Differences in self-rated health at each point on a 4-point Likert scale among older patients

This study aimed to examine whether there are differences in SRH for each of the four points among older patients using VAS.

The participants were 115 patients aged ≥ 65 years who attended our hospital and did not interfere with this study.

SRH was assessed using a 4-point scale in the first question of a 10-item questionnaire and the VAS in the 10th question. To avoid two consecutive questions, questions 2–9 were excluded; however, questions on fatigue, exercise routine, regional activities, history of falls, and pain were included. SRH was assessed by asking about their feeling on their health.” A 4-point scale was used to obtain answers from “unhealthy, not very healthy, healthy, and very healthy.” For the VAS, a blank paper sheet was filled in with a 100-mm-long horizontal line with the left and right ends as “unhealthy” and “very healthy,” respectively.

Statistical analysis was conducted using Spearman’s rank correlation coefficient to examine the relationship between the 4-point scale and VAS scores regarding SRH. The Steel–Dwass multiple comparison method was used to examine whether there was a difference in the VAS results among the four points using a 4-points scale. The significance level for all tests was set at 1%.

The median and interquartile range of the median VAS of 115 participants (mean age 80.7±5.7, 80.8% female) in each point of a 4-point scale were 19 (16.5–20.5) mm; unhealthy; three participants, 49 (35–55) mm; not very healthy; 19 participants, 63 (48.8–72) mm; healthy; 88 participants, 86 (84–100) mm; very healthy; five participants.

The correlation between the 4-point scale and VAS was moderate (ρ=0.48). If the VAS was compared among the four groups, significant differences were found in the “not very healthy - healthy” and “not very healthy - very healthy” groups (p0.01). No other significant differences were observed.

Significant differences were found between “not very healthy” and “healthy”, “very healthy” in the SRH using a 4-point scale.

Conversely, there was no significant difference between “unhealthy” and other points, suggesting that this is different from the conventional SRH grouping method.

This study contributes to the SRH grouping method using a 4-point scale.