Cross-diagnostic validity of the Nottingham health profile index of distress NHPDReportar como inadecuado

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Health and Quality of Life Outcomes

, 6:47

First Online: 02 July 2008Received: 05 November 2007Accepted: 02 July 2008


BackgroundThe Nottingham Health Profile index of Distress NHPD has been proposed as a generic undimensional 24-item measure of illness-related distress that is embedded in the Nottingham Health Profile NHP. Data indicate that the NHPD may have psychometric advantages to the 6-dimensional NHP profile scores. Detailed psychometric evaluations are, however, lacking. Furthermore, to support the validity of the generic property of outcome measures evidence that scores can be interpreted in the same manner in different diagnostic groups are needed. It is currently unknown if NHPD scores have the same meaning across patient populations. This study evaluated the measurement properties and cross-diagnostic validity of the NHPD as a survey instrument among people with Parkinson-s disease PD and peripheral arterial disease PAD.

MethodsData from 215 PD and 258 PAD people were Rasch analyzed regarding model fit, reliability, differential item functioning DIF, unidimensionality and targeting. In cases of cross-diagnostic DIF this was adjusted for and the impact of DIF on the total score and person measures was assessed.

ResultsThe NHPD was found to have good overall and individual item fit in both disorders as well as in the pooled sample, but seven items displayed signs of cross-diagnostic DIF. Following adjustment for DIF some aspects of model fit were slightly compromised, whereas others improved somewhat. DIF did not impact total NHPD scores or resulting person measures, but the unadjusted scale displayed minor signs of multidimensionality. Reliability was > 0.8 in all within- and cross-diagnostic analyses. Items tended to represent more distress mean, 0 logits than that experienced by the sample mean -1.6 logits.

ConclusionThis study supports the within- and cross-diagnostic validity of the NHPD as a survey tool among people with PD and PAD. We encourage others to reassess available NHP data within the NHPD framework to further evaluate the strengths and weaknesses of this simple patient-reported index of illness-related distress.

Electronic supplementary materialThe online version of this article doi:10.1186-1477-7525-6-47 contains supplementary material, which is available to authorized users.

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Autor: Christine Wann-Hansson - Rosemarie Klevsgård - Peter Hagell


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