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Journal of Aging and Health
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Symptoms, Affects, and Self-Rated Health

Evidence for a Subjective Trajectory of Health

Laraine Winter, PhD

Thomas Jefferson University

M. Powell Lawton, PhD

Abramson Center for Jewish Life

Christopher A. Langston, PhD

Hartford Foundation

Katy Ruckdeschel, PhD

Philadelphia Veterans' Administration Medical Center

Robert Sando, MPA

Everest Field Technologies

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. Method: 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. Discussion: 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.

Key Words: self-rated health • affect • physical symptoms

Journal of Aging and Health, Vol. 19, No. 3, 453-469 (2007)
DOI: 10.1177/0898264307300167
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