Self-rated health

Last updated

Self-rated health (also called Self-reported health, Self-assessed health, or perceived health) refers to both a single question such as "in general, would you say that your health is excellent, very good, good, fair, or poor?" and a survey questionnaire in which participants assess different dimensions of their own health. This survey technique is commonly used in health research for its ease of use and its power in measuring health. [1]

Contents

Single question

Self-rated health measures the present general health and gives answer choices, typically structured like a Likert Scale. The self-rated health question may take different forms. It may be formulated as "in general, would you say that your health is excellent, very good, good, fair, or poor?" as the first question in the SF-36 questionnaire. [2] It may also be formulated as "In general, how would you rate your health today," with the possible choices being "very good" (1), "good" (2), "moderate" (3), "bad" (4) or "very bad" (5), as used by the World Health Organization. [3] All questions do not necessarily have five answer choices; there can be more or less[ citation needed ].

The self-rated health question is purposely vague so as to seize people's own assessment of health according to their own definition of health. [4] Although the answer to the self-rated health question is based on what people think—and thus is subjective—it is a statistically powerful predictor of mortality in the general population [5] [6] [7] and has also been shown to predict morbidity. [8]

However, it is also possible that there are systematic differences in how individuals with specific characteristics report their health. A study of data collected from England's annual health survey found that people who reported their health as 'poor', living in areas of high deprivation generally had worse health than those who reported their health as 'poor' living in the least deprived areas. [9] [10] This could mean that using self-reported health data may under-estimate health inequalities or health disparities.

Methodological strength

Validity

The strong association between self-rated health and mortality [5] is used as proof that this measurement is valid, because mortality is considered as the most objective measurement of the general health of an individual. [11]

Reliability

The self-rated health question has been found to be a reliable measurement of general health since respondents rated the same general health assessment within a period where their health was unlikely to change. [12] Despite the reliability of the measurement, the self-rated health question "in general, would you say that you health is excellent, very good, good, fair, or poor?" is particularly vague. Thus, this measurement has low level in reliability test than other self-rated measurements that assess a more specific aspect of health. [12]

Questionnaires

Self-rated health, as measured by a questionnaire, attempts to measure health in all its dimensions. In such a questionnaire, participants answer a series of questions which are typically structured using a Likert Scale. The SF-36 questionnaire is an example of tool for self-assessed overall health. The SF-36 questionnaire addresses several dimensions of physical and mental health.[ citation needed ]

Uses of self-rated health

Considering that self-reported health is a powerful predictor of mortality [5] and considering its easy application, this subjective measure of health is often used in health research and large-scale surveys. [4] [13] This measure helps follow the evolution of health across time and between populations.[ citation needed ]

Publication

See also

Related Research Articles

<span class="mw-page-title-main">Epidemiology</span> Study of health and disease within a population

Epidemiology is the study and analysis of the distribution, patterns and determinants of health and disease conditions in a defined population.

<span class="mw-page-title-main">Mortality rate</span> Deaths per 1000 individuals per year

Mortality rate, or death rate, is a measure of the number of deaths in a particular population, scaled to the size of that population, per unit of time. Mortality rate is typically expressed in units of deaths per 1,000 individuals per year; thus, a mortality rate of 9.5 in a population of 1,000 would mean 9.5 deaths per year in that entire population, or 0.95% out of the total. It is distinct from "morbidity", which is either the prevalence or incidence of a disease, and also from the incidence rate.

Survey methodology is "the study of survey methods". As a field of applied statistics concentrating on human-research surveys, survey methodology studies the sampling of individual units from a population and associated techniques of survey data collection, such as questionnaire construction and methods for improving the number and accuracy of responses to surveys. Survey methodology targets instruments or procedures that ask one or more questions that may or may not be answered.

<span class="mw-page-title-main">Likert scale</span> Psychometric measurement scale

A Likert scale is a psychometric scale named after its inventor, American social psychologist Rensis Likert, which is commonly used in research questionnaires. It is the most widely used approach to scaling responses in survey research, such that the term is often used interchangeably with rating scale, although there are other types of rating scales.

<span class="mw-page-title-main">Personality test</span> Method of assessing human personality constructs

A personality test is a method of assessing human personality constructs. Most personality assessment instruments are in fact introspective self-report questionnaire measures or reports from life records (L-data) such as rating scales. Attempts to construct actual performance tests of personality have been very limited even though Raymond Cattell with his colleague Frank Warburton compiled a list of over 2000 separate objective tests that could be used in constructing objective personality tests. One exception, however, was the Objective-Analytic Test Battery, a performance test designed to quantitatively measure 10 factor-analytically discerned personality trait dimensions. A major problem with both L-data and Q-data methods is that because of item transparency, rating scales, and self-report questionnaires are highly susceptible to motivational and response distortion ranging from lack of adequate self-insight to downright dissimulation depending on the reason/motivation for the assessment being undertaken.

A self-report study is a type of survey, questionnaire, or poll in which respondents read the question and select a response by themselves without any outside interference. A self-report is any method which involves asking a participant about their feelings, attitudes, beliefs and so on. Examples of self-reports are questionnaires and interviews; self-reports are often used as a way of gaining participants' responses in observational studies and experiments.

Suicide risk assessment is a process of estimating the likelihood for a person to attempt or die by suicide. The goal of a thorough risk assessment is to learn about the circumstances of an individual person with regard to suicide, including warning signs, risk factors, and protective factors. Risk for suicide is re-evaluated throughout the course of care to assess the patient's response to personal situational changes and clinical interventions. Accurate and defensible risk assessment requires a clinician to integrate a clinical judgment with the latest evidence-based practice, although accurate prediction of low base rate events, such as suicide, is inherently difficult and prone to false positives.

A patient-reported outcome (PRO) is a health outcome directly reported by the patient who experienced it. It stands in contrast to an outcome reported by someone else, such as a physician-reported outcome, a nurse-reported outcome, and so on. PRO methods, such as questionnaires, are used in clinical trials or other clinical settings, to help better understand a treatment's efficacy or effectiveness. The use of digitized PROs, or electronic patient-reported outcomes (ePROs), is on the rise in today's health research setting.

The CAGE questionnaire, the name of which is an acronym of its four questions, is a widely used screening test for problem drinking and potential alcohol problems. The questionnaire takes less than one minute to administer, and is often used in primary care or other general settings as a quick screening tool rather than as an in-depth interview for those who have alcoholism. The CAGE questionnaire does not have a specific intended population, and is meant to find those who drink excessively and need treatment. The CAGE questionnaire is reliable and valid; however, it is not valid for diagnosis of other substance use disorders, although somewhat modified versions of the CAGE questionnaire have been frequently implemented for such a purpose.

A depression rating scale is a psychometric instrument (tool), usually a questionnaire whose wording has been validated with experimental evidence, having descriptive words and phrases that indicate the severity of depression for a time period. When used, an observer may make judgements and rate a person at a specified scale level with respect to identified characteristics. Rather than being used to diagnose depression, a depression rating scale may be used to assign a score to a person's behaviour where that score may be used to determine whether that person should be evaluated more thoroughly for a depressive disorder diagnosis. Several rating scales are used for this purpose.

<span class="mw-page-title-main">Quality of life (healthcare)</span> Notion in healthcare

In general, quality of life is the perceived quality of an individual's daily life, that is, an assessment of their well-being or lack thereof. This includes all emotional, social and physical aspects of the individual's life. In health care, health-related quality of life (HRQoL) is an assessment of how the individual's well-being may be affected over time by a disease, disability or disorder.

Self-report sexual risk behaviors are a cornerstone of reproductive health–related research, particularly when related to assessing risk-related outcomes such as pregnancy or acquisition of sexually transmitted diseases (STDs) such as HIV. Despite their frequency of use, the utility of self-report measures to provide an accurate account of actual behavior are questioned, and methods of enhancing their accuracy should be a critical focus when administering such measures. Self-reported assessments of sexual behavior are prone to a number of measurement concerns which may affect the reliability and validity of a measure, ranging from a participant's literacy level and comprehension of behavioral terminology to recall biases and self-presentation.

The Patient Health Questionnaire (PHQ) is a multiple-choice self-report inventory that is used as a screening and diagnostic tool for mental health disorders of depression, anxiety, alcohol, eating, and somatoform disorders. It is the self-report version of the Primary Care Evaluation of Mental Disorders (PRIME-MD), a diagnostic tool developed in the mid-1990s by Pfizer Inc. The length of the original assessment limited its feasibility; consequently, a shorter version, consisting of 11 multi-part questions - the Patient Health Questionnaire was developed and validated.

The Quality of Life In Depression Scale (QLDS), originally proposed by Sonja Hunt and Stephen McKenna, is a disease specific patient-reported outcome which assesses the impact that depression has on a patient's quality of life. It is the most commonly used measure of quality of life in clinical trials and studies of depression. The QLDS was developed as a measure to be used in future clinical trials of anti-depressant therapy.

The Quality of Well-Being Scale (QWB) is a general health quality of life questionnaire which measures overall status and well-being over the previous three days in four areas: physical activities, social activities, mobility, and symptom/problem complexes.

The Somatic Symptom Scale - 8 (SSS-8) is a brief self-report questionnaire used to assess somatic symptom burden. It measures the perceived burden of common somatic symptoms. These symptoms were originally chosen to reflect common symptoms in primary care but they are relevant for a large number of diseases and mental disorders. The SSS-8 is a brief version of the popular Patient Health Questionnaire - 15 (PHQ-15).

The Mood and Feelings Questionnaire is a survey that measures depressive symptoms in children and young adults. It was developed by Adrian Angold and Elizabeth J. Costello in 1987, and validity data were gathered as part of the Great Smokey Mountain epidemiological study in Western North Carolina. The questionnaire consists of a variety of statements describing feelings or behaviors that may manifest as depressive symptoms in children between the ages of 6 and 17. The subject is asked to indicate how much each statement applies to their recent experiences. The Mood and Feelings Questionnaire has six versions, short and long forms of each of the following: a youth self-report, a version that a parent would complete, and a self-report version for adults. Several peer-reviewed studies have found the Mood and Feelings Questionnaire to be a reliable and valid measure of depression in children. Compared to many other depression scales for youth, it has more extensive coverage of symptoms and more age-appropriate wording and content.

Functional Assessment of Cancer Therapy - General (FACT-G) is a patient-reported outcome measure used to assess health-related quality of life in patients undergoing cancer therapy. The FACT-G is the original questionnaire that led to the development of the larger Functional Assessment of Chronic Illness Therapy (FACIT) collection of quality of life instruments. The survey assesses the impacts of cancer therapy in four domains: physical, social/family, emotional, and functional. The FACT-G is also offered with additional questions measuring cancer-specific factors that may affect quality of life, leading to the creation of the Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N), the Functional Assessment of Cancer Therapy - Lung (FACT-L), and 18 others.

Age-related mobility disability is a self-reported inability to walk due to impairments, limited mobility, dexterity or stamina. It has been found mostly in older adults with decreased strength in lower extremities.

The Attribution Questionnaire (AQ) is a 27-item self-report assessment tool designed to measure public stigma towards people with mental illnesses. It assesses emotional reaction and discriminatory responses based on answers to a hypothetical vignette about a man with schizophrenia named Harry. There are several different versions of the vignette that test multiple forms of attribution. Responses assessing stigma towards Harry are in the form of 27 items rated on a Likert scale ranging from 1 (not at all) to 9 (very much). There are 9 subscales within the AQ that breakdown the responses one could have towards a person with mental illness into different categories. The AQ was created in 2003 by Dr. Patrick Corrigan and colleagues and has since been revised into smaller tests because of the complexity and hypothetical that did not capture children and adolescent's stigmas well. The later scales are the Attribution Questionnaire-9 (AQ-9), the revised Attribution Questionnaire (r-AQ), and the children's Attribution Questionnaire (AQ-8-C).

References

  1. Lorem, Geir; Cook, Sarah; Leon, David A.; Emaus, Nina; Schirmer, Henrik (17 March 2020). "Self-reported health as a predictor of mortality: A cohort study of its relation to other health measurements and observation time". Scientific Reports. 10 (1): 4886. Bibcode:2020NatSR..10.4886L. doi:10.1038/s41598-020-61603-0. hdl: 10037/18350 .
  2. Ware JE, Gandek B (November 1998). "Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project". Journal of Clinical Epidemiology. 51 (11): 903–12. doi:10.1016/s0895-4356(98)00081-x. PMID   9817107.
  3. Subramanian SV, Huijts T, Avendano M (February 2010). "Self-reported health assessments in the 2002 World Health Survey: how do they correlate with education?". Bulletin of the World Health Organization. 88 (2): 131–8. doi:10.2471/BLT.09.067058 (inactive 5 December 2024). PMC   2814481 . PMID   20428370. Archived from the original on May 27, 2014.{{cite journal}}: CS1 maint: DOI inactive as of December 2024 (link)
  4. 1 2 Snead CM (2007). Ritzer G (ed.). "Self-rated Health". Blackwell Encyclopedia of Sociology: 31–33. doi:10.1111/b.9781405124331.2007.x (inactive 18 December 2024). hdl: 10138/224218 . ISBN   9781405124331.{{cite journal}}: CS1 maint: DOI inactive as of December 2024 (link)
  5. 1 2 3 Idler EL, Benyamini Y (March 1997). "Self-rated health and mortality: a review of twenty-seven community studies". Journal of Health and Social Behavior. 38 (1): 21–37. doi:10.2307/2955359. hdl: 2027.42/150587 . JSTOR   2955359. PMID   9097506.
  6. Singh-Manoux A, Dugravot A, Shipley MJ, Ferrie JE, Martikainen P, Goldberg M, Zins M (December 2007). "The association between self-rated health and mortality in different socioeconomic groups in the GAZEL cohort study". International Journal of Epidemiology. 36 (6): 1222–8. doi:10.1093/ije/dym170. PMC   2610258 . PMID   18025034.
  7. Franks P, Gold MR, Fiscella K (June 2003). "Sociodemographics, self-rated health, and mortality in the US". Social Science & Medicine. 56 (12): 2505–14. doi:10.1016/s0277-9536(02)00281-2. PMID   12742613.
  8. Latham K, Peek CW (January 2013). "Self-rated health and morbidity onset among late midlife U.S. adults". The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences. 68 (1): 107–16. doi:10.1093/geronb/gbs104. PMC   3605944 . PMID   23197340.
  9. "Underestimating health disparities based on self-reported data". 18 September 2024.
  10. Fforde R, Parsons N, Oyebode O (September 2024). "Does socioeconomic status modify how individuals perceive or describe their own health? An assessment of reporting heterogeneity in the Health Survey for England". BMJ Public Health 2024. 2 (2): e000813. doi:10.1136/bmjph-2023-000813.
  11. Quesnel-Vallée A (December 2007). "Self-rated health: caught in the crossfire of the quest for 'true' health?". International Journal of Epidemiology. 36 (6): 1161–4. doi: 10.1093/ije/dym236 . PMID   18056123.
  12. 1 2 Lundberg O, Manderbacka K (September 1996). "Assessing reliability of a measure of self-rated health". Scandinavian Journal of Social Medicine. 24 (3): 218–24. doi:10.1177/140349489602400314. PMID   8878376.
  13. Fayers P (2005). Assessing Quality Of Life In Clinical Trials: Methods And Practice. Oxford: Oxford University Press.