Attitudes towards health questionnaire evaluation

Concepts –
These items were intended to find out about the respondents different concepts of health. The different definitions are positive, holistic and negative, and I had a wide variety of responses from the respondents. I later analyzed these findings to see if their concepts were consistent across the board and also how they affected their attitude towards health. For example having a negative concept may mean the person is less likely to actively look after themselves e.g. visiting the GP or exercising.
Item 5: What is your definition of health?
Figure 1
50% of my respondents gave a positive definition of health; a frequent comment was ‘keeping physically fit’ which explains why 80% of the respondents also rated regular exercise as the most important factor in their health. Those who nearly equally a positive definition of health were equally spread over the age ranges and gender. 100% of the respondents who had a negative view of health were male and in either 16-25 or 26-35 age range. A representative response from this category was ‘If I don’t feel unwell’. Their views on which factors are most important to them are contradictory however to their definitions of health. 100% of them having positive factors as the most important and negative ones such as ‘not smoking’ in their bottom three. This suggests that they may have over simplified their response, or differentiate between factors affecting health and the definition of it. One problem that occurred with this item was the overlapping of the concepts. 20% of the respondents gave a definition that fitted at least two of the concepts. Respondent 1 said ‘By keeping fit and healthy I don’t feel unwell’. This is both a positive and negative concept, as it draws the aspect of actively looking after themselves as well as the absence of illness. I chose to put the respondent 1 in the positive category when collating the data, as I believed they put more emphasis on the positive concept. To eliminate this problem I should have created separate categories for overlapping concepts.
Item 7: Which statement best describes your view of ill health
Figure 2
There is a strong consistency between Item 7 and item 5, which both seek to find the respondents view on health. 100% of the respondents, who gave a negative definition of health in item 5, also chose the negative definition of ill health. With the positive concept, 90% chose positive again, however 10% went on to choose negative. 50% who gave a holistic definition went on to choose the negative view of ill health. This may be due to how I worded the statement using a forced choice style item rather than matching item 5 with an open item. If I wanted to improve the validity of this item I would have used more clear-cut definitions.
Understanding –
Assessing their understanding of ill-health was primarily used to evaluate the validity of their later responses. If the respondents were unaware of the difference between illness, disease and disorder and later used this terminology in their responses, my results would lose validity, as their answers would lack accuracy.
Item 4: Can you match the terms to the health problems?
Figure 3
Females were better able to correctly match the terms illness, disease and disorder to the health problems. Females may have outperformed males due to the fact that out of my sample, two of them had a serious health problem and 100% of them ranked visiting their GP in their top three most important health factors. This suggests that they may have been more educated and / or aware of the correct use of these terms than males. However a simple match test may not be valid as the answers can be chosen correctly at chance. If I were to repeat this item I would ask for their own definitions of disease, disorder and illness. It is quite hard to distinguish if those respondents who initially gave an incorrect response were in fact correct. The terms disease, disorder and illness are not categorical and can overlap in their definitions, even in the medical profession. For example a person with a disorder like diabetes is going to show signs of a disease – a set of diagnosable symptoms. So it is hard to actually label the respondents as giving an incorrect response. Again by asking them to write their own definition and give an example would have been a more practical method of assessment.
Attitudes –
I also sought to find how different factors such as age, disability and religion affected a person’s attitude towards health by asking them the implications of their health and comparing responses to those who specified they did not have a disability or a different age. For example being morbidly obese is going to affect the person’s attitude; they are more likely to have a positive concept of health, as they would be focusing on a balanced diet and regular exercise. Whereas a person in a normal weight range is less likely to focus on these positive factors in their health and may take into account social and intellectual ones.
Item 3: Have you ever had a serious health problem?
Figure 4
20% of the respondents reported having a serious health problem. This is representative of the population and the result I expected to find, as this figure was also reported in the national census (10). Interestingly those who did have a serious health problem also reported at least two of the following behaviours each: excessive drinking, under exercising, smoking and over eating. 100% of these are associated with ill health and can cause serious health problems (11). However it is hard to draw cause and effect from this correlation, as the condition or disability may cause an increase in these behaviours rather than the behaviour causing the health problem. For example the person may be depressed and in turn drink more. I initially chose a closed question to easily collate and compare responses. However this poses the problem of being unable to further investigate why they class themselves as disabled or suffering from a serious health problem. I would have liked the opportunity to find this out, as some respondents who share the same condition such as depression may differ in their views of whether or not it constitutes for a disability or serious health problem.
(10) www.census.gov
(11)
Item 1: What gender are you?
Figure 5
There was a 50:50 split between the genders, which provided a good background for assessing the role of gender in certain aspects of health. By having an equal split I was better able to view the correlations between the two factors without calculating percentages. It was also helpful having the equal split when generalizing to the population, as according to the demographic health study (14) there is roughly an equal split among the sexes. One problem that arose was the use of the word ‘gender’. Gender is not a biological category (25), so the use of the term sex would have been more appropriate in this item when analyzing the affects of the persons sex on health factors.
(14)
(25) www.gender.org.uk
Item 2: How old are you?
Figure 6
Figure 7
I had a wide range of different ages, with 80% of the respondents being spread over 16-45. This keeps in line with the national average, where 66% of the population is aged 15-64. I also had a similar result in the 65+ range, where 10% of the respondents where female and aged 65+, yet again keeping within the national average of 9%. However the government statistics also assessed the 0-14 range, which I chose to avoid in my questionnaire due to the nature of the ‘adult’ factors. This explains the slightly larger spread over 16-45 category (15). By having a wide selection of ages that also keep in line with statistical data, I was able to assess the correlations between age and health factors, as well as infer data that are representative of the different age groups.
(15) statistics.gov.uk
Item 10: Does your culture affect your health, and if so how?
100% of the respondents said that their culture does affect their health. 40% reported that their religion affected the decisions they made, for example respondent 10 said: ‘Being religious means I look after my body as a temple, as that is how God created it and I want to look after it as God intended’. 40% of the respondents stated that living in England under the NHS meant their health was better looked after. This 40% were in the 46-55 range, which means they may be more traveled than the younger respondents, thus able to compare the NHS to other countries such as those less developed. The remaining 20% said that their parent’s religion influenced their decisions even though they weren’t religious. This may be because the different attitudes and understandings of health were taught and ingrained from a young age for these individuals.

Item 6: Which factors are most important for your health? (Please rank factors in order of importance, 1 being the highest, 6 being the lowest)

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Item 6: Which factors are most important for your health? (Please rank factors in order of importance, 1 being the highest, 6 being the lowest)

For respondents aged 15-26, exercise was in the top 3 factors for 100% of them. This may be due to national programs to encourage exercise in young people such as compulsory PE, education in factors affecting health and sports clubs. For respondents aged 65+ not smoking was the most important factor for them. This may be because long term smokers often occur problems associated with smoking later in life, thus upon reflection now realise how important it is not to smoke. 100% of males chose monitoring weight in their bottom 3 most important factors. This is what I hypothesised as monitoring weight is often associated with body image, which is increasingly a female obsession.

Visiting the GP -

Visiting the GP is important to gain treatment, access to hospital, medical advice and learn more about how to look after your own health. Regular health check ups are a good way of regularly assessing a persons health, however they are not compulsory to attend (27). During a physical examination the GP will take a medical history, current symptoms, diagnosis and eventually determine the appropriate treatment for the individual. Visiting can not only affect your health, but your health can also affect you visiting the GP, for example a smoker or alcoholic may be more reluctant to visit than a non smoker or drinker. These items were designed to see the respondent’s willingness to visit the GP, and the correlations between other factors, which may affect this.
(27) ‘AQA AS Health and Social Care’
Item 9: How much do you agree with the following statement: ‘If I’m ill I’ll self treat before visiting the GP’
Figure 4
Item 9 confirms the responses from Item 8: In the last 12 months how often have you visited the GP? With the modal number being 0. It is recommended that people should go for annual check-ups to their GP (1), which only a few of my respondents have, and the majority avoids, visiting the GP. These two behaviors are probably linked by a lack of knowledge of how a GP works or a dislike of them. Two respondents reported having a serious health problem and 50% disagreed with the above statement. This may be due to them being more concerned about the affects on their health if they feel unwell. The 30% of the respondents who strongly agreed with the statement also had a positive concept of health. This may be because they take more responsibility over their health than the other respondents and feel guilty when they’re ill and blame themselves, as they couldn’t stop it (27). The 30% that strongly agreed where aged 46-65+. This may affect them visiting the GP as they may be less aware of what the service can and is intended to provide so choose to ignore it or just unaware. I chose to use a likert-type question for this item on preferences, to compare the responses to the different factors that may affect this answer such as age, disability and culture. Unfortunately by using a closed question I was unable to ask the respondents the reasoning behind their agreeability and can only assume from their concepts and attitudes in previous items.
(1)
(27) ‘AQA AS Health and Social Care’
Eating Sensibly –
Eating sensibly is allowing for growth by energy intake balancing energy output and including all the correct micronutrients and macronutrients they need (27). A balanced diet is an important factor in both exercise and controlling weight according to the government. This is because it burns fat, improves muscle tone and provides the body with the correct nutrients to function the metabolism (20). The following items were intended to asses the respondents ability to define what a balanced diet, if they maintain one and also the other interlinking factors impact on maintaining a balanced diet.
Eating sensibly includes the correct proportions of macronutrients:

Protein – This nutrient is important to promote muscles, skin, hair and nail growth and development.
Fat – A source of energy for the body
Carbohydrates – Provides energy to the body, typically the brain and nervous system.

The correct proportion of Micronutrients:

Vitamins – Antioxidant qualities help prevent disease
Minerals – Support the function of vitamins in the body

As well as: water intake that can clearing toxins and keeping the organs healthy
All of these dietary requirements should be sufficient enough to meet the needs of the individual, in turn positively affecting their well-being and health (2).
(20) Nhlbi.gov.uk
(27) ‘AQA AS Health and Social Care’
(2)
Item 12: What is a balanced diet?
100% of the respondents gave an answer similar to the proper definition: Eating the correct proportions of the 5 food groups (2). For example respondent 8 said: ‘Consuming the right amount of each food group regularly’. This item shows that 100% of the respondents were competent to judge the effect of their lifestyle on their weight in item 14: ‘How could you improve your diet?’ As they are aware of what the ‘correct’ lifestyle and diet includes. Respondent 2 gave the most correctly detailed answer includes the phrases ‘micro and macro nutrients’. This respondent also ranked herself the highest out of the sample when asked how well they maintain a balanced diet. This could suggest that the more educated and aware of what a balanced diet is, the more likely they are maintaining one. Unfortunately I did not include an item on what micronutrients and macronutrients are and the benefit of them. This would have been an interesting item to see how knowledgeable the respondents were in this area.
(2)
Item 13: On a scale of 1-10, 1 being the lowest and 10 being the highest, how well do you maintain a balanced diet?
Figure 5
As previously stated, 100% of the respondents were aware of a balanced diet, and in item 6, 70% of them ranked eating sensibly in their top three most important factors. This item however contradicts these findings as most of the respondents rate their diet on the low end. Because of the small sample group, I cannot generalize these findings, but it is common to be educated and aware of a balanced diet and still not maintain one. This may be due to lack of motivation or not enough money to afford to maintain one. The 10% lowest rated respondents were aged 65+. This can affect their knowledge of what a balanced diet is, as the concept is a relatively knew one in such detail. This means they are unable to maintain a balanced diet, or so sued to how they’ve been brought up on find changing their eating habits too hard. Using a closed question may have been a bad method however, as everyone’s definition of maintaining a balanced diet differs. For example some may believe it refers to always having one, where as others believe it means for the majority of the time. If I had used an open question to follow up their answers, I would have been able to ask then why they gave the rating they did.
Monitoring Weight –
Monitoring weight can be from several methods such as height and weight scales and BMI scales to assess the individuals weight in relation with the norm. There is no recommended time span for when you should monitor your weight. It can however be a useful tool in preventing obesity or malnourishment, as the person can take control over their weight and see the results. Not monitoring enough can be an indicator for a lack of care or knowledge, and monitoring too much can be a sign of obsession over weight. Often monitoring weight can identify small changes in weight that otherwise would not be noticed as it often a gradual process (27). This can be important as a precursor of an illness or giving the ability to the individual to improve the weight before it becomes problematic. These items assessed how often and why the respondents monitored their weight, and the difference between male and female responses.
(27) ‘AQA AS Health and Social Care’
Item 15: How often do you monitor your weight?
Figure 6
50% of the respondents reported monitoring their weight on a weekly basis. This is the modal result I was expecting, and likewise I also predicted that woman would report monitoring their weight significantly more than males. In the two categories of weekly and daily monitoring, 100% of the respondents were female and 100% of them had a positive concept of health. This was expected, as having a positive concept means you’re sure more likely to participate in positive behaviors such as monitoring weight or exercising. Of the 30% of respondents who reported monitoring their weight monthly or yearly, 100% of them also said they did not maintain a balanced diet or exercise at or above the RDA. Both of these factors impact a person’s weight, and if someone is not bothered about monitoring their weight then they are not likely to be bothered with maintaining a balanced diet or exercising to what is recommended.
Alcohol Consumption –
Alcohol consumption can cause serious short term and long-term problems in heavy consumption with such diseases as cirrhosis of the liver, CHD, hypertension, stroke, gastritis, ulcers and renal failure. It is however in moderate use (1-2 units a day) prove as a healthy means of a relaxant, feelings of contentment and decreased risk of stroke and coronary artery disease (27). It is a large topic in media, political agenda, policies and campaigns, so I was expecting this section to be amongst the largest in terms of understanding and knowledge from my respondents. The main factor I expected to be associated with drinking was smoking, and I tried to incorporate this link in the items.
(27) ‘AQA AS Health and Social Care’
Item 19: For your gender, what is the recommended amount of units of alcohol per week?
100% of the respondents failed to give the correct answer of either 14 or 21 units (3). By not being aware of the correct amount of units it is likely that they are going over the limit without realizing. Alcohol can be a high source of calories (4), and as 80% of them monitor their weight on a monthly basis in item 15, they may be putting on weight from the alcohol and not realizing. This is likely as the modal value for the respondent’s intake of alcohol was 30 units, as reported in item 21. This is answer however may not be accurate as 100% of them gave the correct definition of a unit: 10ml of pure alcohol, and may have been confused to what the question was asking them. A common incorrect response was ‘the amount of pure alcohol in the drink’.
(3) www.drinking.nhs.com
(4)
Item 22: Which statement best describes your drinking?
Figure 7
It is recommended that alcohol consumption be spread moderately over the week, according to the NHS (21). This is was 40% of my respondents recorded. 100% of them also rated themselves amongst the highest in terms of maintaining a balanced diet, so were more likely to be health conscious. However two respondents reported that they had health problems, which resulted in them limiting their alcohol consumption, so it is hard to draw valid conclusions. As for the 60% that either drank mostly on the weekend or in one night, they also reported that they smoke, with 50% of them strongly agreeing with ‘I smoke more after drinking’ in item 26. This can pose a serious health threat by binge drinking and smoking (5), especially considering the modal value of units a week at 36 for males and 30 for females. Of those who agreed for the above statement, 100% of them said they had tried to quit smoking 2+ times. Their drinking habits may be a direct cause of their inability to quit if they are binge drinking regularly. The 40% who responded drinking equally over the week or 50% on the weekend, which is considered healthy (21), 100% of them were religious. This may affect their drinking style as they all reported being healthy was important to their religion.
(5)
(21) nhs.uk/livewell
Smoking –
Smoking proves dangerous and a risk to a persons and others health through passive smoking and should be avoided. Difficulties include cancer, CHD, chronic bronchitis, emphysema, peripheral and vascular disease for anyone in regular contact or use of cigarettes. The main components of cigarettes are nicotine: the addictive property absorbed into the blood and affects the brain within 10 seconds, tar: the chronic irritant and carcinogen and carbon monoxide: a competitor with oxygen that can cause hardening of the arteries and coronary thrombosis (41). The main difference between passive and active smoking in terms of symptoms, is passive smoking often causes more eye irritation, headache and nausea than those who actively smoke (21). Smoking during pregnancy can be highly dangerous for the baby. Low birth weight is the main risk to the child, often causing infancy illness, disability and stillbirth. Statistics suggest if you smoke during pregnancy you are up to 8x more likely to cause cot death in your child (40). It can be hard for a person to quit as it easily addictive and often used as a coping mechanism when stressed, depressed or anxious, which makes the process of quitting even harder for the individual (27). In these items I was interested mainly in the respondents who do currently smoke. I wanted to find out about if they had tried quitting before, how it affects their life and if they were aware of the consequences of smoking. On retrospect I should have investigated non-smokers too, as their insight into health implications would have been interesting to see if there was correlation between knowledge and continuing to smoke.
(27) ‘AQA AS Health and Social Care’
(21) nhs.uk/livewell
(40) www.babycentre.co.uk
(41)www.epigee.com
Item 23: Do you smoke?
Figure 8
60% of respondents said that they smoke. This number is twice as much as I was expecting, as the average percentage of the population that smokes is 30% (22). This may be however due to the lack of elderly respondents I had, who are the least likely to smoke (13), in turn reducing the overall percentage. Or this result may be better explained by my small and unrepresentative sample size. Of those 60% who smoke, 50% of them were in the 16-25 age category. This is a common finding considering the majority of people first smoking in adolescence (6). Interestingly 80% of those who did smoked under exercised by at least 2 hours a week. This may be due to the effects of smoking on fitness, such as weaker muscles and less flexibility (7).
(6)
(7)
(12)
(13)
(22) news.bbc.co.uk
Item 27: How did the smoking ban affect your life?
100% of the respondents who smoked said that their life was affected by the smoking ban. 90% reported that they smoked more after drinking, which as respondent 4 said ‘I like to smoke and drink at the same time, so I now have to cut down on smoking if I wanted to stay in a pub or bar’. A couple of the respondents said they are going to try and quit due to the ban, which will have a positive affect on their health. I believed this item worked well as an open question I as received a lot of rich qualitative data.
Exercise –
Regular exercise is physically maintaining strength, stamina and suppleness. It is an evolutionary adaption to keep the body in working order through frequent and prolonged activity. Exercising is important to prevent diseases such as obesity, heart disease, diabetes, joint damage, hernias, strokes and circulatory problems, as well as boost the immune system and improve mental health (28). These items were intended to assess the respondents exercise patterns in terms of hours per week and intensity of activities. Exercise linked well with balanced diet and weight monitoring so I also tried to explore the relationship between them.
(28) www.nlm.nih.gov
Item 28: How many hours of exercise do you do a week?
Figure 9
The recommended amount of exercise per week is 3 1/2 hours. This is advised to be spread over the week, so 7 x 30 minutes (8). This can be from swimming to karate – as long as it keeps the body active. A common activity was running, this might be due to it being free and easy to do (23). Only 20% of the respondents managed to meet this target. However if I had worded the item differently in a measure of minutes, I may have gained a more accurate result, as some respondents who did meet the 3 1/2 targets may have rounded down to 3 hours. Of the 80% who failed to meet the target, only 1 of them managed to correctly identify the risks of under exercising in item 30. By being unaware of the health risks such as high blood pressure (9), they may fail to visit the GP regularly to check on blood pressure and other health problems caused by under exercising, which can be picked up and treated early. Exercise is also known to affect psychological well-being (26). This is part of the holistic concept of health, and if I had created another item as to the reasons behind the stated amount of exercise, I would have been able to see if having a holistic concept of health affected a person’s level of exercise.
(8) www.nhs.uk
(9)
(23) worldofhealthandleisure.co.uk
(26) www.mentalhelp.net

Attitudes towards health questionnaire evaluation

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