Using the Nottingham Health Profile (NHP) among older adult inpatients with varying cognitive function

Abstract

Background: High rates of missing, non-applicable items and insufficient reliability have been frequently reported as limitations of the generic Quality of Life questionnaires for older patients. The Nottingham Health Profile (NHP) might be more suitable as it contains easy to respond (yes/no) items covering moderate-to-severe health deterioration.

Objectives: To assess feasibility, reliability and validity of the NHP in disabled, older patients.

Design: Cross-sectional study.

Setting: Acute care hospital.

Subjects: 134 inpatients aged >or=65 with severe disability, abnormal cognitive function, or other persistent health problems precluding their discharge.

Methods: The (interviewer-administered) NHP, Mini-Mental State Examination (MMSE), Barthel Index, and diagnostic information were recorded.

Results: Completion rates varied from 98% of the 49 patients with normal cognition (MMSE >or=21) and 86.3% of the 51 with moderate cognitive impairment (MMSE 10-20), to 5.9% of the 34 with severe cognitive impairment (MMSE<10). Cronbach's alpha of the total NHP score was near 0.9 (0.82 and 0.87 for patients with MMSE >or= 21 and 10-20, respectively; p = 0.291). The correlation between 'Physical Mobility' of the NHP and Barthel Index was also similar in both cognitive groups (0.39 and 0.40).

Conclusion: Interviewer-administered NHP is suitable, reliable and valid, even in patients with moderate cognitive function.