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Mortality rates - correct answer The most basic form of measuring health status: decrease in mortality = increased health status; increased mortality = decreased health status. Problems with mortality rates - correct answer ...

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  • 29 augustus 2024
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Voorbeeld van de inhoud

Measuring Health

Mortality rates - correct answer The most basic form of measuring health
status: decrease in mortality = increased health status; increased mortality = decreased health status.



Problems with mortality rates - correct answer Mortality needs to change in
line with specified population; age and illness specific circumstances; and corrected for age



Cancer Incidence and Mortality Rates - correct answer Mortality has
decreased. Presumably due to more awareness, a robust screening program and more funding.



Morbidity - correct answer Number of people who have cancer/a diseased
state.



Used to describe how often a disease occurs in a specific area. An example of morbidity is the number of
people who have cancer/or a diseased state.



Recording morbidity - correct answer Usually by counting and recording large
surveys (e.g. The Adult Psychiatric Morbidity Survey (APMS) aged 16 and over (2007).



The APMS findings (2007) - correct answer More than 75 were included in the
survey for the first time in 2007.



Common mental disorders (CMD) were higher in women than men (12.2% of women compared to 6.3%
men - less stigma associated with women seeking MH support).



Nearly 1:4 in England (23%) had at least one psychiatric disorder and 7.2% had two or more.



Activity of Daily Living scales (ADLs) Katz et al., 1970 - correct answer Aims to
assess levels of functioning in the elderly. Therapist or carer to complete (objective health status). The

,index ranks adequacy of performance in the six functions of bathing, dressing, toileting, transferring,
continence and feeding. Baseline then periodically over time to detect deterioration/improvement.



KATZ (1970) Index of Independence in Activities of Daily Living (ADL) - correct answer
The index of ADL encompasses six basic human functions: bathing, dressing, toileting, transfer,
continence, and feeding.



It provides an objective method of classifying heterogeneous groups of people with chronic illnesses,
disabilities and impairments, and of describing their health needs and outcomes.



Interpretations:

6 = High (patient independent)

0 = Low (patient very dependent)



Whilst appearing basic, these are important aspects of daily functioning relevant for practitioners to
determine intervention.



Subjective Health Status - correct answer Katz ammended scale for patients -
people were asked to rate and comment upon their own competencies.



i.e. Are you able to:

1) Dress yourself, including tying shoelaces and doing buttons?

2) Shampoo your hair?

3) Stand up straight from an armless straight chair?

4) Get in and out of bed?



Quality of Life in Research - correct answer Holistic approach to treatment.



Mainly used to explore its predictors

- as an outcome measure: To demonstrate effect in an intervention, e.g. diabetes self-management
program/Diabetes Quality of Life (DQOL) Questionnaire

, - as a health measure: during treatment cardiovasular treatment - HeartQOL



- for disease specific randomised controlled trials (RCT): funded trials require a QOL measure among
outcome variables, not just mortality and morbidity 0 need to know what the patient thinks e.g. testing
a new cancer treatment



[Cochrane Controlled Trials register 1980-1997

less than 5% of trials reported data on QOL; cancer trials it is less than 10% - still not great]



QOL: emotional effects - correct answer Stress; worry/anxiety; depression;
body image; sexual function



QOL: social effects - correct answer Family; work; financial; hobbies



QOL: positive effects - correct answer Focus; priorities; relationships



QOL: cognitive effects - correct answer Memory concentration deficits



QOL: physical effects of cancer and treatment - correct answer Pain; fatigue;
nausea; insomnia



QOL Conceptual Framework 1: Standard Needs Approach - correct answer
Needs rather than wants are central (common to all) - including the researchers reproduction, health,
affection, understanding, leisure - it is all about if these needs are met.



Psychological processes: 'constructed from individual evaluations of personally salient aspects of life'
(Browne et al., 1997)



Still no real consensus on what QOL is from researchers and clinicans (difficult to quantify?)

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