Academic journal article Journal of Nursing Measurement

Reliability, Validity, and Scoring of the Health Status Questionnaire-12 Version 2.0

Academic journal article Journal of Nursing Measurement

Reliability, Validity, and Scoring of the Health Status Questionnaire-12 Version 2.0

Article excerpt

Measuring health status as an indicator of individual, population, and community health is critical in reducing health disparities in populations. The purpose of this study was to test the psychometric properties of the Health Status Questionnaire-12 (HSQ-12) Version 2.0, a brief self-reported health status instrument available within the public domain, in a low-income sample (N = 7,793). The internal consistency reliability was .88. Initial and confirmatory factor analysis revealed two factors explaining 67% of the variance, interpreted as super scales of physical and mental health. Second order factor analysis isolated one factor explaining 82% of the variance, interpreted as a total health status. Comparison of subjects with and without disabilities using t tests and the Mann-Whitney U Test showed that the scale, super scale, and total scale scores differentiated significantly. The HSQ-12 is a reliable, valid, and low-cost measure of health status.

Keywords: health status; instrument validation; public domain

Measuring health status as an indicator of individual, population, and community health is critical in reducing health disparities in populations. Health status instruments must adequately measure the dimensions of health to provide a comprehensive view of health and health disparities. The purpose of this study was to determine the reliability, validity, and adequacy of scoring algorithms of the Health Status Questionnaire-12 (HSQ-12) Version 2.0 (Radosevich & Pruitt, 1996) as a measure of health status.

The health of individuals and communities profoundly impacts the health of a nation (United States Department of Health and Human Services [USDHHS], 2000). Disparities in levels of health status are affected by a dynamic interaction among health determinants (biology, behavior, and environment) unfolding over the life course of individuals, families, and communities (Association of State and Territorial Directors of Nursing [ASTDN], 2000; Institute of Medicine [IOM], 2000; Starfield & Shi, 1999). The cumulative burden of health disparities, such as social, environmental, economic, and political disparities, as well as individual physical and mental conditions and life events, negatively influences perceived health status. Poverty, or low socioeconomic status, is a systemic and ongoing source of vulnerability and poor health for people of all ages (Adler & Ostrove, 1999; Centers for Disease Control and Prevention [CDC], 2002; Ettner, 1996; Feinstein, 1993; Flaskerud et al., 2002; USDHHS, 2000). Poorer health status leads to the possibility of decreased life expectancy, less satisfaction with quality of life, and increased health care costs (CDC, 2002; USDHHS, 2000).

Individuals appear to possess important integrated internal information about biological, psychological, or social dimensions of their life that allows them to make informed predictions of their health, well-being, function, or overall probability of survival (CDC, 2003; Fayers & Sprangers, 2002; Idler & Angel, 1990; Miilunpalo, Vuori, Oja, Pasanen, & Urponen, 1997). Self-reported health status is a powerful predictor of future clinical outcomes, morbidity, and mortality (Eriksson, Unden, & Elofsson, 2001; Fayers & Sprangers, 2002; Froom, Melamed, Triber, Ratson, & Hermoni, 2004; Kaplan & Camacho, 1983). Self-rated health measures are commonly used when monitoring the health of individuals and populations in national studies (CDC, 2005). Therefore, self-rated health measures provide a good indicator for comprehensively monitoring the status of, and trends in, health for individuals and populations. A simple, cost-effective, and multifaceted health status measure such as the HSQ-12 could identify those individuals, populations, and/or communities at risk for disparities in health status and in need of intervention.

BACKGROUND

Perceived Health Status

Perceived health status refers to the judgment of an individual regarding his or her well-being and level of functioning, conceptualized as multifaceted, global, changing over time, and influenced by health determinants (biology, behaviors, social and physical environment, policies, and interventions) (Anderson, 1999; Barry & Kaiser, 2003; Evans, Barer, & Marmor, 1994; Feinstein, 1993; Han, Small, & Haley, 1999; IOM, 2000; Labonte, 1995; Reed, 1995; USDHHS, 2000; Williams, 1990). …

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