The answer depends on pragmatic norms and epistemic reflection. A linguistic and epistemological analysis of the Danish Short Form 36 Health Survey (SF-36)

2021 ◽  
Author(s):  
Esben Nedenskov Petersen ◽  
Brigitte Norgaard
Keyword(s):  
General Population ◽  
Short Form ◽  
Negative Answer ◽  
Careful Attention ◽  
Linguistic Context ◽  
Scalar Implicatures ◽  
Sf 36 ◽  
Gricean Maxims ◽  
Epistemological Analysis ◽  
Answer Option

Abstract Purpose The SF-36 is a commonly used tool for measuring health status in a general population. Despite the overall moderate to high validity scores, we believe that certain communicative dynamics of the questionnaire deserve more careful attention. Our aim was to examine how pragmatic dynamics and epistemic reflection may influence answers to the SF-36.Methods We applied a three-step Gricean analysis, which included identification of the items in which pragmatic dynamics are most likely to have a significant effect, examination of how Gricean maxims might affect the answers given to the items identified, and finally, assessment of whether the combined influence of linguistic context-sensitivity and pragmatic norms is benign.Results Items 6, 9a, 10 and 11a–d were included in the analysis. Regarding these items, our analysis showed that the pragmatic dynamics of scalar implicatures are crucial to the interpretation of answer options. In addition, we raised concerns specifically about the answer option ‘Ved ikke’; rather than representing a neutral midpoint, the answer is compatible with both a positive and a negative answer option. Nonetheless, we found that the communicative dynamics of the questionnaire are mostly benign.Conclusion Compared to the significance of scalar implicatures, the potential effects of epistemic reflection that we identified are minor because they concern only items with a ‘Don’t know’ answer option. However, we raised the concern that attention to epistemic error possibilities might prompt respondents to opt for a ‘Don’t know’ answer despite having evidence supporting a different answer. Therefore, although pragmatic norms of communication are far more significant than attention to epistemic error possibilities in shaping answers to the SF-36, we think that both factors belong in a description of how the questionnaire works.

Quality of Life in Patients with Systemic Sclerosis Compared to the General Population and Patients with Other Chronic Conditions

2009 ◽  
Vol 36 (4) ◽  
pp. 768-772 ◽  
Author(s):  
MARIE HUDSON ◽  
BRETT D. THOMBS ◽  
RUSSELL STEELE ◽  
PANTELIS PANOPALIS ◽  
EVAN NEWTON ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systemic Sclerosis ◽  
General Population ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Short Form ◽  
Mental Component Summary Score ◽  
Population Norms ◽  
Sf 36

Objective.Systemic sclerosis (SSc) affects multiple physical, psychological, and social domains and is associated with impaired health-related quality of life (HRQOL).We compared the HRQOL of SSc patients with individuals in the general population and patients with other common chronic diseases.Methods.HRQOL of SSc patients in the Canadian Scleroderma Research Group registry was measured using version 2 of the Medical Outcomes Trust Short Form-36 (SF-36). Results were compared to US general population norms and scores reported for patients with other common chronic diseases, namely heart disease, lung disease, hypertension, diabetes, and depression.Results.SF-36 scores were available for 504 SSc patients (86% women, mean age 56 yrs, mean disease duration since onset of first non-Raynaud’s manifestation of SSc 11 yrs). The greatest impairment in SF-36 subscale scores appeared to be in the physical functioning, general health, and role physical domains. SF-36 subscale and summary scores in SSc were significantly worse compared to US general population norms for women of similar ages, except for mental health and mental component summary score, which were not significantly different, and were generally comparable to or worse than the scores of patients with other common chronic conditions.Conclusion.HRQOL of patients with SSc is significantly impaired compared to that of the general population and is comparable to or worse than that of patients with other common chronic conditions.

Factors influencing depression endpoints research (FINDER): Study design and population characteristics

2008 ◽  
Vol 23 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Ana Garcia-Cebrian ◽  
Michael Bauer ◽  
Angel L. Montejo ◽  
Nicolas Dantchev ◽  
Koen Demyttenaere ◽  
...  
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Study Design ◽  
Short Form ◽  
Clinical Depression ◽  
Population Characteristics ◽  
Population Norms ◽  
Factors Influencing ◽  
Sf 36

AbstractFactors influencing outcomes of depression in clinical practice, especially health-related quality of life (HRQoL), are poorly understood. The Factors Influencing Depression Endpoints Research (FINDER) study is a European prospective, observational study designed to estimate the HRQoL of adults with a clinically diagnosed depressive episode at baseline, and 3 and 6 months after commencing antidepressant medication. We report here the study design and baseline patient characteristics.HRQoL was assessed by the 36-item Short-Form Health Survey (SF-36) and European Quality of Life-5 Dimensions (EQ-5D). Patient ratings on Hospital Anxiety and Depression Scale (HADS) and pain Visual Analogue Scale (VAS) were also obtained. Results (n = 3468) showed that SF-36 mental component summary (mean 22.2) was more than two SDs below general population norms (mean 50.0) and one SD below clinical depression norms (mean 34.8); the physical component summary (mean 46.1) was similar to general population (mean 50.0) and clinical depression norms (mean 45.0). Mean EQ-5D scores were also lower than general population norms. Mean HADS-Depression and -Anxiety subscores were 12.3 and 13.0, respectively. Fifty-six percent of patients reported an overall pain VAS score of at least 30 mm and 70% of these patients had no physical explanation for their pain.Further investigation into factors associated with HRQoL in depression after treatment initiation is warranted.

Factors affecting quality of life in lower limb amputees

2011 ◽  
Vol 35 (1) ◽  
pp. 90-96 ◽  
Author(s):  
Richa Sinha ◽  
Wim JA van den Heuvel ◽  
Perianayagam Arokiasamy
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Lower Limb ◽  
Short Form ◽  
Treatment Protocol ◽  
Phantom Limb ◽  
Sf 36 ◽  
Prospective Longitudinal ◽  
Lower Limb Amputees

Background: Quality of life (QoL) is increasingly being recognized as an important outcome for rehabilitation programs, and has mainly been used to compare the efficacy of interventions or to compare amputees with other diseased populations. There is relatively a limited number of studies primarily focusing on analyzing the multitude of factors influencing QoL in amputees.Objectives: To identify important background and amputation related factors which affect quality of life (QoL) in lower limb amputees, and to compare QoL profile of amputees’ to that of general population.Study design: Cross-sectional.Methods: Lower limb amputees 18 years and above from a rehabilitation centre, a limb-fitting centre and four limb-fitting camps were interviewed ( n = 605). Structured questionnaires included patient background and amputation characteristics, and the MOS short-form health survey (SF-36) for assessing QoL. The SF-36 was administered to a general adult population using purposive sampling ( n = 184).Results: SF-36 PCS and MCS scores were found to be significantly lower for amputees when compared to those for the general population. In this study, employment status, use of an assistive device, use of a prosthesis, comorbidities, phantom-limb pain and residual stump pain were found to predict both PCS and MCS scores significantly, and explained 47.8% and 29.7% of variance respectively. Age and time since amputation accounted for an additional 3% of variance in PCS scores.Conclusions: The abovementioned factors should be addressed in order to ensure holistic reintegration and participation, and to enable the amputees to regain or maintain QoL. Prospective longitudinal studies are recommended to systematically study the change in QoL over time and to assess its determinants.Clinical relevanceProper appraisal of abovementioned factors in the rehabilitation programme would assist in establishing a treatment protocol, which would adequately address QoL in amputees.

scholarly journals Penilaian Properti Psikometrik Instrumen Kualitas Hidup (HRQol) pada Populasi Umum: Tinjauan Sistematik

2019 ◽  
Vol 9 (2) ◽  
Author(s):  
Restu Nur Hasanah Haris ◽  
Rahmat Makmur ◽  
Tri Murti Andayani ◽  
Susi Ari Kristina
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Construct Validity ◽  
Psychometric Properties ◽  
Short Form ◽  
Internal Consistency Reliability ◽  
Ceiling Effect ◽  
Validity And Reliability ◽  
Sf 36

Quality of life (HRQoL) is a measure of a person's health in physical, spiritual, and emotional, and role functions in the society. Measurement of quality of life (HRQoL) is an important thing to understand and evaluate. Measurements are carried out not only on patients but also on the general population with the use of specific or generic instruments. The instrument used requires a psychometric properties test to ensure its validity and reliability. This article aims to conduct a systematic review of the psychometric properties of quality of life (HRQoL) instruments in the general population. Articles were collected in December 1st to 5th, 2018, from Pubmed and Google Scholar. The assessment was carried out using the checklist properties according to the cohen criteria and included the content validity, construct validity, internal consistency reliability, test-retest, ceiling effect and the level of credibility of the instruments. Among 80 articles obtained there were 24 articles that fulfilled the inclusion criteria. Short Form-36 (SF-36) instrument is the most widely used instrument in measuring the quality of life in the general population (26.6%). Some instruments have not been tested according to the criteria, while almost all instruments show a good level of validation of construct validity using convergent and discriminat validity with cronbach alpha values > 0.7. Test-retest reliability provides a good correlation. Some instruments show a ceiling effect. According to the assessment, the SF-36, SF-6D, EQ-5D, SF-12 and PedsQoL instruments are considered as established instruments. Further validation testing is needed to provide and support the measurement of subsequent quality of life (HRQoL) instruments.

Abstract 13624: Perceived Health and Physical Activity among Patients treated with Ablation for Atrial Fibrillation or Atrial Flutter compared with a Healthy General Population - Results from a Nationwide Survey

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Signe S Risom ◽  
Selina K Berg ◽  
Anne V Christensen ◽  
Ann-Dorthe Zwisler ◽  
Jesper H Svendsen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Atrial Fibrillation ◽  
General Population ◽  
Atrial Flutter ◽  
Short Form ◽  
Perceived Health ◽  
Activity Levels ◽  
Sf 36 ◽  
Physical Activity Levels ◽  
Age And Sex

Introduction: Patients with atrial fibrillation (AF) or atrial flutter (AFL) report poor perceived health and avoidance behavior when suffering the arrhythmia. It is important to investigate if this perception and behavior changes after treatment with ablation, so that normality is regained. Objective: To describe patients’ perceived health and physical activity 6-12 months after ablation for AF or AFL and compare with an age- and sex- matched healthy general population. Methods: The nationwide cross-sectional survey was mailed to participants >18 years old who had been hospitalized for ablation for AF or AFL from January to June 2011. The patients were identified in the Danish National Patient Register (n=714). The mailed questionnaire included Short Form 36 (SF-36) and a question about physical activity and was sent in Dec 2011 to eligible patients (n=627). The nationally representative Danish Health Interview Survey 2005 was used to sample an age- and sex-matched reference population. Differences in perceived health (SF-36) were tested with t-test and chi2-test was used to determine the differences in physical activity levels. Results: The questionnaire was answered by 462 patients (74%). We found in all domains on SF-36 significantly lower scores for patients treated for AF and AFL compared with the reference group (p=0.0001) (see Table 1). Physical activity levels were also significantly lower for the patients treated for AF and AFL (p<0.0001). Conclusions: We found that patients treated for AF or AFL’s perceived health and physical activity levels were significantly impaired compared with a healthy general population. This is vital information for the health professional seeing the patients for follow-up after the ablation and rehabilitation should be considered.

scholarly journals Systematic Review of Change in Bodily pain after Sinus Surgery

2008 ◽  
Vol 139 (6) ◽  
pp. 759-765 ◽  
Author(s):  
Alexander C. Chester ◽  
Raj Sindwani ◽  
Timothy L. Smith ◽  
Neil Bhattacharyya
Keyword(s):  
General Population ◽  
Fixed Effects ◽  
Short Form ◽  
Bodily Pain ◽  
Sinus Surgery ◽  
Population Norms ◽  
Repeated Measures Design ◽  
Pain Scores ◽  
Sf 36 ◽  
Pain Domain

Objectives To determine whether bodily pain is increased in patients with chronic rhinosinusitis (CRS) and if bodily pain improves following endoscopic sinus surgery (ESS). Methods All studies reporting results of more than 10 adult patients analyzing the response of bodily pain to ESS were retrieved by searching MEDLINE, EMBASE, Web of Science, Cochrane databases, and additional web-based sources (from January 1, 1980, to May 1, 2008); by examining bibliographies of retrieved articles; and by contacting investigators in the field. Results Of 279 ESS symptom outcome studies, only studies measuring results using the 36-Item Short Form Health Survey (SF-36) quality-of-life survey instrument measured bodily pain. Eleven observational ESS studies (1019 patients) reported mean preoperative SF-36 bodily pain scores at 0.89 SD below general population norms (24% more severe bodily pain than general population norms) and significantly below norms for a population 25 years older. Using a repeated-measures design, nine of 11 studies noted significant improvement in SF-36 bodily pain domain scores following ESS, with a moderate-sized combined effect of 0.55 (95% confidence interval, 0.45–0.64; I 2 = 44%) using the fixed-effects model. This pooled effect corresponded to a mean improvement of 11.8 U on the SF-36 bodily pain domain scale. Conclusions Bodily pain is increased in patients with CRS awaiting ESS, exceeding the normative bodily pain scores of a general normative population 25 years older. Using within-subject comparisons, a clinically and statistically significant improvement in bodily pain is noted after ESS, an improvement similar to that previously described for fatigue.

scholarly journals Do Patients Profit from Third Time CABG?

2009 ◽  
Vol 2 ◽  
pp. OJCS.S2277
Author(s):  
Malakh Shrestha ◽  
Hassina Baraki ◽  
Nawid Khaladj ◽  
Nurbur Koigeldiyev ◽  
Axel Haverich ◽  
...  
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Operative Mortality ◽  
Short Form ◽  
Single Centre ◽  
Heart Insufficiency ◽  
Sf 36 ◽  
Acceptable Quality

Introduction It has been shown that in experienced hands repeated CABG is doable procedure. However the quality of life after third time CABG has not been evaluated so far. Patients and Methods The peri-operative data of 25 (22 male, mean age of 65.5 ± 8.0 years) consecutive patients in a single centre undergoing third time-CABG from 4/96 to 11/06 were studied. Quality of life (QoL) was assessed by Short Form (SF)-36 Questionnaire. Results 30 day mortality was 12% (3/25). Seven died during follow-up. In 15 survivors median follow-up was 94 months (2–122 months). 1-, 5-, and 10-year survival were 77.8%, 65.0%, and 53.1%, respectively. Present NYHA status was significantly improved in comparison to preoperative values (2.4 ± 0.8 vs. 3.2 ± 0.56, p = 0.012). QoL was comparable with an age matched general population with heart insufficiency. Conclusion Third time CABG can be performed with acceptable peri-operative mortality. Significant improvement of NYHA status and acceptable quality of life results justifies our surgical approach in this challenging patient cohort.

Quality Of Life In CML Patients: Better Outcomes Associated With TKI Interruption

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4004-4004
Author(s):  
Stephane Giraudier ◽  
Etienne Audureau ◽  
Kahina Oukerfellah ◽  
Michel Tulliez
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Short Form ◽  
Univariate Analysis ◽  
Response To Therapy ◽  
Molecular Response ◽  
Younger Age ◽  
Sf 36 ◽  
Mental Hrqol

Abstract Background Recent data indicate that the survival of chronic myeloid leukemia (CML) patients, who are in Major Molecular Response with TKI, is not statistically significantly different from that of the general population and that a subgroup of patients who experienced long-term Complete Molecular Responses can stop therapy without relapse. However, less is known regarding the actual impact of TKI therapies or their cessation on patients’ health-related quality of life (HRQoL). Aim We conducted a monocentric observational quality of life study on CML patients having received or currently receiving Imatinib, Nilotinb or Dasatinib, in order to investigate the relationships between HRQoL and treatment or treatment interruption. Patients and Methods The analysis was performed on 110 CML patients diagnosed and recruited from 1999 to 2012 in our department and followed for more than 3 months. At the time of HRQoL assessment (median duration from diagnosis: 5.6 years; interquartile range [IQR] 2.4-10.1), 8.8% of patients had stopped TKI therapy for more than 3 months because of long-time CMR, 49.6% were treated with Imatinib, 22.1% with Dasatinib and 19.5% with Nilotinib. The total number of different prescribed TKIs in the course of the disease was 1 in 60.2% of the cases, 2 in 23% and 3 in 16.8%. HRQoL was assessed with the 36-Item Short-Form Health Survey (SF-36), using age-sex adjusted standardized scores expressed as standard deviation [SD] from the French general population reference values for age and gender. Key socio-demographic and clinical data including age, gender, education, Sokal risk, response to therapy and duration of treatment, smoking, obesity, hypertension, diabetes, dyslipidemia, number of medications, ECOG performance status, ADL/IADL and Mini Nutritional Assessment scale (MNA) were also taken into account. Univariate and multivariate linear regression analyses were used to identify independent predictors for each SF-36 subscale and summary scores (Physical [PCS] and Mental Composite Scores [MCS]). Results In univariate analysis, factors significantly associated with lower PCS scores included younger age (under 45) (-1.20 SD), lower education level (-0.79SD), obesity (BMI>30) (-1.39SD), pre-existence of dyslipidemia (-1.57SD), ADL with more than 1 limitation (-0.98SD), ECOG >1 (-1.83SD), MNA at risk or poor nutritional status (-1.26SD); factors associated with lower MCS scores were pre-existence of dyslipidemia (-0.92SD), ECOG>1 (-1.31SD), MNA (-0.87SD), current CML treatment (-0.28SD [Imatinib],-0.42SD [Sprycel] and -0.53SD [Nilotinib]) and more than 2 lines of TKI (-0.89SD). In multivariate analysis, only younger age (p=0.009) and dyslipidemia (p=0.023) were negatively correlated to PCS and current CML treatment (p=0.001) and more than 2 TKI (p=0.013) negatively correlated to MCS. In figure 1, we report the standardized SF-36 scores of CML patients according to age (1a), treatment (1b) or treatment lines (1c). Conclusion We confirm previous data indicating worse HRQoL in younger CML patients treated with Imatinib. In our study, this effect was also observed with 2nd-generation TKIs. Our findings were in the same order of magnitude as previously reported (Efficace et al, blood, 2011). We failed to demonstrate any major differential effect between the different TKI (Imatinib, Nilotinib or Dasatinib) on HRQoL suggesting that the choice of TKI therapy cannot be determined by this criterion. Moreover, comparing the number of TKI changes, we failed to demonstrate any effect of “only-one” change of TKI on HRQoL,. This suggests that one change in CML therapy does not worsen QOL , whereas a drastic decrease in mental HRQoL scores was found in patients receiving more than two lines of TKI. The most relevant finding was that patients who benefited from TKI interruption because of stable complete molecular remission had better mental HRQoL outcomes, suggesting that TKI interruption could have a positive impact on HRQoL and hence has to become the objective to achieve in CML to normalize HRQoL. Disclosures: Giraudier: NOvartis: Consultancy, Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding; BMS: Consultancy, Honoraria. Tulliez:Novartis: Consultancy, Honoraria.

scholarly journals Psychosomatic symptoms questionnaire (PSQ-39): a psychometric study among general population of Iranian adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zahra Heidari ◽  
Awat Feizi ◽  
Sara Rezaei ◽  
Hamidreza Roohafza ◽  
Peyman Adibi
Keyword(s):  
General Population ◽  
Construct Validity ◽  
Short Form ◽  
Divergent Validity ◽  
Psychosomatic Symptoms ◽  
Retest Reliability ◽  
Persian Version ◽  
Group Validity ◽  
Sf 36 ◽  
Test Retest Reliability

Abstract Background Psychosomatic symptoms, characterized by physical-bodily complaints not fully explained by organic reasons, are highly prevalent. The present study aimed to culturally adapt and evaluate the psychometric properties of Psychosomatic Symptoms Questionnaire 39-item version (PSQ-39) among Iranian general adult population. Methods This study included 996 Persian-speaking people, living in Isfahan, Iran. The translation of the PSQ-39 was performed using the forward-backward method. Test-retest reliability was evaluated through Intraclass correlation (ICC) coefficient and internal consistency by using Cronbach’s α. Construct validity was investigated by using both exploratory (EFA) and confirmatory (CFA) factor analysis. Short Form Health Survey (SF-36) was used to assess divergent validity. Known-group validity was also assessed. Results The Persian version of the PSQ-39 showed excellent test-retest reliability in all domains (ICCs: 0.95–0.99). The computed Cronbach’s alpha coefficients for domains of PSQ-39 were in the range good to excellent. The PSQ-39 showed good known-group validity and differentiated patients from the general population (Area under the curve [AUC] of 0.78 (95% CI: 0.73, 0.84). Construct validity evaluated by EFA led to extraction of seven factors (Cardiorespiratory, musculoskeletal, psychological, gastrointestinal, general, body balance and Globus), and the CFA confirmed the adequacy of extracted factors by EFA (CFI = 0.91, TLI = 0.90, PCFI = 0.77, PNFI = 0.71, CMIN = 1413.18 (df = 654), CMIN/DF = 2.16, and RMSEA = 0.06). Significant negative correlations between all domains of PSQ and SF-36 revealed an acceptable divergent Validity. Conclusions The Persian version of the PSQ-39 is a reliable and valid questionnaire with applicability in a broad range of Persian language populations for assessing common psychosomatic symptoms in research as well as in clinical practice.

scholarly journals Fit for duty: The health status of New South Wales Paramedics

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Alex James MacQuarrie ◽  
Caroline Robertson ◽  
Peter Micalos ◽  
James Crane ◽  
Richard High ◽  
...  
Keyword(s):  
Health Care ◽  
Health Status ◽  
General Population ◽  
New South ◽  
Short Form ◽  
New South Wales ◽  
Poor Health ◽  
Care Providers ◽  
South Wales ◽  
Sf 36

<p><strong><em>Introduction</em></strong></p><p>Paramedics are mobile health care workers who respond to trauma and medical emergencies. Worldwide, paramedics exhibit disturbingly high rates of injury and illness with increased markers of poor health, such as obesity and hypertension, being common. The primary aim of this study was to explore the self-reported health status of paramedics in New South Wales, Australia, by gender and geographic rostering pattern and to compare it with that of the Australian general population. A secondary aim was to examine paramedics’ attitudes towards exercise.</p><p><strong><em>Methods</em></strong></p><p>In 2015, paramedics employed by NSW Ambulance were invited to complete a web-based survey which composed of the Medical Outcomes Survey Short Form 36 (SF-36), and measures of attitudes towards exercise. Demographic information and participants’ height and weight (for calculating Body Mass Index (BMI)) were also collected. Normative comparator data for the Australian general population (BMI and SF-36 scores) were sourced from the Household Income Labour Dynamics in Australia 2015 survey.</p><p><strong><em>Results</em></strong></p><p>Of the approximately 3,300 paramedics invited to participate, 747 completed the survey (507 male, 240 female).  Mean age and mean years of service were 41.5 ±9.5 (SD) and 13.6 ±9.0 respectively. There were no differences in SF-36 scores except for the Vitality domain where males scored higher than females (p&lt;0.001), and regional paramedics had a higher General Health domain score than metropolitan paramedics (p&lt;0.05). Regional male paramedics had higher BMIs than their metropolitan counterparts (28.04 kg/m<sup>2</sup> ± 3.99 vs. 26.81 kg/m<sup>2</sup> ± 4.67, p = 0.001). Compared to the Australian population, paramedics scored higher in the Physical Function domain (p&lt;0.001) but lower in summary scores for mental and physical health (p&lt;0.001). Paramedics’ BMIs were slightly higher than the general population (27.10 ± 4.30 kg/m<sup>2 </sup>vs.26.47 ±5.42, p&lt;0.001). Paramedics reported lack of time, family, lack of motivation and in regional postings: distance to fitness facilities and shift patterns as barriers to exercise.</p><p><strong><em>Conclusions</em></strong></p><p>Paramedics scored lower on the SF-36 than the general population, which can indicate a lower health-related quality of life.  High BMI and low SF-36 scores may be related to a perceived inability to engage in regular exercise and the effects of shift work, especially in regional areas. Increasing BMI can be associated with the development of markers of poor health. Attention is needed to ensure that these essential health care providers are “fit for duty”.  This survey should be repeated longitudinally to examine trends in the health status of paramedics. Nationally and internationally, ambulance management can and should foster innovative health promotion programs and paramedics themselves need to recognise and value good health.</p>

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