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Nottingham Health Profile (NHP)
Nottingham Health Profile (NHP)
| Availability |
Please visit this website for more information about the instrument: Nottingham Health Profile
*The Nottingham Health Profile is owned by Galen Research Limited and to use this measure it must be cleared through them first. They can be reached here:* Contact | Galen Research (galen-research.com)
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| Classification |
Supplemental: Neuromuscular Diseases (NMD)
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| Short Description of Instrument |
Developed in the 1970s, the Nottingham Health Profile (NHP) is one of the most widely used generic quality of life measures. It is a pen-and-paper questionnaire that is completed by the patient. The NHP consists of 38 items (yes/no), covering the domains of emotional reactions (9 items), energy (3 items), pain (8 items), physical mobility (8 items), sleep (5 items), and social isolation (5 items). The NHP index of distress (NHPD), a sub-set of the NPH items, is a 24-item measure of illness-related distress, specifically omitting items related to physical disability.
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| Comments/Special Instructions |
The development of the NHP grew out of the need for a 'quality of life' measure which would describe the typical effects of ill health, physical, social and emotional. The NHP was developed for three reasons:
There are two parts to the NHP: Part 1 of the NHP consists of 38 statements in the areas of sleep, physical mobility, energy, pain, emotional reactions and social isolation. Part 2 consists of 7 items related to areas of daily life most affected by health, paid employment, jobs around the house, social life, personal relationships, sex life, hobbies and interests and holidays (Hunt et al., 1985)
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| Scoring and Psychometric Properties |
Scoring:
The response for each item of the NHP is 'Yes' or 'No' Because a simple yes or no answer can give misleading results, each 'yes' answer is multiplied by an item weight factor. (Hunt & McEwen, 1980; Post et al., 2001). Within each dimension the weighted scores range from 0 (indicating good health or no quality of life problems) to 100 (indicating poor health or very poor quality of life problems). The NHPD produces a score that ranges from 0-24.
Psychometric Properties:
Validation studies of the NHP discussed in Hunt et al., 1980a. In this study the results showed that "the profile was capable of discriminating between the groups differing in terms of diagnosed chronic illness, number of consultations at primary care level and physiological fitness." (Hunt et al., 1980a) There were statistically significant differences between the groups on all six dimensions (p<0.001 for all dimensions except for Emotional reactions, p<0.005). (Hunt et al., 1980b)
The NHP has been tested for face, content and criterion validity. (Backett et al., 1981).
Test-retest reliability (reproducibility) (Hunt et al., 1980b; Hunt et al., 1985; Hunt et al., 1986)
Spearman rank correlation coefficient:
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| Rationale/Justification |
Strengths: The NHP has the major advantages of efficiency, it covers six domains of perceived health and distress using only 38 questions, it has proven reliability and validity, and it covers domains like sleep and energy that are rarely covered by other generic health status questionnaires. (Post et al., 2001)
Weaknesses: The NHP measures health by its absence by focusing on negative aspects of health--all the statements on the NHP describe problems. The items in NHP Part I represent severe situations. It was found necessary to have such items in preference to less severe statements in order to avoid picking up large quantities of false positives. Scoring on Part I involves six scores which can make analysis of other variables cumbersome if other measures besides the NHP are being used in a study. (McEwen, 1996)
Like other generic questionnaires, the NHP contains several questions about mobility impairments that are not suited for populations that require the use of mobility devices, (i.e., wheelchairs). (Post et al., 2001)
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| References |
Key References:
Hunt SM, McEwen J. The development of a subjective health indicator. Sociol Health Illness 1980; 2: 231-46.
Hunt SM, McKenna SP, McEwen J, Backett EM, Williams J, Papp E. A quantitative approach to perceived health status: a validation study. J Epidemiol Community Health. 1980a Dec;34(4):281-6.
Hunt S, McEwen, McKenna SP. 1980b. Nottingham Health Profile. Galen Research Ltd., 2007. Available from: https://eprovide.mapi-trust.org/instruments/nottingham-health-profile. Accessed: 10 August 2023.
Hunt SM, McKenna SP, McEwen J, Williams J, Papp E. The Nottingham Health Profile: subjective health status and medical consultations. Soc Sci Med A. 1981 May;15(3 Pt 1):221-9.
Hunt SM, McEwen J, McKenna SP. Measuring health status: a new tool for clinicians and epidemiologists. J R Coll Gen Pract. 1985 Apr;35(273):185-8.
Additional References:
Backett EM, McEwen J, Hunt SM. Health and quality of life. Report of the Social Science Research Council. London: SSRC, 1981.
Erola T, Karinen P, Heikkinen E, Tuominen J, Haapaniemi T, Koivukangas J, Myllylä V. Bilateral subthalamic nucleus stimulation improves health-related quality of life in Parkinsonian patients. Parkinsonism Relat Disord. 2005 Mar;11(2):89-94.
Hunt SM. Nottingham Health Profile. In: Assessment of quality of life in clinical trials of cardiovascular therapies. NK Wenger et al. (Eds). New York, Le Jacq Publishing: 165-169, 349-352, 1984.
Hunt SM, McEwen J, McKenna SP. Measuring Health Status. London: Croom Helm. 1986.
Karlsen KH, Larsen JP, Tandberg E, Maeland JG. Influence of clinical and demographic variables on quality of life in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry. 1999 Apr;66(4):431-5.
Karlsen KH, Tandberg E, Arsland D, Larsen JP. Health related quality of life in Parkinson's disease: a prospective longitudinal study. J Neurol Neurosurg Psychiatry. 2000 Nov;69(5):584-9.
McEwen J, McKenna SP. Nottingham Health Profile. In: Spilker B ed. Quality of life and pharmacoeconomics in clinical trials, second edition. Philadelphia: Lippincott-Raven, 1996.
McEwen, J. (1993). The Nottingham Health Profile. In: Walker, S.R., Rosser, R.M. (eds) Quality of Life Assessment: Key Issues in the 1990s. Springer, Dordrecht.
Post MW, Gerritsen J, van Leusen ND, Paping MA, Prevo AJ. Adapting the Nottingham Health Profile for use in people with severe physical disabilities. Clin Rehabil. 2001 Feb;15(1):103-10.
Wilkin D, Hallam L, Dogget MA. Measures of need and outcome for primary health care. Oxford: Oxford University Press, 1992.
Document last updated October 2024
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