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1.
To assess the effect of an exercise intervention using a weighted vest on perceived health status and bone density in older persons, we enrolled 36 seniors in a randomized controlled trial. The vest-use group met weekly for 1 h for a low level exercise class. They wore a weighted vest during the class and as tolerated at home. The discussion controls met for 1 h weekly. At baseline and follow-up (20 weeks), subjects completed a questionnaire that incuded the 20 item MOS Short-Form Health Survey, Multidimensional Health Locus of Control Scale, and Philadelphia Geriatric Center Morale Scale, and bone density was measured by dual energy X-ray absorptiometry. Subjects also completed daily activity diaries. Subjects in the vest group reported a statistically significant dicrease in bodily pain, improved physical functioning, and increased internal health locus of control. Bone density increased by 1% in the vest group and decreased by 0.6% in the controls (p=0.12). We conclude that our exercise intervention had a positive effect on some measures of perceived health in older persons.This work was supported by grants from the Charles A. Dana Foundation, the UCLA Academic Senate, and the Bureau of Health Professions Mid-Career Faculty Training Grant.  相似文献
2.
The purpose of this research was to develop a quality of life (QOL) tool that would help to reveal any physical, mental or emotional changes patients may experience while receiving radiation therapy. Research focusing on quality of life during radiation therapy is in its infancy. Although many tools to measure QOL have been developed, until very recently few had been geared specifically toward those receiving radiation therapy. In addition to a radiation-specific instrument, the goal was to develop a multidimensional measure that would be short in length and could be completed by the patient in 15 min or less. This new Quality of Life Radiation Therapy Instrument (QOL_RTI) is a visual analogue scale with 24 questions and is not site specific. Twenty-one patients with varlous diagnoses and treatment sites completed the questionnalre at baseline and then weekly during the course of radiation therapy. The internal consistency of the instrument (Cronbach's alpha) was 0.87. At baseline each patient also was asked to complete the Ferran's and Powers QLI Cancer Version 6 (QLIC); the correlation between the QLIC and the QOL-RTI was 0.47. These results are based on a small number of patients, but initlal efforts in creating an instrument that is quick and easy for patients to complete have been encouraging. An additional 70–80 patients are now being entered into a study using the QOL-RTI to further evaluate reliabillty and validity.Previously published in abstract form: Qual Life Res 1994; 3: 82–83.  相似文献
3.
During the period 1993–1994 we conducted a study in Israel on a national-based sample of 960 men to examine the relationships between urinary symptoms and various domains of quality of life (QoL). Regression analyses were performed for each of the eight SF-36 domains, separately for the entire population and for those without any co-morbidity. The dependent variable was the SF-36 domain scores. The independent variables included age, origin, education, employment and economic status, the degree of disturbance caused by urinary symptoms and the existence of co-morbidities. There was a significant difference between the entire population and the population without co-morbidities. In the entire population we found that severely bothersome urinary symptoms were related to scores on three QoL domains (social function, role–emotional and mental health) but there was no association with physical functioning and general health perceptions. In men without co-morbidity, urinary symptoms were substantially related to physical functioning and general health perceptions. These findings indicate that the relative weight of the impact of a symptom or disease on QoL domains is changed by the presence of other competing factors, such as co-morbidities or sociodemographic attributes.  相似文献
4.
SummaryObjectives The aim of the paper is to assess the significance of hearing disability as a public health problem through its association with multiple negative health outcomes: subjective health perception, mental health and social well-being.Methods The data come from the participants of the 1997 national health survey in Belgium, who were 15 years and older (n=8560). The presence and severity of the hearing disability was estimated through self-reporting. The association of hearing disability with the studied health outcomes was assessed using logistic regression while controlling for confounding factors such as age, sex, co-morbidity and socio-economic status.Results The prevalence of hearing disability is 7% in the population 15 years and older. The prevalence of subjective ill health (Odds Ratio (OR): 1.32), mental ill health (OR: 1.51), and a low appreciation of the social contacts (OR: 1.73) was higher in subjects with hearing disability. No association was found between hearing disability and the frequency of social contacts or with the functional content of the social contacts.Conclusions Given the health and social consequences of hearing disability, increased public health attention, including both strategies for prevention, for identification and treatment, is warranted.
Der Einfluss der Gehörlosigkeit auf des Wohlbefinden und die Gesundheit
ZusammenfassungFragestellung Ziel der Studie ist es, die Bedeutung der Gehörlosigkeit als ein Public-Health-Problem in Zusammenhang mit vielfältigen Komponenten wie subjektive Wahrnehmung der Gesundheit, mentale Gesundheit und das Wohlbefinden einzuschätzen.Methoden Die Daten stammen von der nationalen Gesundheitsumfrage von 1997 in Belgien. Die Teilnehmer waren mindestens 15 Jahre alt (n=8560). Mittels Umfrage wurden Anwesenheit und Grad der Hörbehinderung festgelegt. Der Zusammenhang zwischen Gehörlosigkeit und Gesundheitszustand wurde mittels logistischer Regression berechnet, unter Einbeziehung der wechselnden Faktoren wie Alter, Geschlecht, Ko-Morbidität und sozio-ökonomischer Status.Resultate Die Prävalenz von Gehörlosigkeit beträgt 7 % in der untersuchten Population. Bei Personen mit Schwerhörigkeit waren die Empfindung einer schlechten subjektiven Gesundheit (Odds Ratio (OR): 1,32), die geistige Gesundheit (OR: 1,51) und die niedrige Schätzung der sozialen Kontakte (OR: 1,73) betonter. Kein Zusammenhang wurde zwischen Gehörlosigkeit und der Häufigkeit oder dem inhalt sozialer Kontakte gefunden.Schlussfolgerungen Im Hinblick auf die Folgen für die Gesundheit und die sozialen Kontakte, vor allem wenn es sich um mässige Schwerhörigkeit handelt, ist es gerechtfertigt, dass eine frühzeitige Feststellung des Gehörverlustes praktiziert wird.

L'impact de l'incapacité auditive sur le bien-étre et la santé
RésuméObjectives Le but de cette étude est d'estimer l'importance de l'incapacité auditive comme un problème de santé publique en association avec de multiples composantes de la santé: la perception subjective de la santé, la santé mentale et le bien-être social.Méthodes Les données proviennent des participants d'une enquête de santé nationale effectuée en 1997 en Belgique, qui avaient 15 ans ou plus (n=8560). La présence et la sévérité de l'incapacité auditive ont été évaluées par une enquête. L'association entre l'incapacité auditive avec l'état de santé a été évaluée en utilisant la régression logistique tout en contrôlant les facteurs confondants tels que l'âge, le sexe, la co-morbidité et le statut socio-économique.Résultats La prévalence de l'incapacité auditive est 7 % dans la population de 15 ans ou plus. La prévalence d'une mauvaise santé subjective (odds ratio (OR): 1,32), d'une mauvaise santé mentale (OR:1,51) et d'une faible appréciation des contacts sociaux (OR:1,73) était plus élevée chez les sujets malentendants. Aucune association n'a été trouvée entre l'incapacité auditive et la fréquence des contacts sociaux ni avec leur contenu (teneur, degré).Conclusions Etant donné les conséquences de l'incapacité auditive sur la santé et sur la vie sociale, il est pleinement justifié de leur accorder d'attention dans le domaine de la santé publique, incluant à la fois des stratégies de prévention, d'identification et de traitement.
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5.
Background and objective: Health perception is an important outcome associated with health-related quality of life. Various correlates of perceived health have been identified, but attempts at multivariate modeling have often failed to mirror the complex system of causal pathways surrounding this concept. The objective of this study was to develop a multivariate model to improve our understanding of how physical, social, and psychological factors interact to influence health perception following a hip fracture. Methods: Patients were interviewed in-hospital during the week following the fracture to obtain information on in-hospital mental status and pre-fracture function, pre-fracture health perception, and pre-fracture social support. A follow-up interview was conducted by telephone to assess function, health perception, and social support 3 months post-fracture. Comorbidities and demographic information were obtained from medical records. Results: This study included 222 hip fracture patients aged 65 + and fracturing a hip between 10 July 1996 and 30 August 1997. Our estimated model was theory-based, developed from existing research identifying the following correlates of health perception: physical function, comorbidities, socioeconomic status, social support, age, and prior health perception. In addition to these correlates, our model was unique in incorporating a variable to assess whether the gap between pre- and post-fracture functioning acted as a separate cause on post-fracture health perception. Initially, the fit between the data and the model was poor, however minor modifications to the model corrected this. While there was a good fit between the data and the estimated model, only about 25% of the variation in both pre- and post-fracture health perceptions were explained. The number of comorbidities and physical function were found to have the strongest influence on health perception. Post-fracture health perceptions were also improved by increased post-fracture social support, higher income/status, and higher pre-fracture health perception. The network of effects indicates that the causal sources of health perception may differ in the pre- and post-fracture periods. This suggests that the causal sources of health perception following major health changes may differ substantially from the causal sources of health perception operating during normal times. Conclusions: The findings suggest that interventions aimed at improving pre-fracture function and post-fracture social support could increase health perception following hip fracture. In interpreting our results, it is important to remember that while we attempted to adjust for measurement error in the analysis, the study may be limited due to the retrospective nature of the questions. Future research should focus on improving the model by including other components of the patient's emotional health. This revised version was published online in June 2006 with corrections to the Cover Date.  相似文献
6.
SummaryObjectives To explore the perceptions of health and physical activity, and the associations between these two areas from a theoretical lifestyle perspective.Methods Data was collected by means of a self-administered questionnaire, among 3019 adults attending centres for preventive medicine in France. Correspondence analysis examined the significance of the relationships between perceptions of health and perceptions of sports and physical activity.Results Four pricipal types of subjects emerged from the factor analyses expressing four different lifestyle patterns. Non physically active lifestyle: a feeling of not being healthy, Physically active lifestyle, pleasure/leisure-oriented, Necessarily physically active lifestyle, regardless of health, Physically active lifestyle aimed at stress relief.Conclusions The sociological approach helps tackle sports and physical activity as behaviour patterns but also and especially as a health orientation connected with the socio-economical climate. This approach also gives sports practice back its meaningful cultural dimension.
ZusammenfassungFragestellung Wie werden Gesundheit und körperliche Aktivitäten und Sport wahrgenommen? Welche Zusammenhänge bestehen zwischen den beiden Parametern in Hinblick auf den Lebensstil?Methoden Die Rohdaten wurden mit Hilfe eines selbst zu beantwortenden Fragebogens gesammelt. Die 3019 Studienteilnehmer sind ausschliesslich Erwachsene, die in einem französischen Vorsorgezentrum während einer freiwilligen Beratungsstunde angesprochen wurden. Der Schwerpunkt der anschliessenden Faktorenanalyse lag in der Suche nach Korrelationen zwischen der Wahrnehmung der Gesundheit und den Eindrücken, die die sportlichen Aktivitäten hinterliessen.Ergebnisse Diese Analyse ermöglicht es, vier Antwortprofile herauszuarbeiten, die letztlich vier verschiedenen Lebensstilen entsprechen: inaktiv, allgemeines Unwohlsein, das sich im klinischen Bereich niederschlägt, aktiv, auf Lustempfindungen orientiert, passiv, fatalistisch, ohne Interesse an Gesundheit, aber gesellschaftsorientiert, aktiv, gesundheitsbewusst, auf Stressabbau orientier.Schlussfolgerungen Aus soziologischer Sicht kann somit die Ausübung körperlicher Aktivitäten einerseits als reines Verhaltensmuster gedeutet werden, andererseits aber auch als gesundheitsorientierte Handlung, eng verknüpft mit den sozioökonomischen Verhältnissen. Sprot an sich erhält somit seine Bedeutung als kulturelle Dimension wieder.

RésuméObjectifs Etudier les perceptions de la santé et de l'activité physique et sportive, ainsi que les relations entre les deux dans la perspective théorique du style de vie.Méthodes Des données ont été recueillies par questionnaire auto-administré auprès de 3019 adultes consultant un centre de médecine préventive français. Une analyse factorielle des correspondances a permis d'étudier les relations d'affinités entre les perceptions de la santé et celles de l'activité physique et sportive.Résultats Quatre profils de réponses se distinguent par cette analyse factorielle qui font émerger quatre styles de vie: physiquement inactif, le sentiment de ne pas être en bonne santé, physiquement actif, orienté vers le plaisir et les loisirs, physiquement actif au travail sans attention pour la santé et physiquement actif pour lutter contre le stress.Conclusions L'approche sociologique permet d'aborder la pratique physique et sportive, comme un comportement mais aussi et surtout comme une orientation de santé, en relation avec les conditions socio-économiques. Elle redonne ainsi à la pratique sportive sa dimension culturelle signifiante.
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7.
This paper focuses on how adults with cystic fibrosis (CF) attending a specialist CF centre in the UK perceive their health. In common with many other genetic diseases, CF is traditionally conceptualised as a fatal childhood disease, yet the average survival age for those with CF has been steadily rising over the past half century. Thus it is now predicted that those born in 1990 will live on average for 40 years. To date, however, most sociological work has focused on children or adolescents affected by CF rather than on adults between the ages of 18 and 40, the focus of the study reported here. The paper shows that these adults' varying perceptions of health are related to the effects of CF, its treatment, and the context in which adults are placed. Four concepts of health are identified (health as 'normal', controllable, distressing and a release) along with certain styles, ways of coping and related strategies. Through these analytic distinctions the paper aims to make a contribution to the sociological understanding of lay concepts of health in adults with childhood or genetic disease.  相似文献
8.
9.
OBJECTIVE: To investigate if dynamic changes in the pattern of alcoholic beverages consumption are associated with modifications in health perception. Design, setting, and PARTICIPANTS: This study investigated 12 332 middle aged men and women from the atherosclerosis risk in communities study who reported drinking status and perceived health triennially from 1987 to 1995. Crude and adjusted risks for change in health perception between visits two and three by change in drinking status between visits one and two were computed. In the multivariate analysis the sample was restricted to participants with stable drinking status between visit two and three and stable health perception between visits one and two, to assure that exposure and outcome were not temporary. Covariates included age, sex, race, income, smoking status, educational level, and obesity. RESULTS: Health for persons who stopped or started drinking, or continued to abstain was more likely to decline than was health for persons who continued to drink even after adjustment and restrictions (drinking cessation: OR = 1.6, 95% CI = 1.1, 2.3; started drinking; OR = 1.4, 95% CI = 0.9, 2.2; continued abstaining from alcohol: OR = 1.5, 95% CI = 1.3, 1.9). Among participants with poor perceived health, starting, stopping, or continuing to abstain from alcohol did not improve health in relation to participants that continued to drink. CONCLUSION: Increasing and decreasing drinking patterns and continuous abstinence were associated with declining health perception in comparison with continuous drinking, while starting or stopping drinking did not improve health perception of persons with poor perceived health. These findings suggest that change in health perception was not biologically related to alcohol consumption.  相似文献
10.
Wilson and Cleary (1995) proposed a conceptual model of health-related quality of life (HRQOL) that integrates both biological and psychological aspects of health outcomes. There are five different levels in their model, namely, physiological factors, symptom status, functional health, general health perceptions, and overall quality of life. Their model has been widely applied to different populations, including patients living with cancer, Parkinson’s disease, arthritis, and HIV+/AIDS. However, their conceptual model has only been partially examined. That is, the five major concepts have not been examined simultaneously. Using structural equation modeling (SEM), the Wilson and Cleary HRQOL model was validated in patients living with HIV from the AIDS Time-Oriented Health Outcomes Study. The results showed that the HRQOL model fit the data adequately, and the relationships between the constructs were all significant (at p<0.05 level). Based on the modification indexes, an alternative model linking symptom status directly with general health perceptions and overall quality of life was specified. Implication and limitation of the findings are discussed.  相似文献
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