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Socioeconomic predictors of smoking and smoking frequency in urban China: evidence of smoking as a social function.

A number of previous studies have documented the worsening smoking problems in China. This paper identifies several key socioeconomic variables associated with smoking among urban working adults and calls researchers' attention to the important function of cigarette smoking as a social connection builder in China. This study argues that a smoking prevention and education program should place more emphasis on making smoking socially unnecessary and/or unacceptable because of the continuing increase in the number of smokers and the low desire to quit among smokers. The findings also suggest that while socioeconomic characteristics are excellent in predicting whether a person smokes or not, they are dismal in predicting smoking frequency among working adults.

Adult↗

Census tract predictors of physical, psychological, and social functioning for needs assessment.

The advantages of census data-based needs assessment cannot be fully realized in the absence of demonstrated relationships between area characteristics and aggregate individual service need. This study sought to ascertain these relationships by using tract characteristics from the 1980 census to predict tract aggregate levels of individually measured social, physical, and psychological functioning. A census tract stratified sample of 3,465 permanent households in eastern Long Island, New York was used for the study. In each household, a randomly selected adult was surveyed regarding physical functioning, depressed mood, and social isolation. Stepwise multiple regression was used to determine which census variables best predicted the tract distributions of each of the functioning measures. Census variables explained from 23 to 30 percent of the variance in tract need level. Study findings have immediate utility for efficient needs assessment and suggest avenues for future improvement of needs assessment methods.

Adolescent↗

Specialised care for early psychosis: symptoms, social functioning and patient satisfaction: randomised controlled trial.

BACKGROUND: The provision of early intervention services for people with psychosis is UK government policy, although evidence for benefit of such services is sparse. AIMS: To evaluate the effects of a service providing specialised care for early psychosis (the Lambeth Early Onset Team) on clinical and social outcomes, and on service user satisfaction. METHOD: One hundred and forty-four people with psychosis, presenting to mental health services for the first or second time (if previously failed to engage in treatment), were randomly allocated to care by the early onset team or to standard care. Information was obtained on symptoms, treatment adherence, social and vocational functioning, satisfaction and quality of life. Relapse and rehospitalisation data have been reported separately. RESULTS: Outcomes for the participants treated by the early onset team were significantly better at 18 months for aspects of social and vocational functioning, satisfaction, quality of life and medication adherence. Symptom improvement did not significantly differ between the groups. CONCLUSIONS: The provision of specialised care for early psychosis can achieve better outcomes. The study therefore provides support for current policy.

Adolescent↗

The health impact of living with a cognitively impaired elderly spouse: depressive symptoms and social functioning.

The purpose of this study was to identify the social and psychological consequences of living with a cognitively impaired spouse among community-dwelling elderly individuals. The study sample consisted of 318 spouse pairs drawn from a representative sample of noninstitutionalized elderly individuals. Our principal findings were that: (a) Cognitive impairment in wives is significantly (p less than .05) associated with depressive symptomatology in husbands, whereas cognitive impairment in husbands is only weakly (p greater than .20) associated with depressive symptomatology in wives; (b) Decreased participation in social/leisure activities is selectively related to spouses' level of cognitive functioning among both men and women; (c) The relationship between wives' cognitive impairment and husbands' depressive symptoms is influenced by perceived availability of financial support from friends and relatives, but not by ADL limitations in wives, lack of emotional or instrumental support from wives, household responsibilities among husbands, or lack of participation in social/leisure activities in husbands.

Activities of Daily Living↗

Self and social functions: individual autobiographical memory and collective narrative.

The personal functions of autobiographical memory build on the basic biological functions of memory common to most mammals that, however, do not have the kind of episodic memories that compose human autobiographical memory according to present theory. The thesis here is that personal autobiographical memory is functionally and structurally related to the use of cultural myths and social narratives, and that the relative emphasis put on the self in different cultural and social contexts influences the form and function of autobiographical memory and the need for developing a uniquely personal life narrative in those contexts. Historical and cross-cultural trends revealed in psychological and literary research are invoked to support this thesis.

Biological Evolution↗

Social functioning and self-care in hospitalized psychogeriatric patients.

Evaluations of social disability have been found useful in determining factors of diagnostic, therapeutic and prognostic significance in the management of psychogeriatric patients. A random sample of 100 psychogeriatric patients aged 65 or over admitted to three Toronto hospitals were studied prospectively. Standardized clinical and social interview schedules were used to assess patients' mental state, self-care capacity, social isolation, burden on the family and household contribution before admission. These assessments were carried out to determine their significance with respect to diagnosis and outcome. Self-care capacity, as measured by the Activities of Daily Living Performance Test or by informant report, was related to diagnosis and outcome measures in this sample. Social isolation was significantly correlated with length of hospital stay. Burden on the family was not found to be significantly associated with diagnosis or outcome although there was a tendency for patients with organic disorders to present more difficulties for their families. The severe burden imposed on relatives suggests the need for utilization of community social and medical services to provide relief for families of psychogeriatric patients. The implications for management are considered in the light of the above findings.

Activities of Daily Living↗

Problems in measuring role strains and social functioning in relation to psychological symptoms.

The problems that people experience in social roles can be regarded as either causes or consequences of psychological symptoms. To reflect one of these possibilities, Pearlin et al. (1981) developed measures of "role strains" which are considered sources of psychopathology. To reflect the other position, Dohrenwend et al. (1981) constructed measures of "role functioning" which are seen as consequences of psychopathology. We show that the measures developed by these two teams of investigators are similar in content and show substantial empirical overlap despite the different meanings attributed to them. In an effort to understand whether these highly correlated measures assess, "role strain" or "role functioning," we conduct an exploratory analysis of marital and housework role problems, using a small panel sample of New York City residents. Specifically, we use instrumental variables to identify reciprocal effects between psychological distress and each role area. We find that the relationship between housework role problems and distress is more consistent with Pearlin et al.'s interpretation, whereas the relationship between marital problems and distress is more consistent with that of Dohrenwend et al. Investigators interested in measuring either role strain or role functioning must bear in mind the strong possibility of contamination from the other construct.

Educational Status↗

Change and predictors of change in communication, cognition, and social function between 1 and 5 years after traumatic brain injury.

OBJECTIVE: To study cognitive, communication, and social changes experienced by individuals between 1 and 5 years after traumatic brain injury (TBI). DESIGN: Prospective cohort. SETTING AND PARTICIPANTS: TBI Model System Database with 927 eligible subjects using a cohort with complete 1- and 5-year data (N = 292). MAIN OUTCOME MEASURES: Change in Functional Independence Measure trade mark -Cognitive (FIM-Cog) items from Year 1 to Year 5 postinjury. RESULTS: On the FIM-Cog Total score, 26% individuals improved, 61% stayed the same, and 14% worsened by more than 1 point from Year 1 to Year 5. On the 2 FIM Communication items, 19% individuals improved, 68% stayed the same, and 13% worsened by greater than 1 point. On the FIM Social Interaction item, 12% individuals improved, 76% stayed the same, and 11% worsened. On the FIM Memory and Problem Solving items, 34% individuals improved, 48% stayed the same, and 19% worsened. Several variables predicted this improvement and worsening, some of which were available at the time of injury and most were those available at 1 year postinjury. The Memory and Problem Solving items, taken together, showed fewer participants at ceiling at Year 1 and more change between Year 1 and Year 5 compared to the Communication and Social Interaction items. CONCLUSIONS: Many individuals did not demonstrate meaningful change on FIM-Cog and its component items from Year 1 to Year 5. In particular, a high proportion of improvement was observed in Memory/Problem Solving, and worsening in Social Interaction. Demographic and functional indicators present at 1 year postinjury may be predictive of subsequent change.

Adolescent↗

Cannabis use in adolescents: the impact of risk and protective factors and social functioning.

The study uses a school-based sample to test the social and familial risk and protective factors relating to cannabis use. Based on a self-completion survey of 2078 14-16-year-olds (mean age of 15 years) attending seven standard state-run secondary schools in south London, an assessment was made of rates and risk factors for cannabis use. Twenty-four per cent of the total sample had ever used cannabis, with 15% having done so in the month prior to assessment. In addition to greater likelihood of illicit drug use, lifetime cannabis users were less likely to spend time regularly with both their mothers and fathers, but more likely to spend free time with friends who smoked, drank alcohol and used illicit drugs, and with friends involved in criminal activities. Among those who had ever used cannabis, frequency of cannabis use was predicted (using linear regression) by two onset factors (earlier initiation of drinking and cannabis use were both linked to more frequent use) and two social factors (more time spent with drug-using friends and less time spent with the mother). Overall, the study showed that early onset, itself predicted by social networks, is linked to more frequent use of cannabis and that this appears to be sustained by less time spent with parents and more with drug-using peers.

Adolescent↗

Predictors of depressive symptomatology of geriatric patients with colorectal cancer: a longitudinal view.

Colorectal cancer constitutes a major health problem for elderly patients. The disease and its stage, treatment, and attendant symptoms can have significant negative impact on the mental functioning of these patients. As part of a larger longitudinal study, 158 patients 65 years of age or older with an incident diagnosis of colorectal cancer were recruited from 23 sites within a Midwestern state. Random effects regression analysis techniques were used to analyze how age, gender, race, presence of a family caregiver, co-morbid conditions, stage of disease at diagnosis, and the time-dependent variables marital status, employment status, symptoms, physical functioning, social functioning, and treatment predict depressive symptomatology at four assessments over the 1st year following diagnosis. Gender, race, co-morbid conditions, physical functioning, social functioning, and symptoms were significant predictors of depressive symptomatology over the four waves of the study. Female patients, African Americans, and patients with two or more co-morbid conditions exhibited more depressive symptomatology. Both more symptoms and more restricted physical and social functioning corresponded to higher levels of depressive symptomatology. At a clinical level of patient care, these findings mandate early identification of psychosocial difficulties experienced, an individualized symptom management plan and the application of other interventions, such as information giving, reassurance and referral to other resources, with particular attention to African American and female patients.

Activities of Daily Living↗

Social functioning, psychological functioning, and quality of life in epilepsy.

PURPOSE: Part of our research intended to explain "Quality of Life" (QoL) differences between people with epilepsy. To this end, a series of already existing generic and disease-specific health status measures were used. In this study, they were considered as determinants of people's QoL, whereas QoL itself was conceived as a general "value judgment" about one's life. METHODS: From the records of four outpatient clinics, 210 persons with epilepsy were randomly selected. During their visit to the outpatient clinic, they completed a questionnaire assessing, among other things, health perceptions and social and psychological functioning. Additional information about their medical and psychosocial status was gathered from the patient files. Data were analysed by using a hierarchical regression analysis. RESULTS: In decreasing order of importance, "psychological distress," "loneliness," "adjustment and coping," and "stigma perception" appeared to contribute most significantly to the outcome QoL as judged by the patients themselves, regardless of their physical status. In the final model, none of the clinical variables (onset, seizure frequency, side effects of antiepileptic drugs) contributed significantly anymore to the patients' "quality-of-life judgement." Apparently the effect of other variables such as seizure frequency and health perceptions, medication and side effects, life fulfillment, self-esteem, and mastery is mediated by these variables. CONCLUSIONS: Because all of the variance in QoL of the patients was explained by the psychosocial variables included in this study, health professionals should be aware of the significance of the psychosocial functioning of the patients and the role it plays in the achievement of a good QoL. Both informal and professional support may be an adjunct to conventional treatment. In future research, this issue should be given high priority.

Adaptation, Psychological↗

The impact of age on the quality of life in persons with HIV infection.

The authors administered the Medical Outcomes Study (MOS 20) Short Form Health Survey to 369 persons with HIV disease. The MOS survey measures six domains of health: physical function, role function, social function, mental health, health perception, and pain. Additional data included sociodemographics, HIV risk group, time since HIV diagnosis, symptoms (dyspnea, diarrhea, fever, chills, sweats, weight loss, weakness, numbness, memory trouble, seizures), and CD4 lymphocyte count within 3 months of the MOS survey. Bivariate analyses revealed worse MOS scores associated with older age in five health domains: physical function (p less than .01), health perception (p <.10), role function (n.s.), social function (n.s.), and mental health (n.s.). Older subjects reported less pain. When controlling for CD4 count and for sociodemographic and clinical variables, older age was significantly (p less than .05) associated with worse MOS scores in physical function, social function, and health perception, nonsignificantly associated with worse MOS scores in role function and mental health, and nonsignificantly associated with less reporting of pain.

Adolescent↗

Family functioning, social adjustment, and recurrence of suicidality.

We examined suicidal and nonsuicidal patients with major depression during and subsequent to their hospitalization. Factors associated with suicidality at the index episode included psychosocial variables as well as measures of family functioning. Previous suicidality, inter-episodic adjustment, changes in family constellation, and perception of family functioning were instrumental in separating nonsuicidal patients at follow-up from patients exhibiting recurrent suicidal behavior. These results indicate that when assessing patients with major depression for suicidality, particular attention should be paid both to the social environment and to family functioning as perceived by the patient.

Adult↗