Exploring the iceberg of morbidity: A comparison of different survey methods for assessing the occurrence of everyday illness
This paper examines problems in measuring the occurrence of acute symptoms of ill health. Health interview surveys and health diaries often lead to different results. Two key hypotheses assume that: 1, interviews using checklists are more sensitive to the respondent's psychological distress than are the open-ended questions of health diaries; and 2, health diaries demand high levels of compliance leading to underreporting of symptoms. An additional 3rd hypothesis assumes that the effect of psychological distress on response patterns is strong for reporting psychological symptoms but insignificant for musculoskeletal symptoms. The hypotheses were tested and explored with data from the Dutch Survey of General Practice, a nationwide study among 161 GPs. A random sample of 100 patients per GP was approached for a health interview and asked to keep a structured health diary during three weeks. Symptoms were recorded during the interview with a checklist and queried in the health diary with open-ended questions. The occurrence of symptoms was modelled with logistic regression. High levels of psychological distress increase the likelihood of recording symptoms for both instruments, but the increase is greater for the interviews. Respondents who have only received limited education, heavy smokers and those who suffer from chronic conditions have a significantly lower likelihood of recording symptoms in the diary as compared to the questionnaire. There was no significant effect of taking an interest in health matters, gender, and work and domestic role obligations. Taking the nature of symptoms into account, it was found that psychological distress had indeed a great effect on the response pattern for psychological symptoms, but not for musculoskeletal symptoms. The criticism that symptom checklists are sensitive to psychological distress rather than to physical illness alone, is confirmed in this study. Open-ended questions prevent biased responses, but result in fewer symptoms being recorded. Health diaries with open-ended questions 'produce' more symptoms but take more effort to complete, requiring sufficiently motivated respondents. It is recommended that a less biased specific list for the assessment of acute symptoms be developed.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 41 (1995)
Issue (Month): 3 (August)
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:41:y:1995:i:3:p:317-332. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Shamier, Wendy)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.