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The Performance of Three Measures of Health Status in an Outpatient Diabetes Population
Author(s) -
Bardsley M.J.,
Astell S.,
McCallum A.,
Home P.D.
Publication year - 1993
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1993.tb00134.x
Subject(s) - medicine , nottingham health profile , diabetes mellitus , quality of life (healthcare) , population , type 2 diabetes , physical therapy , gerontology , alternative medicine , environmental health , nursing , pathology , endocrinology
Both the late complications of diabetes and the means used to prevent them have a significant impact on the lives of people with the condition. Measuring quality of life is therefore important in assessing clinical need and evaluating the success of management. Three approaches to measuring health status were therefore compared in 284 randomly selected out‐patients attending a hospital diabetes service. The measures used were the Nottingham Health Profile (NHP), four categories of an anglicized version of the Sickness Impact Profile (the Functional Limitations Profile (FLP)), and a scale of Positive Well‐being (PWB). The results were found to be independent of questionnaire order and place of completion. The distributions of scores on the NHP and FLP scales were highly skewed, with a majority of cases scoring zero. NHP and FLP scores were related ( p < 0.001) to age, but not otherwise to type of diabetes. Patients with angina, circulatory problems, and neuropathy scored significantly higher (up to p < 0.001) on several dimensions/ categories of the NHP and FLP, but not the PWB scale. Severe visual impairment (worse than 6/36) was only related ( p < 0.005) to NHP ‘Mobility’ and FLP ‘Ambulation’ and ‘Home management’. Validation of scores by interview gave satisfactory results on all dimensions of the NHP except ‘Energy’, and all FLP categories except ‘Recreations and pastimes’. No statistically significant association was observed between the PWB and the interviewer's assessments, but it did correlate (up to tau = 0.45, p < 0.001) with some social and psychological dimensions/categories of the NHP/FLP. In conclusion the PWB scale is independent of physical disability. The NHP and FLP provide a useful assessment of general health in diabetes, but are biased towards identifying the minority of patients who have already developed more severe health problems.