Self-perceived Health Status Research Articles

Changes in Decisional Conflict and Decisional Regret Among Living Kidney Donors From Pre-Donation to 1-Year Post-Donation.

Previous research indicates that most living kidney donors (LKDs) are content with their decision to donate and seldom experience regret. Nevertheless, a small percentage of donors report adverse experiences, such as psychological distress and reduced vitality. Therefore, it is essential to explore the experiences of LKDs, particularly within the context of their decision-making process both before and following kidney donation. This study aimed to examine the decisional conflict and decisional regret experienced by LKDs from the evaluation stage to 12 months post-donation and to identify the associated factors. A longitudinal study design was implemented, and the initial data collection took place when potential LKDs visited the hospital for evaluation (n = 50). Subsequent data collection was conducted at 3 (n = 49), 6, and 12 (n = 46) months post-donation. Variables, including basic demographics, decisional conflict, decisional regret, perceived control, psychological distress, and healthcare orientation, were collected. Generalized estimating equations were used to obtain inferential statistics. Results showed that perceived control characterized by personal control orientation, lower psychological distress, and better healthcare orientation were associated with reduced decisional conflict among LKDs. Meanwhile, lower decisional regret was associated with better self-perceived health status, perceived control inclined toward interpersonal control, and less psychological distress among LKDs. Nurses should assess the decisional conflict and mental health of potential LKDs, and provide clear information to support their decision regarding kidney donation. They should also offer self-care information and stress-coping strategies related to living donor nephrectomy to aid in reducing decisional conflict and regret.

COping with Rheumatic Stressors (CORS) questionnaire: validated German translation and cross-cultural adaptation for patients with axSpA

BackgroundPatients with Rheumatic and Musculoskeletal Diseases, including axial spondyloarthritis (axSpA), may suffer from stressors like pain and functional impairments leading to limitations in their self-perceived health status. The COping with Rheumatic Stressors (CORS) questionnaire was developed to analyze how patients cope with these stressors. The CORS is currently not available in German.ObjectiveFirst, to translate, cross-culturally adapt and to linguistically validate the original Dutch CORS into German. Second, to test the pre-final German translation through cognitive debriefing in patients with axSpA.MethodologyThe original Dutch CORS underwent a multistep cross-cultural adaptation process, as described by Beaton. It was first independently translated into German by bilingual Dutch-German lay and expert translators. Subsequently, it was translated back from the German version into Dutch. Remaining discrepancies were resolved by a scientific committee, resulting in a pre-final German version. This version was then tested through cognitive debriefing by 10 patients with axSpA across a broad spectrum of sociodemographic backgrounds.ResultsForward and backward translations of the CORS revealed minor discrepancies, mainly based on the degree of formal versus informal language usage, minor semantic errors or unusual syntax, which led to minor modifications in the wording. Reviewed by the scientific committee, the pre-final consensus German version was linguistically validated by cognitive debriefing by 10 patients with axSpA. Cognitive debriefing confirmed and ensured closest linguistic validity for German in Germany and highest equivalence to the Dutch original version.ConclusionThe German CORS was shown to have high cross-cultural and face validity for the assessment of coping with rheumatic stressors.

Long‑term physical and mental Health-Related Quality of Life in Italian patients post COVID-19 hospitalisation.

Prior evidence suggests that patients' Health Related Quality of Life (HRQoL) worsens after COVID-19. This study aimed to investigate HRQoL in Italian patients post-hospitalization for COVID-19, focusing on changes in physical and mental HRQoL over time since COVID-19 diagnosis. A cohort of patients hospitalized for COVID-19 at Molinette Hospital in Turin, Italy, was contacted post-discharge to assess HRQoL using the SF-36 questionnaire. Patients completed the questionnaire only once at a different time since diagnosis. This design allowed for the analysis of responses up to three years after diagnosis. Measured scores were compared with normative data from the Italian population using z-scores. HRQoL differences by gender, comorbidities, and self-perception of health status before and after COVID-19 were tested. The effect of time since diagnosis on physical (PCS) and mental (MCS) SF-36 scores was analysed using multiple linear models and stratified analyses. A total of 601 patients completed the questionnaire. HRQoL was significantly lower compared to the normative Italian population. Men and individuals without comorbidities had better HRQoL, and self-perceptions of health status before and after COVID-19 influenced HRQoL. Time since diagnosis was associated with improved PCS, but MCS remained unaffected. Mental health declined in patients using anxiolytics post-COVID-19, and increasing age negatively affected physical health. Our findings highlight the impact of time since diagnosis on HRQoL post-COVID-19 in an Italian population and suggest the need for further investigation into the pandemic's effects on HRQoL. Physicians should implement measures to improve mental HRQoL post-COVID-19.

부산⋅경상지역 보건복지계열 전공 대학생들의 e-헬스 리터러시와 노인에 대한 태도에 관한 연구

Objective : The purpose of this study was to investigate the e-health literacy and attitudes toward the elderly of university students majoring in health and welfare in Busan and Gyeongsang province, e-health literacy and attitudes toward the elderly according to general characteristics. Methods : From November 30, 2024 to December 11 of the same year, a survey on e-health literacy and attitudes toward the elderly was conducted for the university students majoring in health and welfare in Busan and Gyeongsang province. An online survey was conducted using Google, and a total of 120 data were used for result analysis. For data analysis, frequency analysis and descriptive statistics, Independent t-test, One-way ANOVA were conducted using the SPSS 25.0 program. Post-test was conducted with the Scheffé test for significant items. Results : The average of the total score of e-health literacy among college students was 3.91±0.57 points, which was above average, and functional e-health literacy was the highest, followed by communicative and critical literacy. The average of the total score of attitudes toward the elderly was 3.08±0.45 points, which was evaluated as normal. The e-health literacy showed significant differences according to self-perceived health status, health interest, health management time, and volunteer work experience for the elderly(p<0.05). Attitudes toward the elderly showed significant differences according to self-perceived health conditions (p<0.01), and attitude scores were higher when they thought they were 'healthy' or 'very healthy' than the group who thought they were 'unhealthy'. Conclusion : Based on this study, various education and programs that can improve e-health literacy and attitudes toward the elderly should be discussed in order to cultivate university students as health and welfare-related experts who can contribute to the community.

Poor Employment Conditions and Immigrant Health in Europe

Building on the extant literature and utilizing data from the EU-SILC and the EU-LFS surveys conducted between 2009 and 2023, we empirically investigate the impact of poor employment conditions—associated with insecure or precarious employment—on third-country nationals’ (TCNs’) self-perceived health status (SPH). The role of employment conditions in health is examined by employing indicators of temporary, part-time, and self-employment. Driven by theory and empirical analysis, we also investigate the effects of additional variables, including long-term unemployment. Finally, to probe differences across countries, we examine how the effects of employment conditions on TCNs’ health vary across institutional settings, namely across different types of welfare state. Descriptive statistics and regression analyses of panel data reveal that employment conditions affect immigrants’ SPH and surface significant differences across countries. The estimated country-specific effects point to statistical average differences between Germany and two groups of countries: one showing higher effects (i.e., Austria, Belgium, Denmark, Finland, and France) and another with lower effects (i.e., Greece, Ireland, Italy, and Spain). The welfare model adopted by different countries is a qualitative significant predictor of TCNs’ SPH. We conclude with a discussion of the implications of these findings for future research, but also policy initiatives to improve TCNs’ employment conditions and, consequently, their health and overall well-being.

Transforming Chronic Pain Care Through Telemedicine: An Italian Perspective.

Chronic pain (CP) is a complex and debilitating condition that significantly impairs quality of life and imposes a high burden on healthcare systems. This study aims to evaluate the impact of telemedicine on chronic pain management in cancer survivors with complex CP. Our multicenter retrospective investigation of cancer survivors with complex CP included 100 patients (median age 65 years, 62% female). Pain, disability, and self-perceived health status were assessed using the Numeric Rating Scale (NRS), Brief Pain Inventory (BPI), Oswestry Disability Index (ODI), and the EuroQolfive-dimension five-level (EQ-5D-5L) questionnaire. The most common diagnoses were neuropathic pain (54%) and complex chronic pain (32%). Significant clinical improvements were observed after six months of telemedicine intervention (all p < 0.001). NRS scores improved by more than four points in 77% of patients, BPI Worst Pain Scores decreased by four points in 52% and by five points in 28% of patients. All patients' disability levels improved from severe (median ODI score of 52) to moderate (median ODI score of 30). Self-perceived health status improved from 40 to 60 on the EQ-5D-5L scale. Telemedicine interventions significantly reduced pain intensity, decreased disability levels, and enhanced quality of life in chronic pain patients. These findings underscore the transformative potential of telemedicine in chronic pain management and support its broader integration into medical practice.

Age-Related Trajectories of Health Decline Among Immigrants and Natives in Europe: The Effect of Education.

Background: The ability to age healthily is highly dependent on individual characteristics that include gender, social class, a range of biological and contextual factors, and migrant background. Indeed, immigration has changed the demographic composition and social structure of many European countries, generating an increasing interest in how societies, and immigrants in particular, are aging. Research Design: This paper compares the age-related trajectories of health decline in three health measures (activity limitation indicator, self-perceived health, and chronic conditions) among 7,429 immigrants and 81,424 native-born populations aged 50 years old and over using longitudinal data from seven waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) (2004-2020). Analysis: We use descriptive and multivariate models (random-effects regression models) to analyze the association between migration status and each health outcome. We are particularly interested in determining the age-related trajectory of this association across three levels of education, exploring at the same time the effect of the interaction between immigration status and age on health. Results: Our results highlight potential gaps in health between immigrants and native-born people that are particularly large for the low-educated group. In other words, the health decline is more marked for low-educated immigrants compared to native-born populations in particular for activity limitation indicator and self-perceived health, while it is less pronounced with the accumulation of chronic conditions. Conclusions: Our findings should serve to enhance the design of the provision of social services and support and the promotion of equal opportunities.

Depression screening model for middle-aged and elderly diabetic patients in China.

Diabetes is a common global disease closely associated with an increased risk of depression. This study analyzed China Health and Retirement Longitudinal Study (CHARLS) data to examine depression in diabetic patients across China. using 29 variables including demographic, behavioral, health conditions, and mental health parameters. The dataset was randomly divided into a 70% training set and a 30% validation set. Predictive factors significantly associated with depression were identified using least absolute shrinkage and selection operator (LASSO) and logistic regression analysis. A nomogram model was constructed using these predictive factors. The model evaluation included the C-index, calibration curves, the Hosmer-Lemeshow test, and DCA. Depression prevalence was 39.1% among diabetic patients. Multifactorial logistic regression identified significant predictors including gender, permanent address, self-perceived health status, presence of lung disease, arthritis, memory disorders, life satisfaction, cognitive function score, ADL score, and social activity. The nomogram model showed high consistency and accuracy, with AUC values of 0.802 for the training set and 0.812 for the validation set. Both sets showed good model fit with Hosmer-Lemeshow P > 0.05. Calibration curves showed significant consistency between the nomogram model and actual observations. ROC and DCA indicated that the nomogram had a good predictive performance. The nomogram developed in this study effectively assesses depression risk in diabetic patients, helping clinicians identify high-risk individuals. This tool could potentially improve patient outcomes.

Prevalence and Determinants of Household Self-Reported Diabetes Mellitus in Gauteng, South Africa.

Diabetes mellitus is one of the leading causes of morbidity and mortality worldwide. Type 2 diabetes mellitus is the most prevalent type of diabetes mellitus, and it is associated with both hereditary and lifestyle risk factors. South Africa is not exempt from this pandemic; hence, this paper aims to assess the prevalence and determinants of household self-reported diabetes mellitus in Gauteng, South Africa. Data were sourced from the Gauteng City-Region Observatory (GCRO) quality of life survey (2020/2021). Bivariate and multivariate logistic regressions were applied. The prevalence of household self-reported diabetes mellitus in Gauteng was 11.1%. The 'other population' group (which included Whites, Coloureds and Indians), as well as older respondents, higher household monthly food expenditure, poor self-perceived health status and household self-reported hypertension were factors that increased the odds of household self-reported diabetes mellitus. Only informal housing decreased the odds of household self-reported diabetes mellitus. Screening of diabetes mellitus among those with poor living conditions, no medical aid and lack of access to healthcare facilities such as Gauteng township and informal settlement residents should be intensified. This secondary disease prevention intervention is crucial, as it will enhance the appropriate referrals and timeous chronic treatment for those with diabetes mellitus.

Association Between Toothbrushing Habits and Self-Rated Oral Health: Re-Consideration of the 3-3-3 Toothbrushing Campaign.

This study investigates the association between toothbrushing frequency and self-rated oral health to evaluate the effectiveness of the 3-3-3 toothbrushing campaign. Employing a cross-sectional study design, we analysed responses from 13,199 adults using structured questionnaires. The dependent variable was self-rated oral health. The independent variables were toothbrushing habits. We compared both groups; control group: twice a day and case group: three times a day. Predisposing, enabling and need factors were adjusted as confounders based on the Anderson behaviour model. Our findings reveal no significant correlation between toothbrushing frequency (twice vs. three times daily) and self-perceived oral health status. These results suggest re-evaluating the 3-3-3 campaign's recommendations. Further research is necessary to identify factors that more directly influence self-rated oral health. Our research found that increasing toothbrushing from twice to three times daily does not significantly enhance oral health, as evidenced by an odds ratio of 0.97 and a negligible Cohen's d value. We recommend public health campaigns emphasise toothbrushing quality over frequency to improve oral health outcomes.

Defining digital health literacy profiles in Spanish adults: a latent class analysis

Abstract Background According to different reports, Spain is among the European countries that use digital health technologies the most. However, to develop inclusive and fair digital health services, there is the need to feature digital health knowledge, skills, confidence, and a positive attitude about their significance. This work aims to draw a picture of digital health literacy levels in Spain. Methods A stratified sample of the Spanish population regarding gender, age group and area of residence was used. Participants were recruited from an online panel and by direct approach to balance quotas. Between May 2021- May 2022, participants filled a self-administered online survey, including the Spanish version of the eHealth Literacy Questionnaire (eHLQ) and the eHealth Literacy Scale (eHEALS). Results Digital health literacy showed similar mean scores, between 2.6-2.7 out of 5 with similar SD on each of the 7 dimensions of the eHLQ. The highest scores were related to knowledge about filling data in digital health services and knowledge about health and how the body works, and feelings about the usefulness of digital technology for health. In contrast, lower scores were related to sharing health information by technology, thinking that using technology gives access to better health services, and the possibility to contact usual health professionals with technology. Latent profile analysis identified 5 user profiles. Significant differences were found according to age, inhabitants per municipality, technology use, self-perceived health status, educational level, socioeconomic index and eHEALS scores; not by gender. Conclusions As the scores are similar in the different subscales, competencies, attitudes and confidence in digital health that they measure are balanced. However, the main challenge appears in granting users access to digital services that work, which involves the definition and monitoring of strategies until the final implementation. Key messages • Digital Health literacy in Spain differs according to different aspects, not only age, educational or socioeconomic level. • Confidence in usefulness is a common denominator among the five digital health service user profiles identified.

The value of healthy ageing: Estimating the economic value of health at older ages using time use data

Abstract While health naturally has intrinsic value and maintaining health as people age seems to make good economic sense, making the case for investing in health at older ages can be challenging. Much economic growth is historically attributed to the working-age population; however, maintaining good health as people age also enables older people to contribute meaningfully to the economy. Investing in health at older ages, therefore, can be strategic economic policy. We develop a novel method to quantify the economic value of health through time use data. Using data from the United Kingdom Time Use Survey (UKTUS) 2014-15 for individuals aged 65 years-old and older, we apply survey-weighted generalized linear models to predict the time spent in non-market productive activities based on age and self-perceived health. We then quantify the monetary value of time spent engaging in these activities and simulate the monetary impact of health gains at older ages. Both age and self-perceived health status were associated with minutes spent in many non-market productive activities. Being in ‘very good’ instead of ‘very bad’ self-perceived health is associated with an additional production of 439£, 629£, and 598£ per month for an average individual aged 65 to 74 years-old, 75 to 84 years-old, and 85 years-old and older, respectively. Our simulation model indicates that improving the health of 10% of older people in ‘very bad’ health could lead to an economic increase of up to 278£ million through non-market activities. Health at older ages creates considerable economic value which is not captured using standard national accounting measures. Our work highlights the importance of health for functional capacity as people age, allowing them to engage more in non-market activities. Our method to quantify the monetary value of health can be adapted to other settings to make the economic case for investing in healthy ageing.

Work ability data management in multisectoral services for people with disabilities: a cross-sectional study

Successful collaboration between professionals working in multisectoral services for people with disabilities requires access to data on the client’s work ability. This study examines work ability data needs, availability, and acquisition in social and health care services and employment services and explores possible differences between these service sectors. A cross-sectional survey was carried out using a self-developed questionnaire based on Choo’s information management process model, the Work Ability House model and previous research on work ability data. The questionnaire was targeted at physicians, nurses, physiotherapists, psychologists, and experts who support the work ability of people with disabilities and who work in primary health care, specialised health care, social services or employment services. The findings indicate that data on clients’ self-perceived health status is more frequently available than data on self-perceived work ability. This variability in data availability exists across professional sectors, highlighting the need for enhanced data management practices related to work ability assessment and support among professionals in social and health care services and employment services. The study underscores the importance of increasing professionals’ willingness to discuss work ability issues with working-age clients, particularly in primary health care and social services. These findings are pertinent in terms of enhancing multisectoral collaboration among professionals who need to comprehensively assess and support the work ability and employment of people with disabilities. Also, the study provides a diverse list of individual pieces of data related to work ability.

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.

Individual Characteristics Associated with Fears and Prevention Behaviors Related to Respiratory Infectious Disease among South Korean Adults Using Complex Sample Design.

This study aimed to identify the relationships among individual characteristics, COVID-19-related fears, and infection-prevention behaviors using data from 228,932 adults (weighted to 43,583,798.71) aged 19 and older who participated in the 2021 Community Health Survey conducted by the Korea Disease Control and Prevention Agency. The complex sample design analysis using SPSS 20.0 revealed the following. Women had statistically significantly higher COVID-19-related fears and a higher level of preventive behaviors compared to men. During the COVID-19 pandemic, the level of physical activity among men was higher than that of women. Compared to the period before COVID-19, the frequency of smoking and drinking decreased for both men and women, with the reduction being more pronounced in men than in women. The high-exercise group had a lower level of COVID-19-related fears. Self-perceived health status was inversely and significantly related to COVID-19-related fears. The low-exercise group had a lower score for self-perceived health status than the high-exercise group. This study demonstrated that maintaining sufficient physical activity positively influences self-perceived health and reduces anxieties related to COVID-19 infection and fatalities. The results highlight the importance of physical activity and the need to identify strategies that effectively maintain regular exercise while adhering to infection-prevention measures during pandemics.

Health-Related Behaviors and Perceived Health Status According to Water and Sugar-Sweetened Beverage Intake in Korean Adolescents.

The objective of this study was to determine the relationship between water and sugar-sweetened beverage (SSB) intake, health behaviors, and self-perceived health status using data from the 2019 Korea Youth Risk Behavior Web-based Survey (KYRBS). The subjects included in this analysis were 57,302 Korean adolescents from the 7th to 12th grades. The intake patterns of water and SSBs were categorized into four groups: Group I, adequate water intake (≥4 cups/day) and low frequency of SSB intake (≤1-2 times/week); Group II, adequate water intake and high frequency of SSB intake; Group III, inadequate water intake (<4 cups/day) and low frequency of SSB intake; Group IV, inadequate water intake and high frequency of SSB intake (≥3 times/week). Complex sample analyses were used for considering strata, clusters, and weights for samples. Significant differences were observed in the distribution of sociodemographic characteristics between the water and SSB intake groups. As grade levels increased or if students were female, there was a significant increase in the proportion of students characterized by low water intake and high consumption of SSB. Adolescents with healthier beverage habits, characterized by adequate water intake and low frequency of SSB consumption (Group I), generally abstained from smoking and alcohol, were more physically active, and maintained a desirable diet, reporting a better perceived health status. In contrast, those with higher SSB consumption and inadequate water intake (Group IV) were more likely to perceive their health as poor, with higher rates of smoking and alcohol use, lower physical activity levels, and poorer dietary habits compared to Group I. In conclusion, adolescents with desirable beverage consumption habits differed by sex and grade and they reported positive health behaviors and better overall health status. This suggests that there is a need for more active education and intervention in schools and families, as well as increased efforts by adolescents to promote healthy beverage habits.

Socioeconomic determinants and self-rated health among hotel housekeepers in the Balearic Islands (Spain).

Hotel housekeepers constitute an important occupational group in the Balearic Islands (Spain). Housekeeping is considered low-skilled and precarious and typically involves high physical demands and time pressure. The aim of this study is to analyze the association between the socioeconomic determinants of health and hotel housekeepers' self-rated health. This is a cross-sectional study conducted in Primary Health Care in the Balearic Islands (November 2018-February 2019). Hotel housekeepers over 18 years of age with free access to the Balearic Public Health System who had been employed during 2018 were eligible. We enrolled 1,043 hotel housekeepers; the mean score of health perceived status was 72.4/100 (SD 19.0). Those with a lower self-perceived health were statistically significant older, had Spanish nationality, lower level of studies, permanent or recurring seasonal contract, financial difficulties, a higher level of occupational stress, an external locus of control, reported work-life balance difficulties, were former smokers, insufficiently physical active and obese. We found lower scores in self-perceived health status score of -7.159 (CI95% -10.20- -4.12) among hotel housekeepers with osteoarthritis; -6.858 (CI95% -11.89- -1.82) among those with chronic depression; -3.697 (CI95% -6.08- -1.31) among those who reported difficulties in work-life balance; -2.414 (CI95% -4.69- -0.13) among participants who performed insufficient physical activity; -2.107 (CI% -4.44- -0.23) among those who reported financial strain. Lower self-rated health was also associated to a higher perceived stress, -1.440 (CI95% -2.09- -0.79); BMI (kg/m2), -0.299 (CI95% -0.53- -0.07); and longer time working as HH -0.177 (CI95% -0.33- -0.03). Our results underscore the importance of psychosocial (such as difficulties in work-life balance and occupational stress) and material factors (such as financial difficulties) when explaining differences in self-perceived health. Public health interventions aimed at improving health status must consider inequalities in material and working conditions.

Self-perceived health status, psychological resilience, and life satisfaction of healthcare workers after 2 years of COVID-19 pandemic

AbstractBackground:The coronavirus disease 2019 (COVID-19) pandemic not only profoundly changed people’s living and consumption habits but also affected their physical and mental health and life satisfaction. Healthcare workers reportedly have higher anxiety levels than the general population, and their response to major difficult events, including life, work, and natural and man-made disasters, is affected by their resilience level.Objectives:This study aimed to understand the correlation between healthcare workers’ self-perceived health, psychological resilience, and life satisfaction and to further analyze the mediating effect of psychological resilience between self-perceived health and life satisfaction.Methods:This study adopted a cross-sectional, purpose-sampling survey design to recruit, and select participants aged over 20 years at a regional, teaching hospital in Central Taiwan. The questionnaire included basic data, self-perceived health, psychological resilience, and life satisfaction. This study collected answered questionnaires from 399 (88.7%) respondents. The mediating effect of psychological resilience on the relationship between self-perceived health and life satisfaction was examined using Pearson’s product-moment correlation coefficient analysis and bootstrapping.Results:The mean age was 34.51 ± 9.88 years. Self-perceived health, psychological resilience, and life satisfaction were at good levels. Significant differences were noted in sex, position, and education in terms of psychological resilience and life satisfaction. Psychological resilience partially mediated self-perceived health and life satisfaction.Conclusion:Psychological resilience has a partial mediating effect on healthcare workers’ life satisfaction, indicating an important driving factor for life satisfaction. Furthermore, the psychological process of employees’ resilience can be explained by self‑perceived health.

Unmet community care needs among older adults in China: an observational study on influencing factors

BackgroundWith the rapidly aging population in China, there is an urgent need to understand and address the community care needs of older adults. This study sought to examine these unmet community care needs of older adults in China and the factors influencing them, with the goal of providing essential groundwork for the development of community care health policies.MethodsThis study used data from the 2018 China Longitudinal Healthy Longevity Survey of 8,870 adults aged 65 years and older. Logistic regression analysis was performed to identify factors related to unmet community care needs.ResultsThe results showed that lower number of children, increased years of schooling, poorer self-perceived economic and health status, residing in an institution rather than living with household members, not having public old-age pensions, and not having activity due to daily living impairments were associated with a higher likelihood of unmet community care needs among older adults.ConclusionsThese findings indicate the necessity for crafting policies that consider the factors affecting unmet community care needs of older adults, including their health vulnerabilities and individual needs. Implementing national initiatives aimed at enhancing the quality of services delivered to older adults is crucial, along with establishing programmes to proactively address their vulnerabilities and individual needs. This study can contribute to the formulation of policy measures aimed at enhancing community care services of older adults in China.

Effects of aircraft noise exposure on self-reported health through aircraft noise annoyance: Causal mediation analysis in the DEBATS longitudinal study in France.

Previous studies reported an association between transportation noise and self-reported health status (SRHS). They also suggested a mediating role of noise annoyance using conventional statistical methods. These methods are subject to bias in longitudinal studies with time-dependent exposure, mediator and confounding factors. This study aims to investigate the mediating role of aircraft noise annoyance in the effect of aircraft noise on SRHS using a causal inference approach to address time-dependent variables issues. We used data from 881 participants in all three visits in the DEBATS longitudinal study conducted around three French airports. Participants over 18 years of age reported their self-perceived health status, aircraft noise annoyance, and noise sensitivity by completing a questionnaire at three visits in 2013, 2015 and 2017. Noise maps were used to estimate aircraft noise levels outside their homes. Marginal structural models with inverse probability weighting were used to estimate the total effect of aircraft noise levels on SRHS and its decomposition into direct and indirect effect through aircraft noise annoyance. This study showed a deleterious effect of aircraft noise on SRHS. The odds ratio (OR) corresponding to the total effect and comparing the highest aircraft noise category (≥60 dBA) to the reference category (<50 dBA) was significant (ORpoor/fair_SHRS = 1.25 (95%CI: 1.06 to 2.08)). It also showed no direct effect of aircraft noise levels on SRHS, but an indirect effect through annoyance. This indirect effect increased as aircraft noise levels increased, with a statistically significant OR when comparing the highest noise category (≥60 dBA) to the lowest (<50 dBA) (ORpoor/fair_SHRS = 1.16 (95%CI: 1.03 to 1.52)). Nearly 66% of aircraft noise's effect on SRHS was mediated by aircraft noise annoyance. This study supports the deleterious causal effect of aircraft noise on SRHS. The results highlight the important mediating role of aircraft noise annoyance in the causal pathway from exposure to aircraft noise to poor/fair SRHS.