An Integral Assessment Framework of Health Status in Chronic Obstructive Pulmonary Disease (COPD)

被引:44
作者
Vercoulen, Jan H. [1 ,2 ,4 ]
Daudey, Leonie [1 ,2 ]
Molema, Johan [2 ]
Vos, Petra J. [2 ]
Peters, Jeannette B. [3 ]
Top, Mariska [3 ]
Folgering, Hans [4 ]
机构
[1] Radboud Univ Nijmegen, Med Ctr, Dept Med Psychol, NL-6560 AB Groesbeek, Netherlands
[2] Radboud Univ Nijmegen, Med Ctr, Dept Pulm Dis, NL-6560 AB Groesbeek, Netherlands
[3] Radboud Univ Nijmegen, Med Ctr, Dept Med Psychol Pulm Dis, NL-6560 AB Groesbeek, Netherlands
[4] Radboud Univ Nijmegen, Med Ctr, Dept Pulm Dis & Med Psychol, NL-6560 AB Groesbeek, Netherlands
关键词
COPD; health status; validation; assessment; individualized treatment;
D O I
10.1080/10705500802365474
中图分类号
B849 [应用心理学];
学科分类号
040203 [应用心理学];
摘要
Background: To date, many health status instruments exist, but the validity of these instruments is questionable. This is caused by the fact that health status is poorly defined. Purpose: To develop a validated framework that improves conceptual insight into health status and its domains. Methods: Based on theoretical and clinical considerations, we defined the domains of health status into concrete sub-domains by formulating conceptual models. Guided by these conceptual models, for each sub-domain, existing instruments were selected. We validated the conceptual models in the data of 168 COPD patients. Using factor analysis, underlying concepts in the data were identified. Results: The resulting framework included physiological functioning, complaints, functional impairment, and quality of life. These main domains were shown to be subdivided into 15 sub-domains. Conclusions: The present study shows that health status consists of conceptually distinct sub-domains. Integral assessment of health status thus entails measuring all sub-domains. Existing instruments measure only few sub-domains. Integral assessment of health status thus requires the combination of different instruments. The present framework of health status can help in composing such a battery of instruments. Patient profiles obtained by the framework are essential in individualizing treatment.
引用
收藏
页码:263 / 279
页数:17
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