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Biomedical subjects

J Siegrist

Publications and source records attributed to J Siegrist.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Cigarette smoking and psychosocial work stress in middle-management employees].

The association between psychosocial work stress and cigarette smoking is analyzed in a socioeconomically and professionally homogeneous group of 163 middle managers (40-55 years; 48.4 +/- 4.5) in a large industrial company. Psychosocial stress is defined in terms of an imbalance between effort spent and reward obtained at work. The relative risk of regular smoking is 4.34 (odds ratio after controlling for age; 95% CI 1.50-12.54) in those middle managers who suffer from a marked imbalance between effort and reward, compared to those who are free from this type of psychosocial stress at work. This effect persists in the older age group although the proportion of smokers decreases with age. Within the group of regular smokers, every second middle manager suffering from a marked imbalance between effort and reward is a heavy smoker (greater than or equal to 20 cigarettes/day) whereas in the group experiencing less stress at work, only 28% heavy smokers are found. However, due to small numbers this difference is not statistically significant. In conclusion, the data reported in this study demonstrate an association between psychosocial stress at work in terms of high effort and low reward and the risk of regular smoking. This association is not confounded by age, socio-economic status or type of occupation.

Administrative Personnel↗
PubMed1991

Psychosocial and biobehavioral characteristics of hypertensive men with elevated atherogenic lipids.

Epidemiologic studies demonstrated an excess risk of ischemic heart disease (IHD) among individuals who simultaneously exhibit hypertension and elevated atherogenic lipids (coronary high risk (CHR)-status). Yet, relatively little is known about factors which contribute to the development of CHR-status during early and middle adulthood. The present study explores the role of selected biobehavioral and psychosocial factors in explaining CHR-status using data from a prospective 6.5 years investigation of a cohort of 416 middle-aged (40.8 +/- 9.6 years) male blue-collar workers. Multivariate logistic regression analysis shows that overweight (odds ratio (o.r.) 4.14), smoking (o.r. 2.19), low promotion prospects at work (o.r. 2.71), competitiveness at work (o.r. 2.79) and feelings of sustained anger (o.r. 5.41) independently contribute to the explanation of CHR-status. Furthermore, the operational definition of CHR-status is validated by estimating its power in predicting IHD incidence in the study cohort. In conclusion, co-manifestation of hypertension and elevated lipids is more likely to exist among those blue-collar men who exhibit distinct work-related characteristics in addition to established biobehavioral risks such as overweight and smoking. In view of the high prevalence of CHR-status and of IHD among men in the lower socio-economic strata this finding is also of interest for health policy.

Adult↗
PubMed1990

Low status control, high effort at work and ischemic heart disease: prospective evidence from blue-collar men.

An inverse relation between socio-economic class and occurrence of ischemic heart disease (IHD) in advanced societies is an often replicated finding from empirical studies. Yet, the processes which produce these effects remain an open question. One promising explanation concerns the prevalence of stressful working life, especially of distinct 'job strain' occupations. Based on these considerations, we develop a refined concept of work-related socio-emotional distress which considers a mismatch between high workload and low control over occupational status (e.g. job insecurity, poor promotion prospects, status inconsistency) as crucial distress-provoking conditions. Moreover, we assume that the effect of this condition on IHD risk is substantially increased by the presence of a distinct individual pattern of coping with work demand ('need for control'). Based on data from a 6.5 years prospective study on IHD incidence (n = 21) in a cohort of 416 middle-aged blue-collar men this concept is tested using logistic regression analysis. Results indicate that status inconsistency [multivariate odds ratio (o.r.): 4.4], job insecurity (o.r. 3.4), work pressure (o.r. 3,4) and 'need for control' (o.r. 4,5) independently predict IHD occurrence after adjusting for major confounding somatic and behavioral coronary risk factors. In conclusion, a refined model of work-related socio-emotional distress substantially contributes to the explanation of high IHD incidence among blue-collar men.

Adaptation, Psychological↗
PubMed1990

Socioeconomic differences in cardiovascular risk factors in China.

Socioeconomic conditions are important in explaining variation in cardiovascular morbidity in advanced societies. To analyse whether cardiovascular risk factors vary according to socioeconomic status in a developing country, and more specifically, in an urban area of China, we compared data from structured interviews and cardiovascular screenings in a group of 1169 male workers (45-65 years). These men participated in the five-year follow-up of a prospective investigation started in 1982/83 in several plants in Wuhan. Unhealthy behaviours such as heavy cigarette smoking and alcohol consumption were significantly more prevalent among men with low educational attainment and with jobs characterized by heavy physical workload, noise and heat. Men paid according to a new, highly demanding salary system exhibited significant increases in total cholesterol and systolic blood pressure from first to second screening. In conclusion, our findings show significant socioeconomic variation in cardiovascular risk factors among middle-aged male workers in China.

Aged↗
PubMed1990

Measuring the social dimension of subjective health in chronic illness.

This contribution discusses the social dimension of treatment-related subjective health in chronically ill patients. In its first part, it introduces two basic concepts, 'social performance' and 'social well-being'. These terms are further specified and discussed in the broader context of the notions of 'social support' and 'social adjustment'. The second part gives a selective, critical overview of currently used methods in the field. It is concluded that the existing gap between theory and measurement needs to be closed before substantial advancements in a comprehensive assessment of subjective health can be expected.

Activities of Daily Living↗
PubMed1989

Conceptual and methodological problems in research on the quality of life in clinical medicine.

This introductory paper discusses three issues: theory, validity of measurement and benefits of assessment. It is argued that the conceptual entity 'quality of life' remains ill-defined, although researchers commonly agree on its multi-dimensional nature. The selectivity of dimensions under study is illustrated by referring to recent work on the quality of life in cancer and in cardiovascular disease. Despite conceptual weaknesses, promising developments are apparent in research methodology. The issue is discussed with special reference to the convergent and discriminant validity of some widely used research methods. Improvements in therapy and patient-physician relationships are considered among the major benefits of assessing the quality of life in clinical practice. In conclusion, this field of research, if based on appropriate theory, opens important opportunities for cross-fertilization between advanced medicine and the social sciences.

Behavioral Research↗
PubMed1988

Atherogenic risk in men suffering from occupational stress.

Blue-collar workers suffering from chronic occupational stress exhibit significantly higher values of an atherogenic index (ratio between low density and high density lipoprotein cholesterol assessed by quantitative lipoprotein electrophoresis) as compared to men exposed to less stress at work. Chronic occupational stress is defined by interactions of objective (job instability, shift work) and subjective (perceived job insecurity, perceived increase of work load) indicators as assessed by structured interviews. Findings from a prospective epidemiologic study on 416 middle-aged men at entry covering a 2-year period of observation hold true after controlling for several confounding factors such as body weight, age, cigarette smoking and chronic alcohol consumption. Results are in line with experimental animal studies on the influence of chronic social stress on the development of atherosclerosis.

Adolescent↗
PubMed1988

Models of health behaviour.

This short overview focusing on health behaviour as related to coronary risk calls for a distinction between models which aim at explaining initiation of health-damaging behaviour during adolescence and models explaining maintenance of risk behaviour in adult life. With respect to the former, close links between the development of a stable self-concept and risk behaviour are stressed. With respect to the latter, four theoretical models are summarized: the model of risk-taking behaviour; the health belief model; the model of cultural lag and the model of social comparison. The practical implications of these models are discussed briefly.

Adolescent↗
PubMed1987

Impaired quality of life as a risk factor in cardiovascular disease.

Traditionally, quality of life has been considered a major outcome variable in the study of patients with chronic disease or handicap. In this paper, impaired quality of life is analyzed as a risk, that is, a condition influencing early manifestation of cardiovascular disease. Specific social contexts as well as a psychological coping style (need for control) that generates sustained emotional distress are defined, and data from two socio-epidemiological studies are presented. The first is a retrospective case-control study of 380 men with a first myocardial infarction. The second is a prospective study of 416 middle-aged blue-collar workers followed over 3 years. Findings show that indicators of impaired quality of life are related to high levels of cardiovascular risk factors and high prevalence of overt cardiovascular disease. Practical implications point to the importance of a socio-behavioral approach in cardiovascular prevention.

Adult↗
PubMed1987

[Quality of life in antihypertensive therapy].

It is well known that distinct antihypertensive drugs have a different impact on compliance and on quality of life of patients. Therefore, we must ask under what conditions a refusal of antihypertensive medication can be justified and what its consequences are with regard to cardiovascular morbidity and mortality. An aspect of this latter question is answered by a prospective study on cardiovascular risks in a cohort of 416 middle-aged male blue-collar workers followed over three years: In the subgroup of 94 workers with mild or manifest hypertension few aspects of quality of life only were improved in the untreated (54%) as compared to the treated (46%) hypertensives. On the other hand, longterm cardiovascular risk was considerable: every third worker with untreated mild hypertension (140 to 160/90 to 100 mmHg; n = 30) exhibited signs of early left ventricular hypertrophy, as assessed by one- and two-dimensional echocardiography. The most impressive difference was found with regard to the diameter of left atrium (T = 3.02; p less than .01). The second part of the paper presents first results of a test-statistical evaluation: a German version of a well known measurement approach to quality of life in the United States is applied in 50 hypertensives and 56 normotensives. Internal consistency, stability and discriminant power of the questionnaire were very satisfying. Hypertensives compared to normotensives and treated hypertensives compared to untreated hypertensives showed significant differences on several subscales (esp. "general wellbeing", "vitality"). Results indicate that this measurement approach can be reliably used in further studies.

Adrenergic beta-Antagonists↗
PubMed1987

Untreated hypertensives and their quality of life.

Two groups of untreated and treated subjects with persistent manifest or borderline hypertension were identified within a prospective study on cardiovascular risk in 416 middle-aged male blue-collar workers. They were compared with respect to four dimensions of quality of life: physical symptoms, mental alertness, emotional well-being and work performance. Only one symptom (nocturnal sleep disturbances) was significantly less frequent in the untreated group. Whereas short-term benefit from drug refusal seems limited, long-term costs in terms of subclinical end-organ damage are considerable. Echocardiographic findings demonstrated early stages of left ventricular hypertrophy (LVH) in one-third of the subjects with persistent borderline hypertension. Considering the role of LVH in cardiovascular mortality, results suggest that we should reinforce diagnostic and therapeutic activities in subjects with persistent borderline hypertension.

Adult↗
PubMed1986

Sociological concepts in the etiology of chronic disease: the case of ischemic heart disease.

This paper first gives a selective and critical review of conventional sociological variables included into epidemiologic and clinical studies of ischemic heart disease (IHD). In a second section, links between social and biological processes are discussed, and a conceptual sociological approach is developed which relates critical experiences of active distress to impaired long-term control of social status. This approach is elaborated to some extent in order to illustrate possible avenues of future research which strengthen cross-fertilization between medical and social sciences.

Adaptation, Psychological↗