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At least 19 recordsLinked to original sources
PubMed2004

From confounders to suspected risk factors: psychosocial factors and work-related upper extremity disorders.

Psychosocial variables have recently been more prominent among epidemiologic risk factors for work-related upper extremity disorders (WRUEDs), but bio-behavioral mechanisms underlying these associations have been elusive. One reason is that the psychosocial domain has included many broad and disparate variables (e.g. mood, coping skills, job control, job satisfaction, job stress, social support), and this lack of specificity in the conceptualization of psychosocial factors has produced limited hypothesis testing opportunities. Therefore, recent research efforts have focused on identifying and conceptualizing specific psychosocial factors that might more clearly delineate plausible bio-behavioral mechanisms linking psychosocial factors to WRUEDs. One such factor is workstyle, a strategy that workers may employ for completing, responding to, or coping with job demands that might affect musculoskeletal health. Preliminary studies have provided support for measurable differences in workstyle among individual workers and an association with upper extremity pain and discomfort. An initial self-report measure of workstyle has been pilot tested among office workers and shown acceptable reliability and validity. Future studies are needed to study this construct among other working populations and to determine its relationship with other clinical endpoints. Nevertheless, early findings suggest workstyle may be a potential focus of WRUED prevention efforts.

Humans↗
PubMed1989

Influence of personal characteristics, job-related factors and psychosocial factors on the sick building syndrome. Danish Indoor Climate Study Group.

The influence of personal characteristics, life-style, job-related factors, and psychosocial work factors on symptoms of the sick building syndrome was investigated in Greater Copenhagen, Denmark. The buildings were not characterized beforehand as "sick" or "healthy." Of the 4369 employees sent a questionnaire, 3507 returned them. Multivariate logistic regression analyses of the multifactorial effects on the prevalence of work-related mucosal irritation and work-related general symptoms among the office workers showed that sex, job category, work functions (handling of carbonless paper, photocopying, work at video display terminals), psychosocial factors of work (dissatisfaction with superiors or colleagues and quantity of work inhibiting job satisfaction) were associated with work-related mucosal irritation and work-related general symptoms, but these factors could not account for the differences between the buildings as to the prevalence of the symptoms. The building factor (i.e., the indoor climate) was strongly associated with the prevalence of the symptoms.

Adult↗
PubMed1982

[Risk factors and psychosocial factors in psychiatric diseases of old age].

For the specific diseases of old age, of which the basic mechanism is not yet fully understood and not directly amendable by treatment, somatic risk factors and its recompensation, psychosomatic factors (reduction of mobility and other impairments), but especially psycho-social factors, especially social isolation, do play a prominent role. The primary prevention is mainly directed to the avoidance to toxic factors and the minimization of effects of organ-diseases. The secondary prevention has the goal to maintain a physical and intellectual activity level and to detect organ and metabolic derangements at an early state. The tertiary prevention has to avoid chronicity with a prophylaxis against institutionalization and hospitalization.

Aged↗
PubMedDate not supplied

Study of the relative incidences of psychosocial factors before and after heart transplantation and the influence of posttransplantation psychosocial factors on heart transplantation outcome.

Psychosocial factors substance abuse, noncompliance, psychiatric problems, and obesity in relation to the outcome of heart transplantation have been investigated. Data were gathered at the time of initial assessment, and patients (n = 53) were monitored during the follow-up after heart transplantation (mean 18 months). Noncompliance, psychiatric problems, or excessive weight before heart transplantation continued after heart transplantation. Significantly fewer substance abusers exhibited similar behavior after heart transplantation (p < 0.01), although in many cases this exposed other psychiatric or compliance problems. Patients with psychiatric problems after heart transplantation had a higher risk of infection (p < 0.01). Both these patients and those who were noncompliant had higher incidences of hospital readmission (p < 0.01) which were reflected in higher medical costs (p < 0.01) during the second year after heart transplantation in both subgroups. We conclude that (1) heart transplant recipients do not alter previous behavior after heart transplantation except with regard to substance abuse, (2) patients exhibiting substance abuse before heart transplantation and abstaining after heart transplantation have other psychosocial problems, (3) psychosocial problems after heart transplantation do not increase the risk for medical complications in the early posttransplantation period except with regard to infection, and (4) the presence of noncompliance and psychiatric problems after heart transplantation is related to increased readmissions and higher total medical costs.

Age Factors↗
PubMed1999

Relationship between upper gastrointestinal symptoms and lifestyle, psychosocial factors and comorbidity in the general population: results from the Domestic/International Gastroenterology Surveillance Study (DIGEST).

BACKGROUND: The Domestic/International Gastroenterology Surveillance Study (DIGEST) investigated the prevalence and economic/quality-of-life impact of upper gastrointestinal (GI) symptoms over 3 months among the general population of seven international sites (n = 5581). METHODS: Respondents were classified as having relevant or non-relevant symptoms, and were further classified as having gastro-oesophageal reflux disease (GORD)-, ulcer-, or dysmotility-like symptoms, based on their most bothersome symptom. Associations were investigated between the prevalence of relevant upper GI symptoms and these subtypes, and the following potential risk factors: psychosocial variables (income, educational level, marital status, having children, occupation, any significant life event during previous year); lifestyle variables (tobacco use, levels of alcohol and caffeine consumption); comorbidity variables (illnesses or symptoms experienced in the previous 3 months, concurrent conditions diagnosed by a doctor, prescriptions and over-the-counter (OTC) medications taken in the previous 3 months for health problems other than upper GI symptoms). RESULTS AND CONCLUSIONS: The most notable risk factors for the occurrence of upper GI symptoms, including symptoms indicative of GORD, were found to be various indicators of psychological stress (particularly recent life events) and psychiatric disease. A wide range of other non-psychiatric illnesses and their treatments was also clearly associated with the occurrence of upper GI symptoms, consistent with these symptoms occurring in many organic illnesses or as adverse effects of their treatments. Smoking was also found to be associated with GORD-like symptoms.

Adult↗
PubMedDate not supplied

Psychosocial factors and health status in women with rheumatoid arthritis: predictive models.

INTRODUCTION: Health status, and consequently productivity and quality of life, depends on a multitude of factors. Numerous psychosocial factors have been associated with the concurrent health status of individuals with chronic disease. Previous studies have examined the relationship between singular psychosocial factors and health status in rheumatoid arthritis. This study evaluated the simultaneous interrelationships among selected psychosocial variable and health outcomes using data from a study of younger women diagnosed with rheumatoid arthritis (RA). METHODS: The hypothesized models were examined using data from a survey of 185 women with a mean age of 43 years, diagnosed with RA for an average of 6.6 years. Participants in the study completed the following measures: (1) Arthritis Impact Measurement Scales, (2) Multidimensional Pain Inventory, (3) Daily Hassles Scale, (4) Interpersonal Support Evaluation List, and (5) Perceived Self-Efficacy Scale. RESULTS: Using path analysis, the information provided by the LISREL program, and extant theory, two models were tested. The data provided support for all but two of the hypothesized relationships in the model predicting physical functioning. Pain severity and self-efficacy emerged as important variables in understanding individual variations in perceived physical functioning. In the second model, using perceived well-being as the outcome, two bidirectional relationships were noted: one between affective distress and social support, and the second between perceived well-being and daily stress. CONCLUSIONS: The models evaluated in this study support the provision of multifaceted interventions aimed at enhancing a woman's ability to manage her pain and stress while also enhancing her beliefs in her own abilities.

Activities of Daily Living↗
PubMed1995

Wellness and HIV: developing a model for progression from theoretical knowledge about psychosocial factors to application.

Psychosocial factors and immunological markers have been associated not only with progression from HIV to AIDS and AIDS survival, but also with wellness. Not yet identified, and therefore not yet formalized into a system for clinical decision-making, are those individual differences that moderate both the impact of psychosocial factors and the potential benefit of interventions. Therefore the link between theoretical knowledge and application has not yet been established in a manner that would predict the outcome of recommended interventions. Presented here are background considerations to a combination of short-term and longitudinal studies which investigate these issues. The decision process devised here would be suitable for use with individuals with any physical disorder that has a psychosocial component.

Adaptation, Psychological↗
PubMed1991

Psychosocial factors in breast cancer and their possible impact upon prognosis.

Breast cancer is the most common cancer form in women. Numerous biological factors have now been identified and accepted as important risk factors and prognosticators. Psychosocial factors are also considered to be of probable importance. A review of the literature studying these factors reveals major methodological problems in evaluating data: small sample size, retrospective design, lack of cross-referencing for other important factors, cross-sectional studies instead of longitudinal studies, and insufficient statistical analysis. Regarding psychosocial factors, some of the most valid studies indicate that the risk of getting breast cancer may be connected with difficulties in expressing feelings, especially ones of aggression; while coping strategy, amount of stress, and level of activity, seem to be of possible influence to the prognosis. A possible connection between psyche and the immunological system has been proposed, but there has been little data so far. Although a series of studies have shown some influence of psychosocial factors on breast cancer, the methodological problems are so large as to leave open the question whether psychosocial factors have any impact upon the disease.

Breast Neoplasms↗
PubMed1996

The role of psychosocial factors in gastrointestinal illness.

Psychosocial factors have a complex relationship with gastrointestinal illness. Early life factors can contribute to illness susceptibility and condition later illness experiences and behaviors. Existing psychosocial factors, gut physiology and pathology are not associated in a linear or causative fashion, but instead interact to determine symptoms and illness behavior. Investigation of the clinical outcome of these disorders, an area of recent interest, involves both 'hard' (i.e., disability, healthcare use, costs) and 'soft' (i.e., physical and psychologic status and function, health-related Quality of Life) endpoints. In this article I present a biopsychosocial framework for understanding these integrated relationships which are supported by recent data involving both functional and structural (i.e., 'organic') gastrointestinal disorders.

Cost of Illness↗
PubMed2000

Psychosocial factors in adult end-stage renal disease patients treated with hemodialysis: correlates and outcomes.

The first three decades of the ESRD program were devoted to extending patient survival. Few data have been generated regarding the factors associated with successful patient adjustment. Depression and perception of the effects of illness are important responses to the experience of ESRD and may be associated with differential survival. Perception and extent of social support can moderate these factors. The association of psychosocial factors and assessments of quality of life are incompletely understood and are topics of research interest. The role of variation in socioeconomic status in association with these factors has not been extensively studied. The challenges for the next 30 years include understanding the relationship of psychosocial factors to demographic and medical factors in large ESRD patient populations and the refinement of associations between psychosocial factors and patient outcomes, including adjustment, compliance, morbidity, and mortality.

Adult↗
PubMed2001

[Epidemiological studies on the relationship between psychosocial factors and cardiovascular disease].

Psychosocial factors contribute significantly to the pathogenesis and expressions of cardiovascular disease(CVD). Recent studies have demonstrated that 5 specific psychosocial entities are most relevant: (1) depression, (2) anxiety; (3) personality factors and character traits; (4) social isolation, and (5) chronic life stress. Epidemiological studies consistently demonstrate a significant prospective relationship between the occurrence of major depression and the cardiac events. Increasing evidence now links anxiety disorders to the development of CVD events in general populations. Although type A behavior is continuously found to be positively related with increased risk of CVD, a series of studies have reported no correlation between type A behavior and CVD risk. However, hostility, a major attribute of the type A behavior pattern, is considered to be more pathogenic. Social isolation characterized mainly by a relatively small social network has been shown to be associated with increase in the incidence of CVD over time. Finally, chronic life stress, particularly the work-related stress, proved to be closely related to CVD risk. The pathophysiological mechanisms of psychosocial factors on the pathogenesis of CVD are: (1) excessive sympathetic nervous system activation, (2) triggering of myocardial ischemia; (3) promotion of arrhythmogenesis, (4) stimulation of platelet function, and (5) deterioration of endothelial function.

Adult↗
PubMed2003

Psychosocial factors predict coronary heart disease, but what predicts psychosocial risk in women.

OBJECTIVES: Psychosocial factors, including depression, anger, and social isolation, have been associated with increased morbidity and mortality from coronary heart disease (CHD), but predictors of psychosocial burden among women with CHD are poorly defined. The purpose of this study was to determine whether readily measured demographic and risk factors could identify women with psychosocial risk factors that are more difficult to assess in a clinical setting. METHODS: Baseline data on 304 women (mean age 62 years, 52% minority) hospitalized with CHD at 3 academic medical centers participating in a clinical study of adherence to prevention guidelines were evaluated. Standardized questionnaires were used to measure depression (4-item self-report tool from the Primary Care Evaluation of Mental Disorders questionnaire) and anger (Spielberger Trait Anger Scale). One self-report question was used to assess social isolation. RESULTS: Thirty-seven percent of women with CHD reported depression, 50% reported anger, and 41% reported social isolation. In a logistical model controlling for confounders, independent predictors of depression were having dependents (odds ratio [OR] = 2.27, p = .006), age (< or = 65 years) (OR = 1.91, p = .02), and exercise (< 3 days/week) (OR = 3.92, p < .001). Anger was associated with having dependents (OR = 3.16, p < .001), age (< or = 65 years) (OR = 1.95, p = .02), and smoking (OR = 2.05, p = .04). Subjects who had dependents (OR = 2.24, p = .005), were unemployed (OR = 1.93, p = .03), and who did not get enough exercise (< 3 days/week) (OR = 2.07, p = .03) reported higher isolation in adjusted models. Differences in prevalence of psychosocial factors by ethnicity were not statistically significant. However, there was a trend toward increased prevalence of psychosocial risk factors among white women, possibly reflecting the need for more culturally sensitive screening tools. CONCLUSION: These data may be helpful in identifying women who are at risk of increased CHD morbidity and mortality because of psychosocial burden.

Adult↗
PubMed2003

Psychosocial factors and functional capacity evaluation among persons with chronic pain.

Psychosocial factors have been found to have a significant impact on functional activity, particularly among persons with chronic pain. While various systems have been developed to assess functional limitations through functional capacity evaluation (FCE), assessment of psychosocial factors that may impact function have been largely ignored. This paper examines the existing literature on psychosocial factors and FCE performance. Given that there are few studies that have directly addressed this issue, the paper also examines psychosocial factors that have been found to influence function in persons with pain. The results of the literature review indicate that few psychosocial factors have been found to be directly associated with FCE and functional measures, although many are related to various measures of disability. The strongest evidence that psychosocial factors are related to functional performance is based on the studies examining the association between functional activity and pain-related fear, self-efficacy, and illness behavior. Psychosocial factors have also been shown to influence measures of sincerity of effort often obtained during FCE. Proposals for modifying FCE assessment are given based on the available data, as well as suggestions for future research.

Anxiety↗
PubMed1999

The role of psychosocial factors in irritable bowel syndrome.

Psychosocial factors, as appreciated within the context of the biopsychosocial model, are necessary for understanding the clinical expression of irritable bowel syndrome (IBS) by virtue of their key roles in the development, precipitation and perpetuation of IBS. Addressing psychosocial factors in assessment and management leads to improvement in the clinical outcome for IBS patients. Pertinent management components include adopting a 'care' approach within an ongoing collaborative treatment relationship; offering any psychological or psychiatric intervention as part of a multi-disciplinary treatment approach; providing education and reassurance; and using mental health professionals when indicated.

Adaptation, Psychological↗
PubMed1982

Medical manageability and psychosocial factors in childhood asthma.

Five psychosocial factors were empirically derived from a questionnaire administered to 175 asthmatic children who were taken from three subsamples representing hospitalized inpatients, outpatients and private practice patients. The scales included three measures of anxiety labeled Despair Over Social Debilitation, Quality of Life, and Dread of Illness, one attitude scale labeled Orientation Towards Compliance, and one scale labeled Family Communication. These scales correlated with measures of debilitation during the 6 month period prior to treatment, which included the number of asthma attacks, emergency room visits, days hospitalized, days of school missed and parental ratings of interference in physically strenuous activities. Two groups of children were defined for each psychosocial factor by a mean split of the scores. The incidence of children with relatively much anxiety as defined by three of these scales and a poor attitude about compliance was greatest in the inpatient subsample and least in the private practice subsample. Inpatients also experienced the most debilitation during the 6 month period before testing. Follow-up measures of debilitation were recorded for the 6 month period post discharge. The relationship between the debilitation experienced by the children and their anxiety was evaluated. Patient groups with much and little anxiety both showed comparable and significant reductions in debilitation post hospital treatment. The results were interpreted to indicate that the anxiety assessed upon admission was the consequence of a history of poor medical manageability. The anxiety assessed did not appear to contribute to poor control of this illness.

Adolescent↗
PubMed2006

Psychosocial factors and coronary calcium in adults without clinical cardiovascular disease.

BACKGROUND: Psychosocial factors have been linked to coronary events, but the mechanisms underlying these associations have not been established. Evidence is mixed regarding associations of psychosocial factors with subclinical coronary atherosclerosis. OBJECTIVE: To examine associations of 4 psychosocial factors (depressive symptoms, anger, anxiety, and chronic stress) with the presence of subclinical coronary atherosclerosis. DESIGN: Cross-sectional study. SETTING: The Multiethnic Study of Atherosclerosis, a population-based study of subclinical atherosclerosis. PATIENTS: A multiethnic sample of 6789 adults, 45 to 84 years of age, with no history of clinical cardiovascular disease. MEASUREMENTS: Coronary calcium was assessed by using chest computed tomography, and psychosocial factors were assessed by using questionnaires with validated scales. RESULTS: There was no evidence that higher levels of the psychosocial measures were associated with greater prevalence of calcification or with greater amounts of calcium among persons with calcium. Age- and risk factor-adjusted relative prevalences of coronary calcification in men for the top fourth category versus the bottom fourth category of anger, anxiety, and depressive symptoms were 0.94 (95% CI, 0.88 to 1.01), 0.97 (CI, 0.90 to 1.04), and 0.97 (CI, 0.90 to 1.05), respectively; these values for women were 1.01 (CI, 0.90 to 1.15), 0.93 (CI, 0.83 to 1.05), and 0.92 (CI, 0.82 to 1.04), respectively. Relative prevalences for the top versus the bottom category of chronic stress burden were 1.02 (CI, 0.94 to 1.11) for men and 0.88 (CI, 0.79 to 0.99) for women. LIMITATIONS: Current measures of psychosocial factors may be a poor proxy for cumulative exposure during development of atherosclerosis. CONCLUSION: Depressive symptoms, anger, anxiety, and chronic stress burden were not associated with coronary calcification in a multiethnic sample of asymptomatic adults.

Adult↗
PubMed2003

Psychosocial factors and risk of hypertension: the Coronary Artery Risk Development in Young Adults (CARDIA) study.

CONTEXT: Although psychosocial factors are correlated, previous studies on risk factors for hypertension have typically examined psychosocial factors individually and have yielded inconsistent findings. OBJECTIVE: To examine the role of psychosocial factors of time urgency/impatience (TUI), achievement striving/competitiveness (ASC), hostility, depression, and anxiety on long-term risk of hypertension. DESIGN, SETTING, AND STUDY POPULATION: A population-based, prospective, observational study using participant data from the Coronary Artery Risk Development in Young Adults (CARDIA) study. A total of 3308 black and white adults aged 18 to 30 years (when recruited in 1985 and 1986) from 4 US metropolitan areas and followed up through 2000 to 2001. MAIN OUTCOME MEASURES: Fifteen-year cumulative incidence of hypertension (systolic blood pressure of 140 mm Hg or higher, diastolic blood pressure of 90 mm Hg or higher, or taking antihypertensive medication). RESULTS: The incidence of hypertension at year 15 was 15% from baseline and 13.6% from year 5. After adjusting for the same set of hypertension risk factors and each of the psychosocial factors of TUI, ASC, hostility, depression, and anxiety in 5 separate logistic regression models, higher TUI and hostility were significantly associated with risk of developing hypertension at 15-year follow-up for the total sample. Compared with the lowest score group, the adjusted odds ratio (OR) for TUI was 1.51 (95% confidence interval [CI], 1.12-2.03) for a score of 1; 1.47 (95% CI, 1.08-2.02) for a score of 2; and 1.84 (95% CI, 1.29-2.62) for a score of 3 to 4 (P for trend =.001). Compared with the lowest quartile group, the adjusted OR for hostility was 1.06 (95% CI, 0.76-1.47) for quartile 2; 1.38 (95% CI, 1.00-1.91) for quartile 3; and 1.84 (95% CI, 1.33-2.54) for quartile 4 (P for trend <.001). No consistent patterns were found for ASC, depression, or anxiety. Race- and sex-specific analyses and multivariable models with simultaneous adjustment for all 5 psychosocial factors and other hypertension risk factors had generally similar results. CONCLUSION: Among young adults, TUI and hostility were associated with a dose-response increase in the long-term risk of hypertension.

Adult↗
PubMed2005

Why is a treatment aimed at psychosocial factors not effective in patients with (sub)acute low back pain?

Psychosocial factors have been shown to play an important role in the development of chronic low back pain (LBP). In our recently completed cluster-randomized trial we found, however, no evidence of an effect of our minimal intervention strategy (MIS) aimed at psychosocial factors, over usual care (UC) in patients with (sub)acute LBP. To explore the reasons why, this paper presents an evaluation of the processes presumably underlying the effectiveness of MIS. General practitioner (GP) attitude was evaluated by the Pain Attitudes and Beliefs Scale and two additional questions. GP behaviour was evaluated by analysing treatment registration forms and patients' responses to items regarding treatment content. Patients also scored items on satisfaction and compliance. Modification of psychosocial measures was evaluated by analysing changes after 6 and 52 weeks on the Fear Avoidance and Beliefs Questionnaire, the Coping Strategies Questionnaire and the 4-Dimensional Symptom Questionnaire. A total of 60 GPs and 314 patients participated in the study. GPs in the MIS-group adopted a less biomedical orientated attitude than in the UC-group, but were only moderately successful in identification of psychosocial factors. Treatment contents as perceived by the patient and patient satisfaction differed significantly between both groups. Changes on psychosocial measures, however, did not differ between groups. The suboptimal identification of psychosocial factors in the MIS-group and the absence of a relevant impact on psychosocial factors may explain why MIS was not more effective than UC.

Acute Disease↗