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PubMedDate not supplied

Hot flushes, common symptoms, and social relations among middle-aged nonmenopausal French women in the GAZEL cohort.

OBJECTIVE: Many symptoms, including hot flushes (HFs) may appear during the years preceding menopause. Hypotheses to explain these symptoms include biomedical, demographic, and cultural risk factors. Social relations are also associated with various aspects of health. The aim of this study was to analyze the association between social relations and the reporting of HFs and other common symptoms among middle-aged nonmenopausal French women taking into account other factors, including biomedical characteristics. DESIGN: Data came from self-administered questionnaires mailed to 1,180 pre- or perimenopausal women aged 45 to 54 years participating in the French GAZEL cohort. Bivariate and multivariate analyses examined the association between symptoms (HFs, general, psychological, osteoarticular, and breast symptoms) and three scores of social relations (social network, social relations, and satisfaction with social relations). RESULTS: After adjustment, low social support was associated with psychological symptoms (odds ratio [OR] = 2.65; 95% CI: 1.33-5.29) and unsatisfactory social relations were associated with psychological (OR = 2.04; 95% CI: 1.49-2.79) and breast symptoms (OR = 1.38; 95% CI: 1.03-1.84). HFs were not associated with social relations but were related to common symptoms (OR = 2.80; 95% CI: 1.94-4.03). Perimenopausal women were more likely to report HF than premenopausal women (OR = 2.63; 95% CI: 1.88-3.71). CONCLUSION: Social relations were associated with psychological and breast symptoms, but not with HFs. The strong association between common symptoms and HFs suggests that biomedical factors have a greater influence than social relations on the occurrence of HFs.

Cohort Studies↗
PubMed2006

Longitudinal change in positive affect in community-dwelling older persons.

OBJECTIVES: To determine whether positive affect, defined as emotional contentment and happiness, remains stable in late life and to identify predictors of longitudinal change in positive affect. DESIGN: Longitudinal observational study. SETTING: Community. PARTICIPANTS: Six hundred sixty-three individuals aged 70 and older without disability at baseline and free of chronically depressed mood. MEASUREMENTS: Positive affect, social network, social activity, chronic health conditions, activities of daily living, instrumental activities of daily living (IADLs), cognitive functioning, and negative affect measured over 54 months, at 18-month intervals, up to four times. RESULTS: Positive affect remained relatively stable over 4.5 years of follow-up. Higher average levels of social activity and lower levels of negative affect were associated with higher positive affect. An increase of 1 point in negative affect (on a 7-point scale) was associated with a 0.23-point concurrent decrease in positive affect (on a 5-point scale). Needing help in an additional IADL was associated with a decrease in positive affect of 0.04 points. A greater number of chronic conditions at enrollment was associated with lower positive affect. CONCLUSION: Positive affect is directly correlated with social involvement and inversely correlated with negative affect, IADL functioning, and comorbidity. Positive affect was mostly related to factors that do not change over time, although it showed some sensitivity to short- and long-term changes in physical health and functioning.

Activities of Daily Living↗
PubMed1996

An episode of syncope attacks in adolescent schoolgirls: investigations, intervention and outcome.

An increasing number of students in a secondary convent girls school developed syncope attacks over a time course of about two months. Fourteen students who suffered from syncope and 12 other students from the same class with no symptoms were assessed by a team of psychologists and paediatricians with the aim of identifying the cause of the problem and to formulate possible remedial action. Psychological assessments included a mental state examination, developmental, personal and psychological history, state-trait anxiety, self-esteem, hypnotic suggestibility, and students' beliefs about the cause and nature of the syncope attacks. Physical investigations included physical examination, blood pressure and electrocardiogram. The results indicated that most participants and controls had no physical or psychological pathologies. The two groups were not different on the physical and psychological measures. Analyses of the interview data, however, indicated that all the syncope sufferers belonged to a cohesive and exclusive social network. Social psychological circumstances rather than individual psychopathology were noted to be primarily responsible for the spread and maintenance of the mass hysterical influence. Intervention consisted of health education, authoritative reassurance and back-up support. Follow-up assessment after three and 12 months indicated no further syncope episodes.

Adolescent↗
PubMed2001

Ethnic differences in self reported health in Malmö in southern Sweden.

STUDY OBJECTIVE: The aim of this study was to investigate ethnic differences in self reported health in the city of Malmö, Sweden, and whether these differences could be explained by psychosocial and economic conditions. DESIGN/SETTING/PARTICIPANTS: The public health survey in Malmö 1994 was a cross sectional study. A total of 5600 people aged 20-80 years completed a postal questionnaire. The participation rate was 71%. The population was categorised according to country of origin: born in Sweden, other Western countries, Yugoslavia, Poland, Arabic speaking countries and all other countries. The multivariate analysis was performed using a logistic regression model in order to investigate the importance of possible confounders on the differences by country of origin in self reported health. Finally, variables measuring psychosocial and economic conditions were introduced into the model. MAIN RESULTS: The odds ratios of having poor self reported health were significantly higher among men born in other Western countries, Yugoslavia, Arabic speaking countries and in the category all other countries, as well as among women born in Yugoslavia, Poland and all other countries, compared with men and women born in Sweden. The multivariate analysis including age and education did not change these results. A huge reduction of the odds ratios was observed for men and women born in Yugoslavia, Arabic speaking countries and all other countries, and for women born in Poland after the introduction of the social network, social support and economic factors into the multivariate model. CONCLUSIONS: There were significant ethnic group differences in self reported health. These differences were greatly reduced by psychosocial and economic factors, which suggest that these factors may be important determinants of self rated health in certain minority groups.

Adult↗
PubMed1998

Review of psychosocial stress and asthma: an integrated biopsychosocial approach.

Environmental stressors may impact asthma morbidity through neuroimmunological mechanisms which are adversely impacted and/or buffered y social networks, social support, and psychological functioning. In addition, life stress may impact on health beliefs and behaviours that may affect asthma management. Whereas earlier psychosomatic models have supported a role for psychological stress in contributing to variable asthma morbidity among those with existing disease, a growing appreciation of the interactions between behavioural, neural, endocrine, and immune processes suggest a role for these psychosocial factors in the genesis of asthma as well. While a causal link between stress and asthma has not bee established, this review provides a framework in which we can begin to see links between these systems that might provide new insights to guide future explorations. The complexity of these interactions underscore the need for a multidisciplinary approach which combines the idea that the origin of asthma is purely psychogenic in nature with the antithetical consideration that the biological aspects are all important. These distinctions are artificial, and future research that synthesizes biological, psychological, sociocultural, and family parameters is urgently needed to further our understanding of the rising burden of asthma.

Asthma↗
PubMed1999

A new measure of conversational experience: the speaking extent and comfort scale (SPEACS).

Few measures exist which directly assess aspects of conversational experience. We present and provide a psychometric assessment of the Speaking Extent and Comfort Scale (SPEACS), a new 20-item measure which assesses four aspects of past conversational experience: the extent and comfort of both general conversations and in conversations specifically about the self. All four SPEACS subscales exhibited good test-retest reliability. As predicted, the subscales related positively to social competence, disclosure, assertiveness, and perceived availability of someone to talk to, and negatively to social avoidance and social anxiety, providing support for their construct validity. Internal consistency data demonstrated that people tend to vary in how often and how comfortable they feel having conversations with different people. SPEACS offers a range of potential applications in areas with a focus on social networks, social experience and interaction, and the possibility of extension to other dimensions of conversational experience.

Adolescent↗
PubMed2001

The relationship between familism and child maltreatment in Latino and Anglo families.

Familism, or familismo, refers to attitudes, behaviors, and family structures operating within an extended family system and is believed to be the most important factor influencing the lives of Latinos. Because of the complexity of the construct, this article begins by separating out and defining each dimension of familism, and then clarifies its relationship to the broader literature on social networks, social support, and child maltreatment. The analysis tests whether each dimension of familism is related to child maltreatment within and between 35 abusive Latino, 35 nonabusive Latino, 51 abusive Anglo, and 51 nonabusive Anglo families. Nonabusing Latinas appear to have a higher level of familism than the other three groups of mothers. However; when intraethnic comparisons were made, nonabusive Anglos, compared with abusive Anglos, had higher levels of familism on several variables. Hence, familism seems to characterize families--Latino and Anglo--who do not maltreat their children.

Adult↗
PubMed1998

Competence and drug use: theoretical frameworks, empirical evidence and measurement.

Statistics show that use of harmful substances (alcohol, cigarettes, marijuana, cocaine) among women of childbearing age is widespread and serious. Numerous theoretical models and empirical studies have attempted to explain the complex factors that lead individuals to use drugs. The Social Stress Model of Substance Abuse [1] is one model developed to explain parameters that influence drug use. According to the model, the likelihood of an individual engaging in drug use is seen as a function of the stress level and the extent to which it is offset by stress modifiers such as social networks, social competencies, and resources. The variables of the denominator are viewed as interacting with each other to buffer the impact of stress [1]. This article focuses on one of the constructs in this model: that of competence. It presents a summary of theoretical and conceptual formulations for the construct of competence, a review of empirical evidence for the association of competence with drug use, and describes the preliminary development of a multi-scale instrument designed to assess drug protective competence among low-income Hispanic childbearing women. Based upon theoretical and empirical studies, eight domains of drug protective competence were identified and conceptually defined. Using subscales from existing instruments with psychometric evidence for their validity and reliability, a multi-scale instrument was developed to assess drug protective competence. Hypothesis testing was used to assess construct validity. Four drug protective competence domains (social influence, sociability, self-worth, and control/responsibility) were found to be statistically associated with drug use behaviors. Although not statistically significant, expected trends were observed between drug use and the other four domains of drug protective competence (intimacy, nurturance, goal directedness, and spiritual directedness). Study limitations and suggestions for further psychometric testing of the instrument are described.

Adolescent↗
PubMed1998

[New research and considerations in managing minimally conscious coma patients].

The "Wachkoma", minimally conscious state (synonyms in use: "apallic syndrome", "vegetative state"), is a severe, complex condition arising from brain damage of diverse etiologies, for which definitional consensus does not exist internationally; it gives rise to frequent misdiagnosis and carries substantial insecurities concerning treatment outcomes. In the framework of expanding early rehabilitation, however, recent years have seen a distinct shift away from a defect-oriented, reductionist view towards a relational-medicine based understanding of patients with severe brain damage, seeking to gain a comprehensive perception of the patient's altered physical existence and taking a multidisciplinary--nursing, medical, therapeutic and neuropsychological--perspective which includes the patient's relatives and family. Historically, a transition is under way away from the classical brain-pathology focus toward a neuropsychologically grounded, differentiated perspective. Along with in-depth differential diagnostics and assessment of rehab potentials (early intervention diagnostics), comprehensive intervention measures are initiated as early as possible by an interdisciplinary team. These include "coma stimulation" measures, body language forms of interaction ("dialogue management"), and technical communication devices. By building long-term care assistance in ambulatory and residential service delivery systems ("small social network"), social reintegration of these very severely affected patients is attempted, involving the familial and social resources available. Recurrently raised within the bioethical discourse, demands to consider doctor-assisted dying or food withdrawal are to be rejected from a clinical, medical and social-ethical perspective.

Brain Damage, Chronic↗
PubMed2003

Social capital, gold for telemedicine?

Value norms within an interactive social network, social capital, can improve many aspects of the quality of life including health. Effective means of communication are key to making the social capital available. Telemedicine is therefore well placed to playing an important role in providing social capital to many groups in a society, which are at present deprived of this resource for maintaining health.

Communication↗
PubMed2004

[Health status and socioeconomic factors related to home remedy practices among elderly subjects living in a community in Okinawa].

OBJECTIVE: The purpose of the present study was to clarify health status and socioeconomic characteristics of elderly persons who practice home remedies as complementary alternative medicine. Whether such usage is associated with health-related factors was also assessed. METHODS: The subjects are 243 independent elderly living at home in A-village of Okinawa prefecture, aged 65 years or older. A self-administered questionnaire was mailed to all subjects in 2001. Included were questions on socioeconomic indicators, health status, IADL, health habits, social network, social support and home remedy practices. All data were statistically analyzed by Student's t test and the chi-square test. In addition logistic regression was used to calculate the odds ratios for current practitioners for each of the factors. RESULTS: The present study included 200 subjects who responded and completed all questions. (Table 2). The main results are as follows: The practitioner rate for home remedies was 50.8% in males and 71.9% in females, the difference being significant (P<0.05). Usage was found to be significantly related to hypertension (P<0.05), arthritis and rheumatic disease (P<0.01), some health habits and provision nursing of social support (OR = P<0.05). Logistic regression analysis adjusted for age, gender, and income revealed current practitioners of acupuncture to have a significantly higher level of history of hospital admission in the previous year (OR = 0.2 P<0.05), food control habits (OR = 4.3 P<0.05) and provision nursing of social support (OR = 4.2 P<0.05) than non-current practitioners. CONCLUSION: The findings of this study suggest that home remedy practices are associated with health-related habit and provision of social support for good quality of elderly life. The purpose is not only physical care but also health maintenance and promotion.

Aged↗
PubMed1993

[Psychological situation of home care patients in the Federal Republic of Germany].

The demographic development, advances in medicine and also the increase in AIDS and paraplegia at an early age means that we must assume approximately two million people in Germany requiring care and attention or nursing on a longterm basis. Object of the explorative pilot-study is to analyse the conditions for mental well-being in the case of homecare patients and the influence on behaviour, enjoyment of life and the quality of their hopes for the future. In the study two comparable random surveys have been examined in all their demographic and medical characteristics: (1) homecare patients (n = 60) and (2) patients in old people's or nursing homes (n = 30); in so far as they can be compared, another random survey of younger homecare patients (n = 33) will be taken into consideration in some of the questions. Under examination is the hypothesis that the well-being of people requiring nursing is considerably dependent upon (1) the quality, activity and diversity of their social network (social assistance), (2) the extent of their own competence and deficiences (subjective level of performance), (3) the history of illness and the subjective health status (subjective health status), (4) the way in which they interpret and cope with their own illness (situative positioning), (5) their domestic surroundings, the sociodemographic situation and the subjective creative freedom (ecology), (6) the person's lifestyle and the quality of his prophylactic behaviour (biographical behavioural manner), (7) their ideas, opinions and convictions relating to the alternatives homecare and old people's or nursing home. General findings to be emphasized in the case of homecare patients--compared with patients in old people's or nursing homes--are that: homecare facilitates and/or encourages (1) greater personal freedom, own control over the environment, familiarity, security, variety, challenge, individuality, good care and attention, activation of needs, appetite, future orientation (well-being). (2) a higher level of active social contacts (ringing other people; visiting friends, neighbours, family; writing letters, holidays) and passive social contacts (visits, telephone calls and mail from friends, relatives, etc.) Instead of resignedly conforming to the situation, they are receptive for stimulation, learning, positive interpretation of the situation. (3) more possibilities for social contacts, communication, social stimulation: everyday pleasures are experienced more frequently.(ABSTRACT TRUNCATED AT 400 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Are there factors which maintain a subjective symptom-free psychological state? A study exemplified with HIV-infected subjects].

AIMS: In the absence of curative treatment, the diagnosis of HIV infection imposes a heavy burden. Infected persons are therefore confronted with psychological, social and physical problems and cope with them via different strategies and social resources. We investigated the question of what factors help to maintain a psychologically symptom-free state. METHODS: A sample of 117 asymptomatic HIV-infected persons was recruited out of the Swiss HIV Cohort Study (Part A) in 1989 and 1990. The psychological symptoms were assessed with a self-rating questionnaire (SCL-90-R). The structured interview focused on social network, social support (SONET), and coping strategies (FEKB). RESULTS: 79% of the asymptomatic persons did not report psychological symptoms. In multivariate analyses, "rumination" (= preoccupational thinking), female gender, and affectively negative relationships correlated with more, but affectively positive relationships and the strategy "defence against threat" with fewer, psychological symptoms. Additionally, there was no significant correlation between the immunological markers (CD4-, CD8-cell count, p24 antigen) and psychological complaints. CONCLUSIONS: The low number of asymptomatic HIV-infected persons with psychological symptoms (21%) is in accordance with other studies. Psychological symptoms and rumination correlate significantly in our sample. As rumination is difficult to recognize, HIV-infected patients should be directly questioned about rumination and their defence against threat should be supported in order to prevent the development of psychological symptoms.

Adaptation, Psychological↗
PubMed2004

A longitudinal study of black-white differences in social resources.

OBJECTIVES: This study examined the differences in levels of social networks and social engagement between older Blacks and Whites and racial differences in rates of change in social resources over time. METHODS: The sample consisted of 5,102 Blacks and Whites, aged 65 and older, from the Chicago Health and Aging Project, who underwent up to three interviews during an average of 5.3 years of follow-up. Repeated measures of social networks were based on the number of children, relatives, and friends seen at least once a month. Social engagement was measured at each interview with four items related to social and productive activity. Random effects models were fitted to test the effect of race on social resources and change in resources over time. RESULTS: Blacks had smaller social networks and lower levels of social engagement than Whites. Racial differences in these resources were stable during follow-up. Socioeconomic status reduced racial differences in social engagement but not social networks. DISCUSSION: The findings provide evidence for lower levels of social resources among older Blacks. There was little evidence that racial differences were the result of greater decline during old age itself.

Black or African American↗
PubMed1987

Dietary intake and psychosocial factors in 68-year-old men. A population study.

In a representative sample of 621 men aged 68 years 500 (80.5%) participated in a dietary history interview, and in an interview where social network and social support characteristics, marital status, and social class were assessed. Also included was a questionnaire on alcohol consumption and smoking habits, as well as weight and height measurements and an assessment of the men's physical activities. The purpose was to describe dietary habits and to characterize men with inadequate habits according to different psychosocial characteristics. Average intake of energy and nutrients was, in general, well above the recommended. However, the variation was wide. According to the definition used, about 20% were considered to have "inadequate" dietary habits. No proportional differences in social class and marital status were found among these men. However, those with sufficient social network and social support fared better. Overweight, obesity, low physical activity and high alcohol consumption were more common among the men with inadequate diets. Low social anchorage, low physical activity and high body mass index were independent risk indicators of inadequate dietary habits in this population.

Aged↗
PubMed1999

Social relations: network, support and relational strain.

We introduce a conceptual framework with social relations as the main concept and the structure and the function of social relations as subconcepts. The structure of social relations covers aspects of formal relations and social network. The function of social relations covers social support, social anchorage and relational strain. We use this conceptual framework to describe social relations in the Danish population, with questionnaire data from the Danish Longitudinal Health Behaviour Study including a random sample of each of the age groups 25-, 50-, 60-and 70-year olds, N = 2,011. The postal questionnaires were answered by a random sample in each of the age groups. The results show marked age and gender differences in both the structure and the function of social relations. The social network, measured as weekly contacts, weakens with age and so does instrumental support. Emotional support is unrelated to this decline in contact frequency and appears to be at the same level for younger and older individuals. Relational strain, measured as conflicts, declines with age for all kinds of social relations. The weakening of the social network with age does not seem to affect the level of emotional support and in turn seems to be partly compensated for by a simultaneous decline in relational strain.

Adult↗
PubMed1990

The relation between life events and social support networks in a clinically depressed cohort.

Life events and supportive social networks are often treated as separate independent variables in their relations with supposed dependent variables such as depressive disorder. It is important therefore to establish that they are independent of one another. One hundred and twenty one men and women attending psychiatric hospitals with depressive disorders were interviewed at the time of their initial contact by a research psychiatrist and a week later by a non-clinical research worker who enquired about life events (LEDS) and about social networks (IMSR). One hundred and eleven patients were successfully followed up in the same manner, typically 4 months later. Social networks were very stable over time. Where they did change, this could not be explained in terms of losses of social contact due to events such as death of a primary group member. The rating of threatening events and difficulties was also unrelated to the quality of social support networks. Institutional rearing in childhood was associated with substantially smaller adult primary networks. It was concluded that over short periods of time, measures based on the LEDS and IMSR are independent, but that major social disruptions may have life long effects on social support networks.

Adaptation, Psychological↗
PubMed2000

Socioeconomic differences in smoking cessation: the role of social participation.

OBJECTIVES: The aim of this study was to investigate whether psychosocial resources explain socioeconomic differences in smoking cessation and its maintenance. METHODS: A subpopulation of 11,837 individuals from the Malmö Diet and Cancer Study interviewed in 1992-94, age range 45-64 years, was investigated in this cross-sectional study. A multivariate logistic regression model was used to assess relative risks of having stopped smoking, adjusting for age, country of origin, previous/current diseases, and marital status. RESULTS: An odds ratio of 1.9 (1.4-2.5; 95% CI) for men and 2.0 (1.4-2.7; 95% CI) for women of having stopped smoking was found for higher non-manual employees when compared with unskilled manual workers. A decrease in these odds ratios was found when social participation was introduced into the model. The other three social network and social support variables were non-significant. CONCLUSION: High social participation is a predictor of maintenance of smoking cessation. It seems possible to interpret parts of the socioeconomic differences in smoking cessation and its maintenance as a consequence of differing social network resources and social capital between socioeconomic groups.

Age Factors↗