A three-item measure can be used to optimize treatment planning; another measure
identifies needs for support beyond healthcare and can inform referrals
Two measures of patient well-being, designed for use in busy clinical settings, are described in a Perspective piece in a supplement to Medical Care, the official journal of the Medical Care Section of the American Public Health Association. The journal is published in the Lippincott portfolio by Wolters Kluwer.
The Medical Care piece describes perspectives and research surrounding well-being and whole person outcomes and measurement, which was the focus of a recent VA State of the Art (SOTA) conference on this topic. The conference was part of the ongoing effort in VA to move towards a “Whole Health” approach which focuses on what matters most to the veteran.
"In recent years there has been a growing call for healthcare providers to expand their primary focus beyond treating disease to addressing the needs of the 'whole person'," the developers of the tools note. "Yet healthcare providers have received little guidance regarding which well-being measures are best suited to the clinical context or how these measures may be best applied to enhance clinical practice."
In response to this problem, Dawne S. Vogt, PhD, a research scientist at the National Center for PTSD within the VA Boston Healthcare System and a professor of psychiatry at Boston University Chobanian & Avedisian School of Medicine, and colleagues in the Veterans Health Administration created two assessment tools: Well-Being Signs (WBS) and Well-Being Brief (WBB).
Well-Being Signs can guide treatment planning
The WBS can be self-administered or administered by a clinician in less than one minute. On scales of 0 to 10, the patient indicates how often they have participated in the roles and activities that are most important to them, functioned their best in those endeavors, and were fully satisfied with how things are going in those aspects of their lives.
Information from the WBS can prompt discussion between a patient and a healthcare professional about how treatment plans may be designed and/or modified to best optimize the patient’s well-being and whether additional support may be needed to address areas of lower well-being. Psychometric testing is complete and the WBS is now available to the field.
The Well-Being Brief is more in-depth but still efficient
The WBB is a self-administered measure that can be completed in about six minutes and is used to evaluate four areas in which the patient may benefit from support that extends beyond medical care:
- Vocation—How well an individual is doing in their vocational pursuits, including their involvement, functioning, and satisfaction with regard to paid work, education and training experiences, and caregiving activities.
- Financial—How well an individual is doing with regard to their financial circumstances, including their ability to meet basic needs for food and shelter, transportation, and legal needs and their ability to prepare for their financial future.
- Health—The extent to which individuals are experiencing good health states, are engaging in health-promoting behaviors, and perceive that their health and health care access allows them to live their lives as they wish.
- Social—The extent to which individuals have social ties, function well in their social interactions, and are satisfied with their relationships with intimate partners, friends, and family and their broader community.
The WBB was designed to inform referrals to professionals and programs that support well-being. For example, it can identify patients who would benefit from career counseling, financial-management support, or counseling to improve their social relationships.
Dr. Vogt and her colleagues say that although they have only just begun to explore how well-being measurements can be used in clinical care, "we are optimistic that attending to the well-being of the 'whole person' can better meet patients’ needs and improve healthcare outcomes."
