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PubMed2000

Suicidal ideation and suicide attempts among Australian adults.

Too little is known about suicidal thoughts and behaviors at a population level to recommend appropriate preventive strategies. Using data from the Australian National Survey of Mental Health and Wellbeing (NSMHWB), this study examined rates of, and risk factors for, suicidal ideation and suicide attempts. For 10,641 respondents, the 12-month and lifetime cumulative incidence rates of suicidal ideation were 3.4% and 16.0%, respectively; the 12-month and lifetime cumulative incidence rates of suicide attempts were 0.4% and 3.6%, respectively. 12-month ideation was associated with anxiety disorders (relative risk ratio [RRR] = 3.51; population attributable risk percent [PAR%] = 19.6%), affective disorders (RRR = 11.94; PAR% = 38.8%) and substance abuse disorders (RRR = 1.85; PAR% = 6.1%). Attempts in the past 12 months were also associated with anxiety disorders (RRR = 7.06; PAR% = 37.0%), affective disorders (RRR = 12.24; PAR% = 39.5%), and substance abuse disorders (RRR = 2.09; PAR% = 7.7%). Age, marital status, and disability were associated with ideation; marital status and employment status with attempts. Approximately 12% of ideators in the sample progressed to making an attempt; employment status was the only significant predictor. Reducing suicidal ideation and attempts requires a multi-faceted approach that targets those with mental illness but also adopts population-based strategies that address other factors, such as unemployment.

Adult↗
PubMed1997

Quality of life and health in patients with urinary diversion: a comparison of incontinent versus continent urinary diversion.

OBJECTIVE: To compare the quality of life and health in patients with incontinent and continent urinary diversions, in correlation with the initial diagnosis, diversion-related symptoms, psychological status and employment status. MATERIALS AND METHODS: 81 patients (64% male and 36% female) with a mean age of 55 years (18-65 years) were included in this retrospective study. A total of 27 had an incontinent urinary diversion (group A) and 54 a continent diversion (group B). The initial diagnosis was malignant tumor in 75% (n = 61) and nontumor disease in 25% (n = 20). A structured interview and psychometric instrument assessment of the quality of life as well as somatic and psychological symptoms were carried out and analyzed. RESULTS: Patients with nontumor disease, a continent reservoir and employment tended to have the highest level of quality of life. The higher the number and severity of psychological symptoms, such as depression and anxiety, the lower the level of global satisfaction with life, health and urinary diversion, and vice versa. No difference was seen between groups A and B concerning diversion-related symptoms, global satisfaction with life and health and sociodemographic data. CONCLUSIONS: The decision for a continent versus an incontinent urinary diversion must consider not only the medical factors of each individual patient, but also the initial diagnosis, psychological condition and employment status.

Adaptation, Psychological↗
PubMed1992

Demand for alcohol treatment by problem drinkers.

Problem drinkers applying for treatment at both outpatient and inpatient treatment programs were compared with problem drinkers identified in a general population survey. The characteristics in which these populations differ were interpreted as factors contributing to the demand for treatment and, thus, indicative of the need for alcohol treatment. Older problem drinkers appear to apply for treatment more frequently, and the same is true for divorced and unemployed or disabled problem drinkers. More important, age, marital status, and employment status were found to contribute to the demand for alcohol treatment independent of alcohol consumption. It can be concluded from this study that the demand for alcohol treatment is not determined by alcohol consumption alone, suggesting that alcohol treatment should not only focus on alcohol consumption but also focus on problems related to marital and employment status in order to prevent future need for alcohol treatment.

Adult↗
PubMedDate not supplied

Social and psychologic influences on employment of married nurses.

Seven summary factors were obtained from a principal components factor analysis and Varimax rotation of 21 variables, based on 145 pieces of information given by 1,998 nurses in metropolitan Detroit, Michigan, in 1973. Study nurses were under 60 years of age, were married and living with spouse, and had at least one child 18 or younger. The factors were: career desirability, professional attitude, professional behavior, achievement personality, conducive home situation, economic value of work, and satisfaction with nursing. When these factors were compared with employment status-1) current employment activity of all subjects, 2) subjects whose employment status was constant for five years, highest scores were registered in both categories on career desirability, professional behavior, and economic value of work. Both groups of nurses scored lowest on satisfaction with nursing, with the five-year employees scoring lower. When the seven factors were correlated with employment status while controlling financial need and age of youngest child at home, highest correlation scores resulted for professional behavior, career desirability, and, in the case of those with financial need, on the economic value of nursing.

Achievement↗
PubMedDate not supplied

Psychosocial similarities and differences among employed and unemployed heart transplant recipients.

This study investigated the association between employment and selected psychosocial factors in 132 heart transplant recipients from five medical centers. A questionnaire was used to determine employment status and evaluate the psychosocial variables. Variables were employment, self-esteem, identity stability, preoccupation with self, control over destiny, independence versus dependence, depression, anxiety, quality of life, and body image. Multivariate analysis of variance was used to explore whether the four employment status groups (employed, not employed, retired, and disabled) differed on the psychosocial attributes. Analysis of employment status by rejection and infection revealed no differences among groups. Univariate F-ratios for employment status showed significant differences on all psychosocial variables except anxiety and preoccupation with self. Thus it appears that employment is associated with a number of important psychosocial factors. Overall, the employed and retired groups scored the highest on the psychosocial variables tested. The disabled group displayed significantly higher scores on the psychosocial variables than the not-employed group. It may be that the disabled group has a more socially accepted identity than the not-employed group.

Anxiety↗
PubMedDate not supplied

Stressors and alcohol consumption.

The objective of this study was to examine the relationship between negative life events and chronic stressors and drinking behaviour. Data suggested that some life events (getting divorced) and some chronic stressors (financial difficulties, unfavourable marital status, and unfavourable employment status) were positively related to abstinence among men and women. Furthermore, some life events (being a victim of a crime, decrease in financial position, divorce or reporting two or more life events) were positively associated with heavy drinking among men. Chronic stressors, such as unfavourable marital status and unfavourable employment status, were also related to heavy drinking among both men and women. Results presented here suggest that people under stressful conditions are more likely to either abstain or drink heavily rather than to drink lightly or moderately.

Adolescent↗
PubMed1994

Sociodemographic factors and the outcome of rheumatoid arthritis in young women.

OBJECTIVE: To investigate the impact of sociodemographic factors on the outcome of rheumatoid arthritis (RA). METHODS: A group of 138 women with RA of recent onset and a mean duration of follow up of 5.8 years was studied. Additional information on sociodemographic variables at disease onset (level of formal education, marital status and employment status) was related to the initial disease severity and various outcome measures. RESULTS: Patients with lower levels of education showed a trend towards a worse outcome, according to Health Assessment Questionnaire (HAQ) score, erosion score and the patient's and physician's assessment of outcome at the last visit. However, we also found a trend towards an association between lower levels of education and more severe disease at onset, as measured by HAQ score, erosion score and the number of painful and swollen joints. The association between lower levels of education and poorer outcome of RA was weakened after correction for the initial disease severity. Results of other sociodemographic variables were equivocal. CONCLUSIONS: Differences in severity of RA between patients with different levels of education develop or are present in the early stages of the disease.

Adult↗
PubMed1991

Educational differences in health status and health care.

Includes estimates by years of education for limitation of activity, restricted-activity days, assessed health status, physician contacts, hospital discharges and days, incidence of acute conditions, and prevalence of chronic conditions. Level of education is cross-classified by age, sex, race, poverty status, Hispanic origin, geographic region, place of residence, major activity, marital status, and employment status. All estimates are shown as unadjusted and age adjusted and are based on data collected in household interviews by the U.S. Bureau of the Census for the National Health Interview Survey during 1989.

Activities of Daily Living↗
PubMed1982

Symptomatic status and pattern of employment during a five-year period following myocardial revascularization for angina.

The employment status of 100 consecutive male patients between the ages of 30 and 60 years (mean, 49.5 years) operated on for angina and followed for a minimum of 5 years was analysed. There were no early and 4 late deaths. The probability of employment at 1 year was 90%, which was similar to that of a sample from the general population matched for age. This rate, however, showed steady, slow deterioration to 87.6% at 2 years, 82.1% at 3 years, 75.7% at 4 years, and 73.4+ at 5 years. Seventeen patients retired over the 5-year period. There was no correlation between the rate of employment and age (under or over 50) at operation, previous myocardial infarction, or number of grafts inserted.

Adult↗
PubMed1990

Social determinants of nutrient intake in smokers and non-smokers during pregnancy.

STUDY OBJECTIVE: The aim was to investigate the effects of social factors (education, income, marital status, partners' employment status, housing tenure, social class), smoking, and maternal height on the dietary intake of pregnant women. DESIGN: The study was a prospective investigation on a two phase sample. SETTING: The study involved women attending the antenatal clinic at a district general hospital. PATIENTS: A group of pregnant Caucasian women, selected because they were heavy smokers (15+ cigarettes/day) (n = 94) and a randomly selected sample of never smokers (n = 112) were studied. MEASUREMENTS AND MAIN RESULTS: Data on social factors were collected by interviewer administered questionnaire. A 7 day weighed intake method was used to determine dietary intake at 28 weeks gestation. In univariate analyses, income, housing tenure and social class had significant effects on intakes of both macro- and micronutrients, and maternal education and smoking had significant effects on intakes of micronutrients. Using a stepwise multivariate analysis with income, smoking and maternal education, income was a significant factor in the intake of most nutrients but this effect disappeared when social class and housing tenure factors were entered into the model. Only social class and housing tenure had any significant effect on intakes of macronutrients--energy, protein and fat. Smoking and maternal education were the most important determinants of quality of diet (nutrient density); other factors had only negligible effects. Income was the only significant factor in alcohol intake. It is suggested that the effects of social class and income are overlapping. CONCLUSIONS: Smoking, being renters of accommodation, and being of minimum education and low social class are risk factors for poor dietary intake. It is recommended that such higher risk groups be specifically targeted for nutritional advice in pregnancy.

Body Weight↗
PubMed1998

Health-promoting behaviors of rural adolescent women.

A part of a larger study of the health behaviors of adolescent women, this investigation examined health-promoting behaviors and the influence of cognitive, social, and environmental factors on these health-promoting behaviors of rural adolescent women. The sample consisted of 128 rural African-American and white adolescent women. Forty-four percent of the variance in health-promoting behavior of this sample was explained by five variables: self-image, problem solving, mother's education, employment status, and family structure. Self-image was the most salient predictor of health-promoting behavior, explaining 33% of the variance.

Adolescent↗
PubMed1988

Socioeconomic factors affecting fertility in the developing countries and of the developing population groups in South Africa.

"In the present paper...socioeconomic factors affecting the fertility of the developing population groups in South Africa, are discussed and compared with findings [for developing countries] from the WFS [World Fertility Survey]." Data for South Africa are from an independent survey conducted during 1981-1982. "The relationship between socioeconomic factors and three dependent variables (marital fertility, desired family size, and current contraceptive use) is analysed.... The analyses are restricted to the examination of the extent to which the wife's differentials in fertility and associated variables related to education, employment status, and rural/urban residence persist, when other socioeconomic characteristics of the couple are controlled statistically."

Africa↗
PubMedDate not supplied

Situational and financial barriers to prenatal care in a sample of low-income, inner-city women.

The relationship between the use of prenatal care and factors that may impede access to care was examined in a sample of low-income, inner-city women. Situational and financial barriers to care were not important correlates of utilization. In unadjusted analyses, only insurance status and employment status were associated with utilization. Of the sociodemographic characteristics studied, only parity was strongly associated with the use of prenatal care. When the apparent associations between utilization and insurance status and utilization and employment were analyzed controlling for parity, the estimated strength and statistical significance of these relationships diminished considerably. Multiparous women who were more likely than primiparous women to be underutilizers were also more likely to be on medical assistance and to be unemployed. These findings suggest that situational and financial barriers are not important correlates of utilization for low-income, adult women living in urban areas where there are accessible clinic facilities and public transportation. Efforts to identify and surmount other kinds of barriers may prove to be a more effective approach to prenatal outreach for women in these circumstances.

Adult↗
PubMed2002

The effects of primary care depression treatment on patients' clinical status and employment.

OBJECTIVE: To evaluate the effects of depression treatment in primary care on patients' clinical status and employment, over six months. DATA SOURCES/STUDY SETTING: Data are from a randomized controlled trial of quality improvement for depression that included 938 adults with depressive disorder in 46 managed primary care clinics in five states. STUDY DESIGN: Observational analysis of the effects of evidence-based depression care over six months on health outcomes and employment. Selection into treatment is accounted for using instrumental variables techniques, with randomized assignment to the quality improvement intervention as the identifying instrument. DATA COLLECTION/EXTRACTION METHODS: Patient-reported clinical status, employment, health care use, and personal characteristics; health care use and costs from claims data. PRINCIPAL FINDINGS: At six months, patients with appropriate care, compared to those without it, had lower rates of depressive disorder (24 percent versus 70 percent), better mental health-related quality of life, and higher rates of employment (72 percent versus 53 percent), each p<.05. CONCLUSIONS: Appropriate treatment for depression provided in community-based primary care substantially improves clinical and quality of life outcomes and employment.

Depressive Disorder↗
PubMed2005

Long-term botulinum toxin treatment increases employment rate in patients with cervical dystonia.

We examined the impact of cervical dystonia (CD) and long-term botulinum toxin (BTX) treatment on employment status. Data on employment status at onset of CD, at initiation of BTX treatment, and at evaluation of long-term treatment were obtained from 62 CD patients aged 31-66 years (median, 53 years; 61% females) who had been treated for a median of 5 years (range, 1.5-10 years). The employment rate fell from 84% at the onset of CD to 47% before initiation of BTX treatment. With long-term BTX treatment, 72% of those who worked at the initiation of treatment stayed employed, and 67% of those on sick leave returned to work. A younger age and a higher level of education increased the probability of being employed and avoiding disability benefits. Among those who were younger than 55 years at evaluation of BTX treatment (n = 40), the employment rate increased from 47% to 65% with treatment, and among the male patients, it reached the level of the general population (86%). About half of the 34% who received disability benefits did so already before the BTX treatment was initiated.

Adult↗
PubMed1985

Factors associated with unemployment of patients with multiple sclerosis.

As part of a larger study of psychosocial aspects of chronic disease, the employment status of 79 male and 233 female multiple sclerosis patients was evaluated by interview to identify: (1) the relationship between degree of disability and employment status and (2) other determinants of employment status. Seventy-seven per cent of the patients were unemployed. Disability level, age, sex, and level of education accounted for 14% of the differences in employment status, with less disabled, older, more educated males being the most likely to be employed. Employment status was unrelated to marital status or type of occupation. Case histories are presented to illustrate psychosocial and environmental factors which might further account for the differences in employment status.

Adolescent↗
PubMed1980

Women, work and coronary heart disease: prospective findings from the Framingham heart study.

This study examined the relationship of employment status and employment-related behaviors to the incidence of coronary heart disease (CHD) in women. Between 1965 and 1967, a psychosocial questionnaire was administered to 350 housewives, 387 working women (women who had been employed outside the home over one-half their adult years), and 580 men participating in the Framingham Heart Study. The respondents were 45 to 64 years of age and were followed for the development of CHD over the ensuing eight years. Regardless of employment status, women reported significantly more symptoms of emotional distress than men. Working women and men were more likely to report Type A behavior, ambitiousness, and marital disagreements than were housewives; working women experienced more job mobility than men, and more daily stress and marital dissatisfaction than housewives or men. Working women did not have significantly higher incidence rates of CHD than housewives (7.8 vs 5.4 per cent, respectively). However, CHD rates were almost twice as great among women holding clerical jobs (10.6 per cent) as compared to housewives. The most significant predictors of CHD among clerical workers were: suppressed hostility, having a nonsupportive boss, and decreased job mobility. CHD rates were higher among working women who had ever married, especially among those who had raised three or more children. Among working women, clerical workers who had children and were married to blue collar workers were a highest risk of developing CHD (21.3 per cent).

Career Mobility↗
PubMed2004

Can gender differences in the prevalence of mental disorders be explained by sociodemographic factors?

BACKGROUND AND AIMS: Epidemiological studies throughout the world consistently reported higher rates of depression and anxiety disorders in women, whereas men consistently show higher rates of substance and antisocial disorders. The present study examined factors potentially contributing to these gender differences using general population data. METHODS: The sample was drawn from population registries (N=4181) and can be regarded as representative for the adult German population aged 18-65. Mental disorders (DSM-IV) were assessed with a diagnostic interview (CIDI) carried out by clinically trained interviewers. A range of sociodemographic variables was analysed within men, within women, and between genders. RESULTS: The prevalence of common mental disorders (mood, anxiety, substance use and somatoform disorders) is higher among females, with the exception of substance use disorders. Young age was related to substance disorders both in women and in men. Not being married and being unemployed were associated with increased rates of mental disorders in both sexes, but in men stronger than in women. Being retired was associated with depression only in women, whereas belonging to a higher social class, working fulltime and having children appeared to be protective factors for men only. Other sociodemographic factors (concerning education, employment and family status) were not associated with increased rates of mental disorders both in women and men. CONCLUSION: Overall the emotional advantages or disadvantages of marital status, employment status, number of children, parenthood and social class apply equally to men and women. We cannot explain the female preponderance in most mental disorders by detecting specific unfavourable patterns of sociodemographic correlates, suggesting that determinants of gender differences in common mental disorders are still far from being understood.

Adolescent↗