Kivinen P, Halonen P, Eronen M, Nissinen A
Department of Community Health and General Practice, University of Kuopio, Finland.
Age Ageing. 1998 Jan;27(1):41-7. doi: 10.1093/ageing/27.1.41.
To study self-rated and physician-rated health, to analyse concordance of the two methods and to examine factors explaining differences between self-rated and physician-rated health.
Population-based cross-sectional study.
Finnish cohorts of the Seven Countries Study.
470 men aged 70-89 years.
Self-administered questionnaire and clinical examination.
General health status estimated by doctors correlated weakly with self-rated health. The strongest determinants of self-rated health were depression (P < 0.0001), coronary heart disease (P = 0.0112) and dysuria (P = 0.0238). Activity of daily living (P < 0.0001), age (P = 0.0001), coronary heart disease (P = 0.0005) and chronic lung disease (P = 0.0064) were independently related to physician-rated health.
The discrepancy found in ratings of health between physicians and the subjects themselves can be explained by different appreciation of ageing in the assessment of health status. After adjustment for medical conditions, age did not relate to self-perceived health, whereas there was a significant association between age and doctors' ratings. Depression and symptoms which explained self-ratings were not related to physicians' assessments.
研究自评健康状况和医生评定的健康状况，分析两种方法的一致性，并探讨解释自评健康与医生评定健康之间差异的因素。
基于人群的横断面研究。
七国研究的芬兰队列。
470名年龄在70 - 89岁的男性。
自行填写的问卷和临床检查。
医生估计的总体健康状况与自评健康状况的相关性较弱。自评健康状况的最强决定因素是抑郁（P < 0.0001）、冠心病（P = 0.0112）和排尿困难（P = 0.0238）。日常生活活动能力（P < 0.0001）、年龄（P = 0.0001）、冠心病（P = 0.0005）和慢性肺病（P = 0.0064）与医生评定的健康状况独立相关。
医生与受试者自身在健康评定上的差异可以通过在健康状况评估中对衰老的不同理解来解释。在对医疗状况进行调整后，年龄与自我感知的健康状况无关，而年龄与医生的评定之间存在显著关联。解释自评结果的抑郁和症状与医生的评估无关。
