scholarly journals Long-term recovery of upper limb motor function and self-reported health: results from a multicenter observational study 1 year after discharge from rehabilitation

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Thies Ingwersen ◽  
Silke Wolf ◽  
Gunnar Birke ◽  
Eckhard Schlemm ◽  
Christian Bartling ◽  
...  
Keyword(s):  
Health Status ◽  
Motor Function ◽  
Stroke Rehabilitation ◽  
Inpatient Rehabilitation ◽  
Pinch Strength ◽  
Mixed Effect ◽  
Patient Reported ◽  
Reported Health ◽  
Self Reported Health Status

Abstract Background Impaired motor functions after stroke are common and negatively affect patients' activities of daily living and quality of life. In particular, hand motor function is essential for daily activities, but often returns slowly and incompletely after stroke. However, few data are available on the long-term dynamics of motor recovery and self-reported health status after stroke. The Interdisciplinary Platform for Rehabilitation Research and Innovative Care of Stroke Patients (IMPROVE) project aims to address this knowledge gap by studying the clinical course of recovery after inpatient rehabilitation. Methods In this prospective observational longitudinal multicenter study, patients were included towards the end of inpatient rehabilitation after ischemic or hemorrhagic stroke. Follow-up examination was performed at three, six, and twelve months after enrollment. Motor function was assessed by the Upper Extremity Fugl-Meyer Assessment (FMA), grip and pinch strength, and the nine-hole peg test. In addition, Patient-Reported Outcomes Measurement Information System 10-Question Short Form (PROMIS-10) was included. Linear mixed effect models were fitted to analyze change over time. To study determinants of hand motor function, patients with impaired hand function at baseline were grouped into improvers and non-improvers according to hand motor function after twelve months. Results A total of 176 patients were included in the analysis. Improvement in all motor function scores and PROMIS-10 was shown up to 1 year after inpatient rehabilitation. FMA scores improved by an estimate of 5.0 (3.7–6.4) points per year. In addition, patient-reported outcome measures increased by 2.5 (1.4–3.6) and 2.4 (1.4–3.4) per year in the physical and mental domain of PROMIS-10. In the subgroup analysis non-improvers showed to be more often female (15% vs. 55%, p = 0.0155) and scored lower in the Montreal Cognitive Assessment (25 [23–27] vs. 22 [20.5–24], p = 0.0252). Conclusions Continuous improvement in motor function and self-reported health status is observed up to 1 year after inpatient stroke rehabilitation. Demographic and clinical parameters associated with these improvements need further investigation. These results may contribute to the further development of the post-inpatient phase of stroke rehabilitation. Trial registration: The trial is registered at ClinicalTrials.gov (NCT04119479).

EUROQoL-5D as a valid patient-reported outcome measurement (PROM) tool to predict health-related quality of life (HRQoL) and survival in patients with hematological malignancies.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19141-e19141
Author(s):  
Raul Cordoba ◽  
Adriana Pascual ◽  
Javier Martinez-Peromingo ◽  
Ana-Isabel Hormigo ◽  
Elham Askari ◽  
...  
Keyword(s):  
Health Status ◽  
Outcome Measurement ◽  
Patient Reported Outcome ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
Euroqol 5D ◽  
Reported Health ◽  
Self Reported Health Status

e19141 Background: Patient-Reported Outcome Measurement (PROM) is the way to collect not only Health-Related Quality of Life (HRQoL) but also symptoms. EUROQOL-5D is a PROM tool explored widely in patients with cancer, although is not specific for cancer patients. The primary end-point of this project is to analyse the significance of impairments in EUROQOL-5D domains in overall survival of patients with hematological malignances, and the utility to incorporate as a PROM tool in a daily clinical practice. Methods: Patients with hematologic malignancies attended at Fundacion Jimenez Diaz University Hospital were assessed with EUROQOL-5D prior to receive any therapy. Self-reported health status stated as better, equal or worse was recorded at the time of assessment. Other variables such as age, sex, diagnosis and ECOG was collected to analyze their impact in survival. Results: From January 1, 2017 to December 31, 2019, 390 consecutive patients were included. Median age was 72 years (range 18-92), 194 (49.7%) were female, with a diagnosis of lymphoma in 257 (65.9%) and myeloma in 70 (17.9%), and ECOG 0-1 in 78.2% of patients. With a median follow-up of 10.5 months (range 0-32 months), we registered 72 events for overall survival. In the univariate analysis, age > 76 years (AUC 0.739, Likelyhood Ratio 3.321, p < 0.0001), ECOG 2-4 (OR 11.161, 95% CI 5.276-23.610, p < 0.0001), impairment in EUROQOL-5D domains such us mobility (OR 2.896, 95%CI 1.406-5.967, p = 0.003), self-care (OR 3.959, 95%CI 1.732-9.050, p = 0.001) and usual activities (OR 3.190, 95%CI 1.573-6.467, p = 0.001), but not pain/disconfort nor anxiety/depression were identified as prognostic factors for shorter survival. Self-reported health status (OR 3.975, 95%CI 1.845-8.565, p < 0.0001) was also a prognostic factor for survival. Impairments in EUROQOL-5D were also prognostic in patients with ECOG 0-1 (p < 0.001). In the multivariate analysis, only ECOG 2-4 and self-reported health status remained with statistical significance. Conclusions: EUROQOL-5D is a valid tool to be incorporated as a PROM tool in pacients with hematological malignancies. Impairments in mobility, self-care and usual activities will identify a poorer prognosis group that would need closer monitoring.

scholarly journals Does Awareness of the Affordable Care Act Reduce Adverse Selection? A Study of the Long-term Uninsured in South Carolina

2017 ◽  
Vol 54 ◽  
pp. 004695801772710 ◽  
Author(s):  
Lu Shi ◽  
Chaoling Feng ◽  
Sarah Griffin ◽  
Joel E. Williams ◽  
Lee A. Crandall ◽  
...  
Keyword(s):  
South Carolina ◽  
Health Insurance ◽  
Health Status ◽  
Adverse Selection ◽  
Affordable Care Act ◽  
The Past ◽  
Individual Mandate ◽  
Reported Health ◽  
Self Reported Health Status

Adverse selection predicts that individuals with lower health status would be more likely to sign up for health insurance. This hypothesis was tested among the long-term uninsured population in South Carolina (SC). This study used data from an in-person survey conducted from May 2014 to January 2015. Interviews were held with the long-term uninsured individuals at multiple sites throughout the state, using a multistage sampling method. SC residents aged 18 to 64 years who had had no health insurance for at least 24 consecutive months were eligible for the survey. The dependent variable is the participants’ attempt to obtain insurance coverage. Key independent variables are self-reported health status, hospitalization in the past year, use of emergency department in the past year, and presence of serious long-standing health problems. The analysis is stratified by the awareness of the Affordable Care Act (ACA)’s individual mandate while controlling for age, gender, race/ethnicity, and household income. Participants’ self-reported health status was not significantly associated with the attempt to sign up for health insurance in both groups (those aware and those unaware of the individual mandate). Being hospitalized in the previous year was significantly associated with their attempt to sign up for insurance in both groups. Participants with serious long-term health problems were more likely to have attempted to sign up for insurance among those who were not aware of the ACA. However, this association was statistically insignificant among those who had heard of ACA. Sicker people were more likely to attempt to sign up for insurance. However, being aware of the ACA’s individual mandate seemed to play a role in reducing adverse selection.

Self-efficacy predicts self-reported health status in multiple sclerosis

2004 ◽  
Vol 10 (1) ◽  
pp. 61-66 ◽  
Author(s):  
A Riazi ◽  
A J Thompson ◽  
J C Hobart
Keyword(s):  
Multiple Sclerosis ◽  
Health Status ◽  
Self Efficacy ◽  
Psychological Impact ◽  
Inpatient Rehabilitation ◽  
Walking Ability ◽  
Rehabilitation Programs ◽  
Reported Health ◽  
Self Reported Health Status ◽  
Challenging Situation

Self-efficacy is a belief that one can competently cope with a challenging situation. If self-efficacy is a strong predicto r of health status in multiple sclerosis (MS), it may be an important area to target in clinical practice, as such beliefs may be modifiable. The aim of this study was to examine the predictive value of self-efficacy on self-reported health status in MS. Eighty-nine people with MS completed the Multiple Sclerosis Self-efficacy Scale (MSSE function and control scales), the Multiple Sclerosis Impact Scale (MSIS-29), and the Multiple Sclerosis Walking Scale (MSWS-12) at two time points: 1) admission to an inpatient rehabilitation unit (n=43) or for steroid treatment for relapses (n=46); and 2) discharge (rehabilitation group) or six weeks later (steroid group). Multiple regression analyses examined whether baseline and changes in self-efficacy predict changes in self-reported health status. Both baseline and changes in self-efficacy were strong and independent predictors of changes in health status (P-values ranged from 0.025 to B-0.001). That is, pretreatment self-efficacy scores and increases in self-efficacy scores from baseline to follow-up (improvement), were significantly associated with decreases (improvement) in perceived walking ability and physical and psychological impact of MS. The findings suggest that self-efficacy predicts improvement in health status and that self-efficacy would be an important domain to measure and manage actively in education and rehabilitation programs.

Insights From a Developing Country: Self-Reported Health Status of Elderly Men (60 Years and Over) in Jamaica

2013 ◽  
Vol 12 (2) ◽  
pp. 106-120 ◽  
Author(s):  
Chloe Morris ◽  
Kenneth James ◽  
Desmale Holder-Nevins ◽  
Denise Eldemire-Shearer
Keyword(s):  
Health Status ◽  
Developing Country ◽  
Elderly Men ◽  
Reported Health ◽  
Self Reported Health Status

scholarly journals Use of Complementary and Alternative Medical Services by HMO Members, 1995-1996

2001 ◽  
Vol 7 (2) ◽  
pp. 85-98 ◽  
Author(s):  
Evelyn P. Whitlock
Keyword(s):  
Multivariate Analysis ◽  
Patient Satisfaction ◽  
Health Status ◽  
Service Users ◽  
Improve Patient Satisfaction ◽  
Kaiser Permanente ◽  
Reported Health ◽  
Self Reported Health Status ◽  
Improve Patient ◽  
Complementary And Alternative

We investigated HMO members' use of complementary and alternative medicine (CAM) providers outside the HMO in 1995-1996. A random 2% survey of Kaiser Permanente Northwest members addressed HMO service satisfaction, self-reported health status and behaviors, and HMO utilization. Among respondents, 15.7% (n = 380) used CAM providers (chiropractors, naturopaths, acupuncturists, others) in the prior 12 months, while 35% were ever users. Multivariate analysis found that those more likely to consult CAM providers were females, more educated, and more dissatisfied with the HMO. These results suggest that HMOs may wish to focus efforts to improve patient satisfaction among CAM service users.

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