Poor Perceived Health Status Research Articles

Trajectories of depressive symptoms in Korean adults with diabetes: Individual differences and associations with life satisfaction and mortality.

We examined trajectories of depressive symptoms and their predictors in adults with diabetes. We assessed whether these trajectories were related to life satisfaction and mortality. Longitudinal, prospective observational study. We analysed data from 1217 adults with diabetes (aged ≥45 years) in the Korean Longitudinal Study of Aging (2006-2018). Three trajectories of depressive symptomology were identified in growth mixture models: low/stable (i.e., low and stable levels of symptoms; 85.56%), high/decreasing (i.e., high levels of symptoms with a decreasing trajectory; 7.47%), and moderate/increasing (i.e., moderate levels of symptoms with an increasing trajectory; 6.98%). Participants with poor perceived health status at baseline were more likely to be in the moderate/increasing or high/decreasing classes than in the low/stable class. The moderate/increasing class had the lowest satisfaction with quality of life, followed by the high/decreasing and low/stable classes. The moderate/increasing and the high/decreasing classes had lower satisfaction with relationships with spouse and children than the low/stable class. The high/decreasing class had a higher mortality risk than the low/stable class. Long-term monitoring of depressive symptoms in adults with diabetes is warranted given their potential adverse impact on life satisfaction and mortality.

Prevalence and Risk Factors of Self-Reported Sarcopenia and Its Association With Multimorbidity in Community-Dwelling Older Adults: A Cross-Sectional Study.

This cross-sectional study aimed to identify the impact of multimorbidity on self-reported sarcopenia and compare the differences in the prevalence and associated factors of sarcopenia in community-dwelling older adults with and without multimorbidity. We enrolled 876 community-dwelling older adults in South Korea. Multimorbidity was defined as the coexistence of two or more chronic diseases, and sarcopenia was evaluated using the Strength, Assistance in walking, Rising from a chair, Climbing stairs, and Falling Questionnaire. Binomial logistic regression analyses were performed. Our study revealed that the prevalence of sarcopenia was significantly higher (43.5%) in older adults with multimorbidity than in those without multimorbidity (20.8%). This finding underscores the significant impact of multimorbidity on sarcopenia. We also found that poor perceived health status was the strongest predictor of sarcopenia in older adults with multimorbidity, while oldest-old age (≥ 85 years) was the strongest predictor of sarcopenia in those without multimorbidity. Large prospective cohort studies using objective sarcopenia screening tools are needed to demonstrate the synergistic effects of multimorbidity and sarcopenia on health outcomes among community-dwelling older adults.

Perceived Health Status Predicts Resilience after Hip Fracture in Older People.

Background and Objectives: Perceived health status (PHS) is associated with various health outcomes in older adults, but its relationship with resilience in the context of events with a major impact on functional status (FS), such as hip fracture, has not been explored. Our objective was to evaluate whether older adults who report good PHS before a hip fracture have a higher probability of returning to their baseline physical performance (PP) and personal independence. Materials and Methods: We analyzed data from waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe (SHARE) study, enrolling patients ≥ 65 years who experienced a hip fracture between these two waves. As study outcomes, we analyzed changes in PP and functional abilities (FAs). Results: We included 149 participants with a mean age of 75.7 years (SD: 6.5); women comprised 66%. The incidence of loss of PP was 51.7% among participants with good PHS and 59.6% among those with poor PHS. FA worsened in 40% of participants with good PHS and 58.4% in those with poor PHS. Relative risk (RR) for loss of FA in people with good PHS was 0.68 (95% CI: 0.48-0.98), which did not change after an adjustment for age, gender, baseline FA, depression, number of comorbidities, education, income, and social support, despite it not reaching statistical significance. After adjustment, the risk of worsening PP in participants with good PHS was reduced by 34% (95% CI: 0.41-1.06). Conclusions: A simple question on PHS may predict the resilience of older adults after an acute stressor. A systematic evaluation of PHS can help identify patients with a higher probability of regaining function after a hip fracture and thus provide useful information for resource allocation.

The Impact of the COVID-19 Pandemic on Suicidal Ideation and Depression in Community-Dwelling Elderly.

This study examined the effects of the coronavirus disease 2019 (COVID-19) pandemic on depression and suicidal ideation in community-dwelling elderly in Korea. Data were employed from a survey on elderly mental health in Jeollanam-do (southwest province in Korea), conducted by the Jeollanam-do Provincial Mental Health and Welfare Center. A total of 2423 people were recruited from all 22 cities in Jeollanam-do from April to October, 2021. We used self-reported questionnaires including sociodemographic factors, COVID-19-related stress, the Geriatric Depression Scale-Short Form Korean Version, the Multidimensional Scale of Perceived Social Support, the Satisfaction With Life Scale and the Brief Resilience Scale. Logistic regression was performed to examine the factors of depression and suicidal ideation. Of the 2423 subjects, 622 (25.7%) reported depressive symptoms and 518 (21.4%) reported suicidal ideation. The multivariate logistic regression analysis revealed that living alone, poor perceived health status, worry of COVID-19 infection, and restriction of daily activities due to COVID-19 pandemic are significantly associated with depression. Female gender, poor perceived health status, inability to perform household chores, and depressive symptom are risk factors of suicidal ideation. These findings show that old age, negative perception of health, and restriction of daily activities due to COVID-19 are risk factors of depression in community-dwelling elderly in the context of the COVID-19 pandemic. Female gender, poor self-perceived health status, and depression increase the risk of suicidal ideation among the elderly. Social support and life satisfaction are protecting factors of both depression and suicidal ideation. Resilience decreased risk of depression but not in suicidal ideation.

Use of complementary and alternative medicine among persons with diabetes at Mzuzu Central Hospital in Malawi: A cross-sectional study

BackgroundThe prevalence of CAM use among populations with diabetes worldwide varies widely, depending on the country or geographic region. In the general population, some of the characteristics that are associated with CAM use are; gender, race, age and education. In addition other predictors of CAM use include poor perceived health status and the presence of multiple health complaints. Besides, diabetes has been discovered to be an independent predictor of CAM use in the general population and in individuals with diabetes. The primary aim of this study was to assess utilisation of complementary and alternative medicine among patients with diabetes at Mzuzu Central Hospital in Malawi. MethodsA descriptive cross sectional quantitative study was conducted among 385 clients with diabetes seeking care at Mzuzu Central Hospital who were diagnosed with diabetes for at least one month prior to conducting this study. Participants were recruited through simple random sampling technique. Data was collected using a structured interviewer administered questionnaire. A chi-square test was performed to establish the association between CAM use and socio-demographic factors. Bivariate and multivariate (controlling for socio-demographic factors) logistic regression was done to find predictors of CAM in diabetes. The p-value was set at 0.05 with 95 % CI. ResultsThe study found that 54 % of the participants used CAM in managing their condition with the point prevalence of 151 per 1000 patients; however, cumulative prevalence was estimated at 538 per 1000 patients. Age, educational level, occupation, duration of diabetes, no health insurance, family history of CAM use and cultural or religious beliefs were factors influencing use of CAM. ConclusionThe study findings confirm use of CAM among clients with diabetes at Mzuzu Central Hospital in Malawi.

Trajectories of care of community-dwelling people living with dementia: a multidimensional state sequence analysis

BackgroundThe type and level of healthcare services required to address the needs of persons living with dementia fluctuate over disease progression. Thus, their trajectories of care (the sequence of healthcare use over time) may vary significantly. We aimed to (1) propose a typology of trajectories of care among community-dwelling people living with dementia; (2) describe and compare their characteristics according to their respective trajectories; and (3) evaluate the association between trajectories membership, socioeconomic factors, and self-perceived health.MethodsThis is an observational study using the data of the innovative Care Trajectories -Enriched Data (TorSaDE) cohort, a linkage between five waves of the Canadian Community Health Survey (CCHS), and health administrative data from the Quebec provincial health-insurance board. We analyzed data from 690 community-dwelling persons living with dementia who participated in at least one cycle of the CCHS (the date of the last CCHS completion is the index date). Trajectories of care were defined as sequences of healthcare use in the two years preceding the index date, using the following information: 1) Type of care units consulted (Hospitalization, Emergency department, Outpatient clinic, Primary care clinic); 2) Type of healthcare care professionals consulted (Geriatrician/psychiatrist/neurologist, Other specialists, Family physician).ResultsThree distinct types of trajectories describe healthcare use in persons with dementia: 1) low healthcare use (n = 377; 54.6%); 2) high primary care use (n = 154; 22.3%); 3) high overall healthcare use (n = 159; 23.0%). Group 3 membership was associated with living in urban areas, a poorer perceived health status and higher comorbidity.ConclusionFurther understanding how subgroups of patients use healthcare services over time could help highlight fragility areas in the allocation of care resources and implement best practices, especially in the context of resource shortage.

The effect of COVID-19 pandemic on depression and suicidal ideation in Korean community dwelling elderly

IntroductionThe impacts of the coronavirus disease of 2019 (COVID-19) pandemic on mental health have been relatively severe.ObjectivesThis study examined the influence of the COVID-19 especially on depression and suicidal ideation in community-dwelling elderly in Korea.MethodsData were employed from a survey on elderly mental health in Jeollanam-do (southwest province in Korea). A total of 2,423 elderlies were recruited from 22 counties in Jeollanam-do between April and October 2021. We used self-reported questionnaires, including sociodemographic factors, COVID-19 related stress, suicidal ideation, Geriatric Depression Scale-Short Form Korean Version (GDS-SF). Logistic regression was performed to examine the factors on depression and suicidal ideationResultsOf the 2423 subjects, 622 (25.7%) reported depressive symptoms and 518 (21.4%) reported suicidal ideation. The multivariate logistic regression analysis revealed that living alone, poor perceived health status, the worry of COVID-19 infection and restriction of daily activity due to COVID-19 pandemic were significantly associated with depression. Male sex, poor perceived health status, disability in house chores and depressive symptom are risk factors for suicidal ideation.Image:Image 2:Image 3:ConclusionsThese findings showed that increased risk factor for depression and suicidal ideation in community dwelling elderly during COVID-19 pandemic. We confirmed that feelings of isolation and negative perception of health were risk factors on depression in community dwelling elderly in the context of the COVID –19 pandemic. Also male, poor self-perceived health status, difficulty of independent living and worry and depression are increased the risk of suicidal ideation among the elderly.Disclosure of InterestNone Declared

Predicting postnatal depressive symptoms in a prospective cohort study in Rwanda: the impact of poor maternal social support.

Postnatal depression is a significant public health issue that demands attention, and recent evidence indicates that rates are relatively high in low-income countries such as Rwanda. However, lack of social support is recognized as a potential risk factor for postnatal depressive symptoms. This study sought to explore the influence of poor maternal social support on postnatal depressive symptoms in a sample of women in Rwanda. A prospective cohort research design was conducted with women recruited from four different health centers in Rwanda's Southern Province. A sample of 396 pregnant women accessing antenatal care services was recruited at the baseline from their late second term or later, then followed up after giving birth. The dropout rate was 21.46%; thus, the data of 311 women were analyzed. The outcome variable was the presence of depressive symptoms (Edinburgh Postnatal Depression Scale (EPDS) (≥12 cut-off score), while predictor variables included maternal social support measured using a modified Maternal Social Support Scale (MSSS), perceived health status, socio-demographic information (marital status, wealth class, age, education, occupation), negative life events, gestational and obstetric information (parity, pregnancy intention, age at birth, children given birth, and mode of delivery). Univariate and multivariate analyses were performed. From a sample of 311 participants, over a quarter (20.9%) had elevated postnatal depressive symptoms (EPDS ≥ 12 scores). Elevated scores were predicted by poor perceived health status; respondents reporting neither poor nor good (AOR = 0.28, CI = 0.11; 0.72, p = 0.007) or good health (AOR = 0.14, CI = 0.05; 0.37, p = 0.001) were less likely to be affected. Poor maternal social support was also linked with postnatal depressive symptoms; poor partner support (AOR = 4.22; CI = 1.44; 12.34; p = 0.009) was associated with high risk, while good friend support (AOR = 0.47, CI = 0.23; 0.98, p = 0.04) was a significant protector. Additionally, violence or negative life events were also independent predictors of postnatal depressive symptoms (AOR: 2.94, CI: 1.37-6.29, p = 0.005). Postnatal depressive symptoms were found to affect one in five Rwandan women. However, good maternal social support can be a strong protector. Early interventions targeting mothers in the postnatal period and strengthened social support networks for women at risk should be developed.

The relationship between diabetes burden and successful ageing in diabetic elderly patients.

The aim of this study was to determine the diabetes burden in elderly individuals along with successful ageing, which defines how well individual ages contribute to coping with the disease and diabetes management. This study also aimed to evaluate the relationship between diabetes burden and successful ageing in elderly individuals with type 2 diabetes. The data for this descriptive study were collected from 526 individuals who were 65 years old patients diagnosed with type 2 diabetes in the diabetes polyclinic of a research and training hospital between January and June 2021. It was found that the Successful Ageing Scale score was higher in women, those who had regular diabetes control, and those who had easy access to health services. Elderly Diabetes Burden Scale scores were found to be higher in men, those whose diabetes treatment was insulin, and those with poor perceived health status. No statistically significant relationship was determined between the Elderly Diabetes Burden Scale total score and the Successful Ageing Scale total score (p>0.05). Accordingly, by enabling the elderly to have easy access to healthcare services, preventing complications, and providing elderly healthcare services, it will be possible to reduce the diabetes burden in the elderly and enable them to age successfully.

Symptom Experience and Perceived Health Status of People With Long COVID in Thailand.

Despite the World Health Organization declaring COVID-19 no longer a public health emergency, reports of long COVID persist globally, raising concerns about its impact on individuals. This retrospective study aimed to explore the symptom experiences of individuals with long COVID-19 and examine the relationship between those experiences and perceived negative health status in Thailand. The study focused on individuals with moderate to severe COVID-19 infections. Between July 3, 2022 and December 1, 2022, we conducted telephone interviews with 86 individuals who tested positive for SARS-CoV-2 and received outpatient care in Bangkok. The COVID-19 Yorkshire Rehabilitation Screening was utilized to measure symptom occurrence, duration, severity, and health status on an 11-point numerical rating scale from 0 (none or excellent) to 10 (the worst). A Spearman rank correlation was used to analyze the relationships between long COVID symptoms and negative perception of health status. Among the participants, 75.6% had long COVID, with a median of three symptoms lasting for a median duration of 5.6 months. Difficulties in performing daily activities were most common, reported by 50.8% of participants. The majority (80.0%) experienced itching, headache, cognition, muscle pain, continence, and sleeping problem for 6 months. Loss of taste was the most severe symptom, with a mean severity rating of 8.8. There were significant positive relations between a negative perception of health status and multiple symptoms, symptom severity, functional disability, and additional symptoms. Individuals with moderate to severe COVID-19 infection who experienced long COVID had poorer perceived health status. To effectively manage and improve the health status of individuals with long COVID, nurses should provide follow-up care, assess not only the occurrence of symptoms but also their duration and severity, and evaluate performance outcomes.

Comorbidities and perceived health status in persons with history of cancer in the USA.

Comorbidities can further challenge prognosis and general wellbeing of cancer patients. This study aimed to assess the association between comorbidities and perceived health status (PHS) of US persons with cancer. This cross-sectional study used 2019 Medical Expenditure Panel Survey (MEPS) data and included individuals who were alive throughout the year, aged 18 to 84years, and had diagnosis for cancer. Using adjusted logistic regression models, we estimated the association of comorbidities (no, few [1/2], and more [3 or more] comorbidities) with PHS. Analyses accounted for the complex design of MEPS. The dataset included 28,512 participants, 1739 of which were eligible for the study. Of these, 11.16% (95% CI 9.64, 12.59%); 41.73% (95% CI 39.21, 43.96%); and 47.10% (95% CI 44.86, 49.73%) reported having no, few, and more comorbidities, respectively. While breast (N = 356), prostate (N = 276), and melanoma (N = 273) were the most common cancers, hypertension (88.3%), hypercholesterolemia (49.5%), and arthritis (48%) were the most prevalent comorbidities. Adjusted logistic regression showed that, compared with those with no comorbidities, persons with few and more comorbidities had 1.58 (95% CI = 0.79, 3.15) and 2.27 (95% CI = 1.19, 4.32) times greater odds of poor PHS. Younger or male patients, those with less formal education, low-income, pain, functional limitation, or poor perception of mental health were more likely to regard their health as poor. About 88% of persons with history of cancer in the USA aged 18-84years reported at least one comorbidity. Having more comorbidities, along with several other variables, was associated with poor PHS. Comorbidities management must be given special consideration to improve the prognosis and general wellbeing of persons with cancer.

S1372 Changes in Acute Hepatic Porphyria Health Impacts Since Initial Diagnosis: Results From the Porphyria Worldwide Patient Experience Research (POWER) Study

Introduction: Acute hepatic porphyria (AHP) is caused by genetic mutations in heme biosynthetic enzymes, affecting the liver. Patients can experience acute neurovisceral attacks, chronic symptoms, long-term complications, and negative impact on many quality-of-life domains. This study evaluated patient perceptions of changes in their disease characteristics and impacts on quality-of-life domains since AHP diagnosis among the overall study population and in subgroups based on time since first symptoms/diagnosis. Methods: Adults with > 1 AHP attack within the past 2 years or receiving intravenous hemin and/or glucose for attack prevention were administered in an online survey from January 19 to April 26, 2021. Patients taking givosiran were excluded. Subgroup analyses evaluated differences in patients experiencing active disease for 0–5 years versus ≥ 6 years. Patient-reported outcomes for anxiety and depression were assessed using the Generalized Anxiety Disorder-7 (GAD-7) scale (0–21) and the Patient Health Questionnaire (PHQ-8) scale (0–24), respectively. Results: Of 92 patients with AHP, mean age was 41.1 years, and 90% of patients were women. Mean time to diagnosis was 6.4 years, and mean duration of disease was 16.9 years. Most patients experienced negative (very or somewhat negative) impacts on emotional health (90%), physical health (87%), financial health (75%), social health (70%), and cognitive health (66%) since diagnosis. Disease characteristics described as worsening (much worse or somewhat worse) since diagnosis, included chronic pain (66%), kidney disease (55%), and acute pain (48%) (Figure). Patients with active disease for 0–5 years (N=20, 22%) had mean age 33.9 years and experienced median 2.5 attacks in the past 2 years versus 43.4 years and 5 attacks in patients with active disease for ≥ 6 years (N=67, 73%). GAD-7 scores ≥ 10 and ≥ 15 (severe anxiety) were reported in 35% and 20%, respectively, of patients experiencing AHP for 0–5 years and in 51% and 28%, respectively, of patients experiencing AHP for ≥ 6 years. A PHQ-8 score ≥ 10, indicating moderate-to-severe depression, was reported in 30% of patients experiencing AHP for 0–5 years compared with 66% for those experiencing AHP for ≥ 6 years. Conclusion: Patients with AHP experience negative impacts across multiple health domains and worsening in some disease characteristics since initial diagnosis. Patients with longer duration of disease activity (≥ 6 years) may have poorer perceived health status than those with 0–5 years.Figure 1.: Patient Perceptions of Changes in Disease Characteristics Since Disease Onset.

Outcomes and predictors of stress among Turkish family caregivers of patients with acquired brain injury

Objective This study examined family caregiver stress and factors predicting the stress among caregivers of patients with acquired brain injury (ABI). Methods Sixty caregivers of patients with ABI took part in this study. All participants completed assessments of Caregiver Strain Index, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, Nottingham Health Profile (NHP), and Satisfaction with Life Scale (SWLS). The patients with ABI were also assessed on the Functional Independence Measure, Disability Rating Scale, Rancho Los Amigos Cognitive Scale-revised, Functional Ambulation Classification Scale, and Neurobehavioral Rating Scale-revised. Relationship between caregiver’s stress and clinical outcomes was analyzed, together with factors significantly associated with stress. Results Elevated levels of stress were determined in 40% of caregivers. Higher stress was seen in caregivers of patients with shorter disease duration, worse functioning, who had more depression and anxiety, poorer perceived health status particularly for pain and emotional reaction domains, and less life satisfaction. Linear regression analysis demonstrated that caregiver’s stress was predicted by NHP pain domain (β = 0.062, p = 0.016) and SWLS (β = -0.133, p = 0.040). Conclusion Caregivers with more pain and less life satisfaction are at higher risk of developing stress. In order to overcome this difficult process and improve the quality of care, it would be appropriate to reveal predictors of stress and produce appropriate interventions/approaches.

Associations Of Physical Activity, Mental Health, And Quality Of Life With Sarcopenic Obesity In Elderly

PURPOSE: This study aimed to evaluate the associations of physical activity (PA), mental health, and quality of life (QoL) with sarcopenic obesity (SO) in Korean older adults. METHODS: This cross-sectional study included 11,253 participants (men: 5040, women: 6213) over 60 years who participated in Korea National Health and Nutrition Examination Survey from 2014 to 2019. SO is defined as the maximum handgrip strength value of <26 kg in men and < 18 kg in women and waist circumference value of ≥90 cm for men and ≥ 85 cm for women. Participants were divided into four groups: normal, obesity, sarcopenia, and SO. PA data were obtained from the Korean version of the Global Physical Activity Questionnaire (GPAQ), and mental health data were based on the self-report portion of the Mental Health Questionnaire. Furthermore, the QoL section used the Korean version of the European Health-Related QoL Questionnaire. In addition, we performed multivariate logistic regression analyses adjusted for covariates including age, sex, height, weight, income level, education level, occupation, smoking, alcohol consumption status, and medical history to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs). RESULTS: Participants who met both the aerobic and muscle-strengthening PA guidelines had significantly decreased the prevalence of SO (OR 0.18, 95% CI 0.10-0.32) compared to the normal group after adjusting for age. Moreover, participants with poor-perceived health status, higher perceived stress, depression symptoms, or lower QoL had an increased prevalence of SO (perceived health status: OR 2.00, 95% CI 1.58-2.54; perceived stress: OR 1.70, 95% CI 1.39-2.07; depression symptom: OR 1.98, 95% CI 1.48-2.67; and QoL OR 3.35, 95% CI 2.74-4.09) compared to participants without each condition. CONCLUSIONS: Adherence to PA guidelines, good mental health, and high QoL was associated with a lower prevalence of SO in Korean older adults.

Burden of infectious diseases among undocumented migrants in France: Results of the Premiers Pas survey.

IntroductionAn increase in migration rates to the European Union has been observed over the last few years. Part of these migrants is undocumented. This work aimed to describe the reported frequency of infectious diseases and their associated factors among unselected samples of undocumented migrants in France.MethodologyThe Premier Pas survey is a cross-sectional epidemiological survey of a random sample (two-stage sample design) conducted among undocumented migrants recruited in Paris and the Bordeaux region, in places and facilities likely to be frequented by undocumented migrants. The percentages were weighted. The analysis was performed using Stata 15.1 software.ResultsA total of 1,223 undocumented migrants were recruited from 63 places and facilities, with a participation rate of 50%. Most of them were between 30 and 40 years of age (36%), 69% were men, aged mainly 30–40 (36%) years old, from sub-Saharan Africa (60%) or North Africa (25%), and 60% had arrived <3 years earlier. Among the participants, 24.8% declared a poor perceived health status and 33.5% a chronic health condition. Dental infections concerned 43.2% of the participants. Apart from dental issues, 12.9% reported suffering from at least one infectious disease: HIV infection (3.5%), chronic hepatitis B virus infection (3.1%), upper respiratory tract infection (1.7%), skin mycosis (1.2%), skin and soft tissue infection (0.8%), chronic hepatitis C infection (0.8%), urinary tract infection (0.7%), lower respiratory tract infection (0.7%), scabies (0.3%), tuberculosis disease (0.2%), vaginal mycosis (0.6%), and herpes (0.1%). Regarding HIV, HBV, and HCV infections, 56, 71, and 89%, respectively, were diagnosed after their arrival. Chronic viral infections were more often reported by undocumented migrants from sub-Saharan Africa and Latin America. In multivariate analysis, a higher risk of reporting chronic viral infection was observed among people food insecure.ConclusionThis original study on a large random sample confirms the frequency of infectious diseases among undocumented migrants in France and the importance of integrating their screening during a health Rendezvous and their management into early access to care and inclusive medico-psycho-social management.

Smoking in the workplace: A study of female call center employees in South Korea.

Smoking among women is characteristically high among call center employees and is associated with various individual and work-related characteristics, which have been paid little attention so far. This study explored the differences in intrapersonal and interpersonal characteristics and environmental factors among Korean women working in call centers by smoking status, based on an ecological model. In this cross-sectional study, an anonymous online survey was conducted among a sample of female employees from three credit card-based call centers (N = 588). Differences in intrapersonal (social nicotine dependence, smoking attitudes, emotional labor), interpersonal (smoking among family or friends, social support), and environmental factors (smoking cessation education, and perceived and preferred smoking policy at work) were compared according to smoking status (smokers, ex-smokers, and never smokers). Approximately 20% (n = 115) were smokers. Smokers were younger, mostly unmarried, had lower education, and had poorer perceived health status than ex- and never smokers. The mean scores for social nicotine dependence and smoking attitude were the highest among smokers, indicating their tendency to underestimate the negative effects of smoking. They also reported the highest level of emotional labor, with about half (50.4%) and almost all (95.7%) reporting smoking behaviors in their families and friends, respectively. Smokers took a lenient stance on the smoking ban policy. The results indicated the necessity to develop tailored smoking cessation programs to motivate female call center employees to quit smoking. As call centers may have a smoking-friendly environment, comprehensive smoking prevention programs considering multilevel factors are required to support smoking cessation.

Factors Affecting the Health-related Quality of Life of Older Adults with Unmet Healthcare Needs Based on the 2018 Korean National Health and Nutrition Examination Survey: A Cross-Sectional Study

Purpose: This study aimed to identify the factors influencing the health-related quality of life (HRQoL) of older adults with unmet healthcare needs. Methods: Data from the 2018 Korean National Health and Nutrition Examination Survey were used. From a pool of 7992 participants, a final sample of 153 participants was analyzed using complex descriptive statistics, independent t-test, and multiple regression analysis. Results: In general, young age, being married, employment, higher income, no hypertension, health insurance coverage as an employee, and living with someone were associated with higher the HRQoL. The following factors were significantly associated with lower HRQoL scores: activity restriction (B=-0.15, p&lt;.001), poor perceived health status (B=-0.14, p&lt;.001), and higher depressive symptom score (B=-0.01, p=.002). The explanatory power was approximately 58%, and the model was deemed suitable (Wald F=16.86, p&lt;.001). Conclusion: This study provides insights into the influence of various characteristics of older adults with unmet healthcare needs on their HRQoL. Healthcare providers should develop strategies to reduce these unmet healthcare needs.

Influence of Social Adversity on Perceived Health Status and Depressive Symptoms among Portuguese Older People.

This study aims to investigate how exposure to poverty, food insecurity, and abuse at older ages relates to health outcomes. A questionnaire collecting data on sociodemographic and economic characteristics, health status, depressive symptoms, food insecurity, and abuse was administered to a sample of 677 older adults. Logistic regression was used to quantify the association of poverty, food insecurity, and abuse with perceived health status and depressive symptoms. If the older person only reported experiences of abuse, it was more likely to report the presence of depressive symptoms, even after adjustment for covariates. If it was only reported the experience of food insecurity, it was more likely to report a worse health status. Older people exposed to at least two factors of vulnerability were significantly more likely to report (very) poor perceived health status (OR: 7.11, 95% CI: 2.77–18.25) and the presence of relevant depressive symptoms (OR: 4.34; 95% CI: 2.04–9.22). Thus, the combined effect of vulnerabilities was significantly associated with worse health among older people. Public health policies to mitigate these adverse exposures should be developed to promote health and well-being in this population.

Abstract LB080: Evaluation of disparities in perceived health status among female cancer survivors in the United States

Abstract Introduction. Studies have shown that cancer survivors are more likely to report having a poor health status when compared to the general population; however, few studies have focused on the impact of cancer on perceived health status among women from disadvantaged health populations (e.g., racial/ethnic minorities, those of lower socioeconomic position [SEP], those with chronic conditions). Methods. The current study includes 46,726 women with and without a history of cancer from the National Health and Nutrition Examination Survey (NHANES) (1999-2016). Self-reported data were available for race/ethnicity, cancer history, health status, comorbidities, and other sociodemographic factors. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were estimated using multivariable logistic regression for the associations between control/survivor status and odds of perceived health status (poor vs excellent/good/fair [referent]), adjusting for age at interview, education, marital status, body mass index, current smoking status, number of alcoholic drinks/day, physical activity, and insurance status. An additional predictor of cancer type (controls, short-term [≤ 5 years], long-term survivors [≥6 years]) was evaluated. Models were stratified by race, federal poverty line (FPL; at/below, above), education (no college, some college+), and having at least one comorbidity (no, yes). Statistical interactions between these variables and control/survivor status and type of cancer were also examined. Results. A total of 2,415 (5.2%) women had a history of cancer with breast cancer as the most common site (n=704, 29.2%). While most of the survivors were non-Hispanic white (68.4%), 15.2% were Hispanic, 12.1% were non-Hispanic Black, and 4.3% were additional racial groups. Overall, women with a history of cancer were more likely to report a poor health status (OR, 4.69; 95% CI: 1.87-11.7, p=0.001) compared to controls. By cancer type, the only significant association with poor perceived health status was observed among breast cancer survivors compared to controls (OR, 1.91, 95% CI: 1.21-3.01, p=0.005). In stratified analysis by poverty level, breast cancer survivors were found to report poorer health perceptions specifically if they lived at or below the FPL (p-interaction=0.01). There were no significant interactions between our predictors of interest and race/ethnicity, education, or comorbidity status. Conclusion. Overall, cancer survivors had higher odds of self-reporting poor health status compared to women without a history of cancer. Poor health perceptions may be particularly important to address among women with a history of cancer living at/below the FPL. Using this information, researchers and clinicians can better tailor health interventions to improve perceived health status among women cancer survivors, particularly among socioeconomically disadvantaged women. Acknowledgement of Funding. KD was supported by the National Cancer Institute (NCI) Cancer Epidemiology, Prevention, and Control Training Grant (T32CA009314) and MK was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Clinical Research and Epidemiology in Diabetes and Endocrinology Training Grant (T32DK062707). Citation Format: Kate E. Dibble, Maneet Kaur, Avonne E. Connor. Evaluation of disparities in perceived health status among female cancer survivors in the United States [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr LB080.

The impact of pre-existing conditions and perceived health status on mental health during the COVID-19 pandemic.

Patients with pre-existing conditions and poor health status are vulnerable for adverse health sequalae during the COVID-19 pandemic. We investigated the association of pre-existing medical conditions and self-perceived health status with the risk of mental health complications during the COVID-19 pandemic. In October-December, 2020, 1036 respondents completed online survey that included assessment of pre-existing conditions, self-perceived health status, depressive (Patient Health Questionnaire-8 score≥10), anxiety (Generalized Anxiety Disorders-7 score≥10) and post-traumatic stress (Impact of Events Scale Revised) symptoms, alcohol use (AUDIT), and COVID-19 fear (COVID-19 Fears Questionnaires for Chronic Medical Conditions). Study participants were predominantly women (83%), younger than 61years of age (94%). Thirty-six percent of respondents had a pre-existing condition and 5% considered their health status as bad or very bad. Pre-existing conditions and poor perceived health status were associated with increased risk for moderate to severe depressive and anxiety symptoms, fear of COVID-19 and post-traumatic stress symptoms, independently from respondents' age, gender, living area, smoking status, exercise, alcohol consumption and diet. Pre-existing medical conditions and poor perceived health status are associated with increased risk of poor mental health status during the COVID-19 pandemic.