Sickness impact profile: The state of the art of a generic functional status measure

doi:10.1016/0277-9536(92)90240-Q

Social Science & Medicine

Volume 35, Issue 8, October 1992, Pages 1003-1014

https://doi.org/10.1016/0277-9536(92)90240-Q Get rights and content

Abstract

The Sickness Impact Profile (SIP) is a widely used health status measure, known to be valid and reliable. After the final development and testing in 1978, however, in which several methodological aspects were investigated, no descriptions of research projects that systematically evaluate the methodological and theoretical aspects of the instrument were found. In this article a review is presented of literature on the SIP. This review is the first step taken in a project that evaluates the SIP. The instrument appears to be a reliable instrument with sufficient content validity. It shows good correlations with other health status and functional status measures. Yet a number of questions about the SIP remain unanswered. Theoretical implications of the construct of sickness, the effect of age and gender on SIP scores, the construct validity judged by factor analysis, the responsiveness of the instrument, and the possibilities to use proxy-respondents or to shorten the list and to simplify the scoring procedure still have to be studied. If the instrument is to be used as an international standard measure of functional status, these topics should be thoroughly examined.

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In chronic fatigue syndrome (CFS) little is known about how partner-related factors influence patients' fatigue symptoms and treatment outcome. We examined partners' fatigue severity, and determined the role of partner-related factors for patients' symptoms and the outcome of cognitive behavioural therapy (CBT).
1356 CFS patients and their partners completed baseline measures of fatigue severity (Checklist Individual Strength), causal attributions of symptoms, partner responses to patient symptoms, and relationship satisfaction. Fatigue in partners of patients with CFS was compared with fatigue in age- and gender-matched controls from the Dutch population. Associations between partners' fatigue severity and other partner-related factors were determined. In a subgroup of 760 CFS patients who completed CBT, logistic regression analyses were used to identify partner-related baseline predictors for treatment outcome (fatigue severity, functional impairment).
Partners' fatigue (M = 21.66, SD 11.60) was significantly lower than in controls (M = 24.58, SD = 11.02) (p < .001) and not related to patients' fatigue (r = −0.02, p = .58). Partners' fatigue was correlated with patients' functional impairment (p = .001), partners' and patients' relationship dissatisfaction, negative partner responses, and partners' and patients' psychological attributions of patient symptoms at baseline (all p < .001). After controlling for patients' baseline fatigue severity and functional impairment, only relationship dissatisfaction as reported by (female) patients significantly predicted worse treatment outcome. For male patients with female partners, higher partners' fatigue severity predicted higher fatigue severity after CBT.
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Q fever fatigue syndrome (QFS) is characterized by chronic fatigue following acute Q fever. Previously, it was shown that cognitive behavioural therapy (CBT), and not doxycycline, was significantly more effective than placebo in reducing fatigue severity in QFS patients. However, this effect was not maintained after one year. The aim of this study is to elucidate the cognitive and behavioural variables which mediate the positive effect of CBT on fatigue during the treatment and the relapse of fatigue after completion of CBT, by using multiple mediation analysis.
Additional analyses were performed on data of a randomized controlled trial that investigated the efficacy of CBT and antibiotics compared to placebo for QFS [1]. Only those patients in the CBT group who completed the allocated CBT treatment, and those patients in the medication group who did not follow additional CBT during follow-up, were included in this study. Two mediation models were tested, using respectively assessments at baseline and end-of-treatment (EOT), and EOT and follow-up, comparing the CBT group (n = 43) with the medication group (n = 89).
During treatment, the decrease in fatigue brought on by CBT was completely mediated by an increase in self-efficacy with respect to fatigue. A reduction in self-efficacy partly mediated the increase in fatigue at follow-up in the CBT group.
Given the decline in self efficacy, booster sessions focussing on restoration and maintenance of self-efficacy with respect to fatigue, may lead to elongation of the initial positive effects of CBT for QFS.
Management of post-traumatic long bone defects: A comparative study based on long-term results
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Reconstruction of post-traumatic long bone defects is a formidable problem. To date, the approaches for bony reconstruction remain controversial. Thus, we aimed to compare the different methods in the treatment of patients with post-traumatic long bone defects, based on the long-term functional and self-evaluation results.
We retrospectively reviewed data on patients with post-traumatic long bone defects of the lower extremities from January 2006 to January 2015. The patients were divided into three groups according to the surgical method used to treat the defects (group 1, free vascularized fibular transfer; group 2, distraction osteogenesis; group 3, the induced membrane technique). Data including the complication rates, entire treatment period, long-term visual analog scale scores, and Sickness Impact Profile (SIP) scores during follow-up were recorded.
A total of 317 patients were included, with 106, 132, and 79 patients in groups 1, 2, and 3, respectively. The major complication rates were 22.6%, 25.8%, and 26.6% for the groups (P > 0.05), respectively. The mean treatment durations for bony defects, from surgery to non-protected weight-bearing, were 65.1, 46.5, and 56.6 weeks for each group, respectively. At 2 years postoperatively, the average SIP scores for each group were 10.5, 11.7, and 11.5, respectively (P > 0.05).
Patients who sustained long bone defects can be advised that either one of these three methods which typically results in long-term outcomes equivalent to others.
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Prediction of long-term outcome after cognitive behavioral therapy for chronic fatigue syndrome
2019, Journal of Psychosomatic Research
To determine which variables predicted long-term outcome after cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS).
A cohort of 511 CFS patients from four different CBT for CFS studies, i.e. two cohort studies and two RCT's. Before treatment, all patients fulfilled the 2003 US CDC criteria for CFS and treated with CBT, were assessed at long-term follow-up, up to 10 years after end of treatment. We tried to predict fatigue severity and physical functioning at follow-up with demographics, cognitive-behavioral perpetuating factors, and CFS characteristics as predictors in linear regression analyses. Logistic regression analysis was used to explore significant predictors of fatigue scores within normal limits at long-term follow-up.
Lower fatigue severity at long-term follow-up was predicted by a shorter duration of CFS symptoms and lower fatigue levels at baseline, and lower frustration in response to fatigue and lower fatigue levels directly post-treatment. Fatigue scores within normal limits at follow-up was predicted by lower fatigue severity and lower levels of frustration in response to fatigue, both assessed directly post-treatment. Better physical functioning at follow-up was predicted by higher sense of control over fatigue, better physical functioning at post-treatment, and being younger at baseline. In some of the additional analysis pain at baseline also predicted physical functioning at follow-up.
The finding that lower fatigue severity and higher physical functioning at long-term follow-up were positively associated with its outcomes at post-treatment underline the importance of fully maximizing the positive effects of CBT for the sustainment of outcomes. Furthermore, augmenting sense of control and starting treatment sooner after diagnosing CFS could positively influence long-term outcome. Interventions aimed at pain management deserve more attention in research.
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2019, Journal of Infection
Q fever fatigue syndrome (QFS) is a state of prolonged fatigue following around 20% of acute Q fever cases. It is thought that chronic inflammation plays a role in its etiology. To test this hypothesis we measured circulating cytokines and the ex-vivo cytokine production in patients with QFS and compared with various control groups.
Peripheral blood mononuclear cells (PBMCs), whole blood, and serum were collected from 20 QFS patients, 19 chronic fatigue syndrome (CFS) patients, 19 Q fever seropositive controls, and 25 age- and sex-matched healthy controls. Coxiella-specific ex-vivo production of tumor necrosis factor (TNF)α, interleukin (IL)-1β, IL-6, and interferon (IFN) was measured, together with a total of 92 circulating inflammatory proteins.
PBMCs of QFS patients produced more IL-6 (P = 0.0001), TNFα (P = 0.0002), and IL-1β (P = 0.0005) than the various control groups when stimulated with Coxiella antigen. QFS patients had distinct differences in circulating inflammatory markers compared to the other groups, including higher concentrations of circulating IL-6 and IFNγ.
QFS patients showed signs of chronic inflammation compared to asymptomatic Q fever seropositive controls, CFS patients, and healthy controls, of which the monocyte-derived cytokines TNFα, IL-1β, and especially IL-6, are likely crucial components.
Long-term effect of cognitive behavioural therapy and doxycycline treatment for patients with Q fever fatigue syndrome: One-year follow-up of the Qure study
2019, Journal of Psychosomatic Research
Previously, we reported a randomized placebo-controlled trial, the Qure study, showing that cognitive behavioural therapy (CBT), and not doxycycline, was significantly more effective than placebo in reducing fatigue severity in Q fever fatigue syndrome (QFS) patients. This follow-up study evaluates the long-term effect of these treatment regimens, 1 year after completion of the original trial.
All patients who completed the Qure study, CBT (n = 50), doxycycline (n = 52), and placebo (n = 52), were included in this follow-up study. Between twelve and fifteen months after end of treatment (EOT), patients filled out web-based questionnaires including the main outcome measure fatigue severity, assessed with the Checklist Individual Strength (CIS), subscale fatigue severity.
Fatigue severity in the CBT, but not doxycycline or placebo, group was significantly increased at follow-up compared to EOT (respective means 39.5 [95% CI, 36.2–42.9] and 31.3 [95% CI, 27.5–35.1], mean difference 8.2 [95% CI, 4.9–11.6]; P < .001). Fatigue severity scores of CBT (adjusted mean 39.8 [95% CI, 36.1–43.4]) and doxycycline (adjusted mean 41.0 [95% CI, 37.5–44.6]) groups did not significantly differ from the placebo group (adjusted mean 37.1 [95% CI, 33.6–40.7]; P = .92 and P = .38, respectively).
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Sickness impact profile: The state of the art of a generic functional status measure

Abstract

J. Chron. Dis.

Pain

J. clin. Epidemiol.

Med. Care

J. Chron. Dis.

Anesthesiology

Com. Dent. Oral. Epidemiol.

J. Am. Geriatric Soc.

Int. Symp. on Quality of Life

ASAIO Trans.

Med. Care

Keynote address: State of science 1986: quality of life and functional status as target variables for research

J. Chron. Dis.

Measuring Health: A Guide to Rating Scales and Questionnaires

The Sickness Impact Profile: conceptual formulation and methodology for the development of a health status measure

Int. J. Hlth Serv.

A Chicano version of the Sickness Impact Profile. A health care evaluation instrument crosses a linguistic barrier

Cult. Med. Psychiat.

Sickness Impact Profile-SIP, en metode til vurdering af helbred

Ugeskr. for Laeger

The Sickness Impact Profile; results of an evaluation study of the Dutch version

Ned. Tijdschr. Geneesk.

Standardization of comparative health status measures: using scales developed in America in an English speaking country

Survey Research Methods: Third Biennial Conference

The Sickness Impact Profile: an instrument for overall health assessment; a basic evaluation

TGO/JDR

The quality of life in women with urinary incontinence as measured by the Sickness Impact Profile

J. Am. Ger. Soc.

The Sickness Impact Profile, validation of a health status measure

Med. Care

Behavioral dysfunction in hypotheroidism, improvement with treatment

Arch. Int. Med.

Physical and psychosocial function in rheumathoid arthritis. Clinical use of a self-administered health status instrument

Arch. Intern. Med.

Reliability and Validity Assessment

Foundations of Behavioral Research

Pitfalls in measuring the health status of Mexican Americans comparative validity of the English and Spanish SIP

Am. J. Publ. Hlth

Measuring functional outcomes in chronic disease: A comparison of traditional scale and a self-administered health status questionnaire in patients with rheumathoid arthritis

Med. Care

Psychological and physical variables as predictors of coping strategies

Percept. Mot. Skills.

General versus disease specific measures. Further work on the Sickness Impact Profile for head injury

Med. Care

The specificity of quality of life measures among the seriously ill

Med. Care

The impact of psychologic factors on measurement of functional status: assessment of the Sickness Impact Profile

Med. Care

The sickness impact profile: final development and testing 1975–1978

Charactering patients dysfunction in Alzheimers-type dementia

Med. Care

The validity of proxy-generated scores as measure of patient health status

Med. Care

Use of a surrogate for the Sickness Impact Profile

Med. Care

A randomized control study of a home health care team

A. J. P. H.

Assessing the functional status of older patients with chronic illness

Fam. Med.

Evaluating health-measures, commentary: measuring overall health, an evaluation of three important approaches

J. Chron. Dis.

Health status measures: an overview and guide for selection

Ann. Rev. Publ. Hlth

Toward clinical applications of health status measures: sensitivity of scales to clinically important changes

Hlth Serv. Res.

The functional status of ESRD patients as measured by the SIP

J. Chron. Dis.

The Sickness Impact Profile: development and final revision of a health status measure

Med. Care