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[Factors influencing sexual satisfaction in women who have had a hysterectomy: a comparative group study].

This descriptive study was done to identify factors influencing sexual satisfaction in women who had had a hysterectomy and to compare these women who had not had a hysterectomy. The purpose was to contribute theoretical understanding on which to base nursing care planning. One group of subjects were 156 women who had had a hysterectomy, between one and 18 months post surgery, living with their spouse, having no complications, and menstruating before surgery. The other group of subjects were 282 healthy women who were living with their husbands and menstruating. The study tool consisted of 108 items including item concerning personal characteristics, characteristics related to the hysterectomy, husband's support, body image, emotions, attitude toward the sexual relationship, knowledge of sexuality, sexual behavior, and sexual satisfaction. Sexual satisfaction was measured by a tool based on Derogatis Sexual Function Inventory. The range of the internal level of the study tool was from .5208 to .9462. Data collection was done during the period from June 20 to Aug. 20, 1989. The same questionnaire was used of data collection for both groups, but a mail survey method was used for the women who had had a hysterectomy, and an interview method was used for the women who had not had a hysterectomy. Data analysis was done using frequency, ratio, mean and S.D. for the characteristics of the subjects and level of sexual satisfaction. t-test or ANOVA was used for the differences between the groups with regard to the general and hysterectomy related characteristics. The relationship between the score for sex life related factors and the level of sexual satisfaction was analyzed using the Pearson Correlation, and the influencing factors on sexual satisfaction were analyzed by stepwise multiple regression. The results of this study were as follows; 1. Mean age and income level were the only general characteristics for the two groups that were significantly different. The mean age, and income level of the group who had had a hysterectomy were 45 years, and 1,150,000 won respectively, and for those who had not had a hysterectomy, 41 years and 999,000 won. 2. There was no statistical difference of the sexual satisfaction score between the two groups. 3. There was differences in the factors influencing sexual satisfaction between the two groups. Factors influencing sexual satisfaction for the group who had had a hysterectomy were husband's support (R = .5793, P = .000) and the women's Knowledge of sexuality (R = .6670, P = .000) (total variance: 33.56).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Utilization of medical services by single-parent and two-parent families.

The purpose of this study was to examine the influence of family structure on the utilization of health care services. Data from the Family Health Utilization Survey, a six-month prospective study, showed that when confounders were controlled using a multiple regression model, being in a single-parent family was predictive of a statistically significant increase in overall utilization of ambulatory health care services. There were no differences between single-parent and two-parent families in rates of hospitalization or emergency room visits. There was a trend toward a higher rate for obtaining telephone advice by the single-parent families and a higher rate of after-hours care among the two-parent families. Single-parent families were also more likely to feel they needed care but did not obtain it. Differences that exist in the health care utilization patterns of single- and two-parent families should be considered in assessing health care needs of families.

Adolescent↗

Multiple roles of middle-generation caregivers: contextual effects and psychological mechanisms.

Caregiver role experiences of 106 women in the context of their other role experiences as mother and wife were investigated. The study examined role-specific stressors as predictors of well-being (physical health, positive and negative affect), and investigated role-specific feelings of adequacy as a mediator between stress in a given role and well-being. Hierarchical regression analyses revealed that different patterns of role stress were important in explaining different indices of well-being, and that the mother and wife roles contributed unique variance beyond the caregiver role. Path analyses indicated that feelings of adequacy served as a mediator in the role-specific stress process, especially that involving the caregiver and wife roles and the affective indices of well-being. This study suggests the importance of examining caregivers' role experiences in the context of their other family roles and identifies a psychological mechanism through which chronic role stress is related to well-being.

Adult↗

Genetic monitoring of the human population from high-level natural radiation areas of Kerala on the southwest coast of India. I. Prevalence of congenital malformations in newborns.

In the densely populated monazite-bearing sands of Kerala, on the southwest coast of India, natural radiation dose rates range from 1. 0 to over 35.0 mGy per year in certain well-defined high-level natural radiation areas. As a part of the program to assess the health effects of this naturally occurring high-level natural radiation on human populations, monitoring of newborns is being undertaken to determine the incidence of congenital malformations. From August 1995 to December 1998, a total of 36,805 newborns were screened, including 212 (0.58%) stillbirths. There were 36,263 singletons, 536 (1.45%) twins, and 6 born as triplets. The overall incidence of malformations was 1.46% and was dependent on maternal age. The stillborns exhibited a very high malformation rate of 20.75% compared to 1.35% among the live births. Likewise, twins also had a higher malformation rate (2.99%) compared to singletons (1.44%). About 3.5% of the newborns originated from consanguineous marriages. Consanguinity also led to a relatively higher rate of malformations (1.97%) as well as of stillbirths (1.18%). About 92% of the deliveries took place by the maternal age of 29 years and only 1.2% among women above 34 years old. The stratification of newborns with malformations, stillbirths or twinning showed no correlation with the natural radiation levels in the different areas. Thus no significant differences were observed in any of the reproductive parameters between the two population groups based on the monitoring of 26,151 newborns from high-level natural radiation and 10,654 from normal-level natural radiation (dose rate </=1.5 mGy/year) areas of the Kerala coast.

Abnormalities, Radiation-Induced↗

[Suicide attempts according to age and sex].

This study reports of a further analysis on the data presented in a previous work. The intention of the present study was to analyse exhaustively the relationship between some social and demographic variables with some aspects of attempts to suicide. The variables for this study were chosen on the basis of the completeness of data. Sex, age, single vs. married, and family relationship of the subjects were the predictive variables; the aspects of attempts to suicide considered were: number, kinds, means, and motives of attempts. An analysis of canonical correlation failed to show clearly any common relationship of the demographic variables in regard to the aspects of attempts to suicide. In fact, the first group of covariates resulted in a correlation of .40 whose chi square was 22.16 for a p less than .10. However, an univariate analysis of multiple regression for each of the four aspects of attempts to suicide over the four demographic variables showed that a) age of subjects has a definite relationship with the motives to commit suicide, that is, with age; the motives to attempt suicide change predominantly from family difficulties to problems of a more social and professional character; b) also, it was observed a generalized tendency on the part of male subjects to show attempts to suicide of a more serious nature, namely, they plan their attempts and make use of means of a more lethal nature (poison instead of simple drugs). However, it must be noted that the male sample was older than the female, making it hard to decide in this case whether age or sex of the subjects would be the best predictor.

Adolescent↗

Spinal cord injury and sexuality in married or partnered men: activities, function, needs, and predictors of sexual adjustment.

The sexual behaviors, functioning, needs, and sexual satisfaction levels of men with spinal cord injuries (SCI) were studied. A sample of 50 men with SCI (median age = 50; median age at injury = 25.0), either married or in a committed relationship, responded to an anonymous survey of a large southern California regional spinal injury rehabilitation center. Multiple regression analyses indicated that perceived partner satisfaction, relationship quality, and sexual desire were significant predictors of sexual satisfaction and behavior. Erectile function, level of genital sensation, and orgasmic capacity all varied widely in the sample, as well. However, none of these variables were significantly related to sexual satisfaction. A varied sexual repertoire was independently related to sexual satisfaction and behavior, but did not offer additional predictive power. Results suggest that for married or partnered men with SCI, relationship factors including partner satisfaction and relationship quality are significantly and positively related to sexual satisfaction. Married or partnered men with SCI who report low relationship satisfaction, have difficulty satisfying their partner, and/or report low sexual desire may benefit from assessments and interventions that address these issues.

Adaptation, Psychological↗

Marital behavior, parenting behavior, and multiple reports of preschoolers' behavior problems: mediation or moderation?

Associations among positive and conflictual marital behavior and multiple reports of child behavior problems were examined in a community sample of 78 families with 3-year-old children. Maternal and paternal parenting behaviors were tested as potential mediators and moderators. Parents reported on child behavior problems and were observed during parent-child interaction and couple discussion in the presence of the child. Observers and preschool teachers also reported on child behavior problems. Less positive marital engagement and greater conflict were associated with observers' reports, but not with parents' or teachers' reports, of more behavior problems. Associations between marital behavior and child behavior problems were not explained by maternal or paternal behavior; stronger support was found for moderating effects of parenting. Also, positive marital engagement was a slightly better predictor of child behavior problems than was marital conflict.

Adult↗

Determinants of body mass index: a study from northern Italy.

Overweight and obesity are associated with increased mortality and morbidity, and human weight is influenced by multiple factors, both genetically and environmentally determined. We investigated the influence of some socioeconomic, behavioral, dietary and reproductive factors on body mass index (BMI). Data were obtained from a comparison group of a case-control study of gastrointestinal cancers from the four largest teaching and general hospitals in Milan, northern Italy. The subjects were 1,188 men and 832 women admitted between January 1985 and June 1992 to the hospitals under study for diseases other than malignant or digestive and not known or suspected to be related to alcohol or tobacco. The following were measured: BMI (Quetelet's index, weight, kg/height, m2) and the corresponding standard errors (s.e.) in strata of selected variables, linear regression coefficients (beta) and correlation coefficients between BMI and each variable. Mean BMI increased with age until 35-44 years in men and 45-54 years in women. In both sexes BMI was inversely associated with education and social class. Smokers tended to be leaner than non-smokers, but no consistent trend was observed with increasing numbers of cigarettes. Alcohol drinkers had mean BMI similar to non-drinkers, except heavy drinking women who were lighter. BMI was not significantly associated with coffee, decaffeinated coffee, tea, bread, vegetable and fruit consumption. No relation was observed between total estimated caloric intake and BMI. In women BMI was directly associated with marriage and number of children, and inversely with oral contraceptive use.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

It's not just who you're with, it's who you are: personality and relationship experiences across multiple relationships.

The present study examined the influence of stable personality traits on romantic relationships using longitudinal data on a large, representative sample of young adults. Relationship experiences (quality, conflict, and abuse) showed relatively small mean-level changes over time and significant levels of rank-order stability, even across different relationship partners. Antecedent personality traits (assessed at age 18) predicted relationship experiences at age 26 and change in relationship experiences from age 21 to 26. Conversely, relationship experiences also predicted change in personality. Importantly, these findings generally held across relationship partners, suggesting that some people tend to be generally happy (or unhappy) across relationships, and this is due, in part, to stable individual differences in personality. Discussion focuses on the broader implications of the findings, in particular the need for relationship researchers to consider the importance of personality for why relationships thrive or fail and the need for personality researchers to consider the impact of relationship experiences on intraindividual personality development.

Adaptation, Psychological↗

Current status of reproductive behaviour in Africa.

The current annual population growth rate of 3.2% in Africa will double the population by the year 2025. The majority of this population is below 15 years of age, and Africa concurrently also has the highest incidence of infertility in the world. Sexual behaviour, which has been poorly studied in Africa, has a direct impact on reproductive health [including fertility, infertility and sexually transmitted diseases (STDs)]. The multiple cultures and religions which characterize the African continent also affect reproductive health. Factors that have a significant effect on reproductive health in Africa include greater prevalence of extramarital/commercial sexual activity, polygamy, lower prevalence of contraceptives, reliance on traditional practices, high incidence of STDs and teenage pregnancies. High risk reproductive behaviours are predominantly displayed by adolescents, and the prevalence of STDs, including HIV (human immunodeficiency virus), is very high in this group. Pregnancy-related complications are the major cause of health-related problems in 15-19 year old girls. Maternal mortality rates in most countries remain high. Literacy rates affect these behaviours. It is apparent that changing the sexual behaviour of adolescents is one way of reversing the adverse trends, such as STD transmission, unwanted pregnancy and poor general reproductive health.

Adolescent↗

Social support and depressive symptoms in the elderly.

The purpose of this study was to examine the effect of characteristics of social networks and support on depressive symptoms in the elderly. The subjects were 1,962 noninstitutionalized persons 65 years and older from the New Haven Establishment of Populations for Epidemiologic Study of the Elderly in 1982, who were available to give a complete follow-up interview in 1985. Baseline depression, functional disability in 1982, and any change in disability by 1985 were considered as additional influences on 1985 depression, requiring adjustment along with sociodemographic variables. Multiple regression procedures were used to simultaneously examine the variables. Baseline depression, functional disability, and change in functional disability made the largest contribution to explaining the variance in depression. Among the social support and network characteristics, loss of a spouse, adequacy of emotional support, and its change during 1982-1985 made the largest contributions. Other significant characteristics in relative order of magnitude of effect, based on contrast tests, included tangible support adequacy and its change, loss of a confidant between 1982 and 1985, number of children making weekly visits and change in this number by 1985, and the absence of a confidant in both 1982 and 1985. For mental health outcomes, these findings emphasize the need to consider specific dimensions of social support and networks rather than global measures.

Aged↗

The relationship of psychological distress, extent of disease, and performance status in patients with lung cancer.

This study examined the association between two primary covariates, extent of disease (ED) and performance status rating (PSR), and the outcome of psychological distress in patients with small cell carcinoma of the lung. Patients were studied at the time of entry onto one of three Cancer and Leukemia Group B (CALGB) protocols: 7781 (N = 165) and 8083 (N = 139) for limited disease; and 7782 (N = 151) for extensive disease. Besides ED (limited versus extensive), a four-point rating of PSR was obtained. Psychological distress was measured by the standardized Profile of Mood States (POMS). Gender, age, marital status, education, PSR, ED and two relevant interaction terms (PSR X ED; gender X ED) were analyzed using multiple linear and hierarchical regressions. Of the six main variables, gender and PSR had significant association with POMS total mood disturbance, a summary score for POMS emotional subscales, and most of the individual subscales. The PSR X ED interaction provided a rationale for testing a new regression model in which PSR and ED were combined into a single index of impairment. The final index resulted in five levels of physical impairment which bear an approximately linear relationship to increasing levels of distress (Overall regression, P less than 0.001). These data suggest that PSR is an important factor in modelling POMS distress at both levels of ED, and that ED becomes an important factor with poorer performance status only.

Adult↗

Multiple drug regimens: medication compliance among veterans 65 years and older.

In this study we attempted to develop a profile that could be used prospectively to identify veterans over 64 years of age who might be at risk for medication noncompliance. Male veterans (N = 249) having from one to seven oral daily prescribed medications were studied. Instruments administered to determine their relationship to compliance were the Paired-Associate Test, the Mini Mental State, the Multidimensional Health Locus of Control, and the Standard Depression Scale. Compliance was determined by a pill count made at two home visits. Seventy-three percent of the subjects were noncompliant. Variables significantly related to noncompliance by bi-variate analysis were included in the stepwise logistic regression to develop a predictive model of noncompliance. Ethnicity and number of daily prescribed pills were the only significant variables in the final model. The model correctly classified the subjects as compliant/noncompliant in 77% of the cases. Discussions during home interviews revealed a number of common problems.

Age Factors↗

Sexuality and marital life: results of a survey.

This article presents the results of a telephone survey regarding the conjugal and sex life of men and women from the Montreal region. Surprising as it may seem, the relationship between sexual and marital functioning within the couple has been the focus of little study to date. In fact, relatively little is known about the relationship among sexual behavior, sexual attitudes, sexual fantasies, and marital functioning. In this survey, a questionnaire covering these four variables was administered to 996 subjects chosen at random. The results indicate that women seem to have a more positive perception of their sexual behavior, whereas men seem to have a more positive perception of their marital life. Multiple regression analyses were run to examine the relationship between marital functioning and items related to sexual functioning. The links between sexual satisfaction and other items of the questionnaire concerning sexual behavior, sexual attitudes, and sexual fantasies were also analyzed. For this purpose, we subdivided the subjects into two age groups (under 60 and 60 and over) based on the loss of interest in sexual activity that the questionnaire allowed to discern in the 60+ group. The relationship between marital functioning and items related to sexual behavior proved statistically significant. Various items pertaining to sexual functioning also proved to be related to a global assessment of sexual satisfaction. Cognitive variables (sexual attitudes and sexual fantasies) were found to influence sexual satisfaction but had a lesser impact on marital functioning. Gender and age (under 60 or 60 and over) also had an effect on these relationships.

Adult↗

Epidemiologic comparison of cancer of the testis and Hodgkin's disease among young males.

In 1970 the epidemiologic similarities between Hodgkin's disease and multiple sclerosis were first described, suggesting that a common agent or agents might be involved in their etiology. The hypothesis proposed at that time was that the agents followed the paralytic polio model: widespread infection with an agent of low pathogenicity at an early age, resulting in acquired immunity in later life. Lack of early infection results in the disease appearing in adulthood, with severe repercussions. This article extends the paralytic polio model to include testicular carcinoma, since the epidemiologic similarities between it and Hodgkin's disease are striking. Specifically, the authors compare age at clinical onset, histologic type, time trends, race, socioeconomic status, geographic variation, occupation, and familial aggregation. It is suggested that the possibility of common etiologies involved in the pathogenesis of these two cancers be tested further by epidemiologic, clinical, or laboratory studies.

Adolescent↗

Factors associated with marital satisfaction and mood among spouses of persons with chronic back pain.

UNLABELLED: Few studies have examined the impact of chronic pain on the spouse. In this study the impact of pain and disability as rated by both the patient and the spouse on spouse marital satisfaction and affective distress was examined in 110 couples. Zero-order correlations indicated that absolute ratings of perceived disability by the spouse, rather than discrepancies between spouse and patient ratings, were most highly associated with spouse marital dissatisfaction and affective distress. Predictors of spouse marital satisfaction and distress were examined by using simultaneous multiple regression. Spouse ratings of greater physical disability were significantly related to greater spouse affective distress. Spouse ratings of higher psychosocial disability, lower spouse marital satisfaction, and being a patient of male gender were marginally related to higher spouse affective distress. Spouse marital dissatisfaction was significantly associated with patient ratings of greater psychosocial disability and lower pain. Spouse-rated psychosocial disability and affective distress were also marginally related to spouse marital satisfaction. These findings highlight the importance of patient disability, particularly limitations in function as perceived by the spouse, on spouse adjustment. PERSPECTIVE: The impact of chronic pain on the spouse of the person with pain has received little empirical attention. The present study examines the relationship between patient and pain-related factors and psychosocial adjustment in the spouse.

Activities of Daily Living↗

Cognitive, interpersonal, and behavioral predictors of patients' and spouses' depression.

BACKGROUND: This study examined the relationship between five theory-based variables and the severity of depression. The variables were self-concept, self and spouse ascribed hostility, spouses' level of depression, and involvement in home activities. METHODS: Based on DSM-IV criteria and Beck Depression Inventory (BDI) scores, 75 wife-depressed couples and 59 husband-depressed couples were included in the study. In addition to the BDI, both spouses completed questionnaires relating to self-concept, self- and spouse ascribed hostility, and involvement in home activities. RESULTS: Multiple regression analyses for male and female patients and spouses revealed that in the four groups self-concept was significantly related to the severity of depression. Irrespective of clinical status, involvement in home activities was significantly associated with the severity of depression of women. The relationship between spouse ascribed hostility and the level of depression of both spouses in husband-depressed couples approached significance so did the relationship between patient's and spouse's level of depression in wife-depressed couples. In husband-depressed couples the association between spouses' level of depression reached significance. CONCLUSIONS: The shared and gender-related predictors of severity of depression support an integrative theoretical approach to depression and offer practical implications.

Adult↗

Sociocultural determinants of the help-seeking behavior of patients with mental illness.

This descriptive study employed semistructured interviewing and questionnaire administration to delineate the sociocultural determinants of the help-seeking process in 48 psychiatric patients. The help-seeking process is considered in two stages. The first stage starts from the recognition of initial symptoms and ends in the first contact with a mental health professional. The second stage is defined as that time between the first contact and actual participation in a planned treatment program. In both stages, patients typically go through phases of lay consultation, nonpsychiatric professional consultation, and referral. The multiple steps which are usually involved in help seeking often result in significant delay of both mental health contact and treatment. The help-seeking process was found to correlate strongly with ethnicity. Both Asians and Blacks showed more extended family involvement, and the involvement of key family members tended to be persistent and intensive in Asians. Ethnicity was also associated with the length of delay, with Asians showing the longest delay and Caucasians the least. These ethnic differences were also reflected in help-seeking pathway assignment using Lin's criteria. Although modernity and parochialism, as measured by the level of modernization and the cohesiveness of the social network system of the subjects, were also found to be correlated with delay, they appeared to exert an influence independent from that of ethnicity.

Adult↗