University of Montana, Missoula, MT, USA.
University of Montana, Missoula, MT, USA.
Soc Sci Med. 2020 Jan;244:112647. doi: 10.1016/j.socscimed.2019.112647. Epub 2019 Oct 31.
The six-question disability set from the American Community Survey serves as the national standard for measuring disability across all surveys conducted by the U.S. Department of Health and Human Services. These questions are intended to identify people who experience a long-term disability, and data from these questions are frequently interpreted as capturing discrete groups of individuals. Recent research has shown that a significant proportion of individuals respond to these questions inconsistently over time, possibly indicating that the six-question set also identifies transitory disability. However, it is unclear if these inconsistent responses are associated with changes in health status. We begin to test the validity of these observations by exploring how changes in health related quality of life correspond to changes in disability status.
We recruited 525 participants to complete a longitudinal paper and pencil survey four times over 18 months that included the six disability questions, measures of health related quality of life, and mobility equipment use. We computed within person changes in health related quality of life variables to investigate how changes in disability status are associated with changes in health status.
Among respondents who reported disability, half or less consistently reported the same disability. Additionally, respondents who changed disability responses also reported changes in health related quality of life. For example, when individuals transition into walking disability, their health-related quality of life index decreases by, on average, 0.18 s.d. (p<0.05), and when individuals transition out of walking disability their health-related quality of life index increases by, on average, 0.27 s.d. (p<0.001).
The six-question set identifies people who experience both enduring and transitory disability. Changes in health related characteristics correlate with changes in disability status. This suggests that observed transitions in disability reflect real changes in perceived health and impairment.
美国社区调查的六问题残疾问卷是美国卫生与公众服务部进行的所有调查中衡量残疾的国家标准。这些问题旨在识别长期残疾的人，并且这些问题的数据经常被解释为捕捉到不同个体群体。最近的研究表明，相当一部分人在时间上对这些问题的回答不一致，这可能表明六问题问卷也识别出了短暂的残疾。然而，这些不一致的反应是否与健康状况的变化有关尚不清楚。我们通过探索健康相关生活质量的变化与残疾状况的变化如何对应，开始检验这些观察结果的有效性。
我们招募了 525 名参与者，在 18 个月的时间里完成了四次纵向纸质和铅笔调查，其中包括六残疾问题、健康相关生活质量的测量和移动设备的使用。我们计算了健康相关生活质量变量的个体内变化，以调查残疾状况的变化与健康状况的变化有何关联。
在报告残疾的受访者中，有一半或更少的人始终报告相同的残疾。此外，残疾反应发生变化的受访者也报告了健康相关生活质量的变化。例如，当个体转变为步行残疾时，他们的健康相关生活质量指数平均下降 0.18 个标准差（p<0.05），而当个体从步行残疾中转变出来时，他们的健康相关生活质量指数平均增加 0.27 个标准差（p<0.001）。
六问题问卷识别出了经历持久和短暂残疾的人。健康相关特征的变化与残疾状况的变化相关。这表明观察到的残疾转变反映了感知健康和损伤的真实变化。
