Lower General Life Satisfaction Research Articles

Patient activation levels and socioeconomic factors among the Amazonas population with diabetes: a cross-sectional study

BackgroundThe presence of chronic conditions such as type 2 diabetes mellitus (T2DM) requires behavioral lifestyle changes mediated by individuals’ motivation for change and adherence to treatment. This study aims to explore activation levels in individuals with T2DM treated in primary care facilities and to identify the association between demographic, clinical, psychosocial factors, and patient activation amongst populations in the Brazilian state of Amazonas.MethodsSAPPA is a cross-sectional study conducted in Amazonas, approved by the Universidade Federal do Amazona’s IRB in Brazil. Individuals with T2DM were evaluated in their homes (n = 4,318,325). The variables were sex, age, skin color, education level; health-related variables such as body mass index, nutritional behavior, and frequency of physical activity. Measures related to patient self-management behaviors over the past 6 months (Patient Activation Measure – PAM-13) were included in the survey. Descriptive and frequency data are presented as mean (standard deviation (SD)) or numeric percentage). Statistical testing was performed using IBM SPSS V.26, and a p-value of < 0.050 showed significance. Activation levels were dichotomized into low activation (Levels 1 and 2) and high activation (Levels 3 and 4). A multivariate linear model assessed the association between the PAM-13 score and the following variables: age, sex, BMI, skin color, number of comorbidities, burden of symptoms, and number of medications.ResultsLogistic regression analyses indicated a statistically significant association between sex, age, education, self-rated health, and general satisfaction with life. men were 43% more likely to score lower levels (p < 0.001). The results also indicated that advanced age had lower PAM levels (p < 0.001). Participants with fewer years of education were 44% more likely to have lower levels of PAM (p = 0.03). Worse self-rated health (p < 0.001) and lower general life satisfaction (p = 0.014) were associated with lower PAM levels.ConclusionsLow patient activation was associated with worse sociodemographic, health, and psychological conditions in the Amazon population. The low level of patient activation observed in this sample highlights an important impediment to diabetes disease management/self-management in disadvantaged populations.

Social determinants of health influence preschool and caregiver experiences during symptoms and exacerbations of wheezing

BackgroundSocial determinants of health have been inadequately studied in preschool children with wheezing and their caregivers but may influence the care received. ObjectiveTo evaluate the symptom and exacerbation experiences of wheezing preschool children and their caregivers, stratified by risk of social vulnerability, over 1 year of longitudinal follow-up. MethodsA total of 79 caregivers and their preschool children with recurrent wheezing and at least 1 exacerbation in the previous year were stratified by a composite measure of social vulnerability into “low” (N = 19), “intermediate” (N = 27), and “high” (N = 33) risk groups. Outcome measures at the follow-up visits included child respiratory symptom scores, asthma control, caregiver-reported outcome measures of mental and social health, exacerbations, and health care utilization. The severity of exacerbations reflected by symptom scores and albuterol use and exacerbation-related caregiver quality of life were also assessed. ResultsPreschool children at high risk of social vulnerability had greater day-to-day symptom severity and more severe symptoms during acute exacerbations. High-risk caregivers were also distinguished by lower general life satisfaction at all visits and lower global and emotional quality of life during acute exacerbations which did not improve with exacerbation resolution. Rates of exacerbation or emergency department visits did not differ, but intermediate- and high-risk families were significantly less likely to seek unscheduled outpatient care. ConclusionSocial determinants of health influence wheezing outcomes in preschool children and their caregivers. These findings argue for routine assessment of social determinants of health during medical encounters and tailored interventions in high-risk families to promote health equity and improve respiratory outcomes.

Living without Partnered Sex in Germany. Results From the First Representative, Population-based German Health and Sexuality Survey (GeSiD)

Broader insights into the life situations of sexually inactive adults in Germany are widely unexplored. Within the nationally-representative survey GeSiD (German Health and Sexuality Survey), undertaken 2018-2019, data of 4,758 participants with lifetime interpersonal sexual experience aged 18-75 years (men: n = 2234; women: n = 2524) were analyzed in regards to partnered sexual inactivity in the past 12 months (PSI; no genital-involving sexual contact with another person). Overall, advanced age, being single and impaired health conditions were associated with PSI. Data showed gender-specific associations with PSI, such as less alcohol, smoking and drug use in women. PSI was associated with lower general life satisfaction throughout different age groups.

Help or hindrance? Minority versus majority cross-ethnic friendships altering discrimination experiences

We examined the interplay between perceived ethnic discrimination (PED) as a risk factor, and cross-ethnic friendships as a protective factor in culturally diverse classrooms, and how they relate to the socioemotional adjustment of ethnic minority boys and girls. We conducted multi-level analyses of 327 Turkish-heritage ethnic minority early-adolescents in Germany (62 classrooms; Mage = 11.59 years, SDage = 0.76). Higher rates of PED were associated with more depressive symptoms and disruptive behaviors and lower general life satisfaction—though these effects differed by gender. Unexpectedly, cross-ethnic friendships with ethnic majority peers exacerbated the negative effects of PED on socioemotional adjustment. This effect was decreased, though, when adolescents perceived the classroom climate to be supportive of intergroup contact toward majority-minority cross-ethnic friendships. Supportive classroom climate also buffered the effects of PED for youth with minority cross-ethnic friends. Results indicate the need to differentiate types of cross-ethnic relationships and account for the intergroup climate.

Low heart rate variability in unemployed men: The possible mediating effects of life satisfaction

Unemployment has consistently been associated with increased risk of cardiovascular disease and premature mortality, and impaired autonomic modulation of the heart might be one mechanism partly explaining this. This study examined whether the possible effect of unemployment on cardiac autonomic modulation is in part mediated by lower psychological well-being. The sample comprised of 15 job-seeking men aged 30–49 years matched with 15 employed men on age, type of job, smoking habits, alcohol intake, frequency of physical activity, and body mass index. Heart rate variability (HRV) during a modified orthostatic test was the measure of cardiac autonomic modulation, and life satisfaction was the measure of psychological well-being. Unemployed men had significantly lower overall HRV (p = .040) than controls. This association was partially mediated through lower general life satisfaction, and in particular, by low financial satisfaction, independently of demographic and/or behavioral factors that influence HRV. These findings suggest that seeking a job is a potential stressor that may reduce overall HRV and contribute towards disturbance of cardiac autonomic modulation in men. Financial difficulties could be one mechanism through which the effects of unemployment are translated into impaired autonomic modulation.

Institutional rearing is associated with lower general life satisfaction in adulthood

We analyzed whether individuals reared in institutions differ in their general life satisfaction from people raised in their families. The data comprised of 19,210 German adults (51.5% female) aged from 17 to 101years and were provided by the SOEP, an ongoing, nationally representative longitudinal study in Germany. Compared to people raised in families, individuals reared in institutions reported lower general life satisfaction in the manner of a dose response relationship controlling their parents’ education and occupational prestige. The association was moderated by participants’ age such that with increasing age the association between institutional rearing and lower general life satisfaction decreased. Further, the relationship was partly mediated by the individuals own education/socio-economic attainment in adulthood, physical health, and relationship status.

Sexual Function and Depressive Symptoms Among Female North American Medical Students

Depression and sexual dysfunction are often comorbid. We explored the relationship between sexuality, sexual dysfunction, and depressive symptoms in female medical students in North America. Female North American medical students were invited to participate in an internet survey. The CES-D was utilized to screen for depressive symptoms and an abbreviated Spielberger State-Trait Anxiety Index (STAI) was used to quantify anxiety symptoms. Subjects completed an ethnodemographic survey, a sexuality survey, and modified instruments for the quantification of sexual function (the Female Sexual Function Index [FSFI] and the Index of Sexual Life [ISL]). Multivariable logistic regression was used to explore the relationship between sexuality and depressive symptoms. There were 1,241 female subjects with complete data on CES-D and STAI. Mean age was 25.4 years. Depressive symptoms (CES-D>16) were present in 46% of respondents and were more common in subjects with anxiety symptoms. Subjects who were Caucasian, younger than 28, heterosexual, and in a relationship were least likely to report depressive symptoms. High risk of female sexual dysfunction (HRFSD) was significantly associated with greater likelihood of depressive symptoms (odds ratio [OR] 2.25, P<0.001). After adjusting for ethnodemographic and sexual history factors, HRFSD remained significantly positively associated with depressive symptoms (OR 1.85, P<0.001). Analysis of FSFI and ISL domains indicated that depressive symptoms were most directly associated with worse orgasmic function, interference in sex life from stress and lack of partner, and lower general life satisfaction (P<0.05). Interestingly, greater ISL-sexual satisfaction was associated with greater odds of depressive symptoms (OR 1.40, P=0.01). Depressive symptoms are common in female medical students. HRFSD is associated with depressive symptoms, although the relationship is complex when psychosocial factors are included in the multivariate model. Attention to sexuality factors from student health providers may enhance quality-of-life, academic achievement, and patient care.

Differences in Fertility Patterns between East and West German Women. Disentangling the roles of cultural background and of the transformation process

The present study compares parity-specific fertility patterns of West and East German women (from birth cohorts 1970 and younger) after German re-unification using panel data from the GSOEP (waves 1990 through 2006). Whereas the transition rate for the birth of the first child tends to be higher in the East German than in the West German sub-sample, the likelihood of second births remains considerably higher among West German women across time. The analyses presented comprise a detailed comparative test of different intervening mechanisms, represented by sociocultural orientations and social inequalities resulting from the societal transformation process. Although the transition rate to first births among East German women is lowered by their higher education and work aspirations, their higher degree of family orientation promotes their propensity to start a family. Surprisingly, the higher proportion of persons without a denomination in East Germany promotes the transition to parenthood because it accelerates both the engagement in and the consolidation of intimate relationships. The lower transition rate to second births among East German women is partly accounted for by the higher work aspirations, by the lower religiosity and by the lower general life satisfaction in this subgroup.

General and health-related life satisfaction of patients with community-acquired pneumonia

When assessing the quality of care, patients' characteristics such as general and health-related life satisfaction, are of major significance. Our study examined the general and health-related life satisfaction of patients with community-acquired pneumonia (CAP). To quantify the general and health-related life satisfaction, we used the validated instrument Questions on Life SatisfactionModules by Henrich and Herschbach. CAP cases included in the German competence network on CAP (CAPNETZ) were asked to answer questions on their personal satisfaction with aspects of their life and health and on the individual importance of each addressed aspect. Data were compared with a normal population sample. In addition, several subgroup analyses were conducted. One thousand eight hundred ninty-nine (50.5%) CAP patients returned the questionnaire within a median time of 3 days. The mean age of the study sample was 55.1 ± 17.1 years, 47.0% were female. The CAP patients reported not only a lower satisfaction with health (52.1 ± 42.6 vs. 74.4 ± 41.5, p < 0.001), but also a lower general life satisfaction (55.0 ± 35.2 vs. 60.5 ± 37.3, p < 0.001) than the normative German sample. Subgroup analyses revealed a significantly impaired general life satisfaction in patients with comorbidities (52.2 ± 34.7) compared with patients without any underlying disease (58.1 ± 35.4, p = 0.001). A non-significant lower general life satisfaction (53.3 ± 35.1 vs. 57.0 5 ± 35.2, p = 0.052) as well as a lower health-related life satisfaction (49.25 ± 42.0 vs. 55.3 ± 43.0, p = 0.602) could be observed in men compared with those in women. Patients aged 65 years and older and patients with a severe CAP reported a lower health-related life satisfaction, but a higher general life satisfaction than younger patients or patients with mild CAP. The lower general life satisfaction observed in patients with CAP was found to reflect comorbidity rather than the effects of the pneumonia itself.

Life Satisfaction Among Ethnic Minorities: The Role of Discrimination and Group Identification

For most immigrants and ethnic minority groups, everyday life in the country of settlement raises question of adaptation and belonging. Aside from factors such as lower income, lower education and poorer health, being an ethnic minority member carries additional factors that can lower general life satisfaction. Using data from two studies the present paper shows that ethnic minority group members (Turkish-Dutch) have lower general life satisfaction than a comparable majority group (Dutch) because they are less satisfied with their life in the country of settlement. In addition, Study 2 showed that higher perceived structural discrimination was associated with lower life satisfaction in the country of settlement, but also with higher ethnic group identification that, in turn, made a positive contribution to general life satisfaction.

Quality of life in schizophrenia: contributions of anxiety and depression

A number of studies have demonstrated a strong relationship between quality of life in schizophrenia and general psychopathology measures, and moreover, that the positive, negative, and disorganized symptoms are less related to quality of life. The current investigation examined the relationship between quality of life and symptomatology in 63 stabilized outpatients diagnosed with schizophrenia or schizoaffective disorder. Consistent with other findings, more severe depression, as rated on the Brief Psychiatric Rating Scale (BPRS) was associated with lower general life satisfaction and lower satisfaction with daily living, finances, health, and social life. In addition, higher anxiety ratings on the BPRS were associated with less satisfaction with global quality of life, daily activities, family, health and social relationship, even when controlling for positive symptoms, negative symptoms, or depression. No other symptoms of schizophrenia were as strongly associated with subjective quality of life. Anxiety was also significantly correlated with a number of positive and negative symptoms while depression was substantially less related. These findings, suggest that more precise analyses of general psychopathology, and anxiety in particular, may be necessary to further clarify the factors involved in quality of life in schizophrenia. In addition, these findings suggest future directions for theories of affect and treatment in schizophrenia.

Later Life Satisfaction and Household Structure: Living with Others and Living Alone

ABSTRACTIn a survey of 1,400 older Americans over 65, two household structures, elders living with others and elders living alone, were compared with older married couples. Results indicated that elders living with others had a greater degree of incapacity and lower income than married couples, but on most indices there were few differences. Elders in three-generation families had somewhat lower general life satisfaction, but the greatest number of elderly people with low life satisfaction were widows who lived alone. Widows living alone were less likely than married couples to own their homes and more likely to perceive that their income was inadequate, that transportation needs were unmet and that no one would care for them in an emergency, all conditions strongly associated with low life satisfaction.