Development and validation of a questionnaire designed to measure foot-health status

The aim of this study was to apply the principles of content, criterion, and construct validation to a new questionnaire specifically designed to measure foot-health status. One hundred eleven subjects completed two different questionnaires designed to measure foot health (the new Foot Health Status Questionnaire and the previously validated Foot Function Index) and underwent a clinical examination in order to provide data for a second-order confirmatory factor analysis. Presented herein is a psychometrically evaluated questionnaire that contains 13 items covering foot pain, foot function, footwear, and general foot health. The tool demonstrates a high degree of content, criterion, and construct validity and test-retest reliability.

The psychometric properties of the Spanish version of the Foot Health Status Questionnaire

Purpose: Clinical studies suggest that foot pain may be problematic in one-third of patients in early disease. The Foot Health Status Questionnaire (FHSQ) was developed and validated to evaluate the effectiveness of conservative (orthoses, taping, stretching) and surgery interventions. Despite this fact, there are few validated instruments that measure foot health status in Spanish. Thus, the primary aim of the current study was to translate and evaluate psychometrically a Spanish version of FHSQ. Methods: A cross-sectional study was designed in a university community-based podiatric clinic located in south of Spain. All participants (n = 107) recruited consecutively completed a Spanish version of FHSQ and EuroQoL Health Questionnaire 5 dimensions, and 29 participants repeated these same measures 48 h later. Data analysis included test–retest reliability, construct and criterion-related validity and factor analyses. Results: Construct validity was appropriate with moderate-to-high corrected item–subscale correlations (α = ≥0.739) for all subscales. Test–retest reliability was satisfactory (ICC > 0.932). Factor analysis revealed four dimensions with 86.6 % of the common variance explained. The confirmatory factor analysis findings demonstrated that the proposed structure was well supported (comparative fit index = 0.92, standardized root mean square = 0.09). The Spanish EuroQoL 5D score negatively correlated with the FHSQ pain (r = −0.445) and positively with general foot health and function (r = 0.261 − 0.579), confirming criterion-related validity. Conclusion: The clinimetric properties of the Spanish version of FHSQ were satisfactory.

An epidemiological study of the relationship between time to surgery and health status for elderly patients with a hip fracture

A hip fracture causes permanent changes to life style for older people. Further, two important mortality indicators found post operatively for this group include, the time until surgery after fracture, and pre-operative health status prior to surgery, yet no research is available investigating relationships between time to surgery and health status. The researchers aimed to establish the health status risks for patients aged over 65 years with a non-pathological hip fracture to guide nursing care interventions. A prospective cohort design was used to investigate relationships between time to surgery and measures on pre-operative health status indicators including, skin integrity risk, vigor, mental state, bowel function and continence. Twenty-nine patients with a mean age in years of 81.93 (SD,9.49), were recruited. The mean number of hours from time 1 assessment to surgery was 52.72 (SD,58.35) and the range was 1 hour to 219 hours. At Time 2, the mean scores of vigor and skin integrity risk were significantly higher, indicating poorer health status. A change in health status occurred but possibly due to the small sample size it was difficult to relate this result to time. However the results informed preoperative care prior to surgery, for this group.

Health status and use of health services among recently arrived men with refugee backgrounds: A comparative analysis of urban and regional settlement in South-east Queensland

Approximately one-third of refugee and humanitarian entrants to Australia are adult men. Many of these men and their families settle in regional areas. Little is known about the health status of refugee men and the use of health services, and whether or not there are differences between those living in urban and regional areas. This paper reports on the cross-sectional differences in health status and use of health services among a group of 233 recently arrived refugee men living in urban and regional areas of South-east Queensland. Overall, participants reported good levels of subjective health status, moderate to good levels of well-being, and low prevalence of mental illness. Men living in urban areas were more likely to have a longstanding illness and report poorer health status than those settled in regional areas. In contrast, men living in regional areas reported poorer levels of well-being in the environment domain and were more likely to visit hospital emergency departments. Targeted health promotion programs will ensure that refugee men remain healthy and develop their full potential as members of the Australian community. Programs that facilitate refugees’ access to primary health care in regional areas may promote more appropriate use of hospital emergency departments by these communities.

Health status of Thai migrants in Brisbane : findings from a cross-sectional investigation

Australia is a multi-ethnic, multi-cultural country with a long history of migration. In 2006, 22% of the population was born overseas. Thai migrants accounted for 0.2% of the population at this time, with a nearly 40% increase from around 19,000 in 1996 to 30,555 in 2006.1 Despite this, little is known about the health of this migrant group. We investigated the health status and health service utilisation of a Thai community through a cross-sectional postal survey conducted from May to September 2010. Participants were members of a Brisbane Thai temple, aged 18 years and older, who self identified as being Thai. Current health status was assessed using the SF-36v22 and self-report of diagnosed medical conditions. Use of health services was assessed using questions adapted from the Welsh Health Survey.3 Socio-demographic variables included gender, age, language spoken at home, year of arrival in Australia and type of health care insurance.

Dieting and non-dieting: Socio-cognitive determinants and associations with nutrition and health status indicators

Dieting and non-dieting are two contrasting approaches to the management of overweight/obesity, but less is known about why people follow non-dieting approaches and how these approaches are associated with health and nutrition status indicators. This thesis enables a greater understanding of why dieting and non-dieting approaches are adopted and provides insight into whether one approach is more favourably associated with nutrition and health status indicators. The findings of this thesis will be useful for clinicians who wish to encourage dieting or non-dieting approaches in their clients and for researchers wishing to understand how best to address overweight and obesity.

Robustness in health research : do differences in health measures, techniques, and time frame matter?

Survey-based health research is in a boom phase following an increased amount of health spending in OECD countries and the interest in ageing. A general characteristic of survey-based health research is its diversity. Different studies are based on different health questions in different datasets; they use different statistical techniques; they differ in whether they approach health from an ordinal or cardinal perspective; and they differ in whether they measure short-term or long-term effects. The question in this paper is simple: do these differences matter for the findings? We investigate the effects of life-style choices (drinking, smoking, exercise) and income on six measures of health in the US Health and Retirement Study (HRS) between 1992 and 2002: (1) self-assessed general health status, (2) problems with undertaking daily tasks and chores, (3) mental health indicators, (4) BMI, (5) the presence of serious long-term health conditions, and (6) mortality. We compare ordinal models with cardinal models; we compare models with fixed effects to models without fixed-effects; and we compare short-term effects to long-term effects. We find considerable variation in the impact of different determinants on our chosen health outcome measures; we find that it matters whether ordinality or cardinality is assumed; we find substantial differences between estimates that account for fixed effects versus those that do not; and we find that short-run and long-run effects differ greatly. All this implies that health is an even more complicated notion than hitherto thought, defying generalizations from one measure to the others or one methodology to another.

Examination of social demographic status, disease status, health behaviours and quality of life in older Australians using the theory of planned behaviour model

The increase of life expectancy worldwide during the last three decades has increased age-related disability leading to the risk of loss of quality of life. How to improve quality of life including physical health and mental health for older people and optimize their life potential has become an important health issue. This study used the Theory of Planned Behaviour Model to examine factors influencing health behaviours, and the relationship with quality of life. A cross-sectional mailed survey of 1300 Australians over 50 years was conducted at the beginning of 2009, with 730 completed questionnaires returned (response rate 63%). Preliminary analysis reveals that physiological changes of old age, especially increasing waist circumference and co morbidity was closely related to health status, especially worse physical health summary score. Physical activity was the least adherent behaviour among the respondents compared to eating healthy food and taking medication regularly as prescribed. Increasing number of older people living alone with co morbidity of disease may be the barriers that influence their attitude and self control toward physical activity. A multidisciplinary and integrated approach including hospital and non hospital care is required to provide appropriate services and facilities toward older people.

The Foot Heath Status Questionnaire : correct scale score calculation

This letter is in response to the recently published article “Evaluation of two self-referent foot health instruments” by Robert Trevethan (RT) and is in regard to the scale scores he derived when using the quality of life measure, the Foot Health Status Questionnaire [1]. Unfortunately, the journal reviewers and editor did not identify, or address, a fundamental flaw in the methodology of this paper. Subsequently, the inference drawn from this paper could, in all reasonableness, mislead the reader

Predictors of mental health in post-menopausal women : results from the Australian healthy aging of women study

Objective: To examine the extent to which socio-demographics, modifiable lifestyle, and physical health status influence the mental health of post-menopausal Australian women. Methods: Cross-sectional data on health status, chronic disease and modifiable lifestyle factors were collected from a random cross-section of 340 women aged 60-70 years, residing in Queensland, Australia. Structural equation modelling (SEM) was used to measure the effect of a range of socio-demographic characteristics, modifiable lifestyle factors, and health markers (self-reported physical health, history of chronic illness) on the latent construct of mental health status. Mental health was evaluated using the Medical Outcomes Study Short Form 12 (SF-12®) which examined and Center for Epidemiologic Studies Depression Scale (CES-D). Results: The model was a good fit for the data (χ2=4.582, df=3, p=0.205) suggesting that mental health is negatively correlated with sleep disturbance (β = -0.612, p <0.001), and a history of depression (β = -0.141, p = 0.024).While mental health was associated with poor sleep, it was not correlated with most lifestyle factors (BMI, alcohol consumption, or cigarette smoking) or socio-demographics like age, income or employment category and they were removed from the final model. Conclusion: Research suggests that it is important to engage in a range of health promoting behaviours to preserve good health. We found that predictors of current mental health status included sleep disturbance, and past mental health problems, while socio-demographics and modifiable lifestyle had little impact. It may be however, that these factors influenced other variables associated with the mental health of post-menopausal women, and these relationships warrant further investigation.

Measuring the biases in self-reported disability status : Evidence from aggregate data

Self-reported health status measures are generally used to analyse Social Security Disability Insurance's (SSDI) application and award decisions as well as the relationship between its generosity and labour force participation. Due to endogeneity and measurement error, the use of self-reported health and disability indicators as explanatory variables in economic models is problematic. We employ county-level aggregate data, instrumental variables and spatial econometric techniques to analyse the determinants of variation in SSDI rates and explicitly account for the endogeneity and measurement error of the self-reported disability measure. Two surprising results are found. First, it is shown that measurement error is the dominating source of the bias and that the main source of measurement error is sampling error. Second, results suggest that there may be synergies for applying for SSDI when the disabled population is larger. © 2011 Taylor & Francis.