| Knowledge Item:
CA-Medical Outcomes-40
Participant Satisfaction and Change in CD4 Counts, Viral Loads,
Quality of Life, and Karnofsky Severity Ratings
This Knowledge Item
also appears as Knowledge Item: CA-Quality of Life and
Health-60
and Knowledge Item:
CA-Program Satisfaction-23.
Knowledge
Item: CA-Quality of Life and Health-39 shows that quality of life
improves over time for the participants in the programs evaluated here.
This Knowledge Item shows that patients who have relatively the most improvement in their quality of
life and whose clinicians rate their progress as most improving (or
least deteriorating) rate the quality of their programs most highly.
That is, patients who see improvements in themselves rate their programs
most highly. Patients whose overall functioning is rated to be better by
their clinicians rate their programs most highly. Program satisfaction
is related to both patient-judged and clinician-judged improvement but
not to changes in traditional medical indicators (CD4 count, viral
load).
In
this Knowledge Item, degree of change is operationalized as the linear
slope parameter from the Hierarchical Linear Modeling (HLM) analyses, or
the degree of sustained change across the entire treatment episode for
the patient.
Knowledge
Item: CA-Medical Outcomes-14 shows the the CD4 counts of patients
in the programs evaluated here increase over time.
Knowledge
Item: CA-Medical Outcomes-22 shows that the viral loads of patients
in the programs evaluated here decrease over time.
Knowledge
Item: CA-Medical Outcomes-18 shows that the Karnofsky Severity
Ratings of patients in the programs evaluated here stay about the same
over time.
This Knowledge Item shows that
patients who have relatively the most improvement in their quality of
life and whose clinicians rate their progress as most improving (or
least deteriorating) rate the quality of their programs most highly.
Relationship Between
Estimated Change in Quality of Life Over Time (from a Hierarchical
Linear Model) and Patient Judgment About Quality of Services
(statistically significant relationship; patients who improve most say
their program has the highest quality)
All
Patients Combined
By Type
of Project
More Information:
Boxplot
Relationship Between
Estimated Change in Clinical Karnofsky Severity Rating (from a
Hierarchical Linear Model) and Patient Judgment About Quality of
Services (statistically significant relationship; patients judged by the
clinician to improve most say their program has the highest quality)
More Information:
Boxplot
The following charts shown the
percentage of individual rating the services as fair/poor, good, very
good, or excellent who improved.
Quality
of Life
Karnofsky
Severity Rating
CD4
Count
Viral
Load
Patients
or Clients?
Knowledge Item Citation:
Huba, G.
J., Melchior, L. A., Panter, A. T., and the HRSA/HAB SPNS Cooperative Agreement
Steering Committee (1998-2001). Knowledge Item: CA-Medical Outcomes-40 from
HRSA/HAB's SPNS Cooperative Agreements on Innovative Models of Care, The
Measurement Group Knowledge Base on HIV/AIDS Care, Online at
www.TheMeasurementGroup.com.
Last Updated:
March 25, 2005; data through June 15,
1999; analyses conducted April - September 2000.
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