Objective: To assess how physical limitations relate to self-rated health among family medicine patients after adjustment for severity of illness.
Design: A telephone survey of family medicine patients, linked with medical record information.
Setting: A large family medicine department in Rochester, Minnesota, USA.
Subjects: Self-ratings of health were linked to medical records for 804 adult patients.
Results: Adjusting for severity and other confounders using multiple logistic regression analysis revealed that having physical limitations was inversely and independently related to good self-rated health (adjusted odds ratio = 0.20, P<0.001). Odds ratios also were lower for high severity of illness (adjusted odds = 0.43). Morbidly obese patients and patients older than 65 years of age also had reduced odds of good self-rated health.
Conclusions: In our sample of family medicine patients, part of the disparity in health status experienced by people with physical limitations is attributable to greater severity of illness, age and obesity.
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References
1.
CDC.Disability and health state chartbook — 2006: profiles of health for adults with disabilities, Nov 30, 2006. Centers for Disease Control, National Center on Birth Defects and Developmental Disabilities. Accessed 26 February 2007, from http://www.cdc.gov/ncbddd/dh/chartbook/default.htm
2.
Grill E., Mansmann U., Cieza A., Stucki G.Assessing observer agreement when describing and classifying functioning with the International Classification of Functioning, Disability and Health . J Rehabil Med2007; 39: 71—76.
3.
Wynia K., Middel B., Van Dijk J. et al. Broadening the scope on health problems among the chronically neurologically ill with the International Classification of Functioning (ICF) . Disabil Rehabil2006; 28: 1445—54.
4.
Bowling A.Just one question: If one question works, why ask several?J Epidemiol Community Health2005; 59: 342—45.
5.
DeSalvo KB, Fan VS, McDonell MB, Fihn SDPredicting mortality and healthcare utilization with a single question. Health Serv Res2005; 40: 1234—46.
6.
Desalvo K., Bloser N., Reynolds K., He J., Muntner P.Mortality prediction with a single general self-rated health question. A meta-analysis . J Gen Intern Med2006; 21: 267—75.
7.
Rohrer J., Young R., Sicola V., Houston M.Overall self-rated health: a new quality indicator for primary care . J Eval Clin Pract.2007; 13: 150—53.
8.
Rohrer JE, Arif A., Denison A., Young R., Adamson SAOverall self-rated health as an outcome indicator in primary care , 2008 (in press).
9.
Rohrer J., Arif A., Pierce J., Blackburn C.Unsafe neighborhoods, social group activity, and self-rated health . J Public Health Manag Pract2004; 10: 124—29.
10.
Rohrer J., Pierce J., Denison A.Walkability and self-rated health in primary care patients. BMC Fam Pract2004; 5: 29.
11.
Han B.Depressive symptoms and self-rated health in community-dwelling older adults: a longitudinal study. J Am Geriatr Soc2002 ; 50: 1549—56.
12.
Han B., Jylha M.Improvement in depressive symptoms and changes in self-rated health among community-dwelling disabled older adults. Aging Ment Health2006; 10: 599—605.
13.
Mulsant B., Ganguli M., Seaberg E.The relationship between self-rated health and depressive symptoms in an epidemiological sample of community-dwelling older adults. J Am Geriatr Soc1997; 45: 954—58.
14.
Ganguli M., Dodge H., Mulsant B.Rates and predictors of mortality in an aging, rural, community-based cohort: the role of depression. Arch Gen Psychiatry2002; 59: 1046—52.
15.
Gama E., Damián J., Pérez de Molino J., López M., López Pérez M., Gavira Iglesias F.Association of individual activities of daily living with self-rated health in older people. Age Ageing2000; 29: 267—70.
16.
Hoeymans N., Feskens E., Kromhout D., van den Bos G.Ageing and the relationship between functional status and self-rated health in elderly men. Soc Sci Med1997; 45: 1527—36.
17.
Charlson M., Pompei P., Ales K., MacKenzie C.A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis1987; 40: 373—83.
18.
Chaudhry S. , Jin L., Meltzer D.Use of a self-report-generated Charlson Comorbidity Index for predicting mortality. Med Care2005 ; 43: 607—15.
19.
Zhang Y., Rohrer J., Borders T., Farrell T.Patient satisfaction, self-rated health status, and health confidence: an assessment of the utility of single-item questions. Am J Med Qual2007; 22: 42—49.
20.
Miller M., Schulz R., Paradis C. et al. Changes in perceived health status of depressed elderly patients treated until remission. Am J Psychiatry1996 ; 153: 1350—52.
21.
Lyness J., King D., Conwell Y. et al. Self-rated health, depression, and one-year health outcomes in older primary care patients. Am J Geriatr Psychiatry2004; 12: 110—13.
22.
Mossey J., Knott K., Higgins M., Talerico K.Effectiveness of a psychosocial intervention, interpersonal counseling, for subdysthymic depression in medically ill elderly. J Gerontol A Biol Sci Med Sci1996; 51: M172—78.
23.
Feldman P., Cohen S., Doyle W., Shoner D., Gwaltney J.The impact of personality on the reporting of unfounded symptoms and illness . J Pers Soc Psychol1999; 77: 377—78.
24.
Smith T.Personality as risk and resilience in physical health. Curr Dir Psychol Sci2006; 15: 227—31.
