Lower Levels Of General Health Research Articles

The anxiety associated with COVID-19, general health, spiritual health, and job satisfaction in healthcare providers: a cross-sectional study

BackgroundPrevious research has shown the impact of pandemic communicable diseases on the mental health of healthcare providers. This study examined the relationship between general health, spiritual health, anxiety associated with COVID-19, job satisfaction, and the mediating role of sex in healthcare providers in Iran in 2021.MethodsThis was a descriptive-analytical and cross-sectional study performed on 163 healthcare providers of which 71.8% were female and 28.2% were male with an age range between 21 and 58 years, an average work experience of 9.5 years, and working as nurses, doctors, laboratory technicians, etc. in some hospitals in Sanandaj. Data were collected using COVID-19 Anxiety, General Health, job satisfaction, and Spiritual Health questionnaires. Then, the data were analyzed using SPSS-22 software, regression test, and path analysis.ResultsAlthough women averaged lower levels of general health, job satisfaction, and anxiety associated with COVID-19, and higher scores in spiritual health than men, none of these differences were statistically significant, and sex didn’t play a significant role here. Also, general health and spiritual health could significantly predict 17.1% of the variance in job satisfaction in the path analysis. However, sex and Covid-19 anxiety could not significantly predict this variable.ConclusionThe results showed that there was not a significant difference between the male and female workers’ general health when facing such pandemics. However, we may prepare interventions to promote their general and spiritual health and to promote healthcare providers’ job satisfaction during such pandemics.

Poor general health and lower levels of vitality are associated with persistent, high-intensity low back pain and disability in community-based women: A prospective cohort study

While low back pain significantly impacts on an individual’s well-being, our understanding of the role of well-being in the natural history of low back pain is limited. This cohort study aimed to investigate the association between psychological and general well-being and the development and progression of low back pain and disability in community-based women over a 2-year period. 506 women recruited from a research database were invited to participate. Overall psychological and general well-being and its subdomains were assessed at baseline using the Psychological General Well-Being Index (PGWB). The intensity of and degree of disability arising from low back pain were examined using the Chronic Pain Grade Questionnaire at baseline and at 2-year follow-up. Participants were categorized as having no, developing, resolving, or persistent high-intensity pain and disability. 444 participants (87.8%) completed the study. Women with persistent high-intensity pain had lower PGWB scores at baseline than those with no high-intensity pain at follow-up, after adjusting for confounders (M(SE) = 69.9(2.55) vs 80.1(2.63), p < 0.005). Furthermore, women with persistent high disability scores had lower well-being scores than those without persistent high disability scores (M(SE) = 69.1(3.49) vs. 81.2(0.802), p = 0.001). Moreover, lower scores in the well-being subdomains of general health and vitality were associated with persistent high pain intensity and disability (all p < 0.007). In summary, lower levels of general health and vitality were associated with persistent high-intensity low back pain and disability, suggesting that improving these aspects of well-being has the potential to reduce high levels of chronic low back pain and disability in community-based women.

How can the health belief model and self-determination theory predict both influenza vaccination and vaccination intention ? A longitudinal study among university students

Background and objectiveSeasonal influenza is frequent among students and often responsible for impaired academic performance and lower levels of general health. However, the vaccination rate in this population is very low. As the seasonal influenza vaccine is not compulsory in France, it is important to improve the vaccination uptake by identifying predictors of both intention and behaviour. This study investigated the effect of decisional balance, motivation and self-efficacy on vaccination acceptance using the Extended Health Belief Model (HBM) and Self-Determination Theory (SDT).Design and Main Outcome MeasuresUniversity students were invited to fill in an online survey to answer questions about their influenza vaccination intention, and HBM and SDT constructs. A one-year longitudinal follow-up study investigated vaccination behaviour.ResultsAutonomous motivation and self-efficacy significantly influenced the intention to have the influenza vaccine, and vaccine behaviour at one-year follow-up. Intention predicted a significant proportion of variation (51%) in behaviour, and mediated the effect of these predictors on vaccination behaviour.ConclusionThese results suggest that motivation concepts of the Self-Determination Theory can be adequately combined with the Health Belief Model to understand vaccination behaviour.

Do characteristics of marijuana use correspond to overall health levels for medical marijuana patients?

ABSTRACTThe current study assesses how characteristics of medical marijuana use are related to general health status and past year change in health. An analytic sample of 312 patients were recruited from 16 medical marijuana dispensaries across Los Angeles, California. Patients completed a short intercept survey and a longer patient survey. Surveys asked information about health, marijuana use behaviors, preferred ways to use marijuana, marijuana recommendation, and sociodemographic information. Data were analyzed using hierarchical linear modeling of patients nested within dispensaries. For general health status, patients who smoke marijuana, have more medical conditions for which they received their medical marijuana recommendation, and use marijuana more times per day report lower levels of general health. The number of days using marijuana per month was related to worse health in the past year. Medical marijuana use does not appear to improve overall health status according to the results presented here, but is limited by the cross-sectional nature of the study. As the legalization of medical marijuana use continues to grow across the United States, identifying how marijuana is related to health will allow physicians to better determine who may benefit from its use.

Assessment of Pain Drawings and Self-Reported Comorbid Pains as Part of the Biopsychosocial Profiling of Temporomandibular Disorder Pain Patients.

To assess drawings of pain sites and self-reported comorbid pains as a part of the biopsychosocial profiling of tertiary care referral patients with temporomandibular disorder (TMD) pain. A total of 135 consecutive patients referred to tertiary care for TMD pain participated. Patients drew all the sites where they had pain on whole-body pain drawings. Other assessments included self-reported comorbid pains in the head and body regions, the Finnish Research Diagnostic Criteria for TMD (RDC/TMD_FIN Axis II), and additional biopsychosocial and treatment-related variables. Patients were grouped into pain drawing profiles (localized, regional, and widespread) and the associations between these profiles and the biopsychosocial variables were statistically evaluated using Bonferroni adjusted P values and with logistic regression using SAS 9.3. A total of 21% of the patients reported localized TMD pain, 20% reported regional pain (headaches and neckaches), and the majority, 59%, reported widespread pain (local/regional and multiple bodily pain sites). Patients with widespread pain profiles formed a heterogenous group in which 28.2% reported severe and 30.8% reported moderate pain-related disability. The widespread pain patients reported significantly higher levels of depression and somatization, lower levels of general health, more sleep dysfunction, decreased ability to control pain, and greater health care needs compared to patients with localized pain (P < .05). Patients with regional pain profiles reported moderate scores on psychosocial functioning compared to the patients with localized or widespread pain. The majority of tertiary care referral patients with TMD pain reported comorbid pains. Pain drawings were found a useful adjunctive tool for screening and as a part of comprehensive biopsychosocial assessment and treatment planning for patients with TMD pain.

Clinical study of infliximab in treatment of patients with juvenile idiopathic arthritis

Objective To explore the clinical efficacy, adverse effect and prognosis of infliximab in treatment of the patients with juvenile idiopathic arthritis (JIA). Methods Thirty-two cases of infliximab-treated JIA patients and 30 cases of JIA control patients were investigated in this prospective study, and their tender joint count (TJC), swollen joint count (SJC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), visual analog scale for general health (GH), disease activity score (DAS) 28, as well as adverse reactions of treatment and follow-up outcomes were analyzed.The infliximab-treated patients were intravenously infused with infliximab at the low dose of <5 mg/(kg·time) or the high dose of ≥5 mg/(kg·time) in 0, 2nd, 6th, 14th, 22nd, 30th week.The JIA control patients were treated with conventional therapy. Results The treatment of infliximab ameliorated the TJC, SJC, ESR, GH, CRP and DAS28 of JIA patients.In the dynamical analysis of these clinical indexes of the infliximab-treated JIA patients, the index of SJC was found to fall firstly in the 2nd week, the indexes of TJC, ESR, GH and DAS28 were found to decline se-condly at 6th week, the indexes of TJC, SJC, ESR, CRP and DAS28 continued dropping till 22nd week, and only the index of GH progressively declined to 30th week.The high-dose infliximab-treated group had lower levels of ESR, GH and CRP than the low-dose infliximab-treated group(t=2.14, 3.04, 2.33, P=0.04, 0.01, 0.04). But there were no statistical difference in TJC, SJC, DAS28 and the incidence of recent adverse reactions between the high and low infliximab dose groups.In the infliximab treated group, 2 cases of patients (6.25%) failed in the therapy of infliximab; 9 cases of patients (28.13%) continued therapy with infliximab to 46th-62nd week; 7 cases of patients (21.88%) stopped therapy with infliximab in the 30th week had good improvement of joint symptoms and inflammatory indexes; 14 cases of patients (43.75%) relapsed and retreated by infliximab after cease the first course of treatment; 1 case of patient died of severe chickenpox infection after therapy with infliximab was ceased. Conclusions Infliximab can alleviate the joint symptoms, inflammatory indexes and DAS28 of JIA patients, and is an effective and safe therapy for JIA patients in the short-term study. Key words: Juvenile idiopathic arthritis; Infliximab; Therapy

Who benefits most from guided self-help for binge eating? An investigation into the clinical features of completers and non-completers

Guided self-help (GSH) is a recommended first step in treatment for bulimia nervosa (BN) and binge eating disorder (BED) (NICE, 2004). It remains unclear what makes some individuals more likely to respond to this form of treatment than others. Forty-eight patients participated in this study using a GSH programme for binge eating. Profiles of treatment completers and non-completers are compared, and reasons for non-completion explored. Completion of treatment was associated with significant improvements in mood, general functioning and on measures of dietary restraint, frequency of objective binge eating (OBE), laxative misuse, self-induced vomiting (SIV) and driven exercise. Improvements were maintained at follow-up. Treatment non-completers reported significantly higher pre-treatment levels of depression and weight concern, and lower levels of general health and vitality. Reasons for discontinuing treatment were related to perceptions of the GSH programme; practicalities of the programme; and readiness to change. Whilst GSH can be effective for a sub-group of patients, factors such as pre-morbid level of depression, degree of weight concern, perceptions of the programme, and readiness to change may increase the likelihood of non-completion.

Type D (distressed) personality is associated with poor quality of life and mental health among 3080 cancer survivors

This study assessed the association between Type D personality (the conjoint effect of negative affectivity and social inhibition) and quality of life (QoL) and mental health of cancer survivors up to 10 years post-diagnosis. All currently alive individuals diagnosed with endometrial or colorectal cancer between 1998 and 2007, or with lymphoma or multiple myeloma between 1999 and 2008 as registered in the Eindhoven Cancer Registry received a questionnaire on Type D personality (DS14), QoL (SF-36 or EORTC-QLQ-C30) and mental health (HADS). Of the 3080 survivors who responded (69%), 572 (19%) had a Type D personality. Type D survivors had clinically meaningful lower levels of general health, social functioning, role-function emotional, mental health and vitality compared to non-Type D's (SF-36: all P's<0.001). They also reported clinically meaningful worse emotional and social functioning, global health status/QoL, and more fatigue (EORTC-QLQ-C30: all P's<0.001). This was also confirmed by multivariate logistic regression analyses showing that cancer survivors with a Type D personality were more likely to experience a decreased QoL on all SF-36 and EORTC-QLQ-C30 scales (all ORs ranging between 1.88 and 5.56). The proportion of survivors reporting an impaired QoL was higher among Type D (35-64%) than non-Type D's (20-36%). Finally, Type D's were more likely to be depressed (44% vs. 13%; P<0.0001) or anxious (51% vs. 14%; P<0.0001). Cancer survivors with a Type D personality are at increased risk of impaired QoL and mental health problems that cannot be explained by socio-demographic or clinical characteristics.

Can parents rate their children's quality of life? Perspectives on pediatric orthopedic outcomes

The ultimate goal of treatment for children with orthopedic problems is to improve their health-related quality of life. Because children may lack the abilities to effectively interpret and answer the questions used to assess a patient's health-related quality of life, parent proxies have been used in such pediatric cases. Unfortunately, previous studies exploring the efficacy of these parent proxies have been inconsistent. It is therefore important to determine the level of agreement between child-parent dyads and whether agreement is mediated by variables such as disease type, demographics, instrument, and the domain being assessed. The purpose of this study was to examine the degree of agreement between children and their parents' ratings in the Child Health Questionnaire (CHQ) and the Pediatric Orthopaedic Data Collection Instrument (PODCI), two instruments commonly used to assess health-related quality of life in children. The CHQ, PODCI, and standard demographic and clinical data were collected from parents and children between the ages of 5 and 18 years with a wide range of musculoskeletal problems. There was a strong level of agreement between child and parent responses for most of the domains in both instruments. Exceptions included Physical Functioning (PF), General Health (GH), and Mental Health (MH) in the CHQ, and Expectations in the PODCI. All four of these domains exhibited significant differences between the two respondent groups and had medium effect sizes. Children reported a higher level of PF and lower levels of both GH and MH than their parents. Additionally, parents reported significantly higher expectations for treatment than children did. None of the regressions yielded significant β values for child age, parent sex, match/no match between parent-child sex, and scoliosis/nonscoliosis diagnosis. These significant discrepancies were not driven by specific subsamples; therefore, we concluded that these discrepancies can be generalized to the pediatric orthopedic population. Our results also indicate that the CHQ is more sensitive than the PODCI to the rating differences between children and parents. The results of this study can serve clinicians in pediatric orthopedic surgery as a guide for not only selecting the most appropriate instruments for assessment but also for interpreting treatment outcomes most meaningfully. Level of Evidence is the Level II Prognostic Study.

A pilot study on perceived stress and PTSD symptomatology in relation to four dimensions of older women's physical health

Objectives: The authors examined whether selected demographic and psychological factors would predict physical health dimensions in a sample of 53 cognitively high-functioning and ethnically diverse women (age 65–105 years). Method: Predictors encompassed posttraumatic stress disorder (PTSD) symptomatology and perceived stress (of a nontraumatic nature and beyond health status) in relation to four dimensions of physical health. Age and income, well-known correlates of health in the target population, were included as potential predictors. The authors first tested the relationship between potential predictors and health dimensions via a canonical correlation analysis, and then employed full multiple regression analyses to simultaneously test the predictors in each health dimension model. Results: Perceived stress was a significant predictor of lower levels of general health (GH), but not of physical role limitations or physical functioning (PF). Conversely, PTSD symptomatology predicted more limitations in role fulfillment (and, to a lesser extent, impairedPF), but not lower levels of GH. As expected, age and income were predictive of some physical health dimensions. The hypothesized predictors failed to account for a significant portion of variance in pain scores. Conclusion: PTSD symptomatology and perceived stress might influence older women's physical health dimensions differentially; additional research on larger samples is needed to corroborate these findings.

A cross-sectional study on health and physical functioning in relation to coping strategies among community-dwelling, ethnically diverse older women

BackgroundAlthough empirical evidence is available on the coping-health link in older age, research on this topic is needed with non-clinical samples of ethnically diverse older women. To contribute to filling such a research gap, we tested whether these women's general health and functional limitations were associated with specific coping strategies (selected for their particular relevance to health issues) and with known health-related demographics, i.e., age, ethnicity, income, and married status.MethodsIn this cross-sectional study, respondents were recruited at community facilities including stores and senior centers. The sample consisted of 180 community-dwelling women (age 52-98) screened for dementia; 64% of them reported having an ethnic minority status. The assessment battery contained the Mini-Cog, a demographics list, the Brief COPE, and the Medical Outcome Study 36-Item Short-Form Health Survey.ResultsHierarchical multiple regression analyses showed that older women who used behavioral disengagement and, to a smaller degree, self-distraction as a form of coping reported lower levels of general health. The opposite was the case for positive reframing and, to a lesser degree, substance use. Moreover, lower income was related to worse general health and (together with more advanced age) physical functioning. None of the coping strategies achieved significance in the physical functioning model.ConclusionsThese cross-sectional findings need corroboration by longitudinal research prior to developing related clinical interventions. Based on the initial evidence provided herein, clinicians working with this population should consider establishing the therapeutic goal of increasing the use of positive reframing while diminishing behavioral disengagement.

A pilot study on perceived stress and PTSD symptomatology in relation to four dimensions of older women's physical health

Objectives: The authors examined whether selected demographic and psychological factors would predict physical health dimensions in a sample of 53 cognitively high-functioning and ethnically diverse women (age 65–105). Method: Predictors encompassed posttraumatic stress disorder (PTSD) symptomatology and perceived stress (of a nontraumatic nature and beyond health status) in relation to all dimensions of physical health of the Medical Outcome Study 36-item Short Form Health Survey (MOS SF-36); (Ware, J.E., & Sherbourne, C.D., 1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30(6), 473–483). Age and income, well-known correlates of health in the target population, were included as potential predictors. The authors first tested the relationship between potential predictors and health dimensions via a canonical correlation analysis, and then employed full multiple regression analyses to simultaneously test the predictors in each health dimension model. Results: Perceived stress was a significant predictor of lower levels of general health (GH), but not of role limitations or physical functioning (PF). Conversely, PTSD symptomatology predicted more limitations in role fulfillment (and, to a lesser extent, impaired PF), but not lower levels of GH. As expected, age and income were predictive of some physical health dimensions. The hypothesized predictors failed to account for a significant portion of variance in pain scores. Conclusion: PTSD symptomatology and perceived stress might influence older women's physical health dimensions differentially; additional research on larger samples is needed to corroborate these findings.

Psychosocial aspects of living-related donor renal transplantation: Quality of life and mood in recipients, donors and controls

Due to the high frequency of living-related donor renal transplantation (LRDRT) in our country, we were concerned both about the recipient and the donor quality of life and psychological well-being. We investigated HRQL and mood in LRDRT recipients, donors, and controls using the Beck Depression Inventory, Beck Anxiety Inventory, and 36-item Short Form Health Survey. The recipient group consisted of 69 individuals who underwent renal transplantation between August 2002 and June 2004. The donor group consisted of 35 and the control group 45 healthy individuals. Multivariate analysis of variance and the post hoc (Tukey) test were used to assess and to analyze differences among and between the three groups. The depression scores of the recipients were higher than donors (P < 0.05) but were similar to controls. The recipient scores indicated poorer physical functioning (P < 0.001), greater physical limitation on roles (P < 0.001), and lower levels of general health (P < 0.01) compared to controls. The donor scores indicated higher vitality (P < 0.01), better social functioning (P < 0.05) and greater mental health (P < 0.01) than controls. Poorer health and mood status among the recipient group might reflect the various negative impacts of chronic debilitating disease. It is therefore recommended to screen recipients regularly for clinically relevant HRQL impairments after transplantation.

A Comparative Study of Pain in Heart Failure and Non-Heart Failure Veterans

Background Progress has been made in addressing pain in specific diseases such as cancer, but less attention has focused on understanding pain in nonmalignant states, including heart failure (HF). Methods and Results From March 2006 to June 2007, 672 veterans were surveyed and scores for the Brief Pain Inventory, pain distress, clinically significant pain levels (moderate to severe pain), and pain locations were compared using univariate and multivariate models. Fifteen percent of the final sample had HF (95/634). In our study, the HF patients were older ( P < .000), reported lower levels of general health ( P = .018), had more co-morbidities ( P < .000), were more likely to have a history of cancer ( P = .035), and suffered more chest pain and fewer headaches ( P = .026, P = .03, respectively) than their non-HF cohorts. When controlling for age, co-morbidity and cancer disorders, HF and non-HF patients did not differ in pain severity, interference, distress or locations. Of the patients currently experiencing pain, 67.3% of HF patients and 68.4% of non-HF patients rated their pain as moderate or severe (pain ≥4 on a 0 to 10 scale). Conclusions Although HF has not been identified as a painful condition, this study suggests the burden of pain is significant for both HF and non-HF ambulatory care patients.

Quality of life and mood in renal transplantation recipients, donors, and controls: preliminary report

Currently, living related donors are involved in approximately 85% of all kidney transplantations performed at our institution. Health-related quality of life (HRQL) is an important outcome factor in chronic disease. Quality of life may be diminished by prolonged illness or certain treatment modalities and by negative, disabling effects on mood. We investigated HRQL and mood in renal transplant recipients, donors, and controls using the Beck Depression Inventory, Beck Anxiety Inventory, and 36-item Short Form Health Survey. Recipient depression scores were significantly higher (indicating more serious depression) than those of donors (P < .05), but similar to those of the controls. There was no significant difference between the donor and the control subjects' depression scores. The anxiety scores of the recipients and donors were similar; and recipient anxiety scores were significantly higher than those of the control subjects (P < .05). The recipient scores indicated significantly poorer physical functioning (P < .001), significantly greater physical limitation on roles (P < .01), and lower levels of general health (P < .01) compared to controls. The recipient scores for vitality, pain, social functioning, and emotional limitations on roles were similar to those of the controls. Our results indicate that most recipients and donors experience anxiety after renal transplantation. This study confirms that recipients have favorable outcomes with respect to social functioning and emotional well-being. Overall, the results of this preliminary study are positive, encouraging us to continue to perform living donor kidney transplantation.

Assessment of pain and health-related quality of life in slowly progressive neuromuscular disease.

Few studies have examined the effect of pain on the quality of life of individuals with slowly progressive neuromuscular disease (NMD). The purpose of this study was to determine the frequency and extent to which subjects with slowly progressive NMD report pain and the association between pain and health-related quality of life in persons with NMD. The study design was a descriptive, nonexperimental survey. Of a total of 1,432 subjects with slowly progressive NMDs recruited from a university-based NMD clinic and the membership rosters of worldwide NMD support organizations, 859 agreed to participate. The primary measurement tool used was the Medical Outcomes Study SF-36 health survey. Our results indicated that, with the exception of adult spinal muscular atrophy (SMA), the frequency and severity of pain reported in slowly progressive NMDs was significantly greater than levels of pain reported by the general US population and was comparable to pain reported by subjects with osteoarthritis and chronic low back pain. There was a significant correlation between increased pain and lower levels of general health, vitality, social function, and physical role. Pain was moderately associated with increased fatigue, inability to cope adequately with stress, and sleep disturbance. In conclusion, with the exception of adult SMA, the frequency and severity of pain reported in slowly progressive NMDs was significant.

Health and well-being among 70-year-old migrants living in Sweden--results from the H 70 gerontological and geriatric population studies in Göteborg.

Comparative epidemiological studies in migrants in Sweden have shown increased prevalence of psychosocial morbidity in young adults, but there is paucity of information on health in people aged 65 years and over. We aim to compare prevalence of mental, physical and social health problems, rates of hospital admission, and mortality in Swedish and non-Swedish born people aged 70 years living in Göteborg, Sweden, and examine associations between social factors, physical health, mood and life satisfaction in the ethnic groups. In addition, we aim to test for the hypothesis that differences in mental health between migrants and natives are explained by social disadvantages rather than ethnicity. Semi-structured interviews were administered to 84 migrants (47 women and 37 men randomly selected) with the help of bilingual interpreters, and 409 Swedes (183 males and 226 females) used as "controls". Complementary health and social data obtained from official sources on the total sample (N = 764, including non-participants in overall medical interviews) were used in comparative analyses of in-patient care and mortality and to check for the possibility of sampling bias. Migrants--originating mainly from Estonia, Poland, Yugoslavia, Germany, Italy and Nordic countries other than Sweden--reported more dizziness, poor vision and urinary problems, and fewer gall bladder problems than indigenous people (p < 0.05). Migrants also had higher levels of anxiety and depression and bodily pain, and lower levels of general health, social and emotional functioning, satisfaction with physical health status, family contacts, housing conditions and economic status than natives (p <0.05). Satisfaction with physical health seemed to be one of the strongest factors related to a lower prevalence of anxiety and depression together with family support and time spent in leisure pursuits. No significant differences in inpatient care in several ICD categories and all-cause mortality were found between overall migrants and the control group notwithstanding differences in self-reported health. The results indicate poorer subjective health in older migrants than natives in Göteborg, and also point to a "healthy migrant" effect on survival.

Treatment outcomes with mandibular removable partial dentures: A population-based study of patient satisfaction

Statement of problem. Little is known about the outcomes of treatment with mandibular removable partial dentures provided by dentists in private dental practice. Purpose. This study examined 15 aspects of patient satisfaction and explored the factors found to be associated with dissatisfaction. Material and methods. A questionnaire was mailed to people whose dental insurance claims included CPT Code 5214 within the last 5 years. A composite measure of treatment outcome was created by combining the responses to the 15 satisfaction items, and 10 factors were then tested statistically to determine their relationship to dissatisfaction. Results. A majority of the respondents were satisfied with the prosthesis, but a substantial amount of dissatisfaction existed. Dissatisfaction was greater when there was no previous wearing experience or when there was an opposing maxillary removable partial denture. Respondents under the age of 60 expressed more dissatisfaction than did those over the age of 60, and subjects with lower levels of general health also reported less satisfaction. One third of the respondents believed their prosthesis required adjustment or replacement, and one fourth said the removable partial denture had caused a problem with the natural teeth. Conclusion. A majority of survey respondents treated with a mandibular removable partial denture in private dental practice were satisfied with the prosthesis, but a substantial amount of dissatisfaction existed. Dissatisfaction was related to age, health, prior experience with a prosthesis, and the type of opposing dentition. (J Prosthet Dent 1998;80:36-45.)