Nottingham Health Profile
The Nottingham Health Profile (NHP) was originally created as a standardised tool to survey health problems and measure medical or social interventions. It was created in the 1970s and developed from more than 2000 statements from more than 700 people about the effects of ill-health.
Specific patient groups or the general population.
Method of Use
The NHP is a patient-reported questionnaire. Respondents tick yes or no boxes to answer questions about their health and its effects on their daily life.
The questionnaire is divided into two parts. The first parts comprises 38 questions in six categories: sleep, physical mobility, energy, pain, emotional reactions, and social isolation. This first section is weighted to reflect how severe an impact the respondent thinks their health is having on the above areas of life. The second part of the NHP is made up of seven statements about areas of life that are commonly affected by health: paid employment, jobs around the house, social life, personal relationships, sex life, hobbies and interests, and holidays. Scores on the NHP can range from 0 i.e. no distress to 100 i.e severe distress.
The NHP is copyrighted so check if your institution has a licence. Copies may be found online, for instance, here.
Many studies have assessed the reliability of the NHP. The original study tested reliability in patients with osteoarthrosis and peripheral vascular disease and found the NHP to be reliable.
Many studies have assessed the validity of the NHP. In particular, the NHP has been found to be valid for the elderly, pregnant women, and those with minor surgery, fractured limbs, stroke, intermittent claudication or lower limb amputation. The NHP is comparable in validity to the SF-36.
The original authors caution that the NHP does not pick up "milder forms of distress" due to more severe nature of the questions in the first part of the NHP, As a result, it may be difficult to compare the general population and detect change.
The original authors note that the NHP assesses negative aspects of health rather than positive e.g. well-being which means the NHP can be at odds with more recent conceptions of quality of life which focus on well-being, rather than the absence of ill health.
The NHP has been compared to the SF-36 frequently in literature when assessing quality of life. Due to differences in ceiling effect and sensitivity, the SF-36 appears to be more robust a measure than the NHP.
- Hunt SM, McEwen J, Mckenna S. Measuring health status: a new tool for clinicians and epidemiologists. Br J Gen Pract. 1985. 35;273: 185–188. Accessed 30 March 2020.
- Sharples LD, Todd CJ, Caine N, Tait S. Measurement properties of the Nottingham Health Profile and Short Form 36 health status measures in a population sample of elderly people living at home: Results from ELPHS. Br J Health Psychol. 2000. 5; 3: 217-233.
- Hunt SM, McKenna SP, McEwen J, et al. Subjective health assessments and the perceived outcome of minor surgery. J Psychosom Re.s 1984; 28: 105-114.
- McKenna SP, McEwen J, Hunt SM, et al. Changes in the perceived health of patients recovering from fractures. Public Health. 1984; 98: 97-102.
- Ebrahim S, Barer Nouri F. Use of the Nottingham Health Profile with patients after a stroke. J Epidemiol Community Health. 1986. 40; 2: 166–169. Accessed 31 March 2020.
- Wann-Hansson C, Hallber IR, Risberg B, Klevsgård R. Health Qual Life Outcomes. A comparison of the Nottingham Health Profile and Short Form 36 Health Survey in patients with chronic lower limb ischaemia in a longitudinal perspective. Health Qual Life Outcomes. 2004; 2: 9. Accessed 31 March 2020.
- Demet, K., Guillemin, F., Martinet, N., & André, J.-M. Nottingham health profile: Reliability in a sample of 542 subjects with major amputation of one or several limbs. 2002. Prosthet Orthot Int. 26; 2: 120–123.
- Cabral DL, Laurentino GEC, Damascena CG, Faria CDCM, Melo PG, Teixeira-Salmela LF. Comparisons of the Nottingham Health Profile and the SF-36 health survey for the assessment of quality of life in individuals with chronic stroke. Braz J Phys Ther. 2012. 16; 4: 301-308. Accessed 31 March 2020.
- Rehabilitation Measures Database. Nottingham Health Profile. Available from https://www.sralab.org/rehabilitation-measures/nottingham-health-profile. Accessed 31 March 2020.