Subjective health assessments and the perceived outcome of minor surgery.

A simple and standardised measure of perceived health status, the Nottingham Health Profile, was used to assess the effect on perceived health status of surgical intervention in a variety of non-acute medical disorders. Patients were assessed a few days before their operation and again two months later and were compared with a control group who had not undergone surgery. Results showed very little change in subjective health from before to after surgical intervention.

A quantitative approach to perceived health status: a validation study.

The current recognition of the importance of perceived health status as a predictor of need for, and utilisation of, health services has led to attempts to produce indicators which assess subjective rather than objective health problems. The development of the Nottingham Health Profile is described, together with a study which tested the validity of the instrument on four groups of elderly people differing in health status. The results showed that the profile was capable of discriminating between groups differing in terms of diagnosed chronic illness, number of consultations at primary care level, and physiological fitness.

A new member of the team? Extending the role of the nurse in British primary care.

533 (77.3%) of a random sample of 690 general practitioner (GP) principals in Britain replied to a postal questionnaire about the appropriateness of nurses undertaking, after suitable training and under the supervision of a doctor, but on their own, certain clinical tasks (history taking, examination, diagnosis, and advice on treatment) in general practice. Those who replied were representative of British GPs.

Health indexes sensitive to medical care variation.

Data from the fifteen Hospital Regions of England and Wales were used to determine the utility of health outcome indexes, derived from existing health statistics, for monitoring the quality and effectiveness of health services. Outcome measures reflect not only the impact of the system of care but also the sociodemographic characteristics of the population. An attempt therefore was made to identify those outcome measures most sensitive to variations in medical care and least affected by sociodemographic differences.

How barefoot? Next steps for the medical auxiliary.

The arguments for and against medical auxiliaries are over and interest must now shift to ways of maximising their effectiveness. An important issue is to what extent the findings of high-technology medicine can be successfully combined with the barefoot concept of delivery. An important question for the future is to what extent they can be applied by the individual to himself.

After the hospital episode.

A scheme by which clinical students follow, after discharge from hospital, the progress of patients for whom they have had responsibility in the ward supplements students' knowledge of the natural history of disease and emphasises the importance of communication and the use of community resources. By commitment to a patient and his problems for a long period, the student can take an active role in care and, in presenting his patient's progress, finds himself in the role of teacher.