Caregiver Physical Health Assessment

Transcription

1 Caregiver Physical Health Assessment LONGSCAN 1991 Description of Measure Purpose To obtain a brief global self-report of a caregiver s recent health status. Conceptual Organization The assessment consists of three questions: one global question about current health status (Excellent, Good, Fair, or Poor), one about major illnesses in the past year, and one about the extent to which poor health affected the caregiver s ability to care for the child. The CAGE Questionnaire, an alcoholism screening tool, is included in the health assessment at the Pre-age 4 and Age 4 interviews. (See CAGE for a description of that measure.) Item Origin/Selection Process The global health rating was selected as one of the most reliable and widely used indicators of physical health (Krause & Jay 1994). The other items were chosen as indicators of the caregiver's experience of morbidity, which has implications for the ability to provide adequate care to the study child. Materials Non-copyrighted form is included in this manual. Time Required Less than 5 minutes Administration Method Interviewer-administered Training Minimal

2 Scoring Individual items. LONGSCAN Use Data Points Pre-Age 4: MW & NW sites only Age 4, 6, 8, 12: all sites. At Age 8, the caregiver health assessment questions were incorporated into the services utilization form (SUA). Respondent Primary maternal caregiver Mnemonic and Version Pre-Age 4 and Age 4: MHLA. Age 6: MH6A. Does not include the CAGE Questionnaire; no other modifications. Age 8: SUA questions The question, "Has illness affected your ability to care for your child", is omitted. Age 12: MHLB, MHLC. B is the paper version and C is the audio-casi version. Age 14: MHLC. Rationale A caregiver s health may affect her ability to care for her child. The global health rating has been shown elsewhere to be one the most reliable indicators of physical health (Krause & Jay, 1994). Results The following tables show primary caregiver responses to questions about their physical health at the time of the Pre-Age 4 (Table 1), Age 4 (Table 2), and Age 6 (Table 3) interviews. Figures in the third column represent the percentage of caregivers with a recent major illness who reported that it affected their ability to care for their children.

3 Table 1 presents Pre-Age 4 data collected at the MW and NW sites. Approximately onequarter (27%) of the MW caregivers reported their health status as fair or poor, and slightly less than one quarter (23%) had experienced a major illness in the past year. At the NW site, approximately one-third (32%) of the participants reported fair or poor health, and almost onehalf (48%) reported a major illness in the past year. Of those reporting major illness at the NW site, 62% said the illness affected their ability to care for their child(ren). Analysis by racial group showed that White, Multiracial, and Other racial groups reported more problems than Blacks and Hispanics. Table 1 about here At Age 4 (Table 2) Hispanic caregivers reported poorer health status than the other racial groups, although White caregivers were more likely to report a major illness. When analyzed by site, the poorest health status on all three indicators was observed at the NW site. Table 2 about here At Age 6 (Table 3), 24.6% of the entire sample reported having fair or poor health, and 32.5% of the caregivers reported a major illness in the past year. Interestingly, there was little relationship between having had a major illness in the past year and a report of one s health as fair or poor. While Hispanic caregivers reported poorer health than caregivers of other racial groups, they were less likely to report a major illness. Caregivers from the NW site reported the worst overall health status in terms of global health ratings and the incidence of a major illness or injury. Table 3 about here Validity Numerous studies have documented a relationship between physical health and mental health, particularly depression (Brown, Ahmed, Gary, & Milburn, 1995; Flaskerud & Tabora, 1998; Hays, Krishnan, George, Pieper, Flint, & Blazer, 1997; Heidrich, 1998). We examined concurrent validity of the Caregiver Physical Health Assessment by comparing scores on the four categories of the global health rating to the caregivers mean scores on the Center for Epidemiologic Studies Depression Scale (CES-D). Primary caregivers who reported poor health

4 were significantly more likely to report higher depression scores compared to those who report fair, good, or excellent health (F(3,709) = 13.8, p <.0001). The mean depression score among primary caregivers reporting poor health was 23, compared to a mean of 10.2 among those reporting excellent health (p = ). References and Bibliography Brown, D. R., Ahmed, F., Gary, L. E., & Milburn, N. G. (1995). depression in a community of African Americans. American Journal of Psychiatry, 152, Flaskerud, J., & Tabora, B. (1998). Health problems of low-income female caregivers with HIV/AIDS. Health Care for Women International, 19, Hays, J. C., Krishnan, K. R., George, L. K., Pieper, C., Flint, E. P., & Blazer, D. G. (1997). Psychosocial and physical correlates of chronic depression, Psychiatry Research, 72, Heidrich, S. M. (1998). Older women s lives through time. Advances in Nursing Science, 20, Krause, N., & Jay, G. (1994). What do global health items measure? Medical Care, 9,

5 Table 1. Caregiver Health Status by Race and Study Site Pre-Age 4 Interview (MW and NW sites) Health Reported as Fair or Poor Illness/Injury in Past Year Illness/Injury Affected Childcare N Total (156) 33.2 (178) 52.8 (94/178) Race White (68) 40.9 (88) 55.7 (49/88) Black (56) 28.4 (59) 52.5 (31/59) Hispanic (10) 17.3 (9) 33.3 (3/9) Multiracial (15) 42.9 (18) 55.6 (10/18) Other (15) 21.1 (4) 25.0 (1/4) Study Site MW (87) 23.2 (74) 40.5 (30/74) NW (69) 47.9 (104) 61.5 (64/104) Source. Based on data received at the LONGSCAN Coordinating Center by 7/8/97.

6 Table 2. Caregiver Health Status by Race and Study Site Age 4 Interview Health Reported as Fair or Poor Illness/Injury in Past Year Illness/Injury Affected Childcare N Total (283) 30.1 (345) 47.0 (162/345) Race White (96) 36.3 (144) 53.5 (77/144) Black (142) 25.9 (151) 43.0 (65/151) Hispanic (24) 29.3 (24) 37.5 (9/24) Multiracial (8) 37.8 (14) 28.6 (4/14) Other (12) 27.3 (12) 58.3 (7/12) Study Site EA (60) 23.6 (56) 44.6 (25/56) MW (38) 24.4 (30) 50.0 (15/30) SO (48) 21.8 (62) 50.0 (31/62) SW (58) 28.2 (89) 33.7 (30/89) NW (79) 43.2 (108) 56.5 (61/108) Source. Based on data received at the LONGSCAN Coordinating Center by 7/8/97.

7 Table 3. Caregiver Health Status by Race and Study Site Age 6 Interview Health Reported as Fair or Poor Illness/Injury in Past Year Illness/Injury Affected Childcare N Total (287) 32.5 (378) 48.5 (183/378) Race White (96) 38.1 (148) 52.7 (78/148) Black (148) 29.2 (183) 45.6 (83/182) Hispanic (30) 27.6 (24) 58.3 (14/24) Multiracial (9) 45.5 (15) 40.0 (6/15) Other (4) 27.6 (8) 25.0 (2/8) Study Site EA (58) 27.6 (69) 42.0 (29/69) MW (54) 29.9 (50) 62.0 (31/50) SO (46) 28.6 (63) 41.3 (26/63) SW (68) 30.6 (91) 46.2 (42/91) NW (62) 45.3 (106) 52.8 (56/106) Source. Based on data received at the LONGSCAN Coordinating Center by 06/30/00.