Is the short form 36 (SF-36) suitable for routine health outcomes assessment in health care for older people? Evidence from preliminary work in community based health services in England.

Hill, Sara; Harries, Ursula; Popay, Jennie

doi:10.1136/jech.50.1.94

Cited by 69 publications

(36 citation statements)

References 16 publications

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“…Several studies have reported a limited effect of exercise on HRQOL in relatively healthy older adults [5,6] . Moreover, although the SF-36 is still the most frequently used HRQOL measure, several studies demonstrated that the SF-36 is limited by ceiling effects and thus may be insensitive to clinically relative changes in HRQOL in healthy elderly subjects [8,[27][28][29][30][31] . In the present study, the baseline scores of the participants in the function group and the control group were in the 50th and 75th percentile of US norm scores for women aged 65 and older [21] and above Dutch norm scores, indicating that the participants were in excellent physical and MH.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Functional Tasks Exercise and Resistance Exercise on Health-Related Quality of Life and Physical Activity

et al. 2006

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Background: Data regarding the effect of exercise programmes on older adults’ health-related quality of life (HRQOL) and habitual physical activity are inconsistent. Objective: To determine whether a functional tasks exercise programme (enhances functional capacity) and a resistance exercise programme (increases muscle strength) have a different effect on the HRQOL and physical activity of community-dwelling older women. Methods: Ninety-eight women were randomised to a functional tasks exercise programme (function group), a resistance exercise programme (resistance group), or normal activity group (control group). Participants attended exercise classes three times a week for 12 weeks. The SF-36 Health Survey questionnaire and self-reported physical activity were obtained at baseline, directly after completion of the intervention (3 months), and 6 months later (9 months). Results: At 3 months, no difference in mean change in HRQOL and physical activity scores was seen between the groups, except for an increased SF-36 physical functioning score for the resistance group compared with the control group (p = 0.019) and the function group (p = 0.046). Between 3 and 9 months, the self-reported physical functioning score of the function group decreased to below baseline (p = 0.026), and physical activity (p = 0.040) decreased in the resistance group compared with the function group. Conclusions: Exercise has a limited effect on the HRQOL and self-reported physical activity of community-living older women. Our results suggest that in these subjects HRQOL measures may be affected by ceiling effects and response shift. Studies should include performance-based measures in addition to self-report HRQOL measures, to obtain a better understanding of the effect of exercise interventions in older adults.

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Section: Discussionmentioning

confidence: 99%

The Effect of Functional Tasks Exercise and Resistance Exercise on Health-Related Quality of Life and Physical Activity

et al. 2006

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“…In order to understand the dynamics of the survey findings at the individual level we develop an argument which has similarly been developed by Hill et al (1996) MacIntyre et al (1993) concerning the need to accumulate empirical information about peopleʼs experiences in different areas.…”

Section: 8mentioning

confidence: 99%

“…The concept of need used in this study can be considered to encompass both met and unmet need in terms of functional status (which takes into account the limitations described by Hill et al (1996)). Through in-depth interviews, using these key themes as guidance, the findings from the SF-36 can be compared with the findings from the qualitative study.…”

Section: 10mentioning

confidence: 99%

Health Experiences of Elderly People in an Outer London Area

Ong¹,

Jordan²

1997

Sociological Research Online

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This paper addresses the use of a combined quantitative and qualitative methodology to assess the needs of elderly people within an outer London area. The study was in two stages; firstly, a postal survey of people aged 65 and over using the health profile tool, the Short Form-36 (SF-36), alongside a demographic questionnaire. This was followed by a small number of qualitative interviews on a subset of people who scored at the worst end of the SF-36. These interviews followed themes arising from answers to the SF-36 survey. The SF-36 was able to pick up inequalities in health within the elderly population; with increasing age, even amongst the elderly, being an important factor in worsening SF-36 scores. Locality also appeared to influence the scoring although this was less conclusive. The qualitative interviews were able to extract more information and greater understanding of the health of the elderly. Whilst the SF-36 could detect problems on a number of important dimensions such as functional status and well-being, the qualitative interviews addressed individual experiences of ill-health and other issues, such as environmental factors, which affected the health of an individual. The mix of quantitative and qualitative methodologies gave a broader understanding of the health experience of elderly people to a greater extent than either could on its own. It is important for health policy to address the needs of populations whilst also accommodating individual needs.

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“…Convergent validity with unidimensional instruments was found for the HSQuale General Outlook, Physical Functioning, and Emotional Well-Being domains. The skewed frequency distribution of patient scores found for the Pfeiffer Short Portable Mental Status Questionnaire (Ͼ90% of subjects scored perfectly) and the Duke-UNC Functional Social Support Questionnaire (nearly 50% of subjects scored Ն38 of 40 points) imply these instruments are inappropriate for 55,56 and it may account for some of the overlapping strong correlations. Construct validity of the OSQ was established by showing appropriate discriminant validity.…”

Section: Discussionmentioning

confidence: 99%

A Quality-of-Life Instrument for Young Hemorrhagic Stroke Patients

Hamedani

Wells

Brass

et al. 2001

Stroke

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Background and Purpose-Hemorrhagic stroke has a high initial mortality rate. While survivors often recover motor function, many experience significant changes in their quality of life (QOL). Available outcome measures assess neurological impairment, disability, or handicap, yet often inadequately characterize the full impact of a stroke on patients' lives. In this study, we develop and validate a QOL instrument specific for young patients with hemorrhagic strokes. Methods-Methodological guidelines for instrument development were initially established. Based on the content of 40open-ended patient interviews, a 54-item instrument (HSQuale) was developed. The reliability (test-retest and internal consistency) and validity (content and construct) of HSQuale were assessed in another 71 patients (18 to 49 years of age, 63% women, 77% white), at 1 year after their hemorrhagic stroke. Comparisons were made between HSQuale and other commonly used outcome measures. Results-HSQuale demonstrated reproducibility (test-retest , 0.40 to 0.96) and internal consistency (Cronbach ␣ Ն0. 80 for 5 of 7 domains). HSQuale scores had broad frequency distributions (Յ33% of subjects scored in any single score decile), avoided ceiling effects found for other outcome measures (Barthel Index and Short Form-36), and discriminated among clinically distinct subject groups (eg, intracerebral versus subarachnoid hemorrhage patients). Conclusions-HSQuale is a reliable and valid QOL instrument. Compared with other outcome measures, it assesses abroader range of deficits and is better able to discriminate among subgroups of hemorrhagic stroke survivors. Key Words cerebral hemorrhage Ⅲ cerebrovascular disorders Ⅲ outcome assessment Ⅲ prognosis Ⅲ quality of life A mong patients with hemorrhagic stroke, the communitybased, 30-day case-fatality rate is 30% to 60%. 1-4 Approximately 70% of survivors, however, are independent in their activities of daily living at 1 year. 2,3 For this reason, some authors have concluded that hemorrhagic stroke patients who survive the first few weeks have a "good" prognosis. 1,3,5 A favorable outcome for hemorrhagic stroke patients, however, has been questioned, as many patients with good motor recovery exhibit marked cognitive disturbances and difficulties with emotional adjustment. 6 -9 Furthermore, while stroke scales, the Barthel Index, 10 and the modified Rankin Scale 11 continue to be the most commonly used stroke outcome measures, these traditional measures do not capture the full range of deficits experienced by stroke survivors. The evaluation of a broader range of patient outcomes (eg, cognitive, occupational) has been advocated. [12][13][14][15] Although the consensus classification system recently developed by the Classification of Stroke Outcome Task Force of the American Heart Association 16 is useful for assessing neurological impairments, disabilities, and handicaps of patients, a consensus instrument for assessing quality-of-life (QOL) outcomes for stroke patients is still lacking.The need for stroke-s...

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Is the short form 36 (SF-36) suitable for routine health outcomes assessment in health care for older people? Evidence from preliminary work in community based health services in England.

Cited by 69 publications

References 16 publications

The Effect of Functional Tasks Exercise and Resistance Exercise on Health-Related Quality of Life and Physical Activity

The Effect of Functional Tasks Exercise and Resistance Exercise on Health-Related Quality of Life and Physical Activity

Health Experiences of Elderly People in an Outer London Area

A Quality-of-Life Instrument for Young Hemorrhagic Stroke Patients

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