Health Perceptions Questionnaire Research Articles

Self-Rated Health among Older Adults: Longitudinal Analyses Examining Sex Differences across Different Birth Cohorts and Educational Levels

Introduction: Given the known female disadvantage in physical and mental health, this study aimed to investigate sex differences in self-rated health (SRH) among older adults, considering the longitudinal course by age, birth cohort, and educational level. Methods: Data from birth cohort 1911–1937 with baseline age 55–81 years (n = 3,107) and birth cohort 1938–1947 with baseline age 55–65 years (n = 1,002) from the Longitudinal Aging Study Amsterdam (LASA) were used. Mixed model analyses were used to examine sex differences in SRH (RAND General Health Perception Questionnaire [RAND-GHPQ], range 0–16) over the age course, testing for effect modification by the birth cohort and educational level (low, middle, high). Results: For both sexes, a decline in SRH was seen with increasing age. Over the age course, there was no significant sex difference in SRH within the older (1911–1937) birth cohort (0.13 lower score on SRH for women compared to men, 95% CI: −0.35 to 0.09) and only a small sex difference in the more recent (1938–1947) birth cohort (0.35 lower score on SRH for women compared to men [95% CI: −0.69 to −0.02], p = 0.04). There was no significant cohort difference in the size of the sex difference (p = 0.279). Those with a higher level of education reported a higher SRH, but between educational levels, there was no significant difference in the size of the sex difference in SRH. Discussion: In this study, no relevant sex difference in SRH over the age course was observed among older adults. Future research on SRH trajectories by sex during aging should take health-related, cognitive, psychosocial, and behavioral factors into account.

The Relationship Between Breast Enlargement And Psychological Stress In Women: Mediating Effects Of Coping Styles

Aim: To study the interactions between breast hyperplasia and psychological stress and coping styles in women. Methods: A total of 230 women were examined, and 130 subjects with breast hyperplasia and 100 subjects without breast hyperplasia were selected and administered the Adult Version of the Coping Methods Questionnaire and the Health Perceptions and Behaviors Questionnaire. Results: There was a significant positive correlation between breast hyperplasia and psychological stress scores in women (R=0.177, P<0.01), a significant negative correlation with positive coping style scores for coping methods (R=-0.153, P<0.05), and a significant negative correlation between psychological stress and positive coping style (R=-0.268, P<0.01). In the mediation effect test, it was found that women with breast enlargement not only acted directly on their psychological stress of health behaviors, but also indirectly through positive coping of coping styles. Conclusion: The use of positive coping styles in patients suffering from breast enlargement is able to reduce their level of psychological stress.

Categorization of the health status and its transition of community-dwelling older adults during the coronavirus disease (COVID-19) epidemic

The purpose of this study was to categorize and clarify transitions in the health status of older adults living in the community during the coronavirus disease (coronavirus disease 2019: COVID-19) pandemic. The participants were older adults (≥65 years of age) who lived in Takasaki City, Gunma Prefecture. The survey items included basic information and subjective health perception (questionnaire for medical checkup of old-old). Latent class analyses were conducted for the first (baseline) and second surveys (6 months). The scores for each item were compared to identify the characteristics of each class at baseline and at 6 months. In addition, transitions in class affiliation from baseline to 6 months were summarized. A total of 434 of 1,953 participants (mean age: 79.1 years, 98 males and 336 females) completed the survey (22.2%). In both time periods, the responses were categorized into four classes: 1) good, 2) poor physical, oral and cognitive function, 3) poor social status and lifestyle, and 4) poor in all except social status and lifestyle. During 6 months of follow-up, a transition from the generally good class to the poor physical, oral and cognitive functions class was observed in many cases. The health status of the older adults living in the community was classified into four classes, and changes in health status occurred even within a short period of time during the COVID-19 pandemic.

Oral-Health-Related Quality of Life as Measured with the Child-OIDP Index and Oral Health Status in Spanish Adolescents.

Background: Our aim was to analyze the relationship between OHRQoL (Oral-Health-Related Quality of Life) assessed by the C-OIDP (Child-Oral Impacts on Daily Performances) indexand oral health status in 13-15 years old Spanish population. Methods: A cross-sectional study was designed in a random sample of 337 adolescents. The C-OIDP and an oral health perception questionnaire were applied. ICDAS II (International Caries Detection and Assessment System) classification was used for assessing caries status, CPI (Community Periodontal Index) for periodontal status and discrepancy in the three planes for occlusal evaluation. Statistical analysis included Mann–Whitney, Kruskal–Wallis and Spearman correlation tests. Results: The prevalence of impact was 48.1%. The most frequently affected dimension was eating (21.4%). The overall mean C-OIDP index was 3.28. Higher DMFT (Decayed Missed Filled Tooth) was significantly associated with C-OIDP index (p = 0.03). Participants with CPI > 0 showed an impact index almost twice as high as those with CPI = 0 (p > 0.05). Significant association was found between quality of life and CPI for women (p < 0.01). Only the molar Angle’s class was associated with the impact index (p = 0.04). Conclusions: The OHRQoL in Spanish adolescents is good. The DMFT index had an impact on adolescents’ quality of life, showing a greater impact in men than in women. Periodontal status had a greater impact in women. No association between the extent of the caries lesion and the impact index was found.

Development of the multidimensional health perceptions questionnaire in English and Spanish

PurposeTo develop the novel multidimensional health perceptions questionnaire (MHPQ), a self-reported assessment of health perceptions inclusive of (1) individuals beliefs about the causes and consequences of health conditions, benefits and barriers to maintaining and improving health, ability to accomplish health-related goals and control health circumstances, and the role of God and/or spirituality in health and healthcare, (2) anticipated discrimination in the healthcare systems, and (3) trust in healthcare providers and medicine, illustrated in our newly proposed Multidimensional Health Perceptions Conceptual Model.MethodsWe developed an initial MHPQβ item set, corresponding to domains of our conceptual model, using a patient-centered outcomes development approach. This include literature review, expert and end-user feedback, translation and language validation (specifically to Latin American Spanish), and cognitive interviewing.ResultsThe initial 104 items of MHPQβ had excellent content validity, with a Content Validity Index of 98.1%. After expert (n = 13) feedback, translation and language validation, and cognitive interviewing among community-dwelling English-speakers (n = 5) and Spanish-speakers (n = 4), the final MHPQβ comprised 93 items rated on a five-point agreement scale (1 = Strongly disagree to 5 = Strongly agree), with a reading grade level of 6th grade in English and 8th grade in Spanish.ConclusionThe MHPQβ is a promising tool to assess individuals’ health perceptions. It has excellent content validity and good reading accessibility. Future work will establish the factor structure and final item set of the MHPQ.

Bacterial contamination of non-contact condensing lenses in National University of Malaysia Hospital isolated using BD BACTEC Peds Plus/F broth bottles versus conventional culture plates.

Introduction. Non-contact condensing lenses (NCLL) are a requirement in ophthalmology examinations. To date, there have been no studies on the types of bacteria found on handheld lenses used to examine patients in an ophthalmology clinic.Hypothesis. The BD BACTEC Peds Plus broth (BACTEC-PP) culture method can isolate more organisms as compared to conventional culture plates (CCP) from NCLL.Aim. To evaluate the organism spectrum cultured from NCCL for fundus examination and to compare the results between BACTEC-PP and CCP. The isolation results were then related to the participant's knowledge and hand hygiene practices (HHP).Methodology. This is a comparative cross-sectional study involving consenting trainee ophthalmologists from a single centre, whose preferred NCCL was swabbed from January to December 2019. The respondents completed the adapted World Health Organization Hand Hygiene Knowledge and Perception Questionnaire, and their HHP were observed by Infective Control Unit nurses. Positive bacterial growth using both methods, in addition to hand hygiene practices, were compared.Results. All samples had positive yields by at least one method. BACTEC-PP had a higher yield of 47 (90.4%) isolates compared to CCP with 37 (71.2%) isolates, P=0.041. CoNS sp (38.9 %) was the most common isolate with both methods, followed by Bacillus sp (25.3 %). At the same time, three fungi were detected with CCP only (3.2 %). There was a significant correlation in bacterial isolation with years of training, with fewer isolates among seniors in both BACTEC-PP (P=0.049) and CCP (P=0.034). There were no significant correlations between HHP and positive yields from either culture method.Conclusions. NCCL used by trainee ophthalmologists are typically contaminated by at least one bacteria, with CoNS sp being the most commonly isolated. More positive cultures occurred in lenses from junior trainees. Contamination was not correlated with knowledge or HHP. BACTEC-PP has significantly higher yields than CCP for bacterial isolation from NCCL, but did not isolate any fungus.

Development, validation, and implementation of a Short Breast Health Perception Questionnaire

BackgroundHealth status and perception can be assessed by general or disease-specific questionnaires, and disease specific questionnaires are more specific than general questionnaires. Considering the importance of breast health perception (BHP) in women’s lives and the lack of any pertinent questionnaires, we performed this study to develop a valid and reliable short BHP questionnaire (BHPQ); and then used it to assess the participants’ BHP.MethodsWe first designed and developed the instrument and then measured its inter-rater agreement (IRA), content validity including content validity index (I-CVI) and scale content validity index (S-CVI), and reliability (through internal consistency and test–retest). We then evaluated the BHP of eligible women with normal breasts and benign breast disorders who attended our breast clinic.ResultsThe IRA index (78.6%) showed the optimal relevance and clarity of the questionnaire. The content validity was acceptable; with S-CVIs of 87.35 and 84.42 for clarity and relevance, respectively. The internal reliability was high (Cronbach’s alpha = 0.93). Three questions were eliminated for internal consistency (intraclass correlation coefficient < 0.7) but the rest of the questions showed good and excellent reliability. In the next step, BHP in the 350 eligible participants showed an overall score of 43.89 ± 9.09.ConclusionThis study introduces a valid and reliable 11-item BHPQ. We propose its use in various circumstances throughout breast cancer screening, diagnosis, and treatment; and in the assessment of BHP in various physiologic and reproductive situations.

Factors Associated With Cardiovascular Disease Prevention Behavior Among Office Workers Based on an Ecological Model

The purpose of this study was to investigate the personal, interpersonal, and organizational factors associated with cardiovascular disease (CVD) prevention behavior among office workers using an ecological model. A total of 221 office workers working in areas such as personnel, design, and accounting, and who work in offices, completed the survey. Health Perception Questionnaire, General Self-Efficacy Scale (GSE), Multidimensional Scale of Perceived Social Support (MSPSS) Scale, the Korean Occupational Stress Scale–Short Form (KOSS-SF), and Social Environment Influencing Health form were used to measure each factor. Health perception (β = .207, p = .003), family support (β = .185, p = .005), and organizational health culture (β = .175, p = .012) were found to have a significant association with the CVD prevention behaviors of office workers. Comprehensive and multidimensional intervention is essential to enhance the CVD prevention behaviors of office workers. This study informs the development of a workplace-based intervention program to prevent CVD among office workers.

Knowledge and perceptions on hand hygiene among nurses in the Asir region, Kingdom of Saudi Arabia

Introduction: Hand hygiene plays a significant role in controlling the spread of health-care infections. As nurses are in direct contact with patients for a significant proportion of the time, they can be a vehicle for cross-contamination within the hospital and as such, good hand hygiene protocols can ensure the safety of patients in a variety of settings. The aim of this study is to assess the knowledge and perception of hand hygiene among nurses in Saudi Arabian hospitals. Materials and Methods: A cross-sectional study was conducted between November 2017 and May 2018 to determine the nurses' knowledge of hand hygiene. Nurses from six hospitals in the Asir region of Saudi Arabia were recruited using multi-stage cluster sampling. The World Health Organization Knowledge and Perception Questionnaire for Health-care Workers were administered to collect the information. Results: During the recruitment phase, 300 nurses were contacted and 243 agreed to participate in the study, indicating a response rate of 81%. About 51.85% of the nurses demonstrated a good level of knowledge about hand hygiene and 50.2% of nurses had a negative perception of hand hygiene. The results have shown a positive association between knowledge, nurses' perceptions, and years of experience, and their participation on a training course about hand washing. Conclusion: Educational interventions should be undertaken to enhance the knowledge of nurses/health-care providers and to promote positive perceptions of hand hygiene among nurses.

Correction of pelvic organ prolapse by laparoscopic lateral suspension with mesh: A clinical series

ObjectiveIllustrating the outcomes of laparoscopic lateral suspension by mesh for pelvic organ prolapse repair. Study designA retrospective observational study was conducted collecting medical records of 48 patients treated between May 2016 and April 2018 in two different centers in Italy. Pre- and post-operative clinical evaluations as well as patients’ satisfaction scores were considered. Patients were followed for two years. Statistical analysis was determined using the chi-square test in intention-to-treat and per-protocol analyses, while Kaplan-Meier curves were built for assessing the prolapse recurrence and the symptoms recurrence. The Steel-Dwass test for pairwise comparisons was used to compare median scores from the King's General Health Perception Questionnaire answers. ResultsRegarding the anatomical result, the outcome was either optimal or satisfactory (PoP-Q ≤1) at 12 months in 92% of patients for anterior compartment, in 100% for apical compartment, and in 75% for posterior compartment (intention-to-treat). Kaplan-Meier curves depicted a repair of prolapse in 70% of cases, with better outcomes for the anterior and the apical compartment. Patient self-perception of health was over 80% at each follow-up evaluation. ConclusionLaparoscopic lateral suspension is a reasonable technique for treatment of pelvic organ prolapse. Further studies are needed to prove such a technique versus alternative surgeries.

What Causes Health Promotion Behaviors in College Students?

Background:College students are exposed to an environment that places their health at risk. As a result, they are vulnerable to health-related problems. In order to improve health promotion behaviors, it is necessary to identify the variables affecting these behaviors. However, few studies have comprehensively examined health consciousness, health perception, and self-esteem as variables in health promotion behaviors among college students.Objective:The purpose of this study is to identify the factors influencing health promotion behaviors in college students.Method:Data were collected from 331 students, using a structured questionnaire based on the Health Promoting Lifestyle Profile (health promotion behaviors), Dutta-Bergman’s Health Consciousness Scale (health consciousness), the Health Perception Questionnaire (health perception), Rosenberg’s Self-Esteem Scale (self-esteem), and sociodemographic data. To assess the factors that influence health promotion behaviors, a multiple regression analysis was performed.Results:Health promotion behaviors were higher when health cognition was higher (r=.421, p<.001), health perception was higher (r=.326, p<.001), and self-esteem was higher (r=.526, p<.001). The constructed model for health promotion behaviors showed that the statistically significant explanatory variables were health cognition, health perception, and self-esteem. The model explained 34.9% of the variance in health promotion behaviors.Conclusion:It will be necessary to develop an intervention program targeting health cognition, health perception, and self-esteem in order to increase health promotion behaviors in college students.

Role of local government in responding to environmental health challenges: a case study of Chungnam.

The purpose of this study is to introduce the establishment process, policy target, and projects for “Chungnam’s master plan on environmental health policy (2017-2020)” as the local government’s role in addressing local environmental health challenges. We first analyzed existing studies and social issues on the media related to “Chungnam’s master plan” to understand Chungnam’s environmental health status and discussed domestic and international policy trends and related plans. An environmental health perception questionnaire survey and a Delphi expert questionnaire survey were conducted among provincial residents to collect various actors’ opinions on Chungnam’s environmental health issues and policy. An expert advisory panel was launched, and a residents’ voice workshop and cities-and-guns-policy-suggestion workshop were held. The vision of Chungnam’s environmental health policy is minimizing environmental hazards. We finally selected “Pleasant environment, healthy people, happy Chungnam” to represent the will to shape a pleasant environment and prevent and manage health damages for a happy Chungnam. We selected five strategies based on status analysis and a review of domestic and international policy trends and related plans and identified 2 targets (policy objectives) to accomplish the strategies. The strategies to achieve the first target, “Leader in environmental health policy: Chungnam,” include ‘Empowering active provincial capabilities,’ ‘Setting up province-specific systems for environmental health surveys and research,’ and ‘Preventing and managing newly emerging pollutants.’ The strategies for the second target, “Everyone is healthy: Chungnam,” include ‘Relieving health inequalities among vulnerable regions and residents’ and ‘Enlarging the resident-friendly environmental health policy.’ We developed 29 projects in total, according to these strategies. The establishment of “Chungnam’s master plan” is highly valuable; we developed it through discussion involving diverse actors to address environmental health challenges together. It is necessary to continue to strengthen participation, communication, and cooperation among actors to develop an environmental health policy model for the future.

FACTORS RELATED TO DEPRESSION AMONG OLDER PEOPLE LIVING IN CIMAHI, WEST JAVA PROVINCE, INDONESIA

Background: Depression is commonly found in older people. The prevalence of depression among older people, particularly in Indonesia is increasing worldwide.&#x0D; Objective: This study aimed to identify the factors related to depression among older people living in Cimahi, West Java Province, Indonesia.&#x0D; Method: A cross sectional design was used with a total of 267 older people aged from 60 to 79 years old. A multi-stage random sampling was used in five public health centers in Cimahi. The instruments comprised of socio-demographic questionnaires, general health perceptions questionnaire, Chula Activities of Daily Living Index (CADLI), and Geriatric Depression Scale-15 (GDS-15). Data analysis was conducted using descriptive statistic, chi-square, and point-biserial.&#x0D; Results: The result revealed that 56.2% of respondents were no depression and 43.8% of respondents was depression. The results also showed that age, marital status, family history of depression, perceived health status, and activities of daily living was significant relationship with depression among older people (p&lt;.01; p&lt;.05).&#x0D; Conclusion: This finding can be used as a reference to implement new strategies to decrease depression among older people.&#x0D; &#x0D; This article has been corrected with a separate erratum: https://doi.org/10.33546/bnj.1141

Exploration of Health Status, Illness Perceptions, Coping Strategies, Psychological Morbidity, and Quality of Life in Individuals With Fecal Ostomies.

In a previous paper focusing on the common sense model (CSM) for ostomies in people with inflammatory bowel disease, cancer, and diverticular disease, we reported that (1) illness perceptions were directly related to illness status, and both illness perceptions and coping strategies (maladaptive coping) directly influenced anxiety and depression; (2) self-efficacy and emotion-focused coping style ameliorated depression but not anxiety; and (3) time since surgery was associated with improved health status, a reduction in negative illness perceptions, and increased emotional-focused coping. The purpose of this article was to perform a secondary analysis with the addition of a stoma quality-of-life measure. One hundred fifty adults with ostomies (54 males, and 96 females; mean age = 44 years) completed an online survey. Descriptive, cross-sectional, questionnaire-based study. Participants completed the Health Perceptions Questionnaire, Brief Illness Perceptions Questionnaire, Carver Brief Coping Questionnaire, Stoma Self-efficacy Scale, Hospital Anxiety and Depression Scale, and the Stoma Quality-of-Life Scale. Using structural equation modeling, the final model provided an excellent fit to the data (χ27 = 19.20, P = .37, χ/N = 1.08, Standardized Root Mean Square Residual (SRMR) <0.03, Steiger-Lind Root Mean Square Error of Approximation (RMSEA) <0.03, Goodness of Fit Index (GFI) >0.98). Extending upon our previous paper, self-efficacy, anxiety, and depression were found to have a significant direct influence on stoma-specific quality of life (β= .47, P < .001, β=-.25, P < .001, and β=-.35, P < .001, respectively). The findings of this secondary analysis extends our previous report by identifying that, consistent with the CSM, illness status, illness perceptions, and coping influence health-related quality of life via self-efficacy, anxiety, and depression. The results suggest that to improve an individual's quality of life, psychological interventions should target the psychological processes underpinning mental illness and also help develop and maintain an individual's self-efficacy in relation to ostomy care.

Factors related to fear of falling among community-dwelling older adults.

To investigate the relationship between age, gender, history of falls, balance and gait status, general health perception, activities of daily living and depression to fear of falling in community-dwelling older people in Danang, Vietnam. Fear of falling is a common and consequential psychosocial problem for older people and can lead to decreased quality of life. There is only limited research on fear of falling in Vietnam. This is a cross-sectional descriptive study. One hundred fifty-three community-dwelling older people were recruited from seven communities of different districts in Danang. Data were collected using six instruments: a demographic questionnaire, the Fall Efficacy Scale-International, the General Health Perception questionnaire, the Barthel Activities of Daily Living, the Geriatric Depression Scale and the Timed Up and Go test. Data were analysed using descriptive and correlational statistics. The mean Fall Efficacy Scale-International score was 35, indicating a high level of fear of falling. ADLs, general health perception and Timed Up and Go were significantly and negatively related to fear of falling (rp =-0·80, rsp =-0·77 and rp =-0·75, respectively). Age, depression and history of falls were significantly and positively related to fear of falling (rp =0·54, rp =0·45 and rs =0·39, respectively). Women were significantly more likely than men to have higher fear of falling (rpb =-0·28). Fear of falling is more common in older people who are female, have a history of falls, have poor balance and gait status, have poor health perception, have greater ADL dependency, are depressed and, within the older people population, are older. Further research could examine additional correlates of fear of falling and develop/evaluate factor-specific intervention strategies to reduce fear of falling among community-dwelling older people. Understanding correlates of fear of falling among older Vietnamese people contributes to healthcare professionals' ability to develop effective cross-cultural and culture-specific interventions to reduce older people's fear of falling and to improve quality of life.

SUN-PP162: Quality of Care and Quality of Life in Home Parenteral Nutrition (HPN): Assessment Using a Subjective Health Perception Questionnaire

SUN-PP162: Quality of Care and Quality of Life in Home Parenteral Nutrition (HPN): Assessment Using a Subjective Health Perception Questionnaire

Exploration of health status, illness perceptions, coping strategies, and psychological morbidity in stoma patients.

We employed the Common Sense Model (CSM) of illness perceptions to examine the relative contribution of illness perceptions, stoma self-efficacy, and coping strategies in explaining anxiety and depression symptoms in patients with a fecal ostomy. The CSM suggests that the consequences of illness activity, such as psychological distress, are influenced by an individual's illness perceptions as well as what coping strategies they engage in. Descriptive, cross-sectional questionnaire-based study. One hundred fifty adults with a stoma (54 males, and 96 females; mean age 44 years) completed an online survey. Several instruments were used to measure study outcomes, including the Health Perceptions Questionnaire, Brief Illness Perceptions Questionnaire, Carver Brief Coping Questionnaire, Stoma Self-Efficacy Scale, and the Hospital Anxiety and Depression Scale. Participants were advised of the study through online forums containing a link to the survey. Outcome measures used in the current study are valid and reliable and have been extensively used in medically ill patients. Using structural equation modeling, the final model provided an excellent fit to the data (χ23= 16.53, P = .22, χ/N = 1.27, SRMR < 0.03, RMSEA < 0.05, GFI > 0.97, CFI > 0.99). There was a direct pathway from health status to illness perceptions months since surgery directly influenced health status, illness beliefs, and adaptive emotion-focused coping (β= .81, P < .001). Several indirect (mediating) pathways were also identified. Illness perceptions mediated the relationship between health status and stoma self-efficacy and maladaptive and adaptive emotion-focused coping. Maladaptive coping mediated the relationship between illness perceptions and depression and anxiety, and adaptive emotion-focused coping mediated the relationship between illness perception and depression. The final model provided support for the CSM, in that illness perceptions were directly related to illness status, and that both illness perceptions and coping strategies directly influenced anxiety and depression. More specifically, maladaptive coping style (eg, ignore problems) exacerbated depression and anxiety symptoms, while self-efficacy and emotion-focused coping style (eg, seek advice) ameliorate depression, but not anxiety. Months since surgery was associated with improved health status, reduced poorer illness perceptions, and increased emotional-focused coping. Illness perceptions and coping were found to mediate anxiety and depression. The results confirm that how individuals perceive their illness and what coping strategies they engage in impacts their psychological well-being. Study findings support the need for designing targeting psychological interventions based on individual illness perceptions and self-efficacy rather than exclusively focusing on coping strategies in patients with a stoma.

Exploring the Relationships Between Health Status, Illness Perceptions, Coping Strategies and Psychological Morbidity in a Chronic Kidney Disease Cohort

BackgroundUsing the common sense model of illness adjustment, this study aimed to explore the impact of chronic kidney disease (CKD) on individual illness perceptions, coping styles and psychological well-being. MethodsEighty individuals (50 men and 30 women) with an average age of 62.66 years (standard deviation, 11.98) were included in the study. All participants were under the care of the Renal Unit of a metropolitan tertiary referral hospital. Twenty-nine patients (36%) had CKD stage 3b-4, and 51 (64%) had CKD stage 5 (or end stage kidney disease [ESKD]). Disease severity was evaluated using the health perceptions questionnaire, coping styles assessed with the Carver brief COPE scale, illness perceptions explored with the brief illness perceptions questionnaire and anxiety and depression measured using the hospital anxiety and depression scale. ResultsThe hospital anxiety and depression scale assessment revealed 13 patients (16.3%) with moderate or severe anxiety and 6 (7.5%) with moderate depression. Consistent with the common sense model, disease activity had a significant direct influence on illness perceptions, while, in turn, illness perceptions had a significant direct influence on depression and anxiety. Adaptive and maladaptive coping were found to mediate the relationship between illness perceptions, and anxiety and depression. ConclusionsThe results provide evidence that it is the perception of an illness rather than the actual symptoms themselves that best account for adaption to CKD. These findings suggest that intervention strategies aimed at increasing psychological well-being need to focus on changing illness perceptions rather than improving symptoms of CKD or coping mechanisms.

Fear of falling and activity restriction{ in older adults from the urban community of Londrina: a cross-sectional study

Objective The objective of this study was to assess the fear of falling and restriction of activities in the elderly of the city of Londrina (PR). Materials and method A cross-sectional study was conducted with individuals over 60 years old of both sexes. They were interviewed at their home with the Falls Efficacy Scale International - Brazil the Survey of Activities and Fear of Falling in the Elderly a socio-demographic and health perception questionnaire. Results The participants were 38 elderly people (mean age 71.6 ± 6.1 years) with a prevalence of women (68.4%). The occurrence of a fall in the last year was reported by 44.7% of the elderly, and the prevalence of the fear of falling again by 56.3%. In the evaluation of the Falls Efficacy Scale, 97.4% of participants reported fear of falling in at least one of the activities while 55.3% had score ≥ 23 points showing high risk for falls. Fifty two percent of the elders restricted their activity due the fear of falling. Conclusion These results show a high frequency of fear of falling associated with restriction of activities and individuals with a high risk potential for falls. The evaluation of this data contributes to establishing indicators and development of preventive strategies and specific interventions for the elderly with fear of falling.

Salud, deporte y vulnerabilidad socioeconómica en una comunidad urbana

ObjectiveTo analyse the association between perceived and diagnosed health, sport practice, and the belonging to a vulnerable socioeconomic group. DesignObservational study. Questionnaire. SettingCasablanca neighbourhood. Primary Health Care Area in the city of Zaragoza (Spain). Participants1032 residents aged over 15 years. Main measurementsa) Perceived health using the Health Perception Questionnaire of Davis and Ware; b) diagnosed morbidity; c) sport practice using the Healthy Lifestyles questionnaire-94 of Herrero, Musitu and Gracia, and d) socioeconomic vulnerability based on the occupational, educational and economic conditions of the family unit. ResultsSocioeconomic vulnerability had a statistically significant association with diagnosed health, self-perceived health, and sport practice. Vulnerability and exercise showed a higher influence over self-perceived health than over diagnosed health. In the analysis stratified by gender, the association could only be observed in men. ConclusionsThe impact of health social factors is modulated by gender. Social stratification and lifestyles, such as sport practice, are predictors of self-perceived health and, thus, of the relationship between the population and the use of health services.