Lower Self-perceived Health Status Research Articles

Health literacy strengths and needs among migrant communities from Portuguese-speaking African countries in Portugal: a cross-sectional study.

Health literacy among migrants is a matter of public health and social justice. Migrants from diverse backgrounds encounter challenges such as linguistic barriers, cultural disparities, restricted access to health services, and heterogeneous migration statuses. Addressing these challenges requires careful consideration of their unique experiences and needs to promote equitable health outcomes. This can hinder their ability to navigate the healthcare system, understand health information, and engage in health-promoting behaviours. However, there is still a significant gap in our understanding of health literacy within migrant communities. This study has a dual aim: to identify health literacy strengths and needs among migrants from Portuguese-speaking African Countries (PALOP) countries in the Lisbon Metropolitan Area and to examine associations between demographic, socioeconomic, migration and health condition characteristics and the health literacy domains. A cross-sectional survey was conducted. Data were collected from 506 PALOP migrants using the Health Literacy Questionnaire (HLQ). We also collected demographic, socioeconomic, migration, and health condition data. We employed multiple linear regression to understand the relationship between the HLQ nine domains and these characteristics. The HLQ scores revealed distinct patterns of health literacy between the groups. Health literacy needs were particularly evident in the domains related to feeling understood and supported by healthcare providers and navigating the healthcare system. Conversely, higher scores and potential strengths were observed in actively managing one's health and understanding enough health information to make informed decisions. However, in these, the average scores suggest that a high proportion of people recognised difficulties. 'The results also indicated that a higher educational level was associated with increased health literacy. In contrast, low self-perceived health status, living alone, shorter duration of residence in Portugal, and being either undocumented or in the process of obtaining legal status were associated with lower health literacy. Our study highlights the importance of migration-related variables and self-reported health status in understanding health literacy among migrant communities. Factors such as length of stay and low self-perceived health status are associated with potentially disadvantageous levels of health literacy, which could exacerbate health inequalities. Assessing these variables is critical to identify gaps in health literacy and develop tailored interventions to reduce health inequalities.

Prevalence of Pain and Its Risk Factors Among ICU Personnel in Tertiary Hospital in China: A Cross-Sectional Study

BackgroundAlthough pain is commonly observed among medical staff, studies on pain among intensive care unit personnel are uncommon, especially intensive care unit (ICU) doctors and workers. Moreover, few studies have focused on the prevalence of pain and the associated factors.PurposeThe aim of this study was to estimate the prevalence of pain among ICU personnel (including doctors, nurses and workers) and explore the risk factors for their pain.MethodsWe conducted an online survey that included sociodemographic and work-related items and questions about pain, ergonomics, and psychological factors. We used the short version of the validated Depression–Anxiety–Stress Scale (DASS-21) to assess the relationship between pain and mental disorders. All ICU personnel at West China Hospital of Sichuan University participated in this study.ResultsA total of 356 ICU personnel were included in the final analysis. The prevalence of pain was 72.2% among ICU nurses, 64.4% among ICU doctors and 52.9% among ICU workers. The most frequent location of pain was the lower back among nurses (65.9%) and workers (47.1%) and the neck among doctors (49.1%). The factors contributing to pain among ICU personnel were bending or twisting the neck, high levels of psychological fatigue, low self-perceived health status, female sex and high body mass index (BMI). Moreover, participants with pain indicated significantly higher depression (p ≤ 0.001), anxiety (p ≤ 0.001), and stress levels (p = 0.002) than those without pain.ConclusionThis study indicates that ICU personnel exhibit a high prevalence of pain. Many factors, especially psychosocial and ergonomic factors, contribute to pain levels among ICU personnel and the poorer mental health levels observed in those experiencing pain. Therefore, disease prevention and health promotion measures are needed to protect the health of ICU personnel.

Risk Factors for Suicidal Ideation among Middle Class Korean: Focusing on Psychosocial Comparison - An Analysis of a Nationwide Survey of the 8th Korea Health Panel Data

The purpose of this study was to examine the prevalence and risk factors of suicidal ideation among middle class Korean. Methods: Cross sectional study was designed for secondary data analysis. From the 8th Korea Health Panel survey (2008~2013), a total of 6,037 data was drawn and analyzed by developmental stage using descriptive statistics including frequency, percentage, x2 test, and logistic regression analysis. Results: Across all age groups, high physical-mental stress, frustration, anxiety about the future and low self-perceived health status or social class were found to be the risk factors of suicidal ideation. Peer-compared subjective health status and frustration significantly influenced the adolescents. The young adults‘suicidal ideation was mainly influenced by physical and mental stress, frustration and absence of economic activity. For the middle-aged, physical and mental stress, frustration, future anxiety, low peer-compared subjective health status were found to be the major influencing factors. The predominant risk factors for the elderly were frustration and low peer-compared subjective health status. Conclusion: Making comparisons to others significantly influence suicidal ideation throughout all life cycles. Improvement of mental health and suicide prevention can be enhanced by avoiding negative comparison to others.

Anxiety and self-perceived health status in Parkinson’s disease

Both anxiety and depression are associated with lower self-perceived health status (HS) in persons with Parkinson’s disease (PD). Given the high co-morbidity with depression and other non-motor symptoms, it is unclear whether anxiety disorders, in general, versus specific anxiety subtypes have an independent effect on HS in PD. To examine this question, comprehensive assessments of motor and non-motor symptoms from 249 subjects with idiopathic PD followed in three community-based movement disorders neurology practices were analyzed. HS was measured using the 8-item PD Questionnaire (PDQ-8). Psychiatric diagnoses were established by consensus using a panel of six psychiatrists with expertise in geriatric psychiatry and movement disorders. Stepwise multiple regression analyses were used, with the PDQ-8 score as the dependent variable, to identify independent predictors of HS among motor, psychiatric, and other non-motor variables. Among the anxiety disorders, only anxiety associated with motor fluctuations was an independent predictor of HS after accounting for co-morbid depression and other clinical features. In addition, depressive disorders were also an independent predictor of lower HS. Prevention or treatment of state-dependent anxiety may improve HS in persons with PD.

Reactions to caregiving in frailty research

Frailty is a syndrome characterized by decreased functional ability and associated with institutionalization. Many community-living frail older people rely upon the support of a family member or friend. However, there is a paucity of research exploring the reactions to caring for older people empirically identified as frail. The objective of this study was to describe carers of community-living older people identified as frail, using accepted criteria, identify care characteristics and ascertain relationships that contribute to reactions to caregiving. A cross-section of carers of community-living frail people (≥70 years) completed a postal questionnaire; the Caregiver Reaction Assessment (CRA) evaluated reactions to caregiving. Ninety-three carers completed the questionnaire (68% response rate). Correlation and multivariate analysis of variance tests (MANOVA) demonstrated statistically significant relationships between several care characteristics and reactions to caregiving. Carers who provide more than 20 h of care per week and report a low self-perceived health status are susceptible to significant health and financial problems and disruption to their daily schedule. Two strategies for improving reactions to caring for persons with frailty are proposed: financial support that assists carers to improve their health status and the provision of regular formal assistance, rather than intermittent respite care.

Association between Self-Perceived Health Status and Health Related Behavior in Routine Health Examinees

Background: Self-perceived health is a good indicator of health status. It is generally accepted that self-perceived health status has important role on one’s health behavior and public health education. Smoking, drinking, and obesity are well known risk factors for one’s health. But its effects on self-perceived health status are not known so well in Korea. This study was planned to evaluate the effect of health behavior such as smoking, drinking, and obesity on self-perceived health status. Methods: We enrolled a total of 6,040 Koreans, visited to one general hospital health promotion center from June, 2004 through June, 2007. Data was collected by questionnaire, including basic demographic variables, family history of cancers or cerobrovascular accidents, psycho-emotional factors such as stress, depression, anxiety, insomnia, and health behaviors including smoking, drinking, and exercise. Risk factors for metabolic syndrome were also obtained including waist circumference, blood pressure, triglyceride, high-density lipoprotein (HDL), fasting blood sugar, and body mass index (BMI). Results: Older age, higher alcohol consumption, higher BMI, and regular exercise were associated with higher selfperceived health status. Higher education status, higher score of stress, symptoms such as depression, anxiety, and insomnia, drug medication, operation history, and abnormal HDL status were associated with lower self-perceived health status. Smoking and metabolic syndrome had no relation with self-perceived health status. Conclusion: Drinking and higher BMI were associated with higher self-perceived health status, indicating discrepancies between self-perceived health status and medical advice. More strict education might be required for those risk factors.

Physical Activity and Self-Perceived Health Status

Recently more attention has been focused on the impact of physical activity on modification of self-perceived heath status in adults. The objective of the study was to evaluate the level of occupational and non-occupational physical activities and their correlation with self-perceived heath status among economically productive individuals. Physical activity of the subjects studied was evaluated by the Seven Day Physical Activity Recall (SDPAR) questionnaire among randomly chosen residents of the city of Lódź (n = 598, including 299 women and 299 men). The examination of the subjective health assessment was conducted based on the analogue visual scale. The multifactorial logistic regression analysis indicated that weekly energy expenditure on occupational physical activity (kcal/week) did not play a significant role in self-perception of health status among men or women. Neither did the outcome of the study provide evidence for the significant effect of housework load on self-perceived health status among the study participants. However, a sufficient level of leisure-time physical activity in a beneficial way affects health-related self-perception of the examined subjects. In the group of men expending 1000 kcal/week or more on leisure-time physical activity, the risk for poor health-related self-report was significantly lower than among men declaring no energy expenditure on this activity (adjusted odds ratio (OR = 0.29, 95% CI: 0.13-0.66). Among females not taking up any recreational physical activity, the risk of low self-perceived health status was also higher than in females reaching a satisfactory level of recreational physical activity (adjusted OR = 0.38, 95% CI: 0.17-0.87). Preventive programs aimed at improving subjective health assessment through the increased leisure-time physical activity should be addressed to all economically productive individuals and particularly to people of older age groups and above all to females.

Is patients' perception of time spent with the physician a determinant of ambulatory patient satisfaction?

Time management in ambulatory patient visits is increasingly critical. Do patients who perceive a longer visit with internists report increased satisfaction? Prospective survey of 1486 consecutively encountered ambulatory visits to 16 primary care physicians (PCPs) in an academic primary care clinic. Patients were queried regarding demographics, health status, perception of time spent before and after ambulatory visits, whether the physician appeared rushed, and visit satisfaction. Physicians were queried regarding time spent, estimated patient satisfaction, and whether they felt rushed. In 69% of 1486 consecutive visits, patient previsit expectation of visit duration was 20 minutes or less. Patient and PCP postvisit estimates of time spent significantly exceeded patient previsit time expectation. Patients who estimated that they spent more time than expected with the PCP were significantly more satisfied with the visit. When patient postvisit estimate of time spent was less than the previsit expectation, visit satisfaction was significantly lower independent of time spent. Patient worry about health and lower self-perceived health status were significantly associated with patient expectation for longer visits. Primary care physicians felt rushed in 10% of encounters. Although PCPs estimated patient satisfaction was significantly lower when they felt rushed, patient satisfaction was identical when PCPs did and did not feel rushed. Patients indicated that PCPs appeared rushed in 3% of encounters, but this perception did not affect patient satisfaction. Perceived ambulatory visit duration and meeting or exceeding patient expectation of time needed to be spent with the physician are determinants of patient satisfaction in an ambulatory internal medicine practice.

Positive Association between Resting Pulse and Cancer Incidence in Current and Former Smokers

PURPOSE: To evaluate the association between resting pulse and cancer incidence in older persons. METHODS: A cohort of 2819 persons, aged 65 to 102 years at baseline, was followed for the development of cancer from 1982 through 1993 by linkage to a statewide cancer registry; 494 incident cases were identified. Resting radial pulse (beats per minute) was measured during an in-person interview at baseline, and sex-specific quintile cutpoints were used in the analysis. RESULTS: After adjustment for age, body mass, smoking, and physical activity, there was a positive association between pulse and cancer incidence in men: compared to men with a pulse of < 63, men with a pulse of 63–68 (relative risk (RR); 95% confidence interval (CI): RR = 1.68; CI = 1.06–2.66), 69–74 (RR = 1.54; CI = 0.95–2.49), 75–82 (RR = 1.62; CI = 1.03–2.55), and > 82 (RR = 1.63; CI = 1.03–2.65) were at elevated risk for any cancer. This association remained unchanged after further adjustment for cardiovascular comorbidity, diabetes, alcohol use, high level of depressive symptoms, and low self-perceived health status. Exclusion of cases diagnosed in the first two years of follow-up did not alter the association. There was no overall association between pulse and cancer incidence in women. Analyses stratified by smoking status showed that the pulse and cancer association was strongest in ever smokers for both men and women. In subsite analysis for men, pulse was mainly associated with smoking-related tumors as a group and colorectal and prostate cancer. CONCLUSIONS: These data suggest that resting pulse is associated with cancer incidence, mainly among ever smokers.

Satisfaction with ambulatory care of persons with AIDS: predictors of patient ratings of quality.

To examine the relation of patient characteristics and site of care to the perception of ambulatory care quality by persons with AIDS (PWAs). Patient surveys and medical record review were used to determine PWAs' perceptions of their ambulatory care, self-perceived health status, primary care relationships, sociodemographic characteristics, and severity of illness. A public-hospital HIV clinic, an academic group practice, and a staff-model health maintenance organization (HMO) that together care for 20% of all Massachusetts PWAs. All active patients as of February 12, 1990, and all new AIDS patients at each of the three sites during the subsequent 13 months. The primary outcome measure was a six-item scale of patient-rated quality of care (PRQC), a newly developed measure that combined patients' ratings of their physician care, nursing care, involvement in medical decisions, and overall quality of care. Multiple logistic regression was carried out with low PRQC (lowest quartile) as the dependent variable, to identify correlates of patient perceptions of poor quality. Patients who had a primary nurse were significantly less likely to have low PRQC scores (OR = 0.50, 95% CI = 0.26 to 0.97). Black patients and patients who used injection drugs were significantly more likely to rate their care in the lowest quartile (OR = 2.22, 95% CI = 1.04 to 4.78; and OR = 2.43, 95% CI = 1.13 to 5.23, respectively), as were those who had lower self-perceived health status, after controlling for confounders; no association was found by site or severity. These results show that primary nursing may be an important determinant of how PWAs rate the quality of their ambulatory care. Furthermore, PWAs who are black or who are injection drug users are less satisfied than are others with the quality of their ambulatory AIDS care.

Predictors of decline in social relationships in the rural elderly.

Prospective evidence for predictors of decline in social relationships over a 3-year follow-up period in an elderly cohort are presented. The cohort consisted of men (n = 903) and women (n = 1,673) over age 65 years in two rural Iowa counties who were interviewed in 1982 and again in 1985. Three separate measures of social relationships were dichotomized into lower and higher levels and included the number of close friends and relatives (less than three vs. three or more), church attendance (less than once per month or not at all vs. once per month or more), and membership in a group (nonmember vs. member). Those with higher social relationship levels at both interviews were compared with those who had higher levels at baseline but lower levels at follow-up (i.e., a decline in social relationship level) using logistic regression. In multivariate analysis, important baseline predictors of decline in social relationship levels included greater age, lower educational level, lower memory test score, the presence of physical disabilities, and a higher level of depressive symptoms. Marital status and lower self-perceived health status were less consistent predictors, and having any living children, history of major illness, and continence status were generally not important predictors of decline in social relationship levels. These findings underscore the multifactorial and complex influences on changes in social relationships, but they also identify factors for possible prevention and intervention strategies.