Because gerontological studies often need to rely on the use of proxy respondents, the comparability of proxy and self-respondents is of particular interest. However, it is often impossible to evaluate response agreement between proxy and self-respondents because the necessary data are not available. This study addresses the problem by using a model of health status to evaluate differences between proxy and self-respondents regarding the conceptalization of health status. The model included three dimensions of physical health: chronic illness, functional limitations, and subjective health. Three groups of respondents who differ regarding proxy status and/or physical health status were compared. A subset of matched self-respondents (n = 146) was selected to be comparable in objective health status to respondents who have proxies (n = 140). The third group consisted of physically healthier self-respondents (n = 1,425). Data came from the Study of Well-Being of Older People in Cleveland, OH. No support was found for the expectation that proxies and self-respondents would weight objective health information differently when providing summary statements of subjective health. The results suggest that proxies rely on a conceptualization similar to self-respondents when providing information about another person's health
Get full access to this article
View all access options for this article.
References
1.
Bender, P. M. , & Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88, 588-606.
2.
Berk, M. L. , Horgan, C. M., & Meyers, S. M. (1986). The reporting of stigmatizing health conditions: A comparison of proxy and self-reporting. Journal of Economic and Social Measurement, 14, 197-205.
3.
Blalock, H. M., Jr. (1967). Causal inferences, closed populations, and measures of association. American Political Science Review, 61, 130-136.
4.
Bumarn, A. , Leaf, P. J., Skinner, E. A., Cotler, L., Melville, M. L., & Thompson, J. W. (1985). Proxy interview. In W. W. Eaton & L. G. Kessler (Eds.), Epidemiologic field methods in psychiatry: The NIMH Epidemiologic Catchment Area Program (pp. 117-139). New York: Academic Press.
5.
Clipp, E. C. , & Elder, G. H. (1987). Elderly confidants in geriatric assessmentComprehensive Gerontology B, 1, 35-40.
6.
Donabedian, A. (1973). Aspects of medical care administration. Cambridge, MA: Harvard University Press.
7.
Epstein, A. M. , Hall, J. A., Tognetti, J., Son, L. H., & Conant L. (1989). Using proxies to evaluate quality of life. Medical Care, 27(Suppl. 3), S91-S98.
8.
Fillenbaum, G. G. (1988). Multidimensional functional assessment of older adults. Hillsdale, NJ: Lawrence Erlbaum.
9.
George, L. K. , & Fillenbaum, G. G. (1985). A decade of experience in geriatric assessment. Journal of the American Geriatric Society, 33, 607-615.
10.
Heider, F. (1958). The psychology of interpersonal relations. New York: Wiley.
11.
Johnson, R. J. , & Wolinsky, F. D. (1993). The structure of health status among older adults: Disease, disability, functional limitation, and perceived health. Journal of Health and Social Behavior, 34, 105-121.
12.
Jones, E. E. , & Nisbett, R. E. (1971). The actor and the observer: Divergent perceptions of the causes of behavior. Morristown, NJ: General Learning-Press.
13.
Jöreskog, K. G. , & Sörbom, D.. (1989). LISREL 7 user's reference guide. Mooreville, IN: Scientific Software.
14.
Jylha, M. , Leskinen, E., Alanen, E., Leskinen, A. L., & Heikkinen, E. (1986). Self-rated health and associated factors among men of different ages. Journal of Gerontology, 41, 710-717.
15.
Kelley, H. H. (1967). Attribution theory in social psychology. In D. Levine (Ed.), Nebraska symposium on motivation. Lincoln: University of Nebraska Press.
16.
Kolonel, L. N. , Hirohata, T., & Nomura, A.M.Y. (1977). Adequacy of survey data collected from substitute respondents. American Journal of Epidemiology, 106(6), 476-484.
17.
Lawton, M. P. , & Lawrence, R. H. (1994). Assessing health. In M. P. Lawton & J. A. Teresi (Eds.), Annual review of gerontology and geriatrics: Vol. 14. Focus on assessment techniques (pp. 23-56). New York: Springer.
18.
Liang, J. (1986). Self-reported physical health among aged adults. Journal of Gerontology, 41, 248-260.
19.
Lohr, M. J. , Essex, M. J., & Klein, M. H. (1988). The relationships of coping responses to physical health status and life satisfaction among older women. Journal of Gerontology: Psychological Sciences, 43, P54-P60.
20.
Maclean, M. , & Genn, H. (1979). Methodological issues in social surveys. Atlantic Highlands, NJ: Humanities Press.
21.
Magaziner, J. (1992). The use of proxy respondents in health studies of the aged. In R. B. Wallace & R. F. Woolson (Eds.), The epidemiologic study the elderly. New York: Oxford University Press.
22.
Magaziner, J. , Hebel, J. R., & Warren, J. W. (1987). The use of proxy responses for aged patients in long-term care settings. Comprehensive Gerontology B, 1, 118-121.
23.
Magaziner, J. , Simonsick, E. M., Kashner, T. M., & Hebel, J. R. (1988). Patient-proxy response comparability on measures of patient health and functional status. Journal of Clinical Epidemiology, 41(11), 1065-1074.
24.
Markides, K. S. , & Martin, H. (1979). Predicting self-rated health among the aged. Research on Aging, 1, 97-112.
25.
McCusker, J. , & Stoddard, A. M. (1984). Use of a surrogate for the Sickness Impact Profile. Medical Care, 22, 789.
26.
Moore, J. C. (1988). Self/proxy response status and survey response quality. Journal of Official Statistics, 4(2), 155-172.
27.
Mosely, R. R., II , & Wolinsky, F. D. (1986). The use of proxies in health surveys: Substantive and policy implications. Medical Care, 24, 496-510.
28.
Rice, D. , & Estes, C. (1984). Health of the elderly: Policy issues and challenges. Health Affairs, 3, 2549.
29.
Rodgers, W. L. , & Herzog, A. R. (1992). Collecting data about the oldest old: Problems and procedures. In R. M. Suzman, D. P. Willis, & K. G. Manton (Eds.), The oldest old (pp. 135-156). New York: Oxford University Press.
30.
Rothman, M. L. , Hedrick, S. C., Bulcroft, K. A., Hickam, D. H., & Rubenstein, L. Z. (1991). The validity of proxy-generated scores as measures of patient health status. Medical Care, 29(2), 115-124.
31.
Rubenstein, L. Z. , Schairer, C., Wieland, O. D., & Kane, R. (1984). Systematic biases in functional status assessment of elderly adults: Effects of different data scores. Journal of Gerontology, 39(6), 686-691.
32.
Schneider, D. J. (1991). Social cognition. Annual Review of Psychology, 42, 527-561.
33.
Shanas, E. , Townsend, P., Weddedburn, D., Friis, H., Milhoj, P., & Stehouer, J. (1968). Old people in three industrialized societies. London: Atherton.
34.
Spector, W. D. , Katz, S., Murphy, J. B., & Fulton, J. P. (1987). The hierarchical relationship between activities of daily living and instrumental activities of daily living. Journal of Chronic Diseases, 40(6), 481-489.
35.
Stoller, E. P. (1984). Self-assessments of health by the elderly: The impact of informal assistance. Journal of Health and Social Behavior, 25, 260-270.
36.
Tissue, T. (1972). Another look at self-rated health among the elderly. Journal o Gerontology, 27, 91-94.
37.
Walker, A. M. , Velema, J. P., & Robins, J. M. (1988). Analysis of case-control data derived in part from proxy respondents. American Journal of Epidemiology, 127(5), 905-914.
38.
Wenger, N. K. , Matson, M. E., Furberg, C. D., & Elison, J. (1984). Assessment of quality of life in clinical trials of cardiovascular therapy. New York: LeJacq.
39.
Whitelaw, N. , & Liang, J. (1991). The structure of the OARS physical health measures. Medical Care, 29, 332-347.
40.
Wolinsky, F. D. , & Johnson, R. J. (1991). The use of health services by older adults. Journal of Gerontology: Social Sciences, 46(6), S345-S357.
