RESUMEN
We enrolled 543 elderly participants of a managed care organization in a cross-sectional study to test whether the association between self-rated physical health and clinically defined illness differs for persons who are not depressed compared with persons with minor or serious depression. Depression was measured with the Diagnostic Interview Schedule (DIS). Clinically defined illness was measured with the Chronic Disease Score (CDS), a pharmacy-based measure. Additional variables included age, sex, and self-reported pain and physical function. Self-rated physical health was associated with both minor and serious depression, independent of clinically defined illness; minor depression was no longer significant when self-reported pain and physical function were added to the model. A significant negative correlation between self-rated physical health and clinically defined illness was observed for minor and no depression, but no correlation was seen for serious depression. These results confirm the association between depression and self-rated physical health and emphasize that, for persons with serious depression, self-rated health provides a less accurate picture of clinically defined illness at both ends of the spectrum. Also, a diagnosis of minor depression should not forestall investigation of inconsistencies between patient report and clinical evidence.
Asunto(s)
Depresión/psicología , Estado de Salud , Anciano , Actitud Frente a la Salud , Enfermedad Crónica , Estudios Transversales , Femenino , Humanos , Masculino , Dolor , Esfuerzo FísicoRESUMEN
The aim of the study was to discover to whom the pharmacy profession adds value and how it describes and documents that value, to inform other health care professionals of that value, and to present a method of review. Definitions of 'values' and 'value' were used to develop this methodology. Three ranking terms (benefit, demand, satisfaction) and three whom-value-serves labels (individual, institution, society) were chosen. Whom-value-serves label(s) were assigned to each article within the core matrix. The search years were 1984 to 1995. The articles were analyzed using the Matrix Method. From this matrix template, further in-depth analyses were completed. Of 86 articles on the core matrix, one-fourth were published in medically-related journals. An article could have more than one whom-value-serves label. As a percentage of total whom-value-serves designations the 'institution' labels were prominent. Within the 'individual' labels, patient and pharmacist groups were identified equally. The 'society' label had no strong emphasis. The core matrix articles revealed the pharmacy profession adds value to hospital/retail organizations and the profession. It describes value in terms of cost containment, provision of services, and quality of care. Our intent is to inform health care professionals that our conceptual framework and methodology will be useful.