Perceived Health Outcomes Research Articles

Environmental And Health Implications of Waste Disposal Sites In The Lesotho Lowlands

Many Southern African countries, including Lesotho, face severe health and environmental issues attributed to waste disposal. The purpose of this study is to assessed the environmental and health impacts on residents living in proximity to disposal sites in the lowlands of Lesotho. A descriptive cross-sectional design was employed, using a semi-structured questionnaire and observation method. A mapping device was used, and photographs were taken to validate the findings. Descriptive statistics and the Chi-square test (?²) were employed to analyze the data. Results indicate that in Lesotho, some landfill sites are located as close as 50 meters from residential areas, and most (60%) received hazardous mixed waste streams. Waste burning and backyard dumping were the most frequently used disposal methods by residents. Several perceived health outcomes and environmental issues were noted, with respiratory and gastrointestinal health issues being the most prevalent. There was a statistically significant association between waste burning and respiratory diseases (P < 0.010) and between backyard dumping and gastrointestinal diseases (P < 0.003). The study concludes that regulatory instruments need to be revised and enforced, requiring hazardous waste producers to take responsibility for end-of-life waste and banning the entry of such waste into disposal sites. The application of waste management strategies to initiate other preferable end-of-life waste procedures, such as recycling of WEEE and waste-to-energy technologies for organic waste in Lesotho, could improve the quality of health for residents and their environment.

Quality of Life Assessment in Romanian Patients with Spinal Muscular Atrophy Undergoing Nusinersen Treatment.

Spinal muscular atrophy (SMA), identified over a century ago, is characterized by severe muscle wasting and early mortality. Despite its rarity, the high carrier frequency of the responsible genetic mutations and the variability in its manifestations make it a significant research focus. This prospective cross-sectional descriptive study evaluated health-related quality of life (HRQoL) across eight health domains in 43 Romanian SMA patients treated with nusinersen, using the SF-36 questionnaire to analyze influencing factors. The survey was conducted online with informed consent, and the data were analyzed using MedCalc software, employing both parametric and non-parametric statistical tests for accurate interpretation. The results revealed significant variations in HRQoL. Most patients were non-ambulatory (74.4%), reflecting SMA's impact on mobility. Urban residents reported better outcomes, particularly in physical functioning (p = 0.014), which may be attributed to improved access to healthcare services. Younger participants (under 14), represented by proxy responses, noted better general health (p = 0.0072) and emotional well-being (p = 0.0217) compared to older participants. These findings suggest that younger patients or their proxies perceive a better health status, highlighting the need for age-specific approaches in SMA management and the potential optimistic bias associated with proxy reporting on perceived health outcomes.

Cigarette and E-Cigarette Harm Perceptions During Pregnancy.

Research suggests that pregnancy status (prior, current, and future intention) is associated with differences in perceived harm of electronic cigarette (e-cigarette) use during pregnancy. However, perceptions of health outcomes attributed to cigarette and e-cigarette use during pregnancy have not been explored among a sample of pregnant women who smoke. The purpose of this study was to explore differences in perceived harms of cigarette and e-cigarette use and perceived birth and health outcomes associated with cigarette and e-cigarette use during pregnancy among a sample of pregnant women who currently smoked. Using a cross-sectional online survey, we examined perceptions about cigarette and e-cigarette use during pregnancy among a sample of U.S. pregnant women ( n = 267) who smoked in the past 30 days. Participants were grouped into categories based on e-cigarette use status (current, past, and never e-cigarette users). Differences between e-cigarette use status and perceived harm (absolute of cigarettes, e-cigarettes, and relative of e-cigarettes) and perceived health outcomes attributed to smoking/e-cigarette use were examined. Among our sample, 45.7%, 39.7%, and 14.6% were current, ever, and never e-cigarette users, respectively. Associations existed between e-cigarette use status and absolute perceived harm of cigarettes, relative perceived harm of e-cigarettes, and perceived health outcomes. Current e-cigarette users believed pregnant women who smoked cigarettes were more likely to lose a child because of miscarriage or sudden infant death syndrome or give birth to a child with low birth weight, reduced lung function, cleft lip, reduced brain function, or attention-deficit/hyperactivity disorder than never e-cigarette users. No associations were found between perceived birth and health outcomes of e-cigarette use by e-cigarette user status. Pregnant women who smoked and used e-cigarettes had lower risk perceptions about e-cigarette use during pregnancy than those who only smoked. Health messages and research about the harms of nicotine exposure during pregnancy should address the risks of dual-use versus only e-cigarette use. In addition, messages about the relative harm of e-cigarettes compared to cigarettes are needed for pregnant women who smoke and have trouble quitting.

Factors influencing baby boomers’ intention to choose a dish featuring plant-based meat alternatives (PBMA) at a restaurant: Findings from an online panel study

The purpose of this study is to examine the psychosocial determinants of baby boomers’—born between 1946 and 1964— intention to choose a menu item featuring plant-based meat alternatives (PBMA) when dining out. The specific objectives are as follows: 1) to identify the baby boomer generation's health-related perceptions about PBMA, and 2) to examine the factors that influence baby boomers' intention to choose a dish featuring PBMA at a restaurant. A total of 174 responses obtained using the Qualtrics panel were analyzed with content analysis and partial least squares structural equation modeling (PLS-SEM). The findings identified various underlying perceptions of baby boomers toward PBMA, such as perceived health outcomes, perceived availability, and willingness to purchase. Furthermore, subjective norm, cues to action, and self-identity were found to be significant predictors of the intention to choose a menu item featuring PBMA when dining out. Theoretical and practical implications are discussed.

Perceived health outcomes of recreation and happiness: exploring the mediating role of resilience.

Previous research has shown that leisure activities can positively influence perceived health outcomes by increasing individuals' levels of physical activity. Yet, little has been discovered about the mechanisms that are driving this association. This study was conducted with the aim of examining the relationship between perceived health outcomes of recreation and happiness as well as the mediating effect of resilience. The study comprised a total of 451 adult individuals residing in seven different geographical regions of Turkey, who were included using a convenience sampling method, and the data were collected between March and June 2023. Respondents completed assessments utilizing the Perceived Health Outcomes of Recreation, Brief Resilience Scale, and The Oxford Happiness Questionnaire-Short Form. Data analysis was executed employing the PROCESS macro for SPSS. The study's findings revealed that perceived health outcomes of recreation had a positive effect on both happiness (β = 0.146, [95% CI: 0.106, 0.186]) and resilience (β = 0.156, [95% CI: 0.107, 0.205]). Resilience had a positive effect on happiness (β = 0.435, [95% CI: 0.362, 0.507]). Furthermore, the relationship between perceived health outcomes of recreation and happiness was partially mediated by resilience (β = 0.068, [95% CI: 0.042, 0.096]). As a result, participating in leisure activities has been found to have a positive impact on perceived health outcomes, which in turn positively affects both happiness and resilience. Additionally, psychological resilience can be said to partially mediate the relationship between perceived health outcomes of recreation and happiness.

INVESTIGATION OF THE RELATIONSHIP BETWEEN SERIOUS LEISURE, EVENT SATISFACTION AND PERCEIVED HEALTH OUTCOMES OF RECREATION: THE OUTDOOR SPORTS EXAMPLE

The aim of this study was to identify the relationship between serious leisure, event satisfaction and perceived health outcomes from recreation for individuals interested in outdoor sports and to determine whether these parameters differed in terms of some variables. The research included 293 volunteer outdoor sports participants (mean age 29.23±8.47 years). The participants answered the Serious Leisure Inventory-Short Form (SLI-SF), Event Satisfaction Scale (ESS) and Perceived Health Outcomes in Recreation Scale (PHORS). The analysis results found that the mean points for the SLI-SF, ESS and PHORS were not significantly different according to gender (p>0.05). According to the frequency of event participation, statistically significant differences were identified for all subscales of the SLI-SF, the ESS and all other subscales of PHORS apart from the prevention of a worse condition subscale (p<0.05). Additionally, there were statistically significant correlations identified between the mean SLI-SF, ESS and PHORS scores with the number of years of involvement in outdoor sports (p<0.05). In conclusion, individuals participating more frequently in outdoor sports activities were observed to have increases in serious leisure, event satisfaction and perceived health levels. At the same time, with the increase in the number of years of involvement of participants in outdoor sports, it can be said that there are increases in serious leisure, event satisfaction and health perception levels related to realization of a psychological experience.

Where the joy comes from: a qualitative exploration of deep GP-patient relationships

BackgroundRelationship-based, whole person care is foundational to quality general practice. Previous research has identified several characteristics of deep General Practitioner (GP)-patient relationships and their association with improved patient concordance, satisfaction and perceived health outcomes. Psychological attachment theory has been used to understand therapeutic relationships, but has only been explored to a limited extent in the general practice context. Additionally, evolving changes in sociocultural and commercial practice contexts may threaten relationship-based care. In view of this, we aimed to explore the nature and experience of deep GP-patient relationships, as identified by patients, from GP and patient perspectives.MethodsSemi-structured interview design. An initial survey assessed patients’ perceived depth of their relationship with their GP, using the Health Care Provider Attachment Figure Survey and Patient-Doctor Depth of Relationship Scale. Patients who reported a deep relationship, and their GPs, were purposively selected for individual interviews exploring their experience of these relationships. A post-interview survey assessed interviewees’ attachment styles, using the Modified and Brief Experiences in Close Relationships Scale. Patient interviewees also rated the patient-centredness of their GP’s clinic using the Person-Centred Primary Care Measure. Transcripts were analysed using thematic analysis.ResultsThirteen patients and five GPs were interviewed. Four themes characterised deep relationships: the ‘professional’; human connection; trust; and ‘above and beyond’. Patient, GP and practice team all contributed to their cultivation.ConclusionsWe present a revised conceptual framework of deep GP-patient relationships. Deep relationships come to the fore in times of patient trouble. Like attachment relationships, they provide a sense of safety, caring and support for patients experiencing vulnerability. They can stretch GP boundaries and capacity for self-care, but also provide joy and vocational satisfaction. Patients may not always desire or need deep relationships with their GP. However, findings highlight the importance of enabling and cultivating these for times of patient hardship, and challenges of doing so within current healthcare climates.

Taking care of family dementia caregivers: A qualitative examination of patient perspectives and perceived health outcomes after receiving usual care and after a digitally supported care management programme

AbstractBackgroundAlmost two‐thirds of people with dementia (PwD) living at home receive care from a family or other informal caregiver. Evidence shows that family caregivers experience increased physical, psychological, emotional, and social stress which, in the long term, results in adverse health outcomes. The development of effective healthcare and support management for family caregivers is vital. Therefore, our aim was to examine and compare the perceptions of participants who received a digitally supported care management programme with those who received usual care.MethodThis study was embedded within a multi‐centre, cluster randomized controlled trial (GAIN study) examining the effectiveness of a care management programme for family caregivers of people with dementia. The trial is registered at ClinicalTrials.gov (NCT04037501). Data collected through semi‐structured interviews with participants of the GAIN trial were audio recorded, transcribed and analysed using framework analysis. We developed two semi‐structured interview schedules, each tailored to the content of the group (control or intervention).ResultWe interviewed 36 dementia caregivers (30 women, six men) of whom 20 were in the intervention and 16 in the control group. The mean age was 68 years (SD 11,28, range 50‐82). The majority was the caregiver for their spouse, six were the caregiver for their parent and one was the caregiver for their aunt. The lengths of interviews varied between 15‐82 minutes with most interviews being 35 minutes long. Six themes were identified: (1) Health and well‐being before participating in GAIN (2) Use of services and support (3) Perceived health changes (4) Additional services discussed & received in the intervention group (5) Impact of study nurse support and (6) Possible improvements. Each theme had further sub‐themes and categories, which will be presented.ConclusionOverall, participants in the care management programme reported benefits and additional services they used as a result of being in the intervention group (e.g., rehabilitation, home adaptations, care services) compared to the control group. Having someone professional by their side was reported to be helpful and motivating. Participants of both groups also reported that they preferred house visits rather than telephone contacts. The results can be used to further improve the care management programme.

Taking care of family dementia caregivers: A qualitative examination of patient perspectives and perceived health outcomes after receiving usual care and after a digitally supported care management programme

AbstractBackgroundAlmost two‐thirds of people with dementia (PwD) living at home receive care from a family or other informal caregiver. Evidence shows that family caregivers experience increased physical, psychological, emotional, and social stress which, in the long term, results in adverse health outcomes. The development of effective healthcare and support management for family caregivers is vital. Therefore, our aim was to examine and compare the perceptions of participants who received a digitally supported care management programme with those who received usual care.MethodThis study was embedded within a multi‐centre, cluster randomized controlled trial (GAIN study) examining the effectiveness of a care management programme for family caregivers of people with dementia. The trial is registered at ClinicalTrials.gov (NCT04037501). Data collected through semi‐structured interviews with participants of the GAIN trial were audio recorded, transcribed and analysed using framework analysis. We developed two semi‐structured interview schedules, each tailored to the content of the group (control or intervention).ResultWe interviewed 36 dementia caregivers (30 women, six men) of whom 20 were in the intervention and 16 in the control group. The mean age was 68 years (SD 11,28, range 50‐82). The majority was the caregiver for their spouse, six were the caregiver for their parent and one was the caregiver for their aunt. The lengths of interviews varied between 15‐82 minutes with most interviews being 35 minutes long. Six themes were identified: (1) Health and well‐being before participating in GAIN (2) Use of services and support (3) Perceived health changes (4) Additional services discussed & received in the intervention group (5) Impact of study nurse support and (6) Possible improvements. Each theme had further sub‐themes and categories, which will be presented.ConclusionOverall, participants in the care management programme reported benefits and additional services they used as a result of being in the intervention group (e.g., rehabilitation, home adaptations, care services) compared to the control group. Having someone professional by their side was reported to be helpful and motivating. Participants of both groups also reported that they preferred house visits rather than telephone contacts. The results can be used to further improve the care management programme.

Understanding health outcome drivers among adherence club patients in clinics of Gauteng, South Africa: a structural equation modelling (SEM) approach

BackgroundThere has been growing interest in understanding the drivers of health outcomes, both in developed and developing countries. The drivers of health outcomes, on the other hand, are the factors that influence the likelihood of experiencing positive or negative health outcomes. Human Immunodeficiency Virus (HIV) continues to be a significant global public health challenge, with an estimated 38 million people living with the aim of this study was therefore to develop and empirically test a conceptual research model using SEM, aimed at explaining the magnitude of various factors influencing HIV and other health outcomes among patients attending Adherence Clubs.MethodThis was a cross sectional survey study design conducted in 16 health facilities in the City of Ekurhuleni in Gauteng Province, South Africa. A total of 730 adherence club patients were systematically sampled to participate in a closed ended questionnaire survey. The questionnaire was assessed by Cronbach's alpha coefficient for internal consistency. The proposed model was tested using structural equation modelling (AMOS software: ADC, Chicago, IL, USA).ResultsA total of 730 adherence club members participated in the study. Of these, 425 (58.2%) were female and 305 (41.8%) were male. The overall results indicated a good reliability of all the scale involved in this study as Cronbach alphas ranged from 0.706 to 0.874, and composite reliability from 0.735 to 0.874. The structural model showed that the constructs health seeking behavior (β = 0.267, p = 0.000), health care services (β = 0.416, p = 0.000), stigma and discrimination (β = 0.135, p = 0.022) significantly predicted health outcomes and explained 45% of its variance. The construct healthcare service was the highest predictor of health outcomes among patients in adherence clubs.ConclusionPatient health seeking behaviour, healthcare services, stigma and discrimination were associated with perceived health outcomes. Since adherence clubs have been found to have a significant impact in improving patient outcomes and quality of life, there is a need to ensure replication of this model.

O.3.2-3 ‘It helped me to disconnect from the problems’: a qualitative study exploring the subjective experiences of people with schizophrenia in a concurrent exercise program

Abstract Purpose The relationship between exercise and its role in mental health is extensively documented and has led to the inclusion of exercise into adjuvant programs for people with mental health disorders. However, considerably less attention is devoted to the experience of taking part in exercise and perceived health outcomes for people with specific mental health disorders. The aim of this study was therefore to investigate the subjective experiences of a concurrent exercise program designed to improve both physical and mental health, through participation, for people with schizophrenia. Methods Participants diagnosed with schizophrenia (n = 35, 41.6±10.3 years) from two locations (a psychiatric hospital and a mental health community support group) received an intensive concurrent exercise program (i.e., aerobic interval training and resistance training within the same session) for a five-month duration, three times a week, at out-of-hospital facilities. Qualitative data was collected via individual, semi-structured interviews, organized, and analyzed with thematic analysis using NVivo software. Results A conceptual model developed from the analysis explains the participants’ subjective experiences, opinions, and perceptions of the role of exercise and their perceived outcomes from participation in the program. Six themes emerged from the analysis. The themes ‘expectations about taking part’ and ‘attitude to exercise, the program, and general lifestyle’ appeared to influence participants to take part. The act (and factors associated with it) of ‘taking part’ then led to subsequent ‘perceived outcomes’ and ‘plans’. Conclusions Findings from the study support the case for the strategic use of exercise as an adjuvant program and maintenance of holistic health for people with schizophrenia. However, this study also demonstrates the paramount importance of building a continuation plan for participation to ensure sustainable and long-term adherence to exercise. The location of the program appears important to consider (i.e., out-of-hospital), as does the constitution of the group, the type of people, and the exercise program itself. For this clinical group, the exercise intervention not only serves a physical and mental enhancement function but also appears to achieve holistic health benefits such as well-being and important opportunities for social interaction.

Qualitative analysis of a remote monitoring intervention for managing heart failure

BackgroundHeart failure (HF) is one of the most common reasons for hospital admission and is a major cause of morbidity, mortality, and increasing health care costs. The EMPOWER study was a randomized trial that used remote monitoring technology to track patients’ weight and diuretic adherence and a state-of-the-art approach derived from behavioral economics to motivate adherence to the reverse monitoring technology.ObjectiveThe goal was to explore patient and clinician perceptions of the program and its impact on perceived health outcomes and better understand why some patients or clinicians did better or worse than others in response to the intervention.ApproachThis was a retrospective qualitative study utilizing semi-structured interviews with 43 patients and 16 clinicians to understand the trial’s processes, reflecting on successes and areas for improvement for future iterations of behavioral economic interventions.Key resultsMany patients felt supported, and they appreciated the intervention. Many also appreciated the lottery intervention, and while it was not an incentive for enrolling for many respondents, it may have increased adherence during the study. Clinicians felt that the intervention integrated well into their workflow, but the number of alerts was burdensome. Additionally, responses to alerts varied considerably by provider, perhaps because there are no professional guidelines for alerts unaccompanied by severe symptoms.ConclusionOur qualitative analysis indicates potential areas for additional exploration and consideration to design better behavioral economic interventions to improve cardiovascular health outcomes for patients with HF. Patients appreciated lottery incentives for adhering to program requirements; however, many were too far along in their disease progression to benefit from the intervention. Clinicians found the amount and frequency of electronic alerts burdensome and felt they did not improve patient outcomes.Trial registrationClinicalTrials.gov Identifier: NCT02708654.

Impact of United States refugee ban and discrimination on the mental health of hypertensive Arabic-speaking refugees.

Hypertension is a global leading cause of death which disproportionately affects refugees. This chronic disease increases the risk of heart disease, stroke, brain, and other end-organ disease, if left uncontrolled. The 2017 United States travel or "Muslim" ban prevented immigrants and refugees from seven Muslim-majority countries from entering the United States, including Syria and Iraq; two major contributors to the global refugee population. As of 2020, the United States has admitted more than 133,000 and 22,000 Iraqi and Syrian refugees, respectively. Studies on the health effects of this policy on refugees are lacking. This study qualitatively explores the impact of the refugee ban on United States resettled Syrian and Iraqi refugees with hypertension. Participants were recruited through a federally qualified health center system that is the largest healthcare provider for refugees in San Diego, CA. All participants were Arabic-speaking refugees diagnosed with hypertension from Syria and Iraq. In-depth interviews took place between April 2021 and April 2022. Inductive thematic analysis was used to analyze data from semi-structured interviews. Participants (N = 109) include 53 women and 56 men (23 Syrian, 86 Iraqi). The average age was 61.3 years (SD: 9.7) and stay in the United States was 9.5 years (SD 5.92). Four themes emerged linking the travel ban's impact on health, in line with the society to cells framework: (1) family factors: the refugee ban resulted in family separation; (2) physiological factors: the refugee ban worsened participants' mental health, exacerbating hypertension and perceived health outcomes; (3) community factors: perpetuation of Islamophobia, xenophobia, and perceived discrimination were structural barriers with links to poorer health; and (4) individual factors: trickle down consequences led to worsened participant self-image and self-perception within their host community. The refugee ban negatively impacted the mental and physical health of United States resettled Arabic-speaking refugees through perceived discrimination, stress, and poor social integration. It continues to have long-lasting effects years after the ban was instated. Centering family reunification within the United States Refugee Admissions Program and tailoring interventions through the healthcare and public health systems are warranted to reduce hypertension disparities in this growing and overlooked population.

From burden to benefit: a multi-site study of the impact of allied health work-based learning placements on patient care quality.

Allied health clinical placements take place within an increasingly overstretched health care system where demand for services often exceeds availability of resources. Within this environment, student placements are often perceived as an additional burden to an already overwhelmed workforce. This study explored whether the quality of patient care was enhanced when services were re-designed using a collaborative partnership approach to more purposefully integrate students into delivery of care. Using an embedded multiple case study design, data were collected through focus groups and interviews, patient experience surveys, and secondary administrative data sources. Cases were across physiotherapy and occupational therapy in six different hospital settings. Perception of care provided by students was viewed positively by all stakeholders, including patients. Perceived health outcomes of faster improvement of health condition, improved mobility and function identified through our qualitative findings were supported by quantitative service delivery markers such as increased therapy sessions, more patients being discharged home instead of to other care facilities and reduced length of stay. Health care providers and students alike perceived improvements in service efficiencies whilst maintaining high quality care. This study has provided preliminary evidence towards improved patient care when a partnering approach is adopted whereby students are intentionally integrated into services that otherwise might not have been delivered. Furthermore, it has shifted the associated narrative from students as additional burden to students as benefit.

Perceived Health Outcomes of Recreation Scale: Measurement Invariance over Gender.

Research handling structural differences among groups presume that the measurement tool works similarly among the groups and the results of measurements provide similar psychometric properties. Therefore, the aim of the study is to provide evidence for measurement invariance of the construct validity Perceived Health Outcomes of Recreation Scale (PHORS). The research sample consisted of a total of 1984 adults who exercise, including 864 women and 1120 men during 2021-2022 in Antalya City, Turkey. The MI of the PHORS was tested by multigroup confirmatory factor analyses, which test the invariance of the covariance structures within the scope of structural equation modelling. Invariance tests were gradually conducted for the implicit variables in the model, CFI (comparative fit index criteria) and AIC (Akaike information criterion) were inquired between structural invariance, where no restriction was applied on the analyses and the other invariance tests (metric invariance, scalar invariance and string invariance respectively) where more restraints are applied. The study yielded evidence showing that the measurement model defined for the factor structure of the scale provided measurement invariance by gender. ΔCFI values were ≤0.010 in all subscales for metric and scalar invariance. The items of PHORS represented the same psychological structure, different groups responded to the items in the same way, the constant values in regression equations generated for the items in regression equations were equal/invariable between the groups.

Human Health and Outdoor Adventure Recreation: Perceived Health Outcomes

Forests and similar types of landscapes offer a myriad of outcomes and benefits often associated with participation in outdoor adventure recreation (OAR) activities. Previous research has shown that OAR participants are able to identify, perceive, and accurately report the effects and benefits of their participation. The health benefits of outdoor experiences, both active and more passive, have received a growing research interest, both as a setting and as a setting/activity complex. Research has identified six primary forms of health and well-being from outdoor and forest-type landscapes, including emotional, environmental, intellectual, social, spiritual, and physical. The preponderance of research in the health and wellness field synthesizes these forms into two primary categories, physical/physiological and mental/psychological. This study considered the health outcomes attributed to highly active OAR participation using three popular OAR activities: mountain biking (MTB), rock climbing (RC) and whitewater paddling (WW; including whitewater kayaking, whitewater canoeing, and whitewater rafting). A survey presented in situ to OAR participants in various areas of the Midwestern and Southeastern United States yielded 288 respondents. Using health perceptions and outcomes instruments as well as semi-structured interviews, the researchers found health to be an important factor for OAR participation. These findings are congruent with previous research that suggest that OAR participants specifically recreate in forested and other natural areas for enhanced physical and psychological health outcomes. The findings in this study also support the efficacy of the participation in OAR activities toward supporting both health improvement and maintenance. With physical and psychological health continuing to be an area of concern in today’s world, this study suggests that participation in OAR on forested and similar landscapes can be a successful health intervention strategy.

Coping strategies moderate the effect of perceived stress on sleep and health in older adults during the COVID-19 pandemic.

Stress in the context of the COVID-19 pandemic may have a significant impact on health, including sleep health. Older adults may be particularly vulnerable. This study examined associations between perceived stress and sleep health, mental health, physical health, and overall perceived health outcomes among older adults. We also examined whether specific coping strategies moderate these associations. Older adults (n=115; Mage =68.62) reported perceived stress, coping strategies, global sleep quality, depressive symptoms, and perceived mental, physical, and overall health before and during the COVID-19 pandemic. Stress-health relationships were modelled with hierarchical linear regression. Higher perceived stress was associated with greater depressive symptoms and poorer mental health concurrently and longitudinally. Coping strategies moderated the association of perceived stress with physical health and overall perceived health. For example, higher perceived stress was associated with poorer overall perceived health among those with lower problem-focussed coping, but not among those with higher problem-focussed coping. Older adults may benefit from prevention and intervention strategies targeting stress management. Furthermore, identifying people with low problem-focussed coping might be a useful strategy to prevent worsening health in future public health crises.

Investigation of Psychological Resilience Levels of Individuals and Perceived Health Outcomes of Recreation During the Covid-19 Pandemic Process

Dünya Sağlık Örgütü (WHO) tarafından COVID-19 olarak adlandırılan koronavirüs pandemisi tüm dünyayı etkisi altına alarak yeni yaşam koşullarını beraberinde getirmiştir. Bu süreçte bireylerin psikolojik durumlarında ve rekreasyonel aktivitelerde algılanan sağlık çıktılarında farklılaşmanın olacağı düşüncesiyle yapılan bu çalışmada bireylerin psikolojik sağlamlık düzeyleri ve rekreasyonda algılanan sağlık çıktılarının incelenmesi amaçlanmıştır. Bu amaç doğrultusunda çalışmaya Türkiye’nin farklı bölgelerinde ikamet eden 516 kişi (255 kadın, 261 erkek) gönüllü olarak katılmıştır. Araştırma verileri pandemi koşulları nedeniyle online ortamda hazırlanan çevrimiçi anket yöntemiyle toplanmıştır. Veri toplama aracı olarak kişisel bilgi formunun yanında Türkçeye Tayfun Doğan (2015) tarafından uyarlanan “Kısa Psikolojik Sağlamlık Ölçeği” ve Yerlisu Lapa vd., (2017) tarafından uyarlanan “Rekreasyonda Algılanan Sağlık Çıktıları Ölçeği” kullanılmıştır. Veri analizinde bağımsız örneklemler için t testi, tek faktörlü ANOVA ve Pearson Korelasyon testleri kullanılmıştır. Araştırmadan elde edilen bulgularda, cinsiyet değişkenine göre katılımcıların psikolojik sağlamlık düzeyleri puan ortalamalarının istatistiksel olarak anlamlı bir şekilde farklılaştığı görülmektedir. Katılımcıların herhangi bir sağlık/fitness merkezine üyelik durumlarına göre yapılan analizde rekreasyonda algılanan sağlık çıktıları ölçeğinin tüm alt boyutlarında, fiziksel aktiviteye katılım durumu değişkeninde ise her iki ölçekte ve tüm alt boyutlarda istatistiksel olarak anlamlı farklılık görülmektedir. Bununla birlikte katılımcıların psikolojik sağlamlık düzeyleri ile rekreasyonda algılanan sağlık çıktıları ortalama puanları arasında pozitif yönde anlamlı bir ilişki olduğu sonucuna varılmaktadır. Sonuç olarak, Covid-19 pandemi sürecinde fiziksel açıdan aktif olan ve düzenli egzersiz yapan bireylerin psikolojik sağlamlık düzeylerinin ve rekreatif aktivitelerde algıladıkları sağlık çıktılarının daha yüksek olduğu belirtilebilir. Bu durumda, katılımcıların psikolojik sağlamlık düzeyleri arttıkça rekreasyondan algıladıkları sağlık çıktıları düzeyinin de arttığı söylenebilir.

The relationship between perceived health outcomes of recreation, exercise dependence, and life satisfaction: A study with fitness center members

Background: This study aimed to investigate the relationship between perceived health outcomes of recreation, exercise dependence, and life satisfaction among fitness center members. Material and methods: The study sample consisted of 490 participants, 336 males, and 154 females, who were members of a private fitness center in Istanbul. The participants were selected using a purposeful sampling method. Data collection tools included the Perceived Health Outcomes of Recreation Scale, developed by Gomez et al. and adapted to Turkish by Yerlisu Lapa et al., the Exercise Dependence-21 Scale, developed by Hausenblans and Downs and adapted by Gürbüz and Aşçı and the Life Satisfaction Scale developed by Diener et al. and adapted by Yetim. The data were analyzed using independent t-test, MANOVA, and Pearson correlation analysis. Results: The independent t-test results showed a significant difference in LSS scores by gender. MANOVA analysis results revealed that the main effect of gender on the sub-dimensions of PHORS was not significant, but there was a difference in the PSYC sub-dimension. Besides, the main effect of gender on ED-21 and all sub-dimensions was significant. Conclusions: There was a positive and moderate relationship between LSS and PHORS; a negative and low-level correlation between LSS and ED-21, and between PHORS and ED-21.

Linking Nonverbal Rapport to Health Outcome: Testing an Organizational Pathway Model

ABSTRACT A growing body of research on medical communication indicates that nonverbal rapport (e.g., smiling, eye contact, closer proximity) is central to productive health care delivery. However, mechanisms integral to the process by which nonverbal rapport influences health improvement remain under-researched. This study breaks new grounds in proposing and testing mediation pathways that take into account organizational factors. We conducted a cross-sectional survey in a private hospital in Singapore among 417 patients to examine their communication with physicians and nurses. Results indicated that nonverbal rapport did not have a significant direct relationship with perceived health outcome in both the patient-physician dyad and the patient-nurse dyad. Instead, communication satisfaction and organizational identity completely mediated this relationship. In addition, respect positively moderated the relationship between nonverbal rapport and communication satisfaction in both dyads, while health literacy was not a significant moderator. The findings suggest that the organizational context should be considered in pathways research.