 2016). För att illustrera typiska PA-beteenden presenteras Baker Strategy Questionnaire (BSQ), som kan användas för att kartlägga PA, i Tabell 1. Det är sällan entydigt att vare sig känna igen PA eller kunna tillämpa kriterier som de i Tabell 1 nämnda. Att skilja mellan befogad oro för barnets trygghet och smutskastning av UF inför barnet själv och/eller hens omgivning kan vara svårt. Föräldrarnas berättelser kan skilja sig diametralt från varandra och AF kan framställa sig själv som en skyddande förälder (Häkkänen-Nyholm, 2010). Barnet kan uppleva en lojalitetskonflikt och därmed ha svårt att berätta om situationen (Karttunen, 2010). Därtill kan det finnas enkla, naturliga förklaringar till en del av de i BSQ pre-senterade beteendena, till exempel kan det i fa
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We estimated clinicians' awareness of depression for patients with current depressive disorder (N = 650) who received care in either a single-specialty solo or small group practice, a large multispecialty group practice, or a health maintenance organization in three US sites. Depressive disorder was determined by independent diagnostic assessment shortly after an office visit. Detection and treatment of depression were determined from visit-report forms completed by the treating clinician. Depending on the setting, from 78.2% to 86.9% of depressed patients who visited mental health specialists had their depression detected at the time of the visit, compared with 45.9% to 51.2% of depressed patients who visited medical clinicians, after adjusting for case-mix differences. Among patients of mental health specialists, there were no significant differences by type of payment in the likelihood of depressive disorder being detected or treated. Among patients of medical clinicians, however, those receiving care financed by prepayment were significantly less likely to have their depression detected or treated during the visit than were similar patients receiving fee-for-service care.
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Functional assessment screening by the physician is useful for evaluating the health status of elderly patients and determining their needs for in-home assistance, home-health services, or institutional placement. In the acute care setting, functional assessment in selected patients facilitates discharge planning, and is essential in patients over 75 years of age. The American College of Physicians recommends that primary care practitioners incorporate within their routine medical management of older adults procedures for measuring functional deficits and identifying dependency needs. Several assessment instruments are available that can either be self-administered by the patient or employed by ancillary staff in 10 minutes or less. Although no single test is universally recommended, selection of a comprehensive screen followed by a group of targeted instruments can be useful in systematically assessing functional deficits that otherwise might be overlooked by conventional examination methods. Relevant skills and procedures for assessing the functional capacity of elderly patients should be systematically integrated into the curricula of undergraduate and graduate education of physicians. Through continuing medical education, practicing physicians should be prepared to perform and to utilize such examinations. Medicare, and other agencies which set standards for payment for physicians' services, should recognize periodic assessment of functional status of the elderly as a discrete procedure, supplementary to the current standards of practice on which levels of reimbursement are based. Professional time and other resource costs for this procedure should qualify for specified reimbursement in fee schedules.
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• This interview study investigated nonspecific psychological distress in the general population. A probability sample of 200 adults was drawn from heterogenous sex, class, and ethnic groups in New York City. Twenty-five scales were developed. Eight reflect a single dimension of nonspecific distress (eg, Poor Self-esteem, Sadness, and Perceived Physical Health) and 17 are distinct from these and from each other (eg, False Beliefs and Perceptions, Manic Characteristics, Insomnia, Antisocial History, and illness-linked Somatic Problems). Both sets of scales have become part of a new interview instrument, the Psychiatric Epidemiology Research Interview (PERI). Questions are raised about the nature of nonspecific distress in relation to Frank's construct of "demoralization," the value of the measured dimensions of psychopathology that contrast with it, and the relation of PERI, which uses a self-report format, to diagnostic interviews developed here and abroad.
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Objective: To assess the reliability and validity of the Medical Outcomes Study (MOS) Short Form Health Survey as an indicator for quality of life in patients infected with the human immunodeficiency virus (HIV). Design: Patient interview survey. Setting: The AIDS Health Services Program in seven sites: Newark and Jersey City, New Jersey; Nassau County, New York; Atlanta, Georgia; Dallas, Texas; Fort Lauderdale and Miami, Florida; New Orleans, Louisiana; and Seattle, Washington. Patients: Patients (520) with HIV infection receiving health services at one of the above sites. Measurements: All components of the MOS Short Form Health Survey were included in the interview. Minor modifications were made to adapt the survey to the particular circumstances of the study. Measured sociodemographic characteristics included age, sex, race, intravenous drug use, and education. Symptoms were assessed by closed-ended questions concerning memory, seizure, weakness or numbness, fever, chills, diaphoreses, dyspnea, diarrhea, and weight loss. Information on the frequency of symptoms was also collected. History of Pneumocystis carinii pneumonia and Kaposi sarcoma was noted. Main results: The sociodemographic characteristics resemble those of patients with the acquired immunodeficiency syndrome (AIDS) reported to the Centers for Disease Control (CDC): mean age, 36; men, 89%; nonwhite, 31%; intravenous drug use, 34%. Neurologic symptoms (memory trouble, seizures, weakness or numbness) occurred in 71% of patients; constitutional symptoms (fever, chills, night sweats, weight loss) in 69%; dyspnea in 50%; and diarrhea in 47%. Although older age, female sex, nonwhite race, and intravenous drug use were associated with lower MOS scores in several areas, the strongest single or adjusted indicator of lower MOS scores was the presence of symptoms. Finally, patients with HIV infection had significantly lower scores than did previously reported patients with other chronic medical conditions (P less than 0.001). Conclusions: The MOS survey is a reliable measure of quality of life for patients with HIV infection. These patients tend to have low scores, suggesting validity of the survey. The MOS survey is extremely sensitive to the effect of symptoms, which suggests that it might be useful as a quality-of-life indicator for AIDS clinical drug trials.
Article
Objective: To compare change over time in symptoms of depression and limitations in role and physical functioning of patients receiving prepaid or fee-for-service care within and across clinician specialties. Method: Observational study of change in outcomes over 2 years for 617 depressed patients of psychiatrists, psychologists, other therapists, and general medical clinicians in three urban sites in the United States. Results: Psychiatrists treated psychologically sicker patients than other clinicians in all payment types. Among psychiatrists' patients, those initially receiving prepaid care acquired new limitations in role/physical functioning over time, while those receiving fee-for-service care did not. This finding was most striking in independent practice associations but varied by site and organization. Patients of psychiatrists were more likely to use antidepressant medication than were patients of other clinicians, but among psychiatrists' patients, there was a sharp decline over time in the use of such medication in prepaid compared with fee-for-service care. Outcomes did not differ by payment type for depressed patients of other specialty groups, or overall. Conclusion: Depressed patients of psychiatrists merit policy interest owing to their high levels of psychological sickness. For these patients, functioning outcomes were poorer in some prepaid organizations. The nonexperimental evidence favors (but cannot prove) an explanation based on care received, such as a reduction in medications, rather than on preexisting sickness differences.
Article
The Medical Outcomes Study was designed to (1) determine whether variations in patient outcomes are explained by differences in system of care, clinician specialty, and clinicians' technical and interpersonal styles and (2) develop more practical tools for the routine monitoring of patient outcomes in medical practice. Outcomes included clinical end points; physical, social, and role functioning in everyday living; patients' perceptions of their general health and well-being; and satisfaction with treatment. Populations of clinicians (n = 523) were randomly sampled from different health care settings in Boston, Mass; Chicago, Ill; and Los Angeles, Calif. In the cross-sectional study, adult patients (n = 22 462) evaluated their health status and treatment. A sample of these patients (n = 2349) with diabetes, hypertension, coronary heart disease, and/or depression were selected for the longitudinal study. Their hospitalizations and other treatments were monitored and they periodically reported outcomes of care. At the beginning and end of the longitudinal study, Medical Outcomes Study staff performed physical examinations and laboratory tests. Results will be reported serially, primarily in The Journal. (JAMA. 1989;262:925-930)
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When prostatectomy is proposed as treatment for the symptoms of prostatism, the decision to operate should depend on how patients evaluate their symptoms and on objective information about the outcomes. We undertook a health interview study to determine the probabilities for symptom relief, improvement in the quality of life, and complications following surgery and to evaluate patient concern about the symptoms of prostatism. The operation was effective in reducing symptoms: 93% of severely and 79% of moderately symptomatic patients experienced improvement; however, a statistically significant improvement in indices of quality of life occurred only among patients with acute retention or severe symptoms prior to surgery. Short-term complications of varying severity occurred in 24% of patients; in addition, 4% reported persistent incontinence and 5%, impotence. Patients with similar symptoms reported considerable difference in the degree to which they were bothered by their symptoms. The result emphasizes the importance of patient participation in the decision to undergo prostatectomy. (JAMA 1988;259:3018-3022)
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We evaluated 15 group practices in general internal medicine in university hospitals with regard to access to and quality of care, patients' satisfaction with that care, and quality of residency education provided. We used these data to speculate about potential changes in ambulatory care programs in university teaching hospitals. All 15 practices participated for 4 years. One third of their patient population had no medical insurance. Practice patients had twice as many chronic illnesses as did the general population, and two fifths of patients stayed at least 2 years in the practice. Few faculty members spent more than 14 hours weekly in the practices, and housestaff worked an average of 4 hours per week. Patient waiting times did not meet ideal standards, but patient satisfaction was higher than in a general population. Compliance with quality of care criteria was not exceptional; for example, 10% of eligible patients received an annual influenza vaccination. Housestaff assigned a relatively low ranking to their educational experience in the practices. We recommend the institution of additional experimental programs in ambulatory care and housestaff education to improve the quality of care in the ambulatory setting.
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This article briefly summarizes methods used in the empirical validation of translations of the SF-36 Health Survey. In addition, information about the IQOLA Project norming protocol and 13 general population norming samples analyzed in this supplement is provided.
Article
Objectives The 36 item short form health survey (SF-36) has proved to be of use in a variety of settings where a short generic health measure of patient-assessed outcome is required. This measure can provide an eight dimension profile of health status, and two summary scores assessing physical function and mental well-being. The developers of the SF-36 in America have developed algorithms to yield the two summary component scores in a questionnaire containing only one-third of the original 36 items, the SF-12. This paper documents the construction of the UK SF-12 summary measures from a large-scale dataset from the UK in which the SF-36, together with other questions on health and lifestyles, was sent to randomly selected members of the population. Using these data we attempt here to replicate the findings of the SF-36 developers in the UK setting, and then to assess the use of SF-12 summary scores in a variety of clinical conditions. Methods Factor analytical methods were used to derive the weights used to construct the physical and mental component scales from the SF-36. Regression methods were used to weight the 12 items recommended by the developers to construct the SF-12 physical and mental component scores. This analysis was undertaken on a large community sample ( n = 9332), and then the results of the SF-36 and SF-12 were compared across diverse patient groups (Parkinson's disease, congestive heart failure, sleep apnoea, benign prostatic hypertrophy). Results Factor analysis of the SF-36 produced a two factor solution. The factor loadings were used to weight the physical component summary score (PCS-36) and mental component summary score (MCS-36). Results gained from the use of these measures were compared with results gained from the PCS-12 and MCS-12, and were found to be highly correlated (PCS: ρ = 0.94, p < 0.001; MCS: ρ = 0.96, p < 0.001), and produce remarkably similar results, both in the community sample and across a variety of patient groups. Conclusions The SF-12 is able to produce the two summary scales originally developed from the SF-36 with considerable accuracy and yet with far less respondent burden. Consequently, the SF-12 may be an instrument of choice where a short generic measure providing summary information on physical and mental health status is required. Crispin Jenkinson DPhil, Deputy Director
Article
Research in progress at the National Center for Health Statistics for evaluating the usefulness of composite measures of health status for assessing the nation's health is described. Three measures suitable for use in the general population, the Health Insurance Experiment-Functional Limitations (HIE-FL), the Health Utility Index (HUI), and the Quality of Well-being (QWB) scale, have been mapped to data collected in the 1980 National Health Interview Survey (NHIS). Analysis using current algorithms for making composite function status measures according to the QWB methods suggests that traditional single indicators of health tend to overestimate the level of health by about 10%. When symptoms and problems are added to the composite function score, the overestimate as measured by the single indicator is at least 50%. The authors are continuing to validate these algorithms, to develop similar ones for the HIE-FL and HUI, and to extend the analysis to data collected in 1977,1979, and 1984. Current results indicate that to realize fully the benefits of composite measures, well-established, valid, and reliable measures of health-related quality of life should be included as part of the regular NHIS data collection procedures.
Article
The Duke Health Profile (DUKE) is a 17-item generic self-report instrument containing six health measures (physical, mental, social, general, perceived health, and self-esteem), and four dysfunction measures (anxiety, depression, pain, and disability). Items were derived from the 63-item Duke-UNC Health Profile, based upon face validity and item-remainder correlations. The study population included 683 primary care adult patients. Reliability was supported by Cronbach's alphas (0.55 to 0.78) and test-retest correlations (0.30 to 0.78). Convergent and discriminant validity were demonstrated by score correlations between the DUKE and the Sickness Impact Profile, the Tennessee Self-Concept Scale, and the Zung Self-Rating Depression Scale. Clinical validity was supported by differences between the health scores of patients with clinically different health problems. Patients with painful physical problems had a DUKE physical health mean score of 58.1, while patients with only health maintenance problems had a mean score of 83.9 (scale: 0.0=poorest health and 100.0=best health). Patients with mental health problems had a DUKE mental health mean score of 49.2, in contrast to 75.7 for patients with painful physical problems and 79.2 for those with health maintenance. The DUKE is presented as a brief technique for measuring health as an outcome of medical intervention and health promotion. (C) Lippincott-Raven Publishers.
Article
To determine the effect of long-term warfarin sodium therapy on quality of life, we surveyed 333 patients participating in a randomized, controlled trial of warfarin for the prevention of stroke in nonrheumatic atrial fibrillation. No significant differences between warfarin-treated and control patients were found on well-validated measures of functional status, well-being, and health perceptions. For example, the summary score for health perceptions was 68.8 in the warfarin-treated vs 66.6 in the control group (scale of 0 to 100; 95% confidence intervals for the difference, —1.6 to 6.0). In contrast, patients taking warfarin who had a bleeding episode had a significant decrease in health perceptions (-11.9; 95% confidence interval, —4.1 to — 19.6 Warfarin therapy is not usually associated with a significant decrease in perceived health, unless a bleeding episode has occurred. Negative effects of warfarin treatment on health perceptions may be balanced by confidence in its protective effects. (Arch Intern Med. 1991;151:1944-1949)
Article
In the course of developing a standardised, non-disease-specific instrument for describing and valuing health states (based on the items in Table 1), the EuroQol Group (whose members are listed In the Appendix) conducted postal surveys in England, The Netherlands and Sweden which indicate a striking similarity in the relative valuations attached to 14 different health states (see Table 3). The data were collected using a visual analogue scale similar to a thermometer (see Table 2). The EuroQol Instrument Is Intended to complement other quality-of-life measures and to facilitate the collection of a common data set for reference purposes. Others interested in participating in the extension of this work are invited to contact the EuroQol Group.
Article
Investigated the effects of mental health status—self-reported psychological distress and psychological well-being—on the use of outpatient mental health services, based on mental health data from the Rand Corporation's Health Insurance Survey. Results reveal that probability of mental health care and intensity of treatment provided by mental health specialists increase significantly with increases in psychological distress, independent of insurance plan, physical health, and sociodemographic variables. Results support the validity of self-report mental health surveys. (42 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)