MEASURING HEALTH A Guide to Rating Scales and Questionnaires THIRD EDITION Ian McDowell OXPORD UNIVERSITY PRESS 2006
List of Exhibits xiii 1. Introduction 3 Background 3 Selection of Instruments for Review 3 Structure of the Book 4 Style and Content of the Reviews 5 Format for the Reviews 5 Evaluating a Health Measurement: The User's Perspective 7 2. The Theoretical and Technical Foundations of Health Measurement 10 The Evolution of Health Indicators 11 Types of Health Measurements 12 Theoretical Bases for Measurement: Psychophysics and Psychometrics 16 Numerical Estimates of Health 18 Scaling Methods 18 Psychometric Methods 20 Methods Derived from Economics and Decision Analysis 23 Identifying and Controlling Biases in Subjective Judgments 25 Conceptual Bases for Health Measurements 27 The Quality of a Measurement: Validity and Reliability 30 Assessing Validity 30 Criterion Validity 31 Construct Validity 34 Correlational Evidence of Validity 34 Factorial Validity 36 Group Differences and Sensitivity to Change 37 Construct Validity: Conclusion 39 Assessing Reliability 39 Internal Consistency 42 Interpreting Reliability Coefficients 45 Summary 46 3. Physical Disability and Handicap 55 The Evolution of Physical Disability Measurements 55 Scope of the Chapter 58 The Pulses Profile 62 The Barthel Index 66 The Index of Independence in Activities of Daily Living, or ADL 74 The Kenny Self-Care Evaluation 78 The Physical Self-Maintenance Scale 84 The Disability Interview Schedule 88 The Lambeth Disability Screening Questionnaire 89 The OECD Long-Term Disability Questionnaire 93 The Functional Status Rating System 95 The Rapid Disability Rating Scale 97 The Functional Status Index 100 The Patient Evaluation Conference System 103 The Functional Activities Questionnaire 108 IX
The Health Assessment Questionnaire 111 The MOS Physical Functioning Measure 119 The Functional Autonomy Measurement System 122 The Functional Independence Measure 141 Conclusion 149 4. Social Health 150 Social Adjustment and Social Roles 151 Social Support 152 Scope of the Chapter 153 The Social Relationship Scale 155 The Social Support Questionnaire 158 The RAND Social Health Battery 161 The MOS Social Support Survey 165 The Duke-UNC Functional Social Support Questionnaire 168 The Duke Social Support and Stress Scale 170 The Katz Adjustment Scales 173 The Social Functioning Schedule 177 The Interview Schedule for Social Interaction 180 The Social Adjustment Scale 184 The Social Maladjustment Schedule 194 The Social Dysfunction Rating Scale 196 The Structured and Scaled Interview to Assess Maladjustment 199 Conclusion 203 5. Psychological Well-being 206 Scope of the Chapter 208 The Health Opinion Survey 210 The Twenty-Two Item Screening Score of Psychiatric Symptoms 216 The Affect Balance Scale 221 The Positive and Negative Affect Scale 225 The Life Satisfaction Index 231 The Philadelphia Geriatric Center Morale Scale 236 The General Weil-Being Schedule 240 The RAND Mental Health Inventory 247 The Health Perceptions Questionnaire 253 The General Health Questionnaire 259 Conclusion 271 6. Anxiety 273 Theoretical Approaches to Anxiety 274 Anxiety and Depression 276 Anxiety Measurements 277 The Taylor Manifest Anxiety Scale 279 The Hamilton Anxiety Rating Scale 286 The Hospital Anxiety and Depression Scale 294 The Zung Self-Rating Anxiety Scale 302 The Zung Anxiety Status Inventory 302 The Beck Anxiety Inventory 306 The Depression Anxiety Stress Scales 313 The State-Trait Anxiety Inventory 319 Conclusion 327 7. Depression 329 Classifications of Depression 330 Measurement of Depression 332 Scope of the Chapter 333 The Beck Depression Inventory 335 The Self-Rating Depression Scale 344 The Center for Epidemiologic Studies Depression Scale 350 The Geriatric Depression Scale 359 The Depression Adjective Check Lists 364
χι The Hamilton Rating Scale for Depression 369 The Brief Assessment Schedule Depression 378 The Montgomery-Asberg Depression Rating Scale 382 The Carrol Rating Scale for Depression 387 Conclusion 390 8. Mental Status Testing 394 Measurements of Cognition, Cognitive Impairment, and Dementia 395 Scope of the Chapter 396 The Dementia Rating Scale 399 The Cognitive Capacity Screening Examination 404 The Clock Drawing Test 407 The Alzheimer's Disease Assessment Scale 411 The Information-Memory- Concentration Test 417 The Dementia Scale 420 The Mental Status Questionnaire 423 The Short Portable Mental Status Questionnaire 426 The Mini-Mental State Examination 429 The Modified Mini-Mental State Test 441 The Informant Questionnaire on Cognitive Decline in the Elderly 449 The Clifton Assessment Procedures for the Elderly 456 The Cambridge Mental Disorders of the Elderly Examination 460 Conclusion 464 Additional Instruments 465 Screening Tests 465 Instruments for Clinical Application 466 Diagnostic Instruments 467 9. Pain Measurements 470 Theoretical Approaches to Pain 470 Approaches to Pain Measurement 472 Questionnaire Techniques 473 Behavioral Measurements of Pain 473 Analogue Methods 474 Scope of the Chapter 474 Visual Analogue Pain Rating Scales 477 The McGill Pain Questionnaire 483 The Brief Pain Inventory 491 The Medical Outcomes Study Pain Measures 496 The Oswestry Low Back Pain Disability Questionnaire 498 The Back Pain Classification Scale 501 The Pain and Distress Scale 506 The Illness Behavior Questionnaire 508 The Pain Perception Profile 514 Conclusion 517 10. General Health Status and Quality of Life 520 Measuring Quality of Life 520 Scope of the Chapter 522 The Arthritis Impact Measurement Scales 526 The Physical and Mental Impairment-of- function Evaluation 535 The Functional Assessment Inventory 538 The Functional Living Index Cancer 541 The Functional Assessment of Cancer Therapy 546 The EORTC Quality of Life Questionnaire 551 The Quality-Adjusted Time Without Symptoms and Toxicity Method 559 The Quality of Life Index 564 The COOP Charts for Primary Care Practices 569 Single-Item Health Indicators 578 The Functional Status Questionnaire 587 The Duke Health Profile 591
xii Contents The OARS Multidimensional Functional Assessment Questionnaire 596 The Comprehensive Assessment and Referral Evaluation 604 The Multilevel Assessment Instrument 609 The Self-Evaluation of Life Function Scale 611 McMaster Health Index Questionnaire 612 The World Health Organization Quality of Life Scale 619 The Sickness Impact Profile 630 The Nottingham Health Profile 639 The Short-Form-36 Health Survey 649 The Short-Form-12 Health Survey 666 The Disability and Distress Scale 671 The Quality of Well-Being Scale 675 The Health Utilities Index 683 The EuroQol EQ-5D Quality of Life Scale 694 Conclusion 702 ll. Recommendations and Conclusions 704 The Current Status of Health Measurement 704 Guidelines for Developing Health Measurements 705 Final Remarks 709 Glossary of Technical Terms 711 Index 719