The meaning of self-perception of health in the UK armed forces

We assessed the characteristics of self-perception of health (SPH) in relation to psychological distress and physical symptoms, and willingness of servicemen to see their Medical Officer (MO) by their SPH rating.

We randomly selected 4,500 servicemen to receive either a full or an abridged screening questionnaire.

The full questionnaire included 6 items from the short-form 36 and the question on SPH, the General Health Questionnaire-12, the post-traumatic stress disorder checklist and 15 symptoms. The abridged questionnaire included a subset of items from the full questionnaire. All 'screen-positive' and a random 'screen-negative' sample were invited to see an MO.

67.1% out of 4,500 servicemen completed the questionnaires. SPH was strongly associated with a summary short form-36 (SF-36) measure. There was a strong association between SPH and all assessment scales regardless of length of the questionnaires (p<.001). Even among those with very good or excellent SPH, high scores denoting psychological distress were prevalent (8.1%). Good SPH provided the largest variations in symptoms and scores. Servicemen with a poor/fair SPH were no more likely to accept a visit to the MO than the rest.

SPH is an excellent question for surveillance because it is highly associated with psychological health but, at an individual level, it may convey different meanings depending on the person's individual interpretation of the term health. Symptomatic social avoidance may be high among servicemen who have a poor/fair SPH and methods, such as buddy support, may be helpful in decreasing isolation among those who may need professional support.