Personal Wellbeing Score (PWS)

Benson T, Sladen J, Liles A, Potts H. Personal Wellbeing Score (PWS) – a short version of ONS4, development and validation in social prescribing. Research Paper 17/03 v2, Revised June 2018 Aims Wellbeing is a key policy objective in health and care services.  Our aim was to develop a short generic measure of personal (subjective) wellbeing for routine use as a performance measure in patient-centred care and healthcare quality improvement alongside other patient-reported outcome and experience measures. Methods The Personal Wellbeing Score (PWS) is a patient-reported outcome measure, based on the Office of National Statistics (ONS) four personal well-being questions (ONS4) and thresholds. PWS has the same look and feel as other measures in the R-Outcomes family of surveys.  Word length and reading age were compared with eight other measures.  Anonymous data from five social prescribing projects, were analysed. Internal structure was examined using distributions, intra-item correlations, Cronbach’s alpha and exploratory factor analysis. Construct validity was assessed using hypothesised associations with health status, health confidence, patient experience, age, gender and medications. Scores on referral and after referral assessed responsiveness. Results Differences from ONS4 include brevity, fewer response options, positive wording and a summary score. PWS is short (42 words) with low reading age (9 years). In this population (1,299 respondents, 60% female, average age 81 years), missing values were less than 2%. PWS showed good internal reliability (Cronbach’s alpha = 0.90). Exploratory factor analysis suggested that the four PWS items relate to a single dimension. PWS summary scores correlate positively with health confidence (r=0.60), health status (r=0.58), patient experience (r=0.30) and age group (r=0.24). PWS is responsive to social prescribing intervention. Conclusions The Personal Wellbeing Score (PWS) is a short variant of ONS4. It is easy to use with good psychometric properties, suitable for routine use in quality improvement and health services research. PWS Research Paper

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Health Confidence Score (HCS) – development and validation

Benson T, Potts HWW, Bark P, Bowman C. Development and testing of a Health Confidence Score (HCS). Research Paper 17/02 v2 September 2017, updated June 2018 Introduction Understanding how confident patients are in looking after their own health is essential to improve patient outcomes and clinical support. With few suitable tools available to measure self-care health confidence, we developed and validated a short, generic survey instrument. Methods The Health Confidence Score (HCS) was developed through literature review, patient and expert focus groups and discussions, before being further validated over a 3-year period. This report covers results of two studies testing construct and concurrent validity: an online survey (n=1031, study1), and a face-to-face survey (n=378, study2). Scores were correlated against the My Health Confidence (MHC) rating scale, howRu (health status) and relevant demographics. Results The Health Confidence Score is short (50 words) with good readability (reading age 8). Items are reported independently and as a summary score. The HCS has four items covering health knowledge, ability to self-manage, access to help and shared decision-making, each having four response options. In study2, the mean summary score was 76.7 (SD 20.4) on 0-100 scale. Cronbach’s alpha = 0.82. Exploratory factor analysis suggests that the four items relate to a single dimension. Correlation of the HCS summary score with MHC was high (Spearman r=0.76). It was also associated with health status (Spearman r=0.49), but negatively with number of medications taken (r=–0.29) and age (r=–0.22). It was not associated significantly with ethnicity, having children or education level. Conclusions The Health Confidence Score is short, easy to use, with good psychometric properties and construct validity. The summary score gives an overall picture of confidence and each item is meaningful independently. It can be integrated into electronic records. HCS research paper

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