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Open access peer-reviewed chapter. Identifying health indicators which provide necessary and appropriate data for the evaluation of clinical outcomes in terms of Health-Related Quality of Life HRQoLas established by the Giopsychosocial Biopsychosocial Model, and which provide appropriate and pertinent information on physical, modek and social factors in patients, can improve decision-making in relation to a comprehensive and global perspective of clinical outcomes of biopsycchosocial various treatments and procedures given to patients.
This chapter aims to provide an overview of the various tools for assessing Health-Related Quality of Life, as a growing number of clinicians, researchers and patient groups wish for comprehensive and not merely biological measures of health. This may be explained by the growing number of self-administered or interview questionnaires which have the aim of measuring changes in health as well what is biopsychosocial model in social work the consequences of the various treatments used mainly on chronicity and chronic health conditions.
During recent decades, numerous tools have been developed and applied to the measurement of the effects of Health-Related Quality of Life in patients based on biological or physical aspects, psychological or mental aspects, and social aspects. This chapter will review the most frequently-used tools for the measurement of Health-Related Quality of Life, and recommendations are made for their use in medical care according to psychometric characteristics and quality criteria, as a guide for use in the field of healthcare, in public health, or in outcomes research.
In Public Health and in Health Planning, population health what is biopsychosocial model in social work are used to show the magnitude of a medical problem, to reflect a change in the health soclal of a patient or a population over time, to compare and assess differences in health status among patients and populations, and to analyse and evaluate the extent to which what is biopsychosocial model in social work goals have been achieved in patients in order to recommend what does impact mean in english treatments for use in clinical ssocial and research [ what is biopsychosocial model in social work2 ].
Measurement of health and Health-Related Quality of Life HRQoL has acquired great importance in recent decades as a means of measuring clinical outcomes in patients and of monitoring the progress of various treatments along with their physical, psychological and social consequences what is the difference between correlation and cause and effect 3 ].
Medical practitioners frequently must choose from among wokr tools with the aim of obtaining essential relevant information for decisions on treatment, with analysis and a multidimensional assessment of these treatments on patients. Meanwhile, countries have iss information how is linear regression used in business which permit the development of a wide variety of health indicators, and thus allow periodic surveys of their healthcare situation.
These indicators provide information on their change over time, which makes it possible to assess trends and geographical distributions. Likewise, the wide availability of these indicators allows comparison with other countries [ 45 ]. Selection of indicator sets is commonly done in countries with well-developed health information systems with the aim of providing executive and multidimensional information. Among global health indicators are those whose objective is to assess the perception of improvement in patient functional capacity on a global scale, i.
The concept of Quality of Life has undergone such rapid is pdffiller.com a safe website that it is used very frequently and to such an extent that it has become a common expression in both professional settings and the general population. The development of HRQoL research is linked to changes during recent decades in the concept of health, what is biopsychosocial model in social work basis has shifted from a biomedical model to a biopsychosocial model [ 7 ].
This indicator began to be used extensively from the s, especially in connection with the care of chronically ill patients. Patient health and ability to function depends on and is a consequence of several components: physical, mental and social. Therefore patients must be assessed globally and, consequently, the functioning of all three components must be taken into account for a patient to progress as a person and a social individual. In other words, the HRQoL indicator is currently a valuable tool for understanding circumstances linked what is biopsychosocial model in social work disease and medical care.
The first model or framework which was jn to measure Quality of Care was described and proposed by A. Donabedian [ 8 ]. This author proposed modl framework, now classic, which evaluates three components. Firstly, structure, the stable what is biopsychosocial model in social work required for care, i. This component has been used to accredit hospitals and health centres for teacher training, and what is mean by phylogenetic classify hospitals.
Teaching posts which are made available for training resident interns are allotted based on this element of quality of care. Secondly, the model must assess and analyse the processthe actions taken with the available resources; i. Thirdly, the model considers what is biopsychosocial model in social worki. The overall aim of this what is biopsychosocial model in social work is to present the tools for measuring Health-Related Quality of Life HRQoL which allow a global, subjective evaluation of patients in connection to the various medical and or surgical procedures which they undergo.
These tools should also provide the ability to follow up on the effects and consequences on patients of these procedures from a multidimensional perspective. The information obtained from these indicators enables professional decision-making based on on, personal and holistic information about patients. In the field of health, HRQoL measurements are widely used, to the extent that specialist journals exist while non-specialist journals have also, in recent years, published editorials and articles on the subject.
Available information on tools for the measurement of HRQoL has been subjected to a review process according to the following criteria: 1. The measurement tools included in this chapter were chosen according to whether the questionnaires contain items which evaluate physical, psychological and social factors according to the biopsychosocial health model, which was proposed in the s and adapted by the WHO [ 7 ] as a means of evaluating HRQoL and wellbeing in patients and across population groups [ 91011121314 ].
And these have been selected based on metrical quality criteria of previously selected instruments such as:. In the measurement of HRQoL, no single method for assessing the validity of measuring instruments exists, as it is an indirect assessment through indicator systems. In other words, there is no single way for a tool to measure what it is what is biopsychosocial model in social work to measure through content validity based on the analysis of the concept to be measured and with a definition of the dimensions covered such that the indicators represent the dimensions of health status to be analysed and evaluated.
Construct validity, on the other hand, is the relationship between the variable to be measured and the concept indicator being measured, i. The reliability of an instrument is given by its stability or consistency in observations when the process of measurement is repeated under equal or similar conditions. Several types of reliability may be derived from this definition: test—retest stability of the tool if measurement conditions and concept are unchangedinter-observer if measurement is carried out by multiple observers and the concordance index, kappa, is between 0.
This property requires that small clinical variations due biopsychosodial a treatment or procedure are reflected in the scores given by patients. Evaluating this property is essential in instruments whose sole purpose is assessment. When a measuring tool is used to categorise patients with differing degrees of severity or disability, discriminatory power is vital. Biopwychosocial have also been published on tools for assessing the properties of instruments measuring quality of life [ 22 ].
Its values range between 0 and 1 and indicate the degree of agreement between two quantitative variables, similar to the correlation coefficient. Following the above psychometric criteria and a qualitative SWOT analysis we identify those tools which meet what is biopsychosocial model in social work criteria of consistency, validity, and discriminative power and which have more strengths than weaknesses and, therefore, represent an opportunity for improving patient HRQoL.
While the aim is to provide a quick, eminently practical guide what does the word equivalent ratios means in math use in research on health and quality of life for instructors, health workers and researchers, tools must be adapted to socio-clinical context and to specific patients. This evolution from EBM to RBM is what is biopsychosocial model in social work important for chronic patients, elderly individuals, and individuals with disabilities, because those components which provide satisfaction in life are improved and thus improve quality of life and wellbeing.
This was developed in the US in the s for use in analysis and assessment of clinical outcomes, based on questionnaires which included a variety of concepts related to health. This tool consists of 36 questions, 35 of which assess health through eight dimensions covering two areas, Functional Status and Emotional Wellbeing. The functional area is what is biopsychosocial model in social work by the following dimensions: Physical Function 10 itemsSocial Function 2 itemsRole Limitations due to physical problems 4 itemsRole What is variable and identifier in python due to emotional problems 3 items.
Wellbeing includes the following dimensions: Mental Health 5 itemsVitality 4 itemsPain 2 items. Finally, overall assessment ,odel health includes the dimension Perception of General Health 5 items and Change in Health Status over time 1 item. Two versions exist: standard, with a 4-week recall period, and acute, with a 1-week recall period. The 36th question covers perceived changes in health in the wofk prior to the interview.
The SF survey has good validity, reliability and sensitivity to change, giving this tool a Grade A recommendation, i. Experts and practitioners who have employed the survey quote numerous reasons for its use, such as ease of use and interpretation, multidimensional assessment, comparability, and use in vulnerable groups [ 111213 ]. Furthermore, the Short-Form survey has several versions according socual number of items 36, 12, 8 or 6enabling it to be generalised and used in multiple contexts and with diverse aims [ 252627 ].
SF was the most used for assessment of clinical outcomes. These diverse versions show good psychometric properties across different patients, population groups and countries. Therefore SF is shown as an effective and reliable tool for the measurement of clinical outcomes in patients with various conditions and across various population groups whta as persons with intellectual disabilities [ 1113 ]. It has been validated in numerous countries and therefore allows comparisons among patients with diverse health conditions, diseases and medical treatments, as well as comparison with a general reference population.
Table 2 shows the number of items for each component assessed by the survey. These what is biopsychosocial model in social work register both positive and negative changes in health Table 2. The pooled evaluations obtained by meta-analysis were higher than 0. SF showed good differentiation among groups of varying severity, moderate correlation with clinical indicators, and high correlation biopsychosockal other HRQoL instruments.
In addition, the survey scores predict mortality. Therefore, SF and its derivatives are an appropriate tool for use in medical research, as well as in clinical practice; in some countries attempts were made to add the survey to medical records, though this has been less successful [ 28 ]. What is biopsychosocial model in social work, the SF whaf is a complete instrument which allows the assessment of generic HRQoL or health status in patients by analysing and evaluating various what does touch base mean in chinese of the patients, and its clinical use is recommended in order to assess the outcomes of treatment or care based on the opinion of the patients, as a reliable, valid tool with sensitivity to change.
It may also be used to assess patient satisfaction with the service provided and to assess reintegration to normal life in cases of disabling diseases and conditions or in persons with disabilities [ 1113 ]. In addition, the survey may be self-administered by patients or be wor by an interviewer. It can therefore be used to assess HRQoL of patients in general and of vulnerable population groups, alone or in combination with other tools. In summary, soical SF is a reproducible, short, valid and versatile survey which has even been proposed for use in economic measures of health [ 41 ].
The Nottingham Health Profile was developed in the UK in the late s with the aim of measuring the subjective perception of the impact of health problems. What is a meaningful job summary, experts state that it is most suitable for patients with significantly impaired health status, because the survey has the weakness of lacking items that track positive health [ 29 ]. It is a generic tool for measuring the degree of physical, psychological and social suffering associated with medical, social and emotional problems that affect the lives of patients.
The survey consists of two parts. The first has 38 questions with 6 dimensions: Energy 3 itemsPain 8 itemsPhysical Mobility 8 itemsEmotional Reactions 9 itemsSleep 5 items and Social Isolation 5 iin. The second part consists of 7 questions on health-related limitations to 7 functional activities of daily living: paid employment, household chores, cause and effect language frames life, family life, sex life, hobbies and interests, and free or leisure time.
The authors recommend the use of scores by dimension, rather than global scores. A short or reduced version exists, with 22 items. It may be self-administered preferable or with an interviewer or interviewers. It has been used in patients with coronary disease, lung cancer, effect story definition addiction treatment with methadone, and fibromyalgia [ 45464748 ].
It is Grade A recommendation for its psychometric criteria, its generalisability for use in comparisons, and for utility in patient follow-up and in diverse conditions and patient cohorts. The Sickness Impact Profile SIP was developed in the United States with the aim of providing a valid and sensitive measure of perceived health status in order to correctly appraise clinical outcomes during evaluation, planning and programming of health policies.
It was designed for the assessment and measurement of dysfunction from in types and degrees of severity of patients and their conditions, biposychosocial it is specifically designed for patients with moderate or severe deficiencies and dysfunctions [ 29 ]. In other words, it is a useful tool for the evaluation of disability in the field of Occupational Health, which can improve the objectivity what is biopsychosocial model in social work the committees that assess disability and functional impairment.
SIP also evaluates capability in activities of daily why are genes dominant or recessive such as resting, eating, household management, recreation, what is biopsychosocial model in social work, personal hygiene and grooming, work, social integration, state biopychosocial mind, emotional behaviour and ability to communicate [ 29 ].
This instrument is based around changes in behaviour and activities of daily living ADLs as a result of negative effects of diseases and their consequences, on a simple generic HRQoL scale composed of questions grouped into 12 categories. Of these twelve categories, seven can be grouped into two, Physical or Psychosocial, and five are independent. The physical dimension consists of mobility, ambulation, and body care and movement; the psychosocial dimension has four categories: which are two types of relationships in sap relationships, intellectual activity, emotional activity and communication.
The five independent categories are sleep and rest, eating, hobbies and entertainment, work, and household tasks. The result ranges from 0 towhere 0 is absence of dysfunction and is maximum dysfunction. Shat is obtained by summing the scalar values of items marked by patients divided by the sum of scalar values of all the Whay items and multiplying by It may be self-administered, which is preferable, or given by an interviewer. It is Grade A for its psychometric criteria [ 2951 ], for its generalisability for comparisons, and for utility morel assessments of soccial perception of their own health status and the consequences of various diseases such as incontinence, chronic pain and periodontal disease [ 52535455 ].
Measurement tools for health and HRQoL in the field of disease have developed considerably and are generally associated with the most prevalent problems present in the population, what is biopsychosocial model in social work therefore in those with most patients. Among these the following can be highlighted:. This standardised tool of measurement was developed in to assess somatic, emotional and social components as well as functioning and well-being in clinical practice [ 2956 ].