Generic, disease-specific and individualised approaches to measuring health-related quality of life among people with heart disease - a comparative analysis.

Increasing emphasis is being placed on the evaluation of health-related quality of life. However, there is no consensus on the definition of this concept and as a result there are a plethora of existing measurement instruments. Head-to-head comparisons of the psychometric properties of existing instruments are necessary to facilitate evidence-based decisions about which instrument should be chosen for routine use. Therefore, an individualised instrument (the modified Patient Generated Index), a generic instrument (the Short Form 36) and a disease-specific instrument (the Quality of Life after Myocardial Infarction questionnaire) were administered to patients with ischaemic heart disease (n=117) and the evidence for the validity, reliability and sensitivity of each instrument was examined and compared. The modified Patient Generated Index compared favourably with the other instruments but none of the instruments examined provided sound evidence for sensitivity to change. Therefore, any recommendation for the use of the individualised approach in the routine collection of health-related quality of life data in clinical practice must be conditional upon the submission of further evidence to support the sensitivity of such instruments.

Breaking the boundaries: Geographical approaches to integrating 200 years of the Census

The census and similar sources of data have been published for two centuries so the information that they contain should provide an unparalleled insight into the changing population of Britain over this time period. To date, however, the seemingly trivial problem of changes in boundaries has seriously hampered the use of these sources as they make it impossible to create long run time series of spatially detailed data. The paper reviews methodologies that attempt to resolve this problem by using geographical information systems and areal inter-polation to allow the reallocation of data from one set of administrative units onto another. This makes it possible to examine change over time for a standard geography and thus it becomes possible to unlock the spatial detail and the temporal depth that are held in the census and in related sources.

Towards a person-centred ‘culture’: the use of community development approaches in the Independent Youth Counselling Service in West Belfast

This paper is drawn from a qualitative study of clients, counsellors and the supervisors views of the value and impact of the Independent Youth Counselling Service (IYCS) in West Belfast. Data collection combined semi-structured interviews, focus groups and an open-ended questionnaire. The findings indicate the significance of factors above and beyond the person-centred counselling experience, in maximising the potential for growth and development for clients and counsellors. This holistic approach to counselling service provision employs a body of community development processes, which collectively combine to embed the counselling service in a complementary principled approach. This paper explores how these community development features bolster the counselling experience to promote a culture of person-centeredness, thereby increasing the empowerment of the client.