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PubMed2005

Prevalence and correlates of depression in Chinese oldest-old.

BACKGROUND: In Hong Kong, the aged population will be increased rapidly in the coming three decades and the oldest-old (aged 80 and above) is the fastest growing age group. In this paper, we examined the prevalence rate and the correlates of depression for the oldest-old. METHOD: This article analyzes cross-sectional data collected from a representative community sample of 1 903 Chinese elderly people aged 60 or above in Hong Kong. Respondents were interviewed in face-to-face format with structural questionnaire. RESULT: Using 8 as the cut-off point for the 15-item Geriatric Depression Scale, we found that the prevalence rate was greater for the oldest-old (31.1% +/- 9.7%) than for the young-old (aged between 60 and 69; 19.1% +/- 2.8%) and the old-old (aged 70 and 79; 22.4% +/- 4.2%) groups. Logistic regression analyses revealed that financial strain, poor self-rated health, loneliness, and heart disease were significantly and positively related to depression in the oldest-old after gender, marital status, education, living arrangement, functional disability, sensory impairment, cognitive ability, and the presence of eight medical conditions were controlled. Interestingly, financial strain, self-rated health, and loneliness were found to be significant correlates of depression in the young-old and the old-old groups, too. CONCLUSION: Depression is a serious problem for the oldest-old but a number of correlates are consistently identified in the oldest-old, as well as the two other age groups in the elderly population. Therefore, aged care service practitioners must take these correlates into consideration in their prevention and treatment for depression for all different age groups in the aged.

Age Distribution↗
PubMed2006

Anxiety symptoms during pregnancy and postpartum.

This cross-sectional study compared the distribution of anxiety symptoms among pregnant, non-pregnant, and postpartum women of lower socioeconomic status. Participants were 807 women who were pregnant (24-36 weeks), postpartum (2-8 weeks), or not pregnant. Anxiety and depressive symptoms were assessed by the state-trait anxiety index and the Beck depression inventory, respectively. English and Spanish versions of the instrument were available. Group differences in anxiety were evaluated using analysis of variance. Multivariate regression was performed to evaluate differences in anxiety while controlling for marital status, education, race/ethnicity, employment, cohabitation, income, parity, history of depression/anxiety, and depressive symptoms. Anxiety scores were lower among postpartum women relative to pregnant and non-pregnant women (both P < 0.001), who did not differ (P = 0.99). After controlling for depressive symptoms and patient characteristics, anxiety remained lowest among postpartum women. Additionally, history of depression/anxiety and depressive symptoms were significant predictors of anxiety in the multivariate analysis. Comparatively low anxiety and depressive symptoms were observed among women who were 2-8 weeks postpartum. Anxiety symptoms that occur postpartum may not appear until later in the postpartum period.

Adult↗
PubMed2003

Psychosocial factors associated with perceived psychological health, perception of menopause and sexual satisfaction in menopausal women and controls.

OBJECTIVES: The study investigated factors associated with attitude towards sex-role, self-image and marital satisfaction on psychological health status, perception of menopause and sexual satisfaction in climacteric women in Ibadan, Nigeria. SUBJECTS AND METHODS: 45 female participants were randomly selected from Ibadan. The mean age was 51.42 +/- 8.05 years (range = 36 - 70 years). The mean age for the 13 non-menopausal women was 42.79 +/- 3. 91 years (range = 42 - 47 years) while the mean age for the 32 menopausal women was 5.16 +/- 6.08 years (range = 47 - 70 years). The mean age of the children of the participants was 16.05 +/- 8.09 years (range = 1 - 36 years). A questionnaire having several subsections (consisting of the psychological health status of women in the climacteric, attitude towards sex role, perception of menopause, social support, marital satisfaction, self-image and sexuality scales was used for the assessment. RESULTS: Post-Menopausal women reported better psychological health compared to the pre-menopausal women (t = 1.86, p < .05) but no significant differences in their attitude to sex role. Post menopausal women had more positive attitude to sex (t = 3.15, p < .01) and were more knowledgeable about menopause (t = 2.15, p < .03). Women with conservative/reactionary preference for traditional sex roles reported negative perception of menopause compared to those with liberal attitude toward sex role (t = 1.82, p < 0.05). Menopausal Status, Educational level and social support predicted positive attitude to sex, (F = 3.62, P < .01). Age, self-image and attitude to sex domain of the marital satisfaction scale predicted better psychological health, and marital cordiality predicted better psychological health as measured by GIIQ (R2 = 25, beta = -43, t = -2.38, P < .02). Marital satisfaction significantly predicted better sexuality, (F = 5.47, R square = 0.11, p <0.05). Sources of information on menopause included health institutions, books, doctors, and books/health workers. CONCLUSION: The study highlights the need for sensitizing menopausal Nigerian women on how to improve their self-image, marital satisfaction, and sexual satisfaction. Conventional treatment options emphasizing hormone replacement therapy, need for nutritional supplement, dietary changes, marital and sex therapy are emphasized.

Adolescent↗
PubMedDate not supplied

[Occupational aging and cardiovascular diseases].

A short review of occupational aging and cardiovascular disease is presented. Coronary and stroke events are typical diseases of aging, in which rare monogenic disorders and common polymorphisms interact with environmental factors. Among these factors, particular attention has been given to social and occupational organizations. Cardiovascular mortality apparently increases with heavy industrialization processes and lower socioeconomic and educational status. Similar data are now available for incidence and case fatality. Since traditional risk factors--e.g., cholesterol, blood pressure and smoking--follow the same pattern, but with a weaker association than expected, observational and preventive studies are considering risk possibilities beyond such factors. Job demand/job decision latitude is the most widely used paradigm to evaluate specific organizational risk at work. A few cohort or population studied and many cross-sectional studies have shown an independent and inverse relationship between decreasing control of the job, coronary disease and blood pressure levels. While such results need further confirmation, they suggest the need for more accurate research on the adverse or mutually protective influences of long-lasting adaptation processes required by prevailing work organization.

Adult↗
PubMed1997

Inequality in health and health service use for mothers of young children in south west England. Survey Team of the Avon Longitudinal Study of Pregnancy and Childhood Team.

OBJECTIVE: To establish the degree of association between relative deprivation and any variation in condition specific morbidity and in consultations with general practitioners for mothers of young children. STUDY DESIGN: Condition specific morbidity and general practitioner consultation (GP) rates were recorded by means of self reports on a postal questionnaire. Subjects were asked to record whether they had suffered from any of 16 common conditions and, if so, whether they had consulted the GP. Relative deprivation was measured using indicators such as home ownership, overcrowded living conditions, car ownership, and partners' employment status. Information was also collected about the women's own employment status, their ages, and parity. SETTING: The three district health authorities of Bristol. All women expecting a baby between April 1991 and December 1992 were invited to participate. SUBJECTS: Altogether 11040 mothers who completed questionnaires about their own health and well being at 8 months postpartum as part of the Avon longitudinal study of pregnancy and childhood. OUTCOME MEASURES: The percentage of mothers reporting any of 16 common conditions since the birth of their child and the proportion of them who consulted the GP if a condition was reported. chi 2 tests of independence were used to examine the association between condition specific morbidity and social, demographic, and maternal characteristics. Latent class analysis was used to "cluster" mothers according to the particular configuration of social, demographic, and maternal characteristics associated with levels of morbidity for each of the six most commonly reported conditions. The probability of consulting a GP was then compared between clusters. RESULTS: Relative deprivation had a greater impact on morbidity and GP consultation for stress related conditions such as depression, anxiety, and headache/migraine. For all these conditions, higher levels of self reported morbidity and a greater probability of consulting the doctor were associated with a cluster of social disadvantage-living in rented accommodation, non-employment, younger age, and lower educational status. For other conditions such as backache, haemorrhoids, and cough/cold, however, higher morbidity was associated with a cluster of advantage-home ownership, uncrowded living conditions, use of car, and partner in employment. Where there was variation in the probability of consulting the GP for these conditions, it was linked to parity rather than socioeconomic factors. Higher levels of morbidity for all but one condition (backache) were also associated with having more than one child, but this cross-cut socioeconomic and demographic cluster characteristics; both more affluent, older mothers and younger, more deprived mothers were likely to be multiparous. CONCLUSIONS: Relative deprivation was associated with poorer mental but not physical health for this population of mothers of young children. These findings have implications for a more targeted approach to reducing inequality in health. The importance of examining inequality in health for women in relation to their own material circumstances, their employment status, and parity, is emphasised.

Adult↗
PubMed1984

Unilateral hearing impairment in children.

An overview and update are offered on difficulties experienced by children with monaural sensorineural deafness. It is the general consensus that children with unilateral hearing loss experience few, if any, communication and/or educational problems. The medical and educational status of a group (N = 60) of children with unilateral, hearing impairment are described. In addition, the auditory, linguistic, and behavioral manifestations of unilateral hearing impairment were studied in considerable detail for a subsample of these 60 children. The results revealed that approximately one third of the children with unilateral hearing loss had failed at least one grade. Nearly 50% of the group had either failed a grade and/or needed resource assistance in the schools. The small subsample of children with unilateral hearing loss performed much poorer than a matched group of children with normal hearing on both a localization and a syllable recognition task. Finally, the data on behavioral and linguistic manifestations of monaural hearing loss indicate that children with unilateral hearing impairment are experiencing more problems than previously supposed.

Audiometry↗
PubMed2003

Oral cancer awareness and prevalence of risk behaviours among dental patients in South-western Nigeria.

The present study, based in a tertiary hospital in South western Nigeria, assessed cancer awareness among patients seeking dental treatment. A specially designed questionnaire was used to collect information on the knowledge, beliefs and habits of those attending the dental hospital within a designated period of the year. Almost 61% of the respondents had post-secondary education. The level of oral cancer awareness was remarkably high (72%), but this was low compared to awareness about occurrence of cancer in other parts of the body (89.9%). Awareness was found to be closely associated with educational status. The study also revealed that 50% had previous information on oral cancers from mass media as against 20.1% who were informed through health care professionals. Almost half of the study sample recalled episodes of previous oral ulceration and of these, greater than 50% indulged in either self medication (38.1%) or no medication at all (18.4%). The prevalence of alcohol consumption and smoking habits among the respondents was low being, 16.3% and 4.2% respectively. The lack of association, in this study, between oral cancer incidence and the known risk behaviours, is an obvious indication for investigation into other predisposing factors such as nutrients, genetic predisposition and the role of chronic infections. Perhaps one or more of these might be more relevant in this environment.

Adolescent↗
PubMed2006

Changing drinking pattern does not influence health perception: a longitudinal study of the atherosclerosis risk in communities study.

OBJECTIVE: To investigate if dynamic changes in the pattern of alcoholic beverages consumption are associated with modifications in health perception. DESIGN, SETTING, AND PARTICIPANTS: This study investigated 12 332 middle aged men and women from the atherosclerosis risk in communities study who reported drinking status and perceived health triennially from 1987 to 1995. Crude and adjusted risks for change in health perception between visits two and three by change in drinking status between visits one and two were computed. In the multivariate analysis the sample was restricted to participants with stable drinking status between visit two and three and stable health perception between visits one and two, to assure that exposure and outcome were not temporary. Covariates included age, sex, race, income, smoking status, educational level, and obesity. RESULTS: Health for persons who stopped or started drinking, or continued to abstain was more likely to decline than was health for persons who continued to drink even after adjustment and restrictions (drinking cessation: OR = 1.6, 95% CI = 1.1, 2.3; started drinking; OR = 1.4, 95% CI = 0.9, 2.2; continued abstaining from alcohol: OR = 1.5, 95% CI = 1.3, 1.9). Among participants with poor perceived health, starting, stopping, or continuing to abstain from alcohol did not improve health in relation to participants that continued to drink. CONCLUSION: Increasing and decreasing drinking patterns and continuous abstinence were associated with declining health perception in comparison with continuous drinking, while starting or stopping drinking did not improve health perception of persons with poor perceived health. These findings suggest that change in health perception was not biologically related to alcohol consumption.

Alcohol Drinking↗
PubMed1999

Age differences in depression and anxiety symptoms: a structural equation modelling analysis of data from a general population sample.

BACKGROUND: There is debate as to whether the elderly are really at lower risk for depressive disorders, or whether endorsement of symptoms is artefactually low. The present paper assesses the effects of age on anxiety and depression, and examines whether age has direct effects on self-report of individual symptoms independent of its effect on the underlying dimensions of anxiety and depression. METHODS: Structural equation modelling was used to assess the structure of the items and their associations with age and a number of demographic variables. The sample of 2622 participants aged between 18 and 79 years from Canberra (Australia) was drawn from the Electoral Roll. Two instruments were used: the anxiety and depression scales of Goldberg et al. (1988) and the Personal Disturbance Scale from the DSSI of Bedford et al. (1976). RESULTS: Both scales were found to fit satisfactorily to a two factor model. Age correlated negatively with depression. After controlling for the effects of gender, marital status, education and financial difficulty, direct effects of age were found on items from both instruments, indicating that certain depression items were associated with a differential probability of endorsement in older people, even when the level of depression was equal to that of younger people. Items with direct age effects reflected physical (feeling slowed down; waking early) and psychological (hopeless about the future) components of depression. Direct effects of age on items from both anxiety scales were also found. CONCLUSIONS: The nature of the depression and anxiety experienced by younger and older people may differ qualitatively. Depression may be associated with an increase in somatic symptoms linked to physical changes and to an increase in endorsement of items which reflect the narrowing of opportunities in the long-term.

Adolescent↗
PubMed2002

Intimate partner violence and physical health consequences.

BACKGROUND: Domestic violence results in long-term and immediate health problems. This study compared selected physical health problems of abused and never abused women with similar access to health care. METHODS: A case-control study of enrollees in a multisite metropolitan health maintenance organization sampled 2535 women enrollees aged 21 to 55 years who responded to an invitation to participate; 447 (18%) could not be contacted, 7 (0.3%) were ineligible, and 76 (3%) refused, yielding a sample of 2005. The Abuse Assessment Screen identified women physically and/or sexually abused between January 1, 1989, and December 31, 1997, resulting in 201 cases. The 240 controls were a random sample of never abused women. The general health perceptions subscale of the Medical Outcomes Study 36-Item Short-Form Health Survey measured general health. The Miller Abuse Physical Symptom and Injury Scale measured abuse-specific health problems. RESULTS: Cases and controls differed in ethnicity, marital status, educational level, and income. Direct weights were used to standardize for comparisons. Significance was tested using logistic and negative binomial regressions. Abused women had more (P<.05) headaches, back pain, sexually transmitted diseases, vaginal bleeding, vaginal infections, pelvic pain, painful intercourse, urinary tract infections, appetite loss, abdominal pain, and digestive problems. Abused women also had more (P< or =.001) gynecological, chronic stress-related, central nervous system, and total health problems. CONCLUSIONS: Abused women have a 50% to 70% increase in gynecological, central nervous system, and stress-related problems, with women sexually and physically abused most likely to report problems. Routine universal screening and sensitive in-depth assessment of women presenting with frequent gynecological, chronic stress-related, or central nervous system complaints are needed to support disclosure of domestic violence.

Adult↗
PubMed1995

Significance of various factors in patients with functional dyspepsia and peptic ulcer disease in Greece. A comparative prospective study.

This prospective study was undertaken to evaluate the significance of factors such as age, sex family history, educational status, residence area, H pylori antral colonization, smoking, alcohol consumption, coffee and cola drinking in Greek patients suffering from functional dyspepsia (FD), duodenal ulcer (DU), and gastric ulcer (GU). The study groups were chosen among consecutive outpatients who had undergone an upper gastro-intestinal (GI) endoscopy during a ten-month period because of dyspepsia, and who completed a suitable questionnaire; 295 patients aged 18-85 years (M: 185, F: 110) were finally included as follows: 54 patients aged 18-80 years M: 21, F: 33) with FD, 166 aged 19-85 years (M: 117, F: 49) with DU, and 75 aged 24-85 years (M: 47, F: 28) with GU. As controls for FD patients, 54 previously studied, healthy non-dyspeptic people, well matched for age and sex, were used. No differences were found between them and FD patients. On the contrary, we found that the 3 groups of patients differed significantly for age (p = 1.07 x 10(-3)) and sex (p = 1.67 x 10(-4)) distribution. There was a rather even age distribution and a discrete female predominance in the FD group. Positive family history for peptic ulcer disease (PUD) was found in 19% of patients with FD as compared with 48.2% (DU) and 37% (GU) (p = 4.84 x 10(-4)). Significantly more patients with PUD were smokers (p = 6.16 x 10(-3)) and alcohol drinkers (p = 1.84 x 10(-4)). H pylori antral colonization was found in 61% of patients with FD as compared with 74% (GU) and 85% (DU) (p = 8.65 x 10(-4)) of patients. Finally, factors such as educational level, area of residence, and cola drink consumption did not differ in the studied groups of patients.

Adult↗
PubMed2006

ACOG Committee Opinion No. 343: psychosocial risk factors: perinatal screening and intervention.

The American College of Obstetricians and Gynecologists advocates assessing for psychosocial risk factors and helping women man-age psychosocial stressors as part of comprehensive care for women. Psychosocial screening of all women seeking pregnancy evaluation or pre-natal care should be performed regardless of social status, educational level,or race and ethnicity. Because problems may arise during the pregnancy that were not present at the initial visit, it is best to perform psychosocial screen-ing at least once each trimester to increase the likelihood of identifying important issues and reducing poor birth outcomes. When screening is completed, every effort should be made to identify areas of concern, validate major issues with the patient, provide information, and, if indicated, make suggestions for possible changes. When necessary, the health care provider should refer the patient for further evaluation or intervention. Psychosocial risk factors also should be considered in discharge planning after delivery. Many of the psychosocial issues that increase the risk for poor pregnancy outcome also can affect the health and welfare of the newborn. Screening should include assessment of barriers to care, unstable housing, unintended pregnancy, communication barriers, nutrition, tobacco use, substance use,depression, safety, intimate partner violence, and stress.

Domestic Violence↗
PubMed2003

The influence of demographic and disease-related factors on health-related quality of life in patients with ulcerative colitis.

OBJECTIVE: The aims of this study were to analyse the health-related quality of life of patients with ulcerative colitis and to assess in what way demographic and disease-related factors influence patients' experiences of this, in order to interpret the results of health-related quality of life assessment more correctly. PATIENTS AND METHODS: We carried out a cross-sectional evaluation of 300 consecutive patients with ulcerative colitis from the catchment areas of Linköping University Hospital and Orebro University Hospital in Sweden. Health-related quality of life was measured using four questionnaires: the IBDQ, the RFIPC, the SF-36 and the PGWB. Disease activity was evaluated using a one-week symptom diary, blood tests and rigid sigmoidoscopy. Demographic factors (gender, age, civil status, educational level), disease-related factors (disease duration, disease extent, disease activity) and presence of co-morbidity were obtained. RESULTS: Health-related quality of life was mainly impaired in the psychological and social areas and to a much lesser degree in physical areas. Patients with relapse had significantly more disease-related worries and concerns (the RFIPC), more impaired social functioning (the IBDQ and SF-36), and a lower feeling of well being (the IBDQ, the SF-36 and the PGWB). However, their physical function (SF-36) was no worse than patients in remission. Besides the symptom burden of the current disease, co-morbidity and female gender were associated with a lower health-related quality of life. CONCLUSION: To correctly interpret health-related quality of life assessments, it is necessary to consider co-morbidity and gender distribution in addition to the symptom burden of the disease studied.

Adult↗
PubMed2006

Association of a traditional vs shared meal decision-making and preparation style with eating behavior of Hispanic women in San Diego County.

OBJECTIVE: To examine the influence of meal decision-making and preparation on Hispanic women's dietary practices. DESIGN: One-on-one structured interviews were conducted, assessing meal decision-making and preparation practices, barriers, and behavioral strategies to eating low-fat and high-fiber diets, fat and fiber intake, demographic, and other psychosocial factors. SUBJECTS/SETTING: The study population included 357 Hispanic women living in the southern or central regions of San Diego County. Participants were recruited via random-digit dialing to a tailored nutrition communication intervention. MAIN OUTCOME MEASURE: Household decision-making style (alone vs with family) by household activity (decides meals, prepares meals, and decides snacks). STATISTICAL ANALYSES PERFORMED: Multiple logistic regressions were used to evaluate associations between the predictors and dependent variable. All models included adjustments for potential confounders, such as marital status, education, employment, age, and acculturation. RESULTS: A positive statistical association between Hispanic women's acculturation level and shared decision-making style was found. Also, Hispanic women in shared decision-making households faced greater psychosocial barriers to healthful eating and reported less healthful eating compared with Hispanic women in traditional households. Women in shared decision-making households were more likely to eat at fast-food restaurants, less likely to engage in behavioral strategies promoting fiber consumption, eat more saturated fat, and encounter more barriers to reduce dietary fat as compared with Hispanic women in traditional households. Acculturation did not attenuate differences in psychosocial and dietary practices between shared decision-making and traditional households. CONCLUSIONS: Study findings suggest intervention efforts should focus on different aspects of healthful eating among Hispanic women in shared-decision, compared with traditional, households.

Acculturation↗
PubMedDate not supplied

Age-related differences in the course of alcohol withdrawal in hospitalized patients.

The aim of this study was to compare the course of alcohol withdrawal (AW) syndromes in different age groups of hospitalized patients. Medical records of 892 patients treated for AW in Nowowiejski Hospital in Warsaw, Poland from 1973 to 1987 were reviewed using a structured questionnaire; a further 321 patients were observed on a prospective basis in the years 1990-1999. We compared severity of the symptoms and the course of AW episodes in five age groups: <30, 30-39, 40-49, 50-59 and > or =60 years old. Although the age groups did not differ in respect of gender, there were significant differences in other demographic variables, such as marital status, education, employment and number of households. We found a greater prevalence of somatic diseases and hypokalaemia in the older age groups. Older patients were hospitalized longer than the younger patients. The amount of alcohol consumed was significantly smaller in the older patients. No significant differences were found between age groups in the duration and severity of AW symptoms. All age groups required comparable doses of medication. The relationship between the duration of AW and the amount of alcohol consumed during the last drinking bout was significant in patients aged >50 years. There was also a significant positive correlation between the occurrence of withdrawal seizures or the severity of AW symptoms and the number of previous AW episodes in patients aged > or =40 years. Although the results did not confirm some previously reported differences in the course of AW between older and younger patients, they point to some new important differences in the conditions and course of AW in the elderly.

Adolescent↗
PubMed1999

Development and testing of a five-item version of the Geriatric Depression Scale.

OBJECTIVE: To develop and test the effectiveness of a 5-item version of the Geriatric Depression Scale (GDS) in screening for depression in a frail community-dwelling older population. DESIGN: A cross-sectional study. SETTING: A geriatric outpatient clinic at the Sepulveda VA Medical Center, Sepulveda, California. PARTICIPANTS: A total of 74 frail outpatients (98.6% male, mean age 74.6) enrolled in an ongoing trial. MEASUREMENTS: Subjects had a comprehensive geriatric assessment that included a structured clinical evaluation for depression with geropsychiatric consultation. A 5-item version of the GDS was created from the 15-item GDS by selecting the items with the highest Pearson chi2 correlation with clinical diagnosis of depression. Sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values were calculated for the 15-item GDS and the new 5-item scale. RESULTS: Subjects had a mean GDS score of 6.2 (range 0-15). Clinical evaluation found that 46% of subjects were depressed. The depressed and not depressed groups were similar with regard to demographics, mental status, educational level, and number of chronic medical conditions. Using clinical evaluation as the gold standard for depression, the 5-item GDS (compared with the 15-item GDS results shown in parentheses) had a sensitivity of .97 (.94), specificity of .85 (.83), positive predictive value of .85 (.82), negative predictive value of .97 (.94), and accuracy of .90 (.88) for predicting depression. Significant agreement was found between depression diagnosis and the 5-item GDS (kappa = 0.81). Multiple other short forms were tested, and are discussed. The mean administration times for the 5- and 15-item GDS were .9 and 2.7 minutes, respectively. CONCLUSIONS: The 5-item GDS was as effective as the 15-item GDS for depression screening in this population, with a marked reduction in administration time. If validated elsewhere, it may prove to be a preferred screening test for depression.

Activities of Daily Living↗
PubMed2003

Social participation and health in a community rich in stock of social capital.

In Finland, members of the Swedish-speaking minority, many of whom live in the province of Ostrobothnia, intermingle with the Finnish-speaking majority. Although the two language communities are quite similar to each other in most societal respects, including socioeconomic status, education and use of health services, significant disparities have been reported in the morbidity, disability and mortality between the Swedish-speaking minority and the Finnish-speaking majority. Since the population genetic, ecological and socioeconomic circumstances are equal, Swedish speakers' longer active life is difficult to explain by conventional health-related risk factors. A great deal of health inequality (between the language groups) seems to derive from uneven distribution of social capital, i.e. the Swedish-speaking community holds a higher amount of social capital that is associated with their well-being and health. Factor analysis revealed four patterns of social capital measures, i.e. voluntary associational activity, friendship network, religious involvement and hobby club activity, of which associational activity, friendship network and religious involvement were significantly associated with good self-rated health. Also, trustful friendship network, hobby club activity and religious involvement as well as avoidance of intoxication-prone drinking behavior were significantly more frequent among the individuals of the Swedish-speaking community. We suggest that health promotion should seek ways of working which would encourage social participation.

Adolescent↗
PubMed2003

The Internet as a source of health information among Singaporeans: prevalence, patterns of health surfing and impact on health behaviour.

OBJECTIVE: The Internet is an increasingly popular source of healthcare information. This study describes the prevalence of health surfers in Singapore and their health-surfing patterns. It also assesses their confidence in online health information and the impact the Internet has on health-seeking behaviour. MATERIALS AND METHODS: A cross-sectional survey using a standardised questionnaire was carried out among residents aged 13 to 55 years in 1852 units in Bishan North. These units were selected by single-stage simple random cluster sampling method. RESULTS: The household response rate was 51% (n = 950) and the individual response rate was 69% (n = 1646). Responding and non-responding households were similar in terms of ethnicity and housing type. Of the responders, 62.9% surfed the Internet and 37.7% have surfed for health information. Health surfers tended to be younger (20 to 39 years) and have higher education status. Indians were also more likely than other ethnic groups to surf for health. Professional health-related sites comprised the majority (68%) of sites visited, and the most common search keywords concern chronic degenerative diseases, e.g. hypertension. The top preferred sources of health information were doctors (25.9%), the Internet (25.3%) and the traditional mass media (20.5%). Almost half (45.1%) considered online health information trustworthy if it was from a professional source or if the website displayed the source, while 10.6% trusted the information if it concurred with the doctors' advice. The vast majority (91.7%) had taken some action in response to the information. CONCLUSION: The Internet is being used as an accessible source of health information by a substantial proportion of the lay public. While this can facilitate greater partnership in healthcare, it underlines the need for doctors to be pro-active in the practice of evidence-based medicine, and for guidelines to enable patients to use this tool in a discerning manner.

Adolescent↗