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Health status measurement in surgical practice

In the last hundred years, improved social conditions and advances in medical science has rendered previously fatal conditions curable. Modern surgical practice is now too complex to be measured by mortality and morbidity alone. Subjective, patient derived outcome measures are slowly gaining influence in other fields. Health status, or Quality of Life (QoL), measurement has not been widely adopted in surgical practice. To test the hypothesis that <i>Health status measures, scientifically applied, provide important additional information to the surgeon</i>, the techniques were applied to three diverse areas of surgical practice as models for broader application. <i>Chemotherapy for advanced breast cancer patients</i> Chemotherapy has little effect on survival in patients with advanced breast cancer. UICC response and toxicity criteria are used to measure outcome and QoL measurement is a rarity. Using a diary developed to make QoL measurement simpler, a randomised trial was mounted to compare QoL scores in patients receiving two regimens of differing toxicity. <i>Psychological screening for Non Specific Abdominal Pain</i> Patients with Non Specific Abdominal Pain (NSAP) are significant consumers of surgical resources but a psychological contributor is often suspected. In a prospective study, 131 patients aged 14-40 admitted with acute abdominal pain were assessed using the General Health-30 (GHQ) and Hospital Anxiety and Depression (HAD) questionnaires, and a structured interview. <i>Health status after minor surgery</i> Fifty seven general surgical patients having day-surgery completed three questionnaires, the NHP the HAD scale and the GHQ before surgery and after 6 months. A success was reported by 78%, improved health by 64% and improved QoL by 69%.

Identiferoai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:651101
Date January 1993
CreatorsFraser, Simon Charles Alexander
PublisherUniversity of Edinburgh
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Sourcehttp://hdl.handle.net/1842/19763

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