P. Kersten et al., Generic health status measures are unsuitable for measuring health status in severely disabled people, CLIN REHAB, 13(3), 1999, pp. 219-228
Objectives: To assess the perceived health status of disabled people.
Design: Perceived health status was evaluated with the Short Form 36 Health
Survey (SF-36) and the Nottingham Health Profile as part of a needs assess
ment project exploring systematic differences in unmet needs for rehabilita
tion as perceived by disabled people, carers and professional staff. Disabl
ed participants completed these health status questionnaires, as part of a
face-to-face interview in participants' own homes.
Subjects: Ninety-two disabled people aged 16-65, recruited into the study f
rom two disability registers.
Outcome measures: The Office of Population Censuses and Surveys (OPCS) Disa
bility Severity Scale, Nottingham Health Profile, SF-36.
Results: Ninety-six disabled people took par? in this study. Four were late
r excluded because of overwhelming communication difficulties. Median OPCS
category was 8 (interquartile range 6-9.75). The pain and physical mobility
domains of the Nottingham Health Profile were not completed by 46/92 parti
cipants (50%) because many questions referred to activities that these peop
le could not perform, particularly walking. The physical functioning domain
of the SF-36 showed severe floor effects. It was not therefore possible to
use these measures to test the effectiveness of services provided to disab
led people, particularly in the areas of physical functioning and pain.
Conclusions: There is a continued need to develop and test instruments that
can measure the outcomes of rehabilitation in severely disabled population
s.