Symptoms, affects, and self-rated health: evidence for a subjective trajectory of health.
OBJECTIVE
Self-rated health (SRH) is known to predict mortality and other health outcomes better than objective ratings, suggesting that patients have important knowledge that physicians do not. The study assessed whether SRH reflects changes in internal states, specifically symptoms and affects.


METHODS
In an event-sampling study, 54 elders completed a SRH measure, positive and negative affect scale, a symptom checklist, and a pain scale every evening for 8 weeks. Using lagged (time series) hierarchical regression, the authors modeled associations of SRH with previous symptoms, moods, and changes in symptoms and mood.


RESULTS
The SRH was highest when symptoms had decreased from the previous day and lowest when symptoms had increased, suggesting that SRH reflects a sense of change. Symptoms and affects contributed independently to SRH. Self-rated health was more sensitive to positive than negative affect and also sensitive to changes of positive but not negative affect.


CONCLUSIONS
Patients may possess a subjective trajectory of health-an awareness of changes in symptoms and affect. This trajectory may constitute an important component of SRH and help to explain its ability to predict health outcomes.
Winter
Laraine
L
Center for Applied Research on Aging and Health, Thomas Jefferson University, Edison Building, Suite 500, 130 South 9th St., Philadelphia, PA 19107, USA.
Lawton
M Powell
MP
Langston
Christopher A
CA
Ruckdeschel
Katy
K
Sando
Robert
R
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010146:Pain; D012647:Self-Assessment; D014481:United States