Medicine:Nottingham Health Profile

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The Nottingham Health Profile (NHP) is a general patient reported outcome measure which seeks to measure subjective health status.[1] It is a questionnaire designed to measure a patient’s view of their own health status, in a number of areas.[2] It can be completed in 5 minutes.[3]

The NHP consists of two parts. The first part focuses on health and comprises 38 items which deal with pain, energy, sleep, mobility, emotional reaction and social isolation.[4] The second part focuses on life areas affected[5] and consists of 7 items which deal with problems regarding occupation, housework, social life, family life, sexual function, hobbies and holidays.[4] The second part of the NHP is optional and can be omitted without ruining the test results.[6]

All questions have only yes/no answer options and each section score is weighted. The higher the score, the greater the number and severity of problems. The highest score in any section is 100.[7]

Development

Work on the NHP began in 1975 at the Department of Community Health at the University of Nottingham. The principle researchers involved in the project were Sonja M. Hunt, J. McEwen and S.P. McKenna. 2200 statements describing the effects of poor health were collected from over 700 patients, which covered social, psychological, physical and behavioural sectors. Key concepts were identified from these statements, and many were removed due to redundancy.

138 statements remained, and a series of studies were conducted between 1976 and 1978 in order to refine the number of statements to a further extent. The studies were conducted on a wide range of patients in order to ensure the general efficacy of the NHP.

In 1978, a grant was received from the Social Science Research Council in order to further develop the NHP into a population survey tool. This meant making the profile easier to read, quick and simple to answer and commonly understood. After further testing, statements that fit this criteria were retained and this resulted in the 45 item questionnaire.[7]

Current copyright of the NHP is owned by Galen Research.[8]

International Use

Since its development, the NHP has been used by a number of organisations worldwide.

The NHP has been translated into 24 languages other than UK English[8] which include Spanish,[9] Danish,[10] French[11] and German.[12]

It has been used in research studies worldwide in order to determine the effect a given disease has on a patient’s quality of life. Examples of such studies are investigations into the effect of insomnia on brain tumour patients,[13] fatigue in post-polio patients[14] and the sleep, fragility and cognition of the elderly.[15]

The profile has also been utilized in clinical research studies in order to determine whether a treatment is effective. If a patient’s score on the questionnaire is significantly different after the treatment, this indicates that the treatment has had an effect. Clinical research studies where the NHP was utilized include investigations into erythropoiesis-stimulating agents,[16] glucocorticoid replacement therapy[17] and transcutaneous electrical nerve stimulation for tinnitus.[18]

References

  1. Hunt, S M; McKenna, S P; McEwen, J; Backett, E M; Williams, J; Papp, E (1980). "A quantitative approach to perceived health status: A validation study". Journal of Epidemiology & Community Health 34 (4): 281–6. doi:10.1136/jech.34.4.281. PMID 7241028. 
  2. Hunt, Sonja M.; McKenna, S.P.; McEwen, J.; Williams, Jan; Papp, Evelyn (1981). "The Nottingham health profile: Subjective health status and medical consultations". Social Science & Medicine. Part A: Medical Psychology & Medical Sociology 15 (3): 221–9. doi:10.1016/0271-7123(81)90005-5. PMID 6973203. 
  3. Ebrahim, Shah; Barer, David; Nouri, Fiona (1986). "Use of the Nottingham Health Profile with patients after a stroke". Journal of Epidemiology & Community Health 40 (2): 166–9. doi:10.1136/jech.40.2.166. PMID 3746178. 
  4. 4.0 4.1 Garellick, Göran; Malchau, Henrik; Herberts, Peter (1998-07-01). "Specific or general health outcome measures in the evaluation of total hip replacement". The Bone & Joint Journal 80-B (4): 600–6. doi:10.1302/0301-620x.80b4.8345. PMID 9699819. http://bjj.boneandjoint.org.uk/cgi/pmidlookup?view=long&pmid=9699819. 
  5. "Nottingham Health Profile". University of Montreal. 2001. http://reseauconceptuel.umontreal.ca/rid=1J1WXGYDK-CPP19Z-1ZQY/Nottingham.pdf. Retrieved 16 October 2013. 
  6. Garcia, Pilar; McCarthy, Mark (1996). Measuring Health: A Step In The Development of City Health Profiles. World Health Organization. ISBN 978-87-985788-2-6. http://www.euro.who.int/__data/assets/pdf_file/0017/101645/WA95096GA.pdf. [page needed]
  7. 7.0 7.1 Hunt, SM; McEwen, J; McKenna, SP (1985). "Measuring health status: A new tool for clinicians and epidemiologists". The Journal of the Royal College of General Practitioners 35 (273): 185–8. PMID 3989783. 
  8. 8.0 8.1 "Measures Database". Galen Research. http://www.galen-research.com/measures-database. Retrieved 16 October 2013. 
  9. Alonso, J; Anto, JM; Moreno, C (1990). "Spanish version of the Nottingham Health Profile: Translation and preliminary validity". American Journal of Public Health 80 (6): 704–8. doi:10.2105/AJPH.80.6.704. PMID 2343954. 
  10. Thorsen, Hanne; McKenna, Stephen P.; Gottschalck, Lise (1993). "The Danish version of the Nottingham Health Profile: Its adaptation and reliability". Scandinavian Journal of Primary Health Care 11 (2): 124–9. doi:10.3109/02813439308994914. PMID 8356362. 
  11. Bucquet, D.; Condon, S.; Ritchie, K. (1990). "The French version of the Nottingham health profile. A comparison of items weights with those of the source version". Social Science & Medicine 30 (7): 829–35. doi:10.1016/0277-9536(90)90207-9. PMID 2315749. 
  12. Kohlmann, Thomas; Bullinger, Monika; Kirchberger-Blumstein, Inge (1997). "Die deutsche Version des Nottingham Health Profile (NHP): Übersetzungsmethodik und psychometrische Validierung" (in German). Sozial- und Präventivmedizin 42 (3): 175–85. doi:10.1007/BF01300568. PMID 9334089. 
  13. Mainio, Arja; Hakko, Helinä; Niemelä, Asko; Koivukangas, John; Räsänen, Pirkko (2013). "Insomnia Among Brain Tumor Patients: A Population-Based Prospective Study of Tumor Patients in Northern Finland". Journal of Psychosocial Oncology 31 (5): 507–16. doi:10.1080/07347332.2013.822048. PMID 24010529. 
  14. Oncu, Julide; Atamaz, Funda; Durmaz, Berrin; On, Arzu (2013). "Psychometric properties of fatigue severity and fatigue impact scales in postpolio patients". International Journal of Rehabilitation Research 36 (4): 339–45. doi:10.1097/MRR.0b013e3283646b56. PMID 23903028. 
  15. Santos, Ariene Angelini dos; Mansano-Schlosser, Thalyta Cristina dos Santos; Ceolim, Maria Filomena; Lost Pavarini, Sofia Cristina Iost (2013). "Sono, fragilidade e cognição: Estudo multicêntrico com idosos brasileiros". Revista Brasileira de Enfermagem 66 (3): 351–7. doi:10.1590/S0034-71672013000300008. PMID 23887783. 
  16. Johansen, K. L.; Finkelstein, F. O.; Revicki, D. A.; Evans, C.; Wan, S.; Gitlin, M.; Agodoa, I. L. (2011). "Systematic review of the impact of erythropoiesis-stimulating agents on fatigue in dialysis patients". Nephrology Dialysis Transplantation 27 (6): 2418–25. doi:10.1093/ndt/gfr697. PMID 22187314. 
  17. Behan, Lucy-Ann; Rogers, Bairbre; Hannon, Mark J.; O'Kelly, Patrick; Tormey, William; Smith, Diarmuid; Thompson, Christopher J.; Agha, Amar (2011). "Optimizing glucocorticoid replacement therapy in severely adrenocorticotropin-deficient hypopituitary male patients". Clinical Endocrinology 75 (4): 505–13. doi:10.1111/j.1365-2265.2011.04074.x. PMID 21521342. 
  18. Aydemir, G; Tezer, M S; Borman, P; Bodur, H; Unal, A (2006). "Treatment of tinnitus with transcutaneous electrical nerve stimulation improves patients' quality of life". The Journal of Laryngology & Otology 120 (6): 442–5. doi:10.1017/S0022215106000910. PMID 16556347.