Presence Of Health Problems Research Articles

Depressive symptoms in old age: relations among sociodemographic and self-reported health variables

Depression in old age is a complex multifactorial phenomenon that is influenced by several biopsychosocial variables. Depressive symptoms are associated with the presence of chronic diseases, with being female, with low education and low income levels, and with poor perceived health assessment. In impoverished areas, older adults may have more physical disability, as they may have less access to health services. Therefore, they may be more likely to report depressive symptoms. Population-based cross-sectional research was undertaken using data from the FIBRA study conducted in Ermelino Matarazzo, a poor subdistrict of the city of São Paulo, Brazil. The participants comprised 303 elderly people, aged 65 years and over, who attended a single-session data collection effort carried out at community centers. The protocol comprised sociodemographic and self-reported health variables, and the Geriatric Depression Scale. The majority of the subjects reported five or fewer symptoms of depression (79.21%), reported one or two self-reported chronic diseases (56.86%), declared themselves to have one or two self-reported health problems (46.15%), and had good perceived health assessment (40.27%). The presence of depressive symptoms was associated with a higher number of self-reported health problems, poor perceived health assessment, and lower schooling levels, in the total sample and in analyses including men only. For women, depressive symptoms were associated with the number of self-reported health problems and family income. The presence of health problems, such as falls and memory problems, lower perceived health, and low education (and low family income for women) were associated with a higher presence of depressive symptoms among elderly people in this poor area of São Paulo.

Attention Demands in the Workplace and the Capacity to Direct Attention of Nurses

This was a descriptive, correlational study designed to evaluate the capacity to direct attention (CDA) of the nurse and to verify an association between the CDA and attention demand situations. For data collection the instruments used were: the Attentional Function Index and the Directed Attention Demands. The participants were 169 nurses of a teaching hospital in the State of São Paulo. The mean perception of performance or CDA was 60.4 which differed between the variables: unit of work (p=0.013), work hours (p=0.044), presence of health problems (p=0.026) and problems of a psychological nature (p=0.005). There was a negative association between the situations of demand and CDA (r = - 0.294, p<0.0001). It was concluded that nurses showed good CDA, which was related to some professional and demographic variables, and the higher the attentional demands, the lower the CDA.

The social net in families with newborn infants at risk during the first year of life: descriptive-exploratory study

Introduction: A birth of a child that presents some survival risk, demands from parents and family a series of adjustment mechanisms in order to face and incorporate that new situation into their lives. Objective: Identify the resources and the social net used by the families of a newborn infant at risk in the quotidian, and in the presence of health problems. Method: A prospective descriptive-exploratory study of the cohort type, accomplished with 238 children born in the municipal district of Maring&aacute;-PR who were included in the Program of Surveillance of Newborn Infants at Risk. Six home visits were accomplished, when the mothers were interviewed through a mixed type questionnaire, containing questions regarding family, mother and child. The information was inserted in a database for obtaining simple frequency. Results: Mother alone or with the help of a companion and of some relatives, is the main caretaker of the newborn infant at risk. However, the grandmother&rsquo;s participation increases as the child grows, due to the mothers' need of going back to work. The Family Health Strategy program was mentioned as support net by 65.4% of the families. Nevertheless, more than half of the children were not visited by the FHS and the number of visits decreased as the children grew. Implications for Nursing: The health professionals need to understand their role as support net to the families. Certainly, this will determine more commitment and involvement in relation to the follow-up on the growth and development of the child, as well as give instruments to the family, especially to the mother, to take a better care of the baby.

Applicability of the stages of change and Weight Efficacy Lifestyle Questionnaire with natives of Sarawak, Malaysia

There is an increase in the prevalence of overweight and obesity in Malaysia. Besides prevalence studies, not much is known about either overweight or obese individuals. The objective of this study was to determine the stages of change in losing weight and the self-efficacy in eating control of three indigenous groups of overweight and obese adults in Sarawak, Malaysia. A cross-sectional study was conducted in one rural region in Sarawak using a purposive sample. A structured questionnaire, which included two scales: (1) Weight: Stages of change (SOC) to assess readiness to change; and (2) Weight Efficacy Lifestyle Questionnaire (WEL) (both adopted from the transtheoretical model of change); and a set of pre-tested questionnaires on socio-demographic data, the presence of health problems and self-assessment of weight appropriateness, was used to interview respondents. The stage distribution for weight loss of these adults respondents (n = 271) showed that 60.5% (n = 164) were in the pre-contemplation stage, 20.7% (n = 56) were in the contemplation stage, 8.5% (n = 23) were in the preparation stage, and 8.9% (n = 24) were in the action stage, while only 1.5% (n = 4) were in the maintenance stage. Except for education, the stage differences were generally stable across age, sex, race, household income, presence or absence of health problem, self-perceived weight and presence of overweight or obesity. Respondents were least able to control their eating under social pressure and food availability, according to their WEL score. A large proportion of the overweight or obese adults was not intending to lose weight. The factor structure of the two WEL original subscales enabled partial differentiation between respondents who were able or unable to resist eating in situations where there were availability of food and experienced physical discomfort. The study results indicate the importance of assessing individuals' SOC score in order to implement stage-matched intervention strategies. More studies should be performed in order to validate the WEL questionnaire for use with a Malaysian sample.

One month after diagnosis: quality of life, coping and previous functioning in siblings of children with cancer1

The aim of the present study is to describe the quality of life (QoL) of siblings of children with cancer and to predict it according to their health before the diagnosis of cancer in the ill child and their ways of coping with the illness. Participants were 83 siblings from 56 families-46 girls and 37 boys, aged 7-18. The assessment took place 1 month to 8 weeks after the diagnosis of cancer in the ill child. The siblings' QoL was assessed with the TNO-AZL children's quality of life questionnaire (TACQOL). Coping strategies were assessed with the Cognitive Coping Strategies Scale for siblings (CCSS-s). Physical problems and eating and sleeping problems that existed before the ill child was diagnosed were determined in a structured interview with the parents. A substantial number of siblings reported impaired cognitive and emotional QoL compared to the reference group. School-aged siblings (7-11 years) reported more trouble with motor functioning than peers. The coping strategy 'predictive control' (maintaining positive expectations regarding the illness) positively predicted siblings' QoL. The presence of health problems before diagnosis was negatively associated with siblings' QoL. Older siblings reported more negative emotions, while girls reported lower social QoL and reliance on 'interpretative control' (trying to understand the illness) was associated with fewer positive emotions. During the first 2 months after the diagnosis of cancer in a brother or sister, siblings have relatively lower QoL than peers. Health problems that existed before diagnosis may be a predictor of later adjustment problems. Positive expectations about the course of the illness appear to protect siblings from distress. Information about the illness is a delicate issue that requires parental guidance.

Motivators and Barriers to Exercise in an Older Community-Dwelling Population

This study aimed to ascertain perceived barriers and motivators to exercise in people age 74–85 and to clarify the meaning of these barriers and motivators by examining participant characteristics that relate to them. 324 community-dwelling participants age 74–85 completed a health questionnaire that included items on barriers and motivators to exercise, as well as questions on demographic variables, health, and exercise. Selected participants then completed a physical-performance battery to measure functional performance. Barriers and motivators were related internally, as well as to many other factors including pain and depressed affect on the Geriatric Depression Scale. The findings suggest a need for individualized and comprehensive approaches to the presentation of exercise programs. Health interventions are needed that will address both physical pain and depressed affect and explain the importance of exercise even in the presence of health problems. An understanding of the context of reported barriers and motivators is necessary for correct interpretation and program development.

Prenatal Care Utilization Among Low-Income African American Women Prenatal Care

The purpose of this study was to assess prenatal care utilization among low-income African American women, examine the relations of demographic and other selected variables to the adequacy of prenatal care utilization, and to describe the women's positive and negative experiences with prenatal care. The sample consisted of 126 African American women who had a child 1 year old or younger. A structured interview developed by the investigator was used. Adequacy of prenatal care utilization (APNCU) was calculated using Kotelchuck's index (Kotelchuck, 1994b). The findings indicated that 13% of the women did not receive any prenatal care and that only 50.8% of the women had adequate utilization of prenatal care. Women who perceived prenatal care as important utilized the services significantly more than other women, &chi2(1, N = 126) = 8.04, p = .01. Demographic variables, presence of health problems during pregnancy, and whether or not pregnancy was planned were not significantly related to APNCU. Several positive aspects of prenatal care were expressed by the women, and 24% of those who obtained care stated that there was nothing negative about it. The negative experiences mentioned by some women were clinic waiting time, waking up in the morning, transportation difficulties, having morning sickness, and disliking seeing a doctor.

Relatives' perceptions of role change, social support and stress after traumatic brain injury

There is general agreement between researchers and clinicians alike that relatives of people with head injuries experience heightened stress as a result of the injury and its consequences. In the present study a single structured interview, including both verbally administered and written response questionnaires, was completed by 18 parents and 11 partners. Measures included the Daily Hassles and Uplifts Scale, the Arizona Social Support Interview Schedule and questions regarding role change and health problems. The combined parents and partners group indicated that they experienced moderate levels of stress and role change. A relatively small proportion of participants reported experiencing health problems. Partners indicated a slightly higher degree of stress and a greater degree of role change than parents, and a larger proportion of partners indicated the presence of health problems. Qualitative differences between the two groups were found in terms of sources of stress. There was little quantitative or qualitative difference between the two groups in sources, utilization of and satisfaction with social support. Positive correlations were found between stress and role change and stress and health problems.

Dependent care, caregiver burden, and self-care agency of spouse caregivers

A convenience sample of 113 spouse caregivers was used to examine the relationships between dependent care, caregiver burden, and self-care agency. Subjects were the spouses of radiation oncology or chemotherapy patients in a large metropolitan hospital. The Denyes Self-Care Agency Instrument was used to measure self-care agency. The Task Scale was used to operationalize dependent care, and the Burden Scales were used to measure caregiver burden. Demographic data were collected on the number of weeks in the caregiver role, presence of health problems in the caregiver, gender, age, income, and education. In the total sample, subjective burden was negatively and significantly related to self-care agency and objective burden, in addition, dependent care and objective burden were also negatively related. When the data were divided into subsamples based on gender, several of the relationships were in opposite directions. The most notable of these were the relationships between dependent care and self-care agency. It is evident that interventions should take these gender differences into account.

Health Perceptions and Survival: Do Global Evaluations of Health Status Really Predict Mortality?

Self-evaluations of health status have been shown to predict mortality, above and beyond the contribution to prediction made by indices based on the presence of health problems, physical disability, and biological or life-style risk factors. Several possible reasons for this association are discussed: (a) methodological shortcomings of previous studies render the association spurious; (b) other psychosocial influences on mortality are involved and explain the association; and (c) self-evaluations of health status have a direct and independent effect of their own. Four-year follow-up mortality data from the Yale Health and Aging Project (N = 2812) are used to explore these possibilities. The analysis controls for the contribution of numerous indicators of health problems, disability and risk factors, and also makes adjustments of standard errors for the complex sample design. The findings favor the third possibility, an independent effect, to the extent that the particular set of psychosocial factors examined did not explain the basic association, and to the extent that the control variables were an adequately comprehensive set.

Factors Affecting Walking Speed of Elderly People

Associations between walking speed and other variables have been investigated in a group of 67 women and 58 men aged between 65 and 90 years and living independently. In men, walking speed was related positively to calf strength, step-score (a measure of customary physical activity), hours spent in active leisure, height and weight, and negatively to age and the presence of health problems. In women, the relations were the same, with the exception of weight, and reported leg pain was negatively associated with walking speed. Multiple regression analysis showed that in men 44% of the variance in walking speed was accounted for by height, calf strength and the presence of health problems, and that in women 42% of the variance was accounted for by height, calf strength, step-score and the presence of leg pain limiting mobility. The significance of these findings to maintenance and improvement of walking speed in the elderly is discussed.

12 ADOLESCENTS' ASSESSMENTS OF BEHAVIORAL RISK: SEX DIFFERENCES AND MATURATION EFFECTS

Adolescents' perceptions of risk involved in specific behaviors were examined in 224 middle/high school students from 11 to 19 years (mean=14.2 years, SD=1.8). 110 subjects were male and 114 were female. Subjects rated the risk of 11 behaviors on a 6-point scale. The behaviors included those associated with morbidity/mortality (drinking beer/wine=DRINKBW;drinking hard liquor=DRINKH;using drugs=DRUGS;being a passenger in a car when driver has had a few drinks=DRVDRK; or is driving fast=DRVFAST; riding a bike/skateboard recklessly=RECK; having sexual intercourse=SEX). Other behaviors rated were smoking cigarettes (CIG); not seeing a physician in presence of health problem (NOMD); eating poorly (EATBAD); and not exercising (NOEX). In decreasing, order of risk, subjects rated the behaviors as follows: DRUGS, DRVDRK, DRINKH, NOMD, CIG, RECK, DRINKBW, DRVFAST, SEX, EATBAD, and NOEX. Risk assessments varied as a function of the adolescents sex, age, and Tanner stage. Behaviors associated with morbidity/ mortality were seen as being significantly more risky by females than by males (p<.005); individual behaviors that females rated as more risky were SEX, DRVFAST, EATBAD (p=<.001) and RECK (p<.01). Older, more physiologically mature adolescents perceived significantly less risk than did younger adolescents for behaviors associated with morbidity/mortality (p's<.001). Specific behaviors for which older, more mature adolescents perceived less risk were: SEX, CIG, DRINKBW, DRINKH (p's<.001) and DRUGS (p=.001). Physiologic age and sex differences need to be considered in designing intervention programs.

1 - Diagnostic Strategy in a Suspected Red Cell Enzymopathy

To determine the prevalence of frailty and the association of sociodemographic characteristics, clinical aspects, and functional capacity with the frailty status of community-dwelling older adults from Curitiba, Southern Brazil.This cross-sectional observational study included 1,716 participants aged ≥60 years. Frailty was assessed using the Fried phenotype indicators of weakness, exhaustion, low activity, slowness, and weight loss. Sociodemographic characteristics, clinical aspects, and functional capacity and functionality were evaluated and compared between the sexes and the different frailty statuses (non-frail, prefrail, and frail). Multinomial logistic regression models were used to identify associations (p<0.05).A high prevalence of frailty (15.8%) and prefrailty (65.3%) were observed, and both were higher in female than in male individuals. The most predominant frailty criterion was weakness, followed by exhaustion. Compared with the non-frail elderly, the prefrail and frail elderly were older in age and presented more health problems, greater dependency for basic and instrumental activities of daily living, and reduced lower extremity strength performance and functional mobility. The highest proportion of illiterate individuals, individuals with 1-4 years of education, widowed individuals, polypharmacy, and possible cognition problems and diseases were seen in the frail elderly group. Moreover, the risk of being prefrail and frail was higher in those who were older and had more health problems, higher body mass index, and reduced lower extremity strength performance. Greater calf circumference and independence in activities of daily living were protective factors for prefrailty and frailty. Furthermore, lower functional mobility increased the chances of being frail.The prevalence of frailty was more pronounced in female than in male individuals, mainly because of a decline in force. Prefrailty was 4 times more prevalent than frailty, and the presence of health problems and reduced functional capacity increased the chances of being prefrail and frail.