[The youthful personality and disease status. Relationships between th e disease and health status and personality in young workers. The result of a sociological study. II].
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Adult↗
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Temperament and satisfaction with health status among persons with rheumatoid arthritis.
PURPOSE: Health-related quality of life is a subjective phenomenon shaped by personal attributes. Research has demonstrated links between temperament and health outcomes. Because temperament is relatively stable, it could function as a moderator of quality of life. This study examined relationships among temperament disposition and satisfaction with health status. DESIGN: The model developed by Sprangers and Schwartz was used to develop a secondary analysis of data collected in a cross-sectional, correlational study with stepwise linear regression analysis. Instruments used were MPQ (dispositions) and AMIS2 (health satisfactions). SETTING: Two rheumatology private practices and 3 rheumatology clinics. SAMPLE: One hundred fifty-three persons diagnosed with rheumatoid arthritis (mean age = 55.4). FINDINGS: Scores reflecting Negative Affectivity (intrapersonal orientation and perception) demonstrated significant positive correlation (r = .26-.58) with all health domain satisfaction scores (P < .001). Negative Affectivity and Positive Affectivity (interpersonal orientation) jointly predicted 8.2%-37.8% of score variance. CONCLUSION: Temperament dispositions are associated with health-related satisfaction. IMPLICATION: Assessment of temperament can facilitate early identification of potential problems in the 3 quality of life domains (meaningfulness, manageability), and comprehensibility, and is useful for selecting or designing tailored interventions.
Activities of Daily Living↗
Relationship between very high physical activity energy expenditure, heart rate variability and self-estimate of health status in middle-aged individuals.
In middle-aged persons, moderate physical activity energy expenditure (PAEE) has been shown to be associated with increased vagal-related heart rate variability (HRV) indexes and better health status. The purpose of this study was to determine whether a very high PAEE has greater effect on vagal-related HRV indexes and self-estimates of well-being in middle-aged subjects having distinct long-term physical activity profiles. Forty-four subjects were divided into three groups on the basis of the sport score of the Modified Baecke Questionnaire for Older Adults: sedentary (SED, n = 15), moderately-trained (MT, n = 16), and highly-trained subjects (HT, n = 13). PAEE was estimated by triaxial accelerometry during one week. Time and frequency domain HRV indexes were determined during quiet periods in the morning on 5-min R-R interval segments under controlled breathing. Quality of life was evaluated using the SF-36 health survey questionnaire. PAEE was significantly different for each group (374.5 +/- 13.8, 616.8 +/- 22.4, and 1086.6 +/- 43.2 kcal . day (-1) for SED, MT, and HT, respectively, p < 0.001). MT presented significantly higher vagal-related HRV indexes than SED and HT (p < 0.05). None of the HRV indexes was significantly greater in HT than in SED. MT and HT had similar health status scores, which were significantly higher than for SED. These results indicate that in middle-aged subjects, habitual moderate PAEE is associated with greater vagal tone and self-estimates of well-being compared to low PAEE. In contrast, very high PAEE is associated with similar vagal-related indexes as low PAEE, despite better overall health status.
Aging↗
Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change.
Changes in scores on health status questionnaires are difficult to interpret. Several methods to determine minimally important changes (MICs) have been proposed which can broadly be divided in distribution-based and anchor-based methods. Comparisons of these methods have led to insight into essential differences between these approaches. Some authors have tried to come to a uniform measure for the MIC, such as 0.5 standard deviation and the value of one standard error of measurement (SEM). Others have emphasized the diversity of MIC values, depending on the type of anchor, the definition of minimal importance on the anchor, and characteristics of the disease under study. A closer look makes clear that some distribution-based methods have been merely focused on minimally detectable changes. For assessing minimally important changes, anchor-based methods are preferred, as they include a definition of what is minimally important. Acknowledging the distinction between minimally detectable and minimally important changes is useful, not only to avoid confusion among MIC methods, but also to gain information on two important benchmarks on the scale of a health status measurement instrument. Appreciating the distinction, it becomes possible to judge whether the minimally detectable change of a measurement instrument is sufficiently small to detect minimally important changes.
Attitude to Health↗
Does addition of inhaled steroid to combined bronchodilator therapy affect health status in patients with COPD?
OBJECTIVE: Withdrawal of corticosteroid is associated with a deterioration of health status in COPD. In this study the aim was to determine whether high dose inhaled corticosteroid improves quality of life in patients with COPD. METHODOLOGY: In total, 38 male patients with moderate COPD were included in the study. Baseline quality of life scores were determined using a Turkish version of the St George's Respiratory Questionnaire (SGRQ). Patients were randomly divided into two groups. Group 1 consisted of 20 patients who received existing bronchodilator therapy plus inhaled corticosteroid (800 micro g budesonide) for 12 weeks, while 18 patients in group 2 received bronchodilator and placebo. The SGRQ was repeated after the treatment period. RESULTS: All patients were male and mean age was 67 +/- 8.2 years. Symptom, activity, impact, and total scores were assessed and a difference of four units with treatment was considered to be clinically significant. Total score and activity score were decreased by six units and eight units, respectively, in the placebo group while symptom and impact scores did not change significantly. Total scores and the three component scores improved significantly in the corticosteroid group compared to the placebo group (Deltatotal score: -22 in corticosteroid group, -6 in placebo group, P < 0.01). CONCLUSION: Inhaled corticosteroid improved quality of life scores in patients with COPD, without significant improvement in airflow obstruction parameters. Since improvement of health status is one of the important aims in COPD treatment, use of inhaled corticosteroids should be considered from this perspective.
Administration, Inhalation↗
Self-assessed oral health status of ethnic minority residents of South London.
OBJECTIVE: To determine the self-assessed oral health status of individuals from minority ethnic communities living in South London. METHOD: A sample of 1,057 individuals from minority ethnic communities (as defined by Office of Censuses and Surveys categories) resident in South London were asked to complete measures of their oral and facial symptoms, the impact of their oral health on their daily functioning and of their satisfaction with the appearance of their teeth and gums. MEASURES: Self-assessed oral health status was determined by means of two short scales addressing oral symptoms and the impact of oral health on activities of daily living. Satisfaction with the appearance of the teeth and gums was also assessed. FINDINGS: No significant differences were found between minority ethnic communities in the number of symptoms reported, in the level of impact which such symptoms cause, or in their dissatisfaction with the appearance of their teeth and gums. Reporting of symptoms and impact were mildly though significantly correlated with dissatisfaction. CONCLUSIONS: There appears to be little difference between ethnic communities in their reporting of oral and facial symptoms, though these groups report higher levels of dissatisfaction with the appearance of their teeth and gums. Social and demographic factors play an important role in determining perceptions of oral health. The findings should be interpreted with caution given the difficulty of sampling minority ethnic communities and the subsequent limited representativeness of the sample.
Activities of Daily Living↗
Potential predictors of information-seeking behavior by homosexual/bisexual (gay) men with a human immunodeficiency virus seropositive health status.
Seeking ways to improve their health, gay men with human immunodeficiency virus (HIV) infections living in San Francisco are developing information networks and patterns of self-care behavior. Drawing from a set of explanatory theories, this cross-sectional survey with retrospective elements examined patterns and potential predictors of information-seeking activity in a cohort or 162 HIV seropositive (HIV+) men, 60 of whom provided complete data sets. The study suggests that 1 year after becoming aware of an HIV+ health status, most patients have developed multifaceted information networks. The amount of tangible aid acquired from these networks and frequency of consultation is positively related to patterns of HIV self-care behaviors and "feeling calm" (p less than 0.01), suggesting that these variables may be important markers for the need of supportive-educative nursing care. Suggestions for nursing practice and research are also described.
Bisexuality↗
Health status of urban American Indians and Alaska Natives. A population-based study.
OBJECTIVE: To use vital statistics and communicable disease reports to characterize the health status of an urban American Indian and Alaska Native (AI/AN) population and compare it with urban whites and African Americans and with AI/ANs living on or near rural reservations. DESIGN: Descriptive analysis of routinely reported data. SETTING: One metropolitan county and seven rural counties with reservation land in Washington State. SUBJECTS: All reported births, deaths, and cases of selected communicable diseases occurring in the eight counties from 1981 through 1990. MAIN OUTCOME MEASURES: Low birth weight, infant mortality, and prevalence of risk factors for poor birth outcomes; age-specific and cause-specific mortality; rates of reported hepatitis A and hepatitis B, tuberculosis, and sexually transmitted diseases. RESULTS: Urban AI/ANs had a much higher rate of low birth weight compared with urban whites and rural AI/ANs and had a higher rate of infant mortality than urban whites. During the 10 years, urban AI/AN infant mortality rates increased from 9.6 per 1000 live births to 18.6 per 1000 live births compared with no trend among the other populations. Compared with rural AI/AN mothers, urban AI/AN mothers were 50% more likely to receive late or no prenatal care during pregnancy. Relative to urban whites, urban AI/AN risk factors for poor birth outcomes (delayed prenatal care, adolescent age, and use of tobacco and alcohol) were more common and closely resembled the prevalence among the African-American population except for a higher rate of alcohol use among AI/ANs. Compared with urban whites, urban AI/AN mortality rates were higher in every age group except the elderly. Differences between urban whites and AI/ANs were largest for injury- and alcohol-related deaths. All-cause mortality was lower among urban AI/ANs compared with rural AI/ANs and urban African Americans, although injury- and alcohol-related deaths were higher for AI/ANs. All communicable diseases studied were significantly (P < .05) more common among urban AI/ANs compared with whites. Tuberculosis rates were highest in the urban AI/AN group, but rates of sexually transmitted diseases were intermediate between urban whites and African Americans. CONCLUSIONS: In this urban area, great disparities exist between the health of AI/ANs and whites across almost every health dimension we measured. No consistent pattern was found in the comparison of health indicators between urban and rural AI/ANs, though rural AI/ANs had lower rates of low birth weight and higher rates of timely prenatal care use. The poor health status of urban AI/AN people requires greater attention from federal, state, and local health authorities.
Adolescent↗
The influence of lifestyle and health status factors on sleep loss among the Japanese general population.
STUDY OBJECTIVE: To examine the relationship between lifestyle, health status factors and sleep loss. DESIGN: A cross-sectional questionnaire survey conducted by the Ministry of Health and Welfare, Japan. SETTING: N/A. PATIENTS OR PARTICIPANTS: Approximately 30,000 subjects selected from the general population in Japan. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: This study indicated that approximately 28% of the general population sleep less than 6 hours nightly and approximately 65% sleep less than 7 hours. However, approximately 80% of the population reported getting sufficient sleep. Multiple logistic regression analysis showed that being females, being of younger age, living in an urban environment, being unemployed, and having an unhealthy lifestyle (i.e., lack of exercise, poor health status, and irregular eating habits) were associated with sleep loss. CONCLUSION: In this study, sleep loss was found to be associated with having an unhealthy lifestyle and being in poor general health. These findings suggest that health education and promotion of a healthy lifestyle should be advocated.
Adult↗
Health status of people with epilepsy compared with a general reference population.
PURPOSE: To study the impact of epilepsy in a representative sample of people with epilepsy and compare with a normal reference population. METHODS: We collected clinical and demographic data and information on health status by using the Short Form 36 (SF-36) questionnaire in two populations: (a) 397 patients with confirmed epilepsy attending a county hospital during a 7-year period, and (b) 1,663 patients from a random sample representative of the entire national population. RESULTS: The respondents with epilepsy had well-regulated disease and showed the characteristics of a community sample: 70% had had no seizures during the last year, and 80% used antiepileptic drugs (AEDs). On six of eight SF-36 scales, patients with epilepsy had lower scores than the normal reference population, and they were less likely to be married, employed, or a full-time student. Seizure-free patients with epilepsy had scores close to those of the normal reference population, with higher scores on the social functioning and mental health scales and lower on the role--emotional scale. There were no differences in health status scores between seizure-free patients using and not using AEDs. CONCLUSIONS: Our results confirm that patients with well-regulated epilepsy have a health status at the level of a general reference population.
Adaptation, Psychological↗
Disability associated with psychiatric comorbidity and health status in Bosnian refugees living in Croatia.
CONTEXT: The relationship between psychiatric symptoms and disability in refugee survivors of mass violence is not known. OBJECTIVE: To determine if risk factors, such as demographics, trauma, health status, and psychiatric illness, are associated with disability in Bosnian refugees. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional survey conducted in 1996 of Bosnian refugee adults living in a camp established by the Croatian government near the city of Varazdin. One adult aged 18 years or older was randomly selected from each of 573 camp families; 534 (93%) agreed to participate (mean age, 50 years; 41% male). MAIN OUTCOME MEASURES: Culturally validated measures for depression and posttraumatic stress disorder (PTSD) included the Hopkins Symptom Checklist 25 and the Harvard Trauma Questionnaire, respectively. Disability measures included the Medical Outcomes Study Short-Form 20, a physical functioning scale based on World Health Organization criteria, and self-reports of socioeconomic activity, levels of physical energy, and perceived health status. RESULTS: Respondents reported a mean (SD) of 6.5 (4.7) unduplicated trauma events; 18% (n=95) had experienced 1 or more torture events. While 55.2% reported no psychiatric symptoms, 39.2% and 26.3% reported symptoms that meet DSM-IV criteria for depression and PTSD, respectively; 20.6% reported symptoms comorbid for both disorders. A total of 25.5% reported having a disability. Refugees who reported symptoms comorbid for both depression and PTSD were associated with an increased risk for disability compared with asymptomatic refugees (unadjusted odds ratio [OR], 5.02; 95% confidence interval [CI], 3.05-8.26; adjusted OR, 2.06; 95% CI, 1.10-3.86). Older age, cumulative trauma, and chronic medical illness were also associated with disability. CONCLUSIONS: In a population of Bosnian refugees who had recently fled from the war in Bosnia and Herzegovina, psychiatric comorbidity was associated with disability independent of the effects of age, trauma, and health status.
Adult↗
Disease-specific health status after stent-assisted percutaneous coronary intervention and coronary artery bypass surgery: one-year results from the Stent or Surgery trial.
BACKGROUND: Functional status and quality of life are important outcomes in the evaluation of revascularization approaches for symptomatic coronary artery disease. Few data are available regarding the comparative improvement in disease-specific health status after CABG versus percutaneous coronary intervention (PCI) in the era of coronary stenting. METHODS AND RESULTS: Cardiac-specific health status was evaluated at baseline and at 6 and 12 months after intervention with the Seattle Angina Questionnaire (SAQ) in patients randomized to stent-assisted PCI (n=488) versus CABG (n=500) in the Stent or Surgery trial. Scores for physical limitation, angina frequency, and quality of life improved significantly for both treatment groups at 6 months (range of improvement from 13.6 to 34.7 points) and 12 months (14.3 to 38.2 points; all P<0.001). CABG patients had greater improvement than those assigned to PCI, although the magnitude of the difference decreased over time (difference at 6 months, 4.03 to 6.48 points; 12 months, 2.05 to 2.93 points). A component of this reduction is accounted for by PCI-arm patients who required repeat intervention. Differences between treatment groups were greatest for the 6-month angina frequency scores (difference=6.48 points; 95% CI 3.96 to 8.99). Overall, treatment satisfaction was high and did not differ significantly between groups. CONCLUSIONS: Both CABG and stent-assisted PCI dramatically improved cardiac-related health status in patients with multivessel disease at 6- and 12-month follow-up. During the first postprocedure year, patients' angina burden and physical limitations were alleviated to a greater extent with CABG.
Angina Pectoris↗
The role of public policies in reducing mental health status disparities for people of color.
Ethnic and racial disparities in mental health are driven by social factors such as housing, education, and income. Many of these social factors are different for minorities than they are for whites. Policies that address gaps in these social factors therefore can address mental health status disparities. We analyze three policies and their impact on minorities: the Individuals with Disability Education Act, Section 8 housing vouchers, and the Earned Income Tax Credit. Two of the three policies appear to have been effective in reducing social inequalities between whites and minorities. Expansion of public policies can be the mechanism to eliminate mental health status disparities for minorities.
Adult↗
[Progress in the world health status of children during the period 1990-2000].
Multiple Indicator Cluster Surveys (MICS) conducted by UNICEF using standardized methods in 66 countries have provided data for evaluating the status of child health during the period between 1990 and 2000. This report presents findings on mortality in children less than 5 years of age, malnutrition indicators, immunization status and integrated management of childhood illness. It is concluded that children at the dawn of the 21st century are exposed to new risks related to poverty, war, violence, urbanization, and VIH/AIDS.
Acquired Immunodeficiency Syndrome↗
[Health status during the occupation years--morbidity].
We refer to several studies on different aspects of the health status of the Norwegian population during World War II. The failure of the food supply led to various symptoms caused by deficient diet which reduced the resistance to infection. Hygienic problems increased, access to medical services deteriorated, and resources in terms of hospital beds, economic appropriations and number of health personnel were reduced, in particular during the final years. A network of factors contributed to deterioration in the health of the population. After the occupation the health status improved very quickly, evidently due to rapid access to the medical resources organized by the Norwegian public authorities in exile.
Disease Outbreaks↗
Cough frequency, cough sensitivity and health status in patients with chronic cough.
BACKGROUND: Little is known about the frequency of cough in health and in patients with chronic cough. METHODS: We measured cough frequency and its relationship with other markers of cough severity in 20 patients with chronic cough and 9 healthy subjects using the Leicester Cough Monitor (LCM), which is an automated ambulatory digital cough monitor that records sound only. All subjects had a 6-h recording and recordings were manually counted. A subgroup of 6 normals and 6 patients with a stable chronic cough had repeat measurements up to 6 months apart. RESULTS: Mean (sem) cough counts/hour were 43(8) in patients with chronic cough and 2(1) in normals (mean difference 41; 95% confidence interval 24-59; P<0.001). The cough counts were repeatable (within subject standard deviation: 23 coughs/hour; intraclass correlation coefficient 0.8). Cough counts correlated significantly with physical (r=-0.6, P=0.03), social (r=-0.7, P=0.01) and total Leicester Cough Questionnaire (LCQ) health status scores (r=-0.6, P=0.03) and cough sensitivity (concentration of capsaicin causing 5 coughs: r=0.9, P=0.008). CONCLUSION: We have shown that there are marked differences in cough frequency between patients with chronic cough and healthy subjects, that these measurements are repeatable, and that they correlate with cough-specific health status.
Adult↗
Highlights on the health status of the Polish population in 1999/2000.
In the paper we describe the main problems of the Polish population health status and their trends in the past years. A meaningful improvement in several health parameters can be noticed in Poland since 1991. In the year 2000 life expectancy was 69.7 and 78.0 for males and females respectively--an increase by 3.6 and 2.7 years in comparison with 1991 values. There have been declining trends in cardiovascular mortality, cancer mortality (more often in younger age groups), infant mortality, incidence of infectious diseases. Mental health problems are the growing issue. It has been stressed that the pace of progress is far too slow to achieve the level of health indicators in EU countries in the not too distant future.
Adolescent↗
Health status and risk behavior of adolescents in the north of Madrid, Spain.
PURPOSE: To study the health status and risk behavior in an adolescent population of Madrid, Spain. METHODS: An anonymous self-administered questionnaire was completed by 2831 pupils aged 14-20 years from urban, suburban, and rural populations in the north of Madrid. A large number of questions were from the Minnesota Adolescent Health Survey questionnaire, which included sociodemographics, health status, drug use, sexual practices, suicidal thoughts, emotional problems, and injury risk. Student's t-test, analysis of variance, and Chi-square statistics are used for analyzing associations between the different variables. RESULTS: A majority (80%) of students thought they are in good or very good health (better for males than females); 18.3% had had intercourse, the average age of the first intercourse was 15.4 years +/- 1.68 SD for males and 16.1 years +/- 1.46 SD for females. Most (73%) had used some kind of contraception. Eighty-five percent had tried alcohol, and regular use (frequently or every day) was as high as 24%. Males drank more than females (28% vs. 20%); 58.2% of the population drink only during weekends, the percentage increasing with age. Seventy percent of the sample had smoked at least once; 34. 5% reported regular tobacco use and this increased with age. Males smoked less than females (27% vs. 42%); 3.2% smoked more than 20 cigarettes/day. The consumption of illegal drugs was very low (20% had tasted cannabis and use by males was higher). Cocaine, heroin, etc. were used by less than 5%. CONCLUSION: In general, our adolescents are in good health with most problems being preventable. Sexual activity was lower than in other European and American countries. The consumption of tobacco and alcohol started early and in general was high. Our study confirms the relationship among different health-compromising behaviors. There is a need to implement health promotion and preventive programs for adolescents.
Adolescent↗