| Purpose:In most descriptive studies of subhealth, subjects were ruled as in "subhealth state" without clinical evaluation, if their "unfitness" symptom had lasted for a certain time and met certain severity criteria. In our preceding study, a subhealth evaluation inventory was designed with collective wisdom of professionals from various health specialties. It includes9first-degree indices which are easily disturbed when general health condition is compromised:gastrointestinal function, sleep, sexual function, fatigue, pain, emotion, anxiety sensitivity social anxiety and social relation. Purpose of this study was to explore the health evaluation power of our inventory on the basis of clinical evaluation.Methods:A mean score of≥3(0-4points) in any first degree index would be grouped as high score, otherwise low score. The evaluation inventory was given out in the out clinic building and health examination center of Peking Union hospital. Study population included passersby and individuals who learned about this study through various ways. All subjects must be more than18years old. Those who were willing to participate after they were informed of the procedure and purpose of this study were excluded. Those whose "unfitness" could be explained by an already diagnosed disease were excluded. An open interview and CIDI interview was done with all enrolled subjects. A judgment of subject’s health state was made by clinical doctors based on the physical, psychological and social information acquired. Classification standards:a) disease: subject’s unfitness caused a decrease in his/her physiological, psychological, or social function, and a relevant disease could be diagnosed; b) subhealth:subject’s unfitness caused a decrease in his/her physiological, psychological, and social function, but no relevant diagnose could be made or found; c) health:this "unfitness" didn’t cause function loss. Psychiatric diagnoses were made by psychiatrists according to ICD-10criteria.Results:Seventeen males and43females with a mean age of35.6±11.4years (range,18to61) were enrolled. None of them had grave physical diseases or severe chronic diseases. Their main "unfitness" complaints were mostly common problems such as fatigue, sleeping problems, emotional stress, work and social stress, etc(57/60). Evaluation results of the subjects’unfitness are as follows:15"health",22"subhealth",23"disease". In high score group,60.7%(17/28) subjects were diagnosed with a disease/disorder;18.8%(6/32) in the low score group. Except for sexual function and pain scores, other first degree indices were all statistically related to health status. These indices were also linearly correlated with health state (coefficient from high to low): emotion (Pearson coefficient0.75, p<0.0001), fatigue(0.59, p<0.0001), sleep(0.56, p <0.0001), social relation(0.53, p<0.0001),social anxiety(0.38,p=0.0025), anxiety sensitivity(0.35,p=0.0058),gastrointestinal function(0.33,p=0.0082). The linear relevance coefficients of physiological, psychological and social function dimension with health state are0.63(0.59, p<0.0001),0.51(0.59, p<0.0001) and0.53(0.59, p<0.0001) separately.Conclusions:1. In our subjects,60.7%in the high score group were diagnosed with a disease. Also, our study showed a great overlapping of function impairment between different health states. These two facts strongly indicate that it is inappropriate to make subhealth conclusion merely on certain symptom’s severity and duration while lacking clinical evaluation.2. The inventory used in this study is a good evaluation tool of individual’s general health; sexual function score is not relevant to health state; as individuals may be very different as to which dimension or which index comes first to sacrifice when general health is imperiled, an integrated bio-psycho-social approach should be taken in health evaluation. |
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