Measuring Health and Illness - 2 PDF

Measuring Health and Illness -2  Learning outcomes  At the end of this lecture, you will be able to;  Describe various approaches to measuring health and illness, and understand the strengths and limitations of each approach.  Discuss the importance of health related quality of life...

Measuring Health and Illness -2  Learning outcomes  At the end of this lecture, you will be able to;  Describe various approaches to measuring health and illness, and understand the strengths and limitations of each approach.  Discuss the importance of health related quality of life and its impact of health conditions and treatments on an individual’s daily life and well-being.  Describe different health status measurement instruments, such as surveys, questionnaires, and clinical assessments in different healthcare settings  Understand the importance of selecting appropriate measures for different health conditions and populations  Contents Need of health and illness measurement Different approaches to health and illness measurement Health-related quality of life Health status measurement Instruments  Health-related quality of life - is a multidimensional concept that captures the impact of health status on an individual's  overall well-being  daily functioning - focuses on how health conditions and treatments affect physical, emotional, and social aspects of life.  General quality of life - Involve all aspects of life  Quality of life (QoL) - is a broad concept that encompasses various dimensions of an individual's overall well-being. - includes factors beyond mere physical health, incorporating aspects of emotional, social, and environmental well-being - Involves :  Physical Health (foundational component of QoL) - It includes:  Physical Functioning: Ability to perform daily activities, mobility, and physical capacity.  Presence of Pain: Impact of pain and discomfort on daily life.  Energy and Vitality: Levels of fatigue and overall energy.  Psychological Well-being - involves:  Mental Health: Emotional stability, absence of anxiety, depression, and stress.  Life Satisfaction: Overall contentment and happiness with life.  Cognitive Functioning: Clarity of thought, concentration, and memory.  Social Relationships - include:  Social Support: Presence of family, friends, and social networks.  Social Interaction: Frequency and quality of interactions and relationships.  Role Fulfillment: Ability to perform social roles and responsibilities, such as work or family duties.  Environmental Factors  Living Conditions: Quality and safety of living environment, housing, and access to essential services.  Financial Stability: Economic status, employment, and access to resources.  Access to Healthcare: Availability and quality of medical care and services.  Personal and Spiritual Well-being  Purpose and Meaning: Sense of purpose, personal goals, and fulfillment.  Spirituality: Religious beliefs, practices, and spiritual life.  Personal Growth: Opportunities for self-improvement and learning  Life Satisfaction and Happiness  Overall Satisfaction: Contentment with various aspects of life including personal achievements and relationships.  Happiness: Emotional state characterized by joy and pleasure.  Safety and Security - Safety and Security are crucial for QoL:  Physical Safety: Protection from harm, crime, and accidents.  Emotional Security: Feeling safe and stable in one’s environment and relationships.  Interrelationships  The different dimensions of QoL are interconnected: Physical Health: Poor physical health can affect emotional well- being and limit social interactions. Psychological Well-being: Mental health issues can influence physical health and social relationships. Social Relationships: Strong social support can improve emotional health and provide practical assistance. Environmental Factors: Living conditions and financial stability impact all other aspects of QoL.  Personal and Spiritual Well-being: A sense of purpose and spiritual fulfillment can enhance overall life satisfaction and resilience.  Measuring Quality of Life - Quality of Life can be assessed using various tools and instruments, which often include: Surveys and Questionnaires: Tools like SF-36, EQ-5D, and WHOQOL- BREF assess different dimensions of QoL. Interviews and Assessments: Personalized assessments to understand individual experiences and needs.  Health related quality of life (HRQoL) - refers to the ways in which an individual’s health influences their quality of life. Includes: Physical Health: How well a person’s physical health affects their ability to perform daily activities and their overall comfort. Emotional and Psychological Health: The impact of health on mood, stress levels, mental well-being, and psychological states. Social Functioning: How health conditions affect social interactions, relationships, and roles in society.  Components of HRQoL HRQoL can be broken down into several key components: Physical Functioning: Measures how health issues impact physical abilities, such as mobility, endurance, and self-care. Role Limitations: Evaluates how physical or emotional health problems restrict a person’s ability to perform work or other daily activities. Bodily Pain: Assesses the intensity and impact of pain on daily life. General Health Perceptions: Reflects overall views on one’s health and how it compares to past experiences or expected health status  Vitality: Measures energy levels and fatigue. Social Functioning: Looks at how health issues affect social activities and relationships. Mental Health: Assesses mood, anxiety, and overall psychological well-being.  Importance of HRQoL - Understanding HRQoL is crucial in various contexts: Patient-Centered Care: Helps healthcare providers understand how health conditions and treatments impact a patient’s daily life, leading to more personalized and effective care. Treatment Evaluation: Measures the effectiveness of treatments not just in terms of clinical outcomes but also in how they improve or impair quality of life. Research and Policy: Provides valuable data for healthcare research and policy-making, aiding in the development of interventions and health programs.  Measuring HRQoL - Several instruments and questionnaires are used to assess HRQoL. Some of the commonly used tools include: SF-36 (Short Form 36): A widely used generic measure that covers eight domains of health-related quality of life, including  Physical functioning,  Bodily pain,  General health,  Vitality,  Social functioning,  Role limitations due to physical and emotional problems, and  Mental health. EQ-5D: - A standardized instrument that evaluates health status across five dimensions: 1. Mobility: Ability to walk or move around. 2. Self-care: Ability to perform personal care activities like washing and dressing. 3. Usual Activities: Ability to carry out usual activities such as work, study, or leisure. 4. Pain/Discomfort: Level of pain or discomfort experienced. 5. Anxiety/Depression: Feelings of anxiety or depression.  It also provides a single index value for health status.  Application in Pharmacy Practice In pharmacy practice, HRQoL assessments can: Guide Treatment Decisions: Help in choosing therapies that not only address clinical symptoms but also improve patients' quality of life. Monitor Outcomes: Evaluate the effectiveness of medications and interventions from the patient’s perspective. Support Patient Counseling: Assist pharmacists in providing advice and support that is tailored to the patient’s overall well-being and daily life impact.  Health status measurement instruments Definition: Tools used to assess, monitor, and evaluate an individual's health status. Importance: Essential for diagnosing conditions, monitoring disease progression, and evaluating treatment efficacy. Overview of different instruments and their application in pharmacy practice.  Importance of Measuring Health Status Why Measure Health Status? Patient Management: Tailoring treatments based on accurate health assessments. Clinical Decision Making: Informing treatment strategies and monitoring outcomes. Research and Development: Evaluating the effectiveness of new drugs and therapies.  Example: Impact on chronic disease management, such as diabetes.  Types of Health Status Measurement Instruments Categories of Measurement Instruments Subjective vs. Objective: Self-reported questionnaires vs. physical measurements. Quantitative vs. Qualitative: Numerical data (e.g., lab results) vs. descriptive data (e.g., patient interviews).  Examples: Self-reported questionnaires, laboratory tests, imaging techniques.  Self-Reported Questionnaires Definition: Instruments where patients report their own health status. Examples:  SF-36: Measures quality of life across 8 domains.  EQ-5D: Assesses health-related quality of life with 5 dimensions. Advantages: Reflects patient perspective, cost-effective. Disadvantages: Subject to response bias, may not capture all aspects of health.  Physical Examination Tools Definition: Instruments used in physical exams to assess various health parameters. Examples:  Blood Pressure Monitors: Measure blood pressure levels.  Stethoscopes: Used for listening to heart and lung sounds.  Thermometers: Measure body temperature. Advantages: Provides immediate, objective data. Disadvantages: Limited in scope, requires trained personnel.  Laboratory Tests Definition: Tests analyzing biological samples to assess health. Examples:  Complete Blood Count (CBC): Evaluates overall health and detects disorders.  Cholesterol Tests: Measures lipid levels to assess cardiovascular risk. Advantages: Detailed, precise data; aids in diagnosing specific conditions. Disadvantages: Can be invasive, may involve high costs.  Imaging Techniques Definition: Techniques used to visualize internal body structures. Examples:  X-rays: Common for bone imaging and detecting some diseases.  MRI: Provides detailed images of soft tissues and organs.  Ultrasound: Non-invasive, used for visualizing organs and fetal development. Advantages: Non-invasive (except X-rays), detailed visualization. Disadvantages: Radiation exposure (for X-rays), high costs, limited in certain contexts.  Digital Health Tools Include various technologies like mobile apps and wearable devices that track health metrics and provide real-time data. Examples:  Wearable Fitness Trackers: Monitor physical activity, heart rate, and sleep patterns.  Mobile Health Apps: Offer functionalities like medication reminders, symptom tracking, and health monitoring.  Application in Pharmacy Practice Patient Assessments: Using instruments to assess patients' response to medications. Monitoring: Tracking disease progression and treatment outcomes. Evaluating Medication Impact: Measures the effectiveness of treatments in improving quality of life and symptom control. Case Study Example: Using SF-36 to evaluate the impact of a new medication on quality of life in patients with chronic conditions.  Challenges and Limitations Accessibility: Availability of instruments and tests. Cost: Financial implications of using certain instruments. Patient Compliance: Adherence to self-reported questionnaires or recommended tests. Solutions: Innovations in technology, cost-effective strategies.  References Author/Editor Title Ed Year Publisher Levin, Bruce Lubotsky; Hanson, Introduction to Public Oxford 2 2018 Ardis; Hurd, Peter Health in Pharmacy University Press D Rickles, Nathaniel Social and Behavioral M.; Wertheimer, Kendall/Hunt Aspects of Pharmacy 1 2016 Albert I; Publishing Practice Schommer, Jon C Harding, Geffrey; Pharmacy Practice 2 2016 CRC Press Taylor Kevin