Feasibility, Acceptability and Internal Consistency Reliability of the Nottingham Health Profile in Dementia Patients

Abstract

Background: Few studies have evaluated subjective health status in dementia patients. Objectives: The aim of the study was to determinate the feasibility, acceptability and internal consistency reliability of measuring subjective health status in dementia patients with the Nottingham Health Profile (NHP). Design: The French version of the NHP was administered to 145 dementia patients and their proxies (family caregivers and formal caregivers). Measures: The refusal rate, type of administration and time for completion were used as indicators of feasibility. Internal consistency reliability was determined with Cronbach’s α coefficient and test-retest reliability assessed with the intraclass correlation coefficient for test-retest values. The measurements obtained were compared by source of information (patient and proxies). Results: The 145 subjects had an average age of 82 and 78% were women. 73% had a Mini-Mental State <16. Ninety-four percent of the items were correctly filled in, but an interviewer had to be present because of problems in attention or comprehension. The test-retest reliability for subjects was good (ρ < 0.7), but response agreement between patients and their proxies was just acceptable for physical domains (ρ < 0.6) and poor for psychological and social domains (ρ < 0.4). Conclusions: Self-rating of perceived health status by dementia patients seems feasible with the questionnaire with adaptations in the administration, but other methods are needed to approach the more subjective domains of the quality of life.

Agreement between dementia patient report and proxy reports using the Nottingham Health Profile

“…This was an inter-rater reliability study: the Nottingham Health Profile (NHP) scores of elderly persons with mild to moderate dementia (MMSE > 9) were compared with NHP scores as provided by two different proxies for each subject. For dementia patients, test-retest validity of the NHP has already been analysed in a previous study (Bureau-Chalot et al, 2002) and was found to range from moderate to excellent according to the dimension. Family proxies for the present study were chosen among people who knew and saw the patient most regularly.…”

Development of the Subjective Memory Complaints Questionnaire

“…However, several studies suggested that awareness of deficit may vary greatly across individuals [34] , and metamemory function is maintained in the early stages of AD [36,37] . In the previous studies, self-assessment questionnaires for physical and psychological symptoms were administrated to mild to moderate dementia patients [38,39] . In addition, a recent study reported that self-rated questionnaires could differentiate nondemented from demented individuals, especially when of mild severity [34] .…”

Measurement of health-related quality of life for people with dementia: development of a new instrument (DEMQOL) and an evaluation of current methodology

“…74 The validity of the Nottingham Health Profile, SF-12 and EQ-5D for people with dementia is also questionable. [75][76][77] The content, format and instructions of HRQoL instruments must be appropriate to people with dementia, given their cognitive difficulties. By definition, generic measures are not necessarily designed in a way that makes them easy for a person with dementia to complete.…”