You are here

  • Home
  • Online First
  • Health measurement instruments and their applicability to military veterans: a systematic review

Article Text

Article menu
Download PDFPDF
Systematic review
Health measurement instruments and their applicability to military veterans: a systematic review
  1. Jane Jomy1,
  2. P Jani2,
  3. F Sheikh3,
  4. R Charide3,
  5. J Mah4,
  6. R J Couban5,
  7. B Kligler6,
  8. A J Darzi7,
  9. B K White8,
  10. T Hoppe8,
  11. J W Busse3,9 and
  12. D Zeraatkar3,10
  1. 1 Faculty of Medicine, University of Toronto Temerty, Toronto, Ontario, Canada
  2. 2 School of Medicine, McMaster University, Hamilton, Ontario, Canada
  3. 3 Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
  4. 4 Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
  5. 5 Michael G DeGroote National Pain Centre, McMaster University, Hamilton, Ontario, Canada
  6. 6 Office of Patient Centered Care and Cultural Transformation, Veterans Health Administration, Washington, District of Columbia, USA
  7. 7 Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
  8. 8 The Canadian Veterans Chronic Pain Centre of Excellence, Hamilton, Ontario, Canada
  9. 9 Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
  10. 10 Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr J W Busse, Department of Anesthesia, McMaster University, Hamilton, ON, Canada; bussejw{at}mcmaster.ca

Abstract

Introduction Accurate measurement of health status is essential to assess veterans’ needs and the effects of interventions directed at improving veterans’ well-being. We conducted a systematic review to identify instruments that measure subjective health status, considering four components (ie, physical, mental, social or spiritual well-being).

Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we searched CINAHL, MEDLINE, Embase, PsycINFO, Web of Science, JSTOR, ERIC, Social Sciences Abstracts and ProQuest in June 2021 for studies reporting on the development or evaluation of instruments measuring subjective health among outpatient populations. We assessed risk of bias with the Consensus-based Standards for the Selection of Health Measurement Instruments tool and engaged three veteran partners to independently assess the clarity and applicability of identified instruments.

Results Of 5863 abstracts screened, we identified 45 eligible articles that reported health-related instruments in the following categories: general health (n=19), mental health (n=7), physical health (n=8), social health (n=3) and spiritual health (n=8). We found evidence for adequate internal consistency for 39 instruments (87%) and good test–retest reliability for 24 (53%) instruments. Of these, our veteran partners identified five instruments for the measurement of subjective health (Military to Civilian Questionnaire (M2C-Q), Veterans RAND 36-Item Health Survey (VR-36), Short Form 36, Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF) and Sleep Health Scale) as clear and very applicable to veterans. Of the two instruments developed and validated among veterans, the 16-item M2C-Q considered most components of health (mental, social and spiritual). Of the three instruments not validated among veterans, only the 26-item WHOQOL-BREF considered all four components of health.

Conclusion We identified 45 health measurement instruments of which, among those reporting adequate psychometric properties and endorsed by our veteran partners, 2 instruments showed the most promise for measurement of subjective health. The M2C-Q, which requires augmentation to capture physical health (eg, the physical component score of the VR-36), and the WHOQOL-BREF, which requires validation among veterans.

  • health services administration & management
  • protocols & guidelines
  • change management

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.

https://doi.org/10.1136/military-2022-002219

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.

    View Full Text

    Footnotes

    • Twitter @janejomy, @Cm_jasmine, @JasonWBusse

    • Contributors JJ, JWB, BK, DZ and AJD conceived and designed the review. RJC conducted systematic searches of databases. JJ, PJ, FS and RC conducted all phases of article screening and collected data. JM conducted additional data searches across all instruments included in this review. BKW and TH contributed data as veteran partners. JJ drafted the manuscript. All authors reviewed and revised the final versions for publication. JJ is the guarantor of the study.

    • Funding Funding for this study was provided by the Chronic Pain Centre of Excellence for Canadian Veterans, a not-for-profit research organisation. The funding organisation had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; or decision to submit the manuscript for publication.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.