Negative Self-perceived Health Research Articles

Falls in older adults: predictors and space distribution

This work seeks to calculate the prevalence of falls in the last 12 months among the elderly from the community of the city of Uberaba; verify the occurrence of falls in the elderly of the community according to sociodemographic and health characteristics; and identify and group the types of falls among the older individuals in the city of Uberba. Cross-sectional study carried out with 612 elderly people living in the urban area of Uberaba. Descriptive and bivariate analyzes were performed using the chi-square test (p<0.05). The kernel density estimation was used to estimate the intensity of the events. This project was approved by the Research Ethics Committee through Protocol No. 573.833. It was found that 24.7% of the elderly had falls in the last 12 months. The highest proportion of the elderly who suffered falls was female (p=0.004); aged 80 years or more (p=0.001); illiterate (p=0.026); who lived alone (p=0.049); without partner (p=0.002); with negative self-perception of health (p<0.001); dependent for BADL (p=0.049) and IALD (p=0.027); with a lower participation in AADL (p=0.003); pre-fragile/fragile (p<0.001); and with low/poor physical performance (p<0.001). The clusters with the most frequently reported falls were in the center-west region of the city, followed by the southeast region. To know the profile and the factors associated with the occurrence of falls among the elderly allows health professionals to develop actions directed to prevent, monitor and control these factors.

Changes in health-related behaviors as predictors of changes in health self-perception: longitudinal study (2011-2015)

Health self-perception is recognized as an interesting health indicator, due to its capacity to predict morbimortality, among others. Studies that investigate its association with health-related behaviors are more recent and, for the most part, cross-sectional, which indicates that this relationship may be better understood in longitudinal studies. This article sought to verify the relationship between changes in health-related behaviors and the incidence of positive and negative health self-perception. We carried out a prospective, population-based cohort study with 883 individuals aged 40 years or more interviewed in 2011 and 2015. We verified the incidence of negative and positive health self-perception according to changes in four health-related behaviors: leisure-time physical activity, fruit and vegetable consumption, abusive alcohol consumption and smoking - using crude and adjusted Poisson regression. The incidence of negative health self-perception was of 27.2%, and was higher, after adjusting for demographic, health, and other behavioral variables, among individuals with negative changes in leisure-time physical activity (RR = 1.88; 95%CI: 1.17-3.05) and in fruit and vegetable consumption (RR = 1.95; 95%CI: 1.15-3.28). The incidence of positive health self-perception was 33.2% and was higher among those who had a positive change in smoking (RR = 8.37; 95%CI: 2.79-25.09) and lower among those who had a negative change in fruit and vegetable consumption (RR = 0.51; 95%CI: 0.29-0.90). We conclude that some changes in health-related behaviors have a possible impact on health self-perception, which reinforces the importance of policies related to health-related behaviors, going beyond their relationship with morbimortality.

Self-perceived health among adult and elderly users of Primary Health Care.

A cross-sectional study was conducted with 1,246 adults and senior men and women in Pelotas (RS), Brasil to evaluate the negative self-perception of health among Primary Health Care users. The prevalence of negative self-perception of health was reported by 41.6% of respondents. Women, those who were unemployed, who reported a diagnosis of three or more chronic noncommunicable diseases, who were food insecure and did not engage in physical activity reported a higher proportion of negative self-perceived health. Users with at least higher education level and those whose households had four or more residents were less predisposed to the outcome. The high prevalence of negative self-perceived health in this population, as well as the associations found, indicate the need for a better understanding of the influence of these factors on the search for care and, consequently, on adherence to treatment.

Impact of sarcopenia, sedentarism and risk of falls in older people’s health self-perception

Abstract Introduction: Sarcopenia, often associated with sedentarism, increases the risk of falls in older people, which may contribute to poorer health. Objective: This study sought to verify the impact of sarcopenia, sedentary lifestyle and risk of falls in older people’s health self-perception. Method: This was an observational, descriptive, cross-sectional study with a quantitative approach. The sample included 317 older people from the municipality of Cruz Alta, who underwent an assessment with specific instruments to evaluate the presence of risk of falls (Downton and Timed Up and Go - TUG) and sarcopenia (Manual Hold Force - MHF and Circumference of the Calf - CP). They were also subjected to the International Physical Activity (IPAQ) and the Self-perception of Health questionnaires. Association between variables was performed using the Pearson chi-square test, with a 95% confidence interval (CI). Results: In respect to TUG, 202 (63.7%) older people presented an average risk of falls, and only 27 (8.5%) presented a high risk of falls. However, Downton showed that a hundred older people (31.5%) were at risk of falling. Sarcopenia as evaluated via CP and MHF was observed in 4.7% (15) and 31.9% older people, respectively. Regarding IPAQ, 161 (50.8%) participants were classified as active, while 156 (49.2%) were classified as inactive. In regards to self-perceived health, 159 (50.2%) older people evaluated their health condition as average or poor. Conclusion: Results suggest that older people’s negative health self-perception is directly associated with predisposing factors for falls, such as sarcopenia and physical inactivity, as well as the presence of risk of falls (as evaluated by instruments that take into account risk factors and individual physical conditions).

Negative self-perceived health associated with school violence in adolescents.

To verify the association between negative self-perception of health and school violence in adolescent students of the Municipality of Olinda (PE), Brazil. This is a cross-sectional, analytical and school-based study with a sample consisting of 2,614 adolescents selected through a strategy of random sampling in conglomerates. The information was obtained through the questionnaire "Youth Risk Behavior Survey" from which the issues of violence and self-perceived health were retrieved. Data were tabulated by Epi-data version 3.1 program and transcribed for SPSS version 22. The Chi-square test and the stepwise binary logistic regression model were used for data analysis. We observed that 26.7% of adolescents had a negative self-perception of health, and this was greater among girls. Concerning school violence, negative self-perception was associated with feelings of sadness, suicidal thoughts, bullying at school, robbery at school and safety at school. Gender and age were also associated (p < 0.05). We reinforce the need for culture and peace actions in adolescence, involving the school environment to reflect on poor health assessed by adolescents and reduce the rate of violence.

Factors associated with the hospitalization of the elderly: a national study

Abstract Objective :to analyze the factors associated with hospitalization among the Brazilian elderly based on multidimensional methodology. Method: a cross-sectional, quantitative study was performed with data from the National Health Survey (2013) population-based study. The sample was composed of 23,815 individuals over the age of 60 years. Hospitalization was considered the outcome variable and 53 independent variables were included, relating to: sociodemographic characteristics; limitations and illness; difficulties in performing basic and instrumental activities of daily living; use of health services and medical emergencies. Results: it was found that 10% of the elderly were hospitalized in the previous year. This event was related to: a negative self-perception of health (OR = 1.35); stopping performing any of their usual activities due to health reasons (OR = 2.14); difficulty going to the doctor (OR = 1.65) or walking alone (OR = 1.55); a recent search for a site, service or health professional for health-related care (OR = 1.47); increased frequency of annual medical visits (OR = 2.93) and household emergency (OR = 5.40). Conclusion: the results reinforce the fact that multiple factors are associated with the hospitalization of the elderly. The analysis of these associations has the potential to make health professionals and administrators aware of the need to improve health care for the elderly and to assist in the organization and planning of the actions of the entire health service network.

Health self-perception and its association with physical activity and nutritional status in adolescents

ObjectiveTo evaluate the association between total physical activities, physical activity in free time and nutritional status with self-perceived health in adolescents of both genders. MethodsThis is a quantitative study that integrates the school-based, cross-sectional epidemiological survey with statewide coverage, whose sample consisted of 6261 adolescents (14–19 years old) selected by random conglomerate sampling. Data were collected using the Global School-based Student Health Survey. The chi-squared test (χ2) and the Poisson regression model with robust variance were used in the data analyses. ResultsIt was observed that 27.3% of the adolescents had a negative health self-perception, which was higher among girls (33.0% vs. 19.0%, p<0.001). After adjusting for potential confounding factors, it was observed that boys who did not practice physical activity during free time (PR=1.44, 95% CI: 1.15–1.81) and were classified as insufficiently active (PR=1.27, 95% CI: 1.04–1.56), as well as girls who did not practice physical activity during free time (PR=1.15, 95% CI: 1.02–1.29) and were classified as overweight (PR=1.27, 95% CI: 1.01–1.29) had a greater chance of negative health self-perception. ConclusionBehavioral issues may have different effects on health self-perception when comparing boys with girls. Negative health self-perception was associated with nutritional status in girls and a lower level of physical activity in boys, and the practice of physical activity in the free time was considered a protective factor against a negative health self-perception for adolescents of both genders.

Prevalência e fatores associados à autopercepção negativa de saúde em adolescentes da região Norte do Brasil

Prevalence and the factors associated with adolescents’ negative self-perception of health in the Northern region of Brazil

Integrative and complementary practices: use by community health agents in self-care.

To verify the use of integrative and complementary practices (ICPs) by community health agents working in family health teams. Cross-sectional, quantitative research, conducted in the city of Montes Claros, Minas Gerais. An structured form was used for the characterization of participants and use of ICPs. Descriptive and bivariate analyses were conducted. Use of ICPs was referenced by 94 (40.7%) agents. The use of medicinal plants was predominant (32.5%). There were associations between: ICPs in general and negative self-perception of health (p=0.032), homeopathy and higher education (p=0.015), massage and living with partner(p=0.024), chiropractic care and income equal to or greater than four minimum wages (p=0.031), relaxation/meditation and religion (p=0.028). The use of ICPs was verified in the healthcare of community agents. It is necessary to strengthen these practices for the promotion of health and prevention of diseases.

Self-perceived health and clinical-functional vulnerability of the elderly in Belo Horizonte/Minas Gerais.

To determine the self-perceived health status and clinical-functional vulnerability of the elderly attended at a Reference Center of Minas Gerais, Brazil and to evaluate the association between these variables through the Clinical-Functional Vulnerability Index (IVCF-20) instrument. This is an epidemiological, retrospective study of 311 medical records. Statistical analyses were performed using the Stata program; the evaluations were by Pearson's Chi-square test and Poisson regression models. The majority of the elderly presented negative self-perceived health status(70.10%); there was statistical significance between negative self-perceived health and the variables of mood and recent hospitalization. Perceived health status influences the morbidity and mortality of the elderly. Mood disorders and recent hospitalizations directly interfere with active aging.

Individual and institutional factors associated with functional disability in nursing home residents: An observational study with multilevel analysis.

BackgroundHigh prevalence of functional limitations has been previously observed in nursing homes. Disability may depend not only on the characteristics of the residents but also on the facility characteristics. The aims of this study were: 1, to describe the prevalence of functional disability in older people living in Spanish nursing homes; and 2, to analyze the relationships between individual and nursing home characteristics and residents’ functional disability.MethodsA cross-sectional study with data collected from 895 residents in 34 nursing homes in the province of Albacete (Spain) was conducted. Functional status was assessed by the Barthel Index. Taking into account both levels of data (individual and institutional characteristics) we resorted to a multilevel analysis in order to take different sources of variability in the data.ResultsThe prevalence of functional disability of the total sample was 79.8%. The best fitting multilevel model showed that female gender, older age, negative self-perception of health, and living in private nursing homes were factors significantly associated with functional disability. After separating individual and institutional effects, the institutions showed significant differences.ConclusionsIn line with previous findings, our study found high levels of functional dependence among institutionalized elders. Gender, age, self-perception of health, and institution ownership were associated with functional status. Disentangling individual and institutional effects by means of multilevel models can help evaluate the quality of the residences.

Factors associated with fear of falling in community-dwelling older adults with and without diabetes mellitus: Findings from the Frailty in Brazilian Older People Study (FIBRA-BR)

PurposeThis study aimed to investigate the associated factors with fear of falling in community-dwelling older adults with and without diabetes mellitus. MethodsData from the Frailty in Brazilian Older People Study (FIBRA-BR), involving 4449 individuals aged 65years or older (19.2% with diabetes), were analyzed. The potential factors associated with fear of falling included sociodemographic data, chronic diseases, health-related variables and functional capacity measures. Logistic regression analysis was performed to identify the factors associated with fear of falling. ResultsFemale gender, arthritis or rheumatism, negative health self-perception, frailty, lower Lawton Scale score and reduced gait speed were independently associated with fear of falling in both groups. Factors associated with fear of falling specific to non-diabetic older adults were depression, visual impairment, falls in the previous 12months, obesity, depressive symptoms, higher Katz Index score and decreased handgrip strength. Lower Mini-Mental State Examination score was an associated factor with fear of falling only in those with diabetes. ConclusionThe factors associated with fear of falling did differ between non-diabetic and diabetic older adults. Health care professionals should consider such differences when planning their therapeutic approaches for a successful management of fear of falling in these older populations.

AGING AND INDIVIDUAL VULNERABILITY: A PANORAMA OF OLDER ADULTS ATTENDED BY THE FAMILY HEALTH STRATEGY

ABSTRACT Objective: identifying conditions of individual vulnerability in older adults and investigating the relationship with health indicators through a household survey. Method: a descriptive cross-sectional study conducted with 368 older adults attended by the Family Health Strategy. Data collection was performed through a structured interview, supported by instruments that include sociodemographic characterization, health indicators and the Vulnerable Elders Survey. A descriptive data analysis and Person's chi-square test were also performed. Results: a prevalence of 52.2% individual vulnerability was found among older adults, in addition to an association with health problems, negative self-perception of health, difficulty with mobility and in performing activities of daily living. Conclusion: identifying vulnerability among the aged population is a relevant initiative for the adequacy of health policies and programs that prioritize the promotion of aging with the maintenance of functional capacity.

Emergency Radiology Practice Patterns: Shifts, Schedules, and Job Satisfaction

PurposeTo assess the practice environment of emergency radiologists with a focus on schedule, job satisfaction, and self-perception of health, wellness, and diagnostic accuracy. MethodsA survey drawing from prior radiology and health care shift-work literature was distributed via e-mail to national societies, teleradiology groups, and private practices. The survey remained open for 4 weeks in 2016, with one reminder. Data were analyzed using hypothesis testing and logistic regression modeling. ResultsResponse rate was 29.6% (327/1106); 69.1% of respondents (n = 226) were greater than 40 years old, 73% (n = 240) were male, and 87% (n = 284) practiced full time. With regard to annual overnight shifts (NS): 36% (n = 118) did none, 24.9% (n = 81) did 182 or more, and 15.6% (n = 51) did 119. There was a significant association between average NS worked per year and both perceived negative health effects (P < .01) and negative impact on memory (P < .01). There was an inverse association between overall job enjoyment and number of annual NS (P < .05). The odds of agreeing to the statement “I enjoy my job” for radiologists who work no NS is 2.21 times greater than for radiologists who work at least 119 NS, when shift length is held constant. Radiologists with 11+ years of experience who work no NS or 1 to 100 NS annually have lower odds of feeling overwhelmed when compared with those working the same number of NS with <10 years’ experience. ConclusionThere is significant variation in emergency radiology practice patterns. Annual NS burden is associated with lower job satisfaction and negative health self-perception.

Self-perceived health in institutionalized elderly.

This study aimed to verify health self-perception, its prevalence and associated factors in institutionalized elderly. A cross-sectional study is presented herein, conducted in 10 Long-Term care Institutions for the Elderly (LTIE) in the city of Natal (Northeast Brazil), between October and December 2013. Sociodemographic variables were analyzed, along with institution-related and health state variables. Descriptive and bivariate analyses were carried out (Chi-squared test, Fisher's exact test or linear trend Chi-squared test), as well as multivariate analysis (logistic regression). The final sample consisted of 127 elderly. The prevalence of negative self-perceived health was 63.19% (CI 95%: 55.07-70.63), and was associated with weight loss (PR: 1.54; CI 95%: 1.19-1.99), rheumatic disease (PR: 1.46; CI 95%: 1.05-2.01) and not-for-profit LTIE (PR: 1.37; CI 95%: 1.03-1.83), adjusted by sex. More than half of the elderly reported negative self-perceived health, which was associated with weight loss, rheumatic disease and type of institution. Actions must be developed to promote better health conditions in LTIE, such as nutrition consulting and physical therapy, to improve quality of life.

Diabetes mellitus em Montes Claros: inquérito de prevalência autorreferida

Objective: To estimate the prevalence of self-reported diabetes mellitus in the population of Montes Claros. Methods: Cross-sectional, analytical study with population and household basis. The data collection instrument was based on the questionnaire proposed by the Ministry of Health to assess behaviors and risk factors for noncommunicable chronic diseases. The prevalence of diabetes mellitus was surveyed through report made by the assessed individuals, in a northern city of Minas Gerais state, Brazil. The association of self-reported diabetes to sociodemographic profile, lifestyle, use of health services, and perception of general health was evaluated through Poisson regression, with analysis of prevalence ratios. The average number of medical appointments in the public sector and hospitalization events in the year were compared between diabetics and nondiabetics. Statistical analysis considered the significance level at p<0.05 and 95% confidence interval. Results: There were 2,149 participants. Of these, 4.5% (n=96) reported having diabetes. The highest prevalence rate was related to the elderly (PR=1.047), those who consume soft drinks (PR=1.054), and those with negative self-perceived health (OR=1.017), p<0.05. The average number of medical appointments in the public sector was higher among diabetics, (2.53±3.420), as well as the average number of hospitalizations, (1.44±0.703), p<0.05. Conclusion: The prevalence of self-reported diabetes mellitus in this population was similar to the national scenario and showed association to the elderly, soft drink consumers and to those who perceive not having a good general health. Diabetes seems to contribute to the increased use of public health services.

Undernutrition and associated factors in a Portuguese older adult community

OBJECTIVE: To evaluate the prevalence of undernutrition in older adults aged &gt;75 years living in communities and to identify the main factors independently associated with undernutrition. METHODS: A cross-sectional study was conducted using a random sample of family physicians' medical records of 86 older adults aged &gt;75 years living in the community studied. Their nutritional status was evaluated using the Mini Nutritional Assessment. RESULTS: A total of 10.5% of the elderly were undernourished and 41.9% were at undernutrition risk. According to the logistic regression multivariable model, the following characteristics: being widowed (OR=6.7; 95%CI=1.8-24.6); being institutionalized (OR=12.6; 95%CI=1.7-90.5); or having a negative self-perception of health (OR=15.0; 95%CI=3.3-69.1) were independently associated with a significant increase of undernutrition risk. CONCLUSION: The current study shows that undernutrition is highly prevalent in Portuguese older adults aged &gt;75 years living in communities. The major factors independently associated with their undernutrition are being widowed and institutionalized and having negative self-perception of health. The results obtained show that undernutrition and its associated factors are very serious problems for older adults and a challenge in their health care.

Factors Related to Self-perceived Health in Rural Men and Women

ABSTRACTThis study examined self-perceived health status among men and women who live on farms, as well as variations in factors related to negative health status observed by gender. Data were collected in the province of Saskatchewan, Canada, in 2013 through the use of a cross-sectional survey. A multistage sample was developed consisting of farms nested within rural municipalities and then agricultural soil zones. The response rate was 48.8% at the farm level, with a final sample of 2,353 (1,416 men, 937 women) from 1,119 farms. Variables under study included self-reports of health status, as well as demographic, behavioral, and farm operational factors that could influence perceived health status. The analysis was initially descriptive followed by multilevel logistic regression analyses. Self-reports of diagnosed comorbidities were strongly associated with negative health status among both men and women. Daytime sleepiness was more modestly associated with negative health status in both genders. Among men, additional risk factors tended to be functional, and included older age, part-time work status, and binge drinking. Among women, additional risk factors included cigarette smoking, overweight or obesity, and lower levels of education. The study demonstrated that there were both similarities and differences between men and women on farms in the factors related to negative self-perceived health status. These findings should inform the content and targeting of health promotion programs aimed at rural populations.

Unawareness of hypertension and its determinants among 'quilombolas' (inhabitants of 'quilombos' - hinterland settlements founded by people of African origin) living in Southwest Bahia, Brazil

This study sought to evaluate the prevalence of unawareness of arterial hypertension (AH) and associated factors among the quilombola population and to describe aspects of the non-pharmacological management of AH. It involved a cross-sectional study with a sample of 358 people with AH aged 18 years or more. AH was considered systolic blood pressure (BP) ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg and/or reported use of antihypertensive drugs. Unawareness of AH was classified as persons answering negatively when asked if they suffered from AH. Poisson regression was then used. The prevalence of unawareness of AH was 44.1% (95% CI: 38.9-49.3). Among those who already knew the diagnosis and had drug treatment only 24.8% had controlled BP. The unawareness of AH was positively associated with the male sex and Stage 1 of AH and negatively with increasing age, overweight, negative self-perception of health and medical visits. For non-pharmacological management, low percentages of quilombola reported appropriate standard recommendations of care. Arterial hypertension is a serious public health issue among the quilombola population, revealing great vulnerability in health due to poor levels of awareness, treatment and control.

Reduction of inequalities in medical visits in Brazil: analysis of the Northeastern and Southeastern regions between 2003 and 2008.

To analyze the socioeconomic inequalities in medical visits (MV) in the past year in Brazil. Data from adults aged ≥ 20 years old who participated in the Brazilian National Household Surveys and living in the Northeastern (2003; n = 75,652 and 2008, n = 79,779) and Southeastern (2003; n = 76,029 and 2008; n = 79,356) regions were analyzed according to MV. We compared MVs according to demographic and health variables in the first (D1) and last (D10) per capita family income deciles. All analyses considered the complex cluster design. The proportion of people who had MV during this period increased in the Northeastern (from 61.2 to 66.9%) and the Southeastern (from 67.9 to 73.5%) regions. The absolute difference (AD) in the use of MV, according to D1 and D10 in this period, was equal to 6.4 percentage points (pp) in the Northeastern and 4.2 pp in the Southeastern regions. Significant reduction in inequalities was observed among men without chronic diseases, in those who had a positive perception of their health, and among those without health insurance which included MV. The Southeastern region has also showed significant reduction among those with chronic disease (8 pp) and with negative health self-perception (6 pp). The increasing number of MVs was found in Brazil. However, persistent inequalities were observed between the poorest and the richest, higher in the Northeastern than in the Southeastern region. More effective and equitable policies to reduce health inequalities should be adopted in Brazil.