The Medical Outcomes Study Framework of Health Indicators

Published in: Measuring Functioning and Well-Being: The Medical Outcomes Study Approach / edited by Anita L. Stewart and John E. Ware, Jr., (Durham, N.C.: Duke University Press, 1992), Ch. 2, p. 12-24

by Anita Stewart

The World Health Organization (WHO) definition of health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity" calls attention to the multidimensionality of health: physical, mental, and social: as well as multiple types of indicators of these dimensions, such as functioning, symptoms, emotional status, and various diagnoses. The MOS assumed two dimensions of health: physical and mental: and incorporated social functioning primarily as an indicator of those dimensions. This chapter sets forth the taxonomy of the framework for MOS, beginning by defining positive health. The MOS framework consists of five categories of physical and mental health: (1) clinical status, (2) physical functioning and well-being, (3) mental functioning and well-being, (4) social/role functioning and well-being, and (5) general health perception. The MOS framework reflects the decision to consider problems in social and role functioning as indicators of such mental health problems as feeling depressed, as well as physical health problems. In this chapter, the elements included in each of the five categories are described and defined, concluding with a table that lists 12 major MOS concepts of functioning and well-being, the chapter in which each is discussed, the definition, and the measures, or operational strategies, of each concept: physical functioning, mobility, role functioning, social functioning, psychological distress/well-being, cognitive functioning, health perceptions, health distress, energy/fatigue, sleep, pain, and physical/psychophysiologic symptoms.

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