Psychosocial factors as mediators between migration and subjective well-being among young Finnish adults

This study examined the role of socioeconomic factors (such as education and employment) and psychosocial factors (such as social support, coping and attitude towards the future), in the relationship between migration, self-reported health and life satisfaction among young adults in a 31-year follow-up study of the Northern Finland Birth Cohort 1966 conducted in 1997-1998. The associations between these outcomes and socioeconomic and psychosocial factors were first examined, stratified by gender and migration, for sample members at 23 and at 31 years of age. Regression modelling was then used to study the association between migration and the outcomes after adjusting for specific socioeconomic and psychosocial factors. Results of binary logistic regression models showed that, although there was more dissatisfaction with life and more poor self-reported health in rural areas, the association was derived mostly from the mediation of unemployment, poorer education, lack of social support, passive coping strategies and greater pessimism among people living in rural areas. It is concluded that special attention should be paid to improving living conditions (educational and vocational opportunities) and enhancing the psychosocial resources of young adults in rural and remote areas.     

Health Status in Immigrants and Native Early Adolescents in Italy

The aim of the study was to compare health status between native and immigrant early adolescents in Italy and to analyze related psychosocial factors. Data were taken from “Health Behavior in School Aged Children”, a cross-sectional survey investigating health behaviors among early adolescents in selected European countries. A representative sample of 6,744 (50.4% males) Italian students (11, 13 and 15-years-old) completed a questionnaire. Students were assessed for demographics characteristics, socio-economic conditions, social support and bullying victimization, and, as dependent variables, for health complaints, self-reported health, life satisfaction and happiness. It turned out that immigrant adolescents, as compared to natives, are more often affected by psychosomatic symptoms, less satisfied about their health and about life, and less happy. A multiple regression model showed that migration itself is related to life satisfaction and happiness. Socio-economic inequalities, lack of social integration and victimization determine the differences between immigrants and natives in terms of health symptoms and self-reported health. Immigrant adolescents demonstrated worse health status then their native classmates. However, the differences in terms of subjective well-being are not explained by socio-economic differences, lack of social integration and discrimination.     

Social capital and health and well-being in East Asia: a population-based study

How individual-level social capital relates to adult health and well-being was examined using data from a cross-sectional interview survey in East Asia (Japan, South Korea, Singapore, five areas in Mainland China, and Taiwan) in 2002-2004. The number of self-reported somatic symptoms, subjective health satisfaction, life satisfaction and social capital indicators, as well as socio-economic status (SES), were analyzed by a logistic regression model. Adjusting for SES, social capital measured by belonging to organizations and weakness in "norms of reciprocity" were related to a greater number of self-reported somatic symptoms (p<0.001 for both). Lack of trust in organizations (p<0.001) and of a person to consult (p=0.012) were related to poor health satisfaction. Lower "interpersonal trust" (p=0.016), weakness in "norms of reciprocity" (p<0.001) and lack of trust in organizations (p<0.001) were related to poor life satisfaction. Gender inequality was observed across countries, but the relationships varied according to the health indicator. Specifically, self-reported somatic symptoms were more numerous and health satisfaction was worse in women (p<0.001), but life satisfaction was worse in men (p=0.017). The analyses provide evidence that dimensions of social capital are positively associated with self-reported somatic symptoms and overall well-being in East Asian countries.     

Quality and quantity: the role of social interactions in self-reported individual health

The public health literature on the detrimental effects of social isolation has shown that the quantity of social connections is positively correlated with individual health. Drawing on pooled cross-sectional data, we test this hypothesis on a representative sample of the Italian population. Our findings show that, in addition to the quantity of interactions, it is their quality--as measured by subjective satisfaction derived from relationships with friends--that works as the best predictor of self-reported health. The frequency of meetings with friends is significantly and positively correlated with good health in all regressions. However, when we add our measure of the quality of relationships to the probit equations, the statistical significance of "quantitative" measures is scaled down. Satisfaction with relationships with friends exhibits a positive and highly significant coefficient. Results of the multivariate probit analysis point out the potential role of unobservable variables suggesting the existence of endogeneity problems which require further investigation. We point out the existence of health disparities based on socio-economic status. There is a higher probability that poorer and less educated individuals report poor health conditions. The risk is even higher for unemployed and retired workers. This paper contributes to the literature in two substantive dimensions. This is the first empirical study of the relationship between social interactions and health in Italy. Second, we add to previous empirical studies by taking into account not only the frequency of various kinds of meetings but also indicators of their "quality", as measured by agents' subjective satisfaction with their social participation. The reliability of the analysis also benefits from the uniqueness and comprehensiveness of our dataset, which tries to overcome a structural deficiency in Italian data by merging information on agents' behaviours and perceptions with data on household income.     

Psychological distress of new Spanish mothers

Background: The birth of a child usually brings about importantchanges in the life of women and many mothers experience psychologicaldistress at this time. The objective of this study was to assessthe impact of social factors and living conditions on new mothers'psychological distress one year after childbirth. In particular,sociodemographic characteristics of the mother, job characteristics,quality of marital life, perinatal factors and the baby's healthwere considered. Methods: The study population were primiparousor secundiparous women who had a child in the main regionalpublic hospital of Valencia (Spain) and who had performed paidwork during pregnancy. Information was collected by means ofa questionnaire sent by post one year after childbirth. Forhundred and ninety-eight women were included in the data analysisafter excluding 30 women who revealed previous psychiatric history.The outcome variable (psychological distress of mothers oneyear after childbirth) was assessed using the 12 item versionof the General Health Questionnaire (GHQ-12). The explanatoryvariables were variables related to characteristics of maritallife, the baby's health, job conditions, perinatal conditionsand sociodemographic characteristics of the mother. Univariateand multivariate analyses were conducted. Results: The percentageof cases with a GHQ-12 score higher than 3 was 29.7. The probabilityof psychological distress of mothers one year after childbirthwas higher among those women who reported that the relationshipwith their partner was fair/poor/very poor (adjusted OR 5.2and 95% CI: 2.5–10.7), among those who argued with theirpartner over the shareout of domestic chores and childcare (adjustedOR 2.6 and 95% Cl: 1.6–4.2), among those whose child hadbeen sick over the past year (adjusted OR 1.9 and 95% CI: 1.1–3.5)and among those who had important financial problems (adjustedOR 2.2 and 95% CI: 1.3–3.7). No statistically significantassociation was found with factors related to perinatal conditionsand job conditions. Conclusions: The psychological distressof mothers during the first year of life of their child is relatedto quality of marital life, the child's health and the existenceof important financial problems.     

杭州市拱墅区中医药社区卫生服务满意度调查分析

目的 了解杭州市拱墅区中医药社区卫生服务满意度现状和影响因素.方法 采用随机抽样方法,确定1000名研究对象,采用自制问卷进行满意度调查.运用单因素分析、多因素分析方法对调查对象的中医药社区卫生服务满意度现状及影响因素进行分析.结果 杭州市拱墅区中医药社区卫生服务满意度为83.3%.X2检验结果显示,不同生活状况、体育锻炼情况、自身健康满意度、吸烟情况、中医药方法保健情况、中医药治疗次数和自评医疗技术水平的居民的医药社区卫生服务满意度之间差异均有统计学意义(P<0.05).多因素logistic回归分析结果显示,每天锻炼、不吸烟、总是进行中医药保健、中医药治疗次数大于等于5次、自评医疗技术水平很好、对中医药持正面看法的居民对中医药社区卫生服务满意度较高(均P<0.05).结论 杭州市拱墅区中医药社区卫生服务满意度较高,体育锻炼情况、吸烟情况、中医药方法保健情况、中医药治疗次数、自评医疗技术水平和对中医药的看法是中医药社区卫生服务满意度的重要影响因素.     

Quality of life and related factors: a questionnaire survey of older people living alone in Mainland China

Purpose

There is a growing population of older people living alone within the context of dramatic population ageing and changing living arrangements. However, little is known about the quality of life (QoL) of older people living alone in Mainland China. This study aimed to investigate QoL and its related factors among Chinese older people who live alone.

Methods

A stratified random cluster sample of 521 community-dwelling older people living alone in Shanghai completed a structured questionnaire through face-to-face interviews. QoL was measured using the Older People’s Quality of Life Questionnaire. Other data collected included self-rated health, physical health, cognitive function, depression, functional ability, loneliness, social support, physical activity, health services satisfaction, satisfaction with overall dwelling conditions and socio-demographic variables.

Results

Older people living alone in Mainland China rated social relationships and financial circumstances as sources of low satisfaction within their QoL. Multiway analysis of variance showed that satisfaction with overall dwelling conditions, self-rated health, functional ability, depression, economic level, social support, loneliness, previous occupation and health services satisfaction were independently related to QoL, accounting for 68.8 % of the variance. Depression and previous occupation had an interaction effect upon QoL.

Conclusions

This study identified nine factors influencing the QoL of older people living alone in Mainland China. Interventions to increase satisfaction with dwelling conditions, improve economic level, social support and functional ability, decrease loneliness and depression and improve health services satisfaction appear to be important for enhancing their QoL.     

应用母婴床旁护理模式的效果

目的:探讨母婴床旁护理模式对产妇及家属的影响,以指导产科护理工作。方法:将120对产妇分为实验组及对照组各60对,对照组按传统护理模式护理,而实验组实施母婴床旁护理模式(各项护理操作及健康教育由专科护士在床旁完成)。出院前统计两组产妇健康教育知识、护理技能掌握情况,调查产妇及家属对护理工作的满意度。结果:实验组产妇健康教育知识达标率及新生儿护理技能掌握情况均明显优于对照组,差异有统计学意义(p<0.05);实验组产妇及家属对护理工作满意度也明显高于对照组(P<0.05)。结论:采用母婴床旁护理模式可以提高护理工作满意度及护理工作质量,同时让产妇、家属掌握母婴保健知识与保健技能,提高了母婴生活质量。     

The relationship between health status, social support and satisfaction with medical care among patients with systemic lupus erythematosus.

OBJECTIVE: To examine the effect of physical and mental health status and social support on patient satisfaction with health care in patients with systemic lupus erythematosus (SLE). STUDY DESIGN: Using a cross-sectional design, 220 SLE patients were recruited from rheumatology departments in two hospitals in the Montreal (Canada) area. Data comprised physician-rated indices of health status and patient-completed questionnaires. MEASURES: Independent variables included demographics, disease duration, physician-rated indices of disease activity (SLAM-R) and disease damage (SLICC/ACR), patient self-reported health status (SF-36), and perceived social support (ISEL). Patient satisfaction with medical care (PSQ-IV) was the dependent variable. ANALYSES: Univariate analyses were performed to describe the sample and examine univariate associations between the independent variables and patient satisfaction with medical care. A hierarchical multiple linear regression analysis was computed to determine the relative importance of physician-rated indices of health status, self-reported physical and mental health status and social support on patient satisfaction after controlling for demographic variables. RESULTS: A multivariate hierarchical regression computed to predict patient satisfaction included the following variables in the equation: age, education, income (step 1), disease duration, SLAM-R, SLICC/ACR (step 2), mental and physical health status (step 3), and perceived social support (step 4). Less education (P< 0.01), better self-reported mental (P< 0.05) and physical health status (P< 0.005) and higher perceived social support (P< 0.005) were significant predictors of patient satisfaction (R2 = 0.15, P< 0.0001). CONCLUSION: The findings suggest that self-reported physical and mental health status and social support are more important than clinical status variables in understanding patient satisfaction with medical care.     

Alone but better off? Adult child migration and health of elderly parents in Moldova

Increasing labor migration and simultaneous aging of societies are two important demographic developments many poor countries face. Elderly people who are left behind may experience a decrease in welfare when their children migrate. This paper investigates the effect of migration on various dimensions of elderly health using unique data from Moldova, which has one of the highest emigration rates in the world. We find positive migration effects on body mass index (BMI), mobility and self-reported health. No effects are found on depression and cognitive capacity. We find evidence that these positive outcomes are linked to an income effect which leads to improvements in diet and identify a reallocation of time use from subsistence farming to leisure and sleep which may have further beneficial effects. These positive effects seem to compensate the elderly for decreasing social contact with their migrant family members.     

Gender differences in the relationship between housing, socioeconomic status, and self-reported health status

This study investigates gender differences in housing, socioeconomic status, and self-reported health status. The analysis focuses on the social and economic dimensions of housing, such as demand, control, material aspects (affordability, type of dwelling) and meaningful aspects (pride in dwelling, home as a refuge) of everyday life in the domestic environment. A random sample, cross-sectional telephone survey was administered in the city of Vancouver, Canada in June 1999 (n = 650). Survey items included measures of material and meaningful dimensions of housing, housing satisfaction, and standard measures of socioeconomic status and social support. The main outcome measure was self-reported health (excellent/very good/good vs. fair/poor). A three-stage analysis provides an overall picture of the sample characteristics for male and female respondents, detects significant relations between individual and housing characteristics and self-rated health status, and investigates male-female differences in the factors associated with fair/poor self-rated health. In multivariate analyses, a small number of socioeconomic dimensions of housing were associated with self-rated health status for women. For men, only one attribute of housing was associated with self-rated health: crowding was positively related to poor health, contradicting expectations and the findings for women. The self-reported strain of housework was unrelated to self-rated health for men, but strongly related to poor health for women. For men and women, satisfaction with social activities increased the likelihood of reporting better health. Future research should focus on the health effects of gendered differences in domestic and paid work, and on home and family roles and the interaction among gender, household crowding, and health.     

Are self-reports of health and morbidities in developing countries misleading? Evidence from India

Self-reported measures of poor health and morbidities from developing countries tend to be viewed with considerable skepticism. Examination of the social gradient in self-reported health and morbidity measures provides a useful test of the validity of self-reports of poor health and morbidities. The prevailing view, in part influenced by Amartya Sen, is that socially disadvantaged individuals will fail to perceive and report the presence of illness or health-deficits because an individual's assessment of their health is directly contingent on their social experience. In this study, we tested whether the association between self-reported poor health/morbidities and socioeconomic status (SES) in India follows the expected direction or not. Cross-sectional logistic regression analyses were carried out on a nationally representative population-based sample from the 1998 to 1999 Indian National Family Health Survey (INFHS); and 1995–1996 and 2004 Indian National Sample Survey (INSS). Four binary outcomes were analyzed: any self-reported morbidity; self-reported sickness in the last 15 days; self-reported sickness in the past year; and poor self-rated health. In separate adjusted models, individuals with no education reported higher levels of any self-reported, self-reported sickness in the last 15 days, self-reported sickness in the last year, and poor self-rated health compared to those with most education. Contrary to the prevailing thesis, we find that the use of self-rated ill-health has face validity as assessed via its relationship to SES. A less dismissive and pessimistic view of health data obtained through self-reports seems warranted.     

Quality of life of coal dust workers without pneumoconiosis in mainland China

The purpose of this cross-sectional study was to evaluate the quality of life (QOL) of coal dust workers without pneumoconiosis in mainland China. Three hundred five coal dust workers and 200 non-dust workers without pneumoconiosis from five coal mines in Shanxi province were enrolled in this study. The Chinese World Health Organization Quality of Life-brief version (WHOQOL-BREF) questionnaire was used. Socio-demographic, working, and health factors were also collected. Multiple stepwise regression analysis was used to identify significant factors related to the four domain scores of WHOQOL-BREF. All functional domains of the Chinese WHOQOL-BREF were significantly worse in coal dust workers compared to non-dust workers except for psychological health. For the physical domain of QOL, educational level, working hours, and work danger were the significant factors. In the psychological domain, types of job, welfare satisfaction, work danger, hobbies, smoking, one-child family, and marital status were the predictive factors. Working hours, welfare satisfaction, educational level, and birthplace were the predictive factors for the social domain of QOL. Finally, the predictors for the environmental domain of QOL were types of job, working hours, welfare satisfaction, work danger, self-reported social status, smoking, and drinking. Coal dust workers without pneumoconiosis had worse QOL than non-dust workers but their subjective feelings were positive. There were four distinct models for the various domains of QOL. Corresponding health policies could be developed to improve their QOL.     

Family effects on self-reported health among Russian wives and husbands.

Alcohol abuse and a transition to the market economy are often blamed for high mortality and low life expectancy in Russia, but little is known about proximate influences on individual health. This study estimates family influences on the self-reported health of Russian wives and husbands. Predicting gender differences in the determinants of health status, hypotheses are presented for the effects on spouses' self-reported health of five family characteristics: economic status, household division of labor, family decision-making, presence of young children, and housing conditions. Controls are included for age, education, sensitivity, alcohol use, job-related time, and urban-rural location. Data from a 1996 sample of couples (n = 925) from Moscow and two rural regions of Russia are analyzed using logistic regression. The findings provide mixed support for the hypotheses, though they do show the important role of family characteristics on spouses' health. Family economic standing is important to both spouses' self-reported health, though young children in the home is not. Family decision-making does influence spouses' health: when Russian wives are the primary decision makers in the family, their own health suffers, though their husbands' health is better. And support is found for the combined effects of job-related time and household labor but only for wives' health. When wife's household labor is low, the probability of her having poor health increases, the more time she devotes to her job. However, when she does substantially more domestic labor than her husband, her job-related time has the opposite effect, reducing the chances of poor health, the more time she spends on job activities. This study is important both in helping to account for poor health of Russians during the current economic and social transition and in identifying aspects of family life that affect men's and women's health cross-nationally.     

First-time parents' prenatal to postpartum changes in health,and the relation of postpartum health to work and partner characteristics

BACKGROUND: The purpose of this study was to evaluate prenatal to postnatal changes in first-time parents' physical and mental health, and to describe social and health predictors of parents' postpartum health. METHODS: This prospective study surveyed 261 expectant fathers and mothers during pregnancy and again at 6 months' postpartum regarding their health, partner, and work characteristics. Postpartum changes in health were evaluated by paired t tests, and predictors of postpartum health were determined using multiple regression analyses. RESULTS: Both fathers and mothers experienced significant postpartum declines in perceived quality of life. In addition, fathers reported an increase in the number of days ill and a decrease in general health and vitality after childbirth. Mothers perceived an increase in vitality despite their diminishing sleep. Parents' postpartum health was associated with mothers' partner satisfaction, fewer illness days, and certain work characteristics, such as total work time and the balance of work between mothers and fathers. CONCLUSIONS: Both mothers and fathers experienced declines in health that persisted at least 6 months after the birth of their first child. Notably, postpartum health was associated with partner satisfaction and work characteristics. This information might be used to develop interventions for improving parents' health during this vulnerable time.     

幼儿教师生存质量和安全感的劳工因素分析

目的探讨劳动合同关系和工作强度对幼儿教师生存质量满意度、安全感的影响,为维护幼儿教师的心理健康提供参考。方法采用世界卫生组织生存质量测定量表简表和安全感量表,通过分层整群抽样,对河北省11所幼儿园437名教师进行调查分析。结果正式工的心理状况、社会关系、生存质量满意度显著高于临时工,低工作强度幼儿教师社会关系满意度显著高于其他工作强度的教师。劳动合同关系和工作强度对环境状况满意度的影响存在交互作用:工作强度低和较低的正式工环境状况满意度高于临时工,工作强度较高和高的临时工环境状况满意度高于正式工。正式工安全感的确定控制感因子得分显著高于临时工,低工作强度教师安全感总分显著高于较高工作强度教师。结论劳动合同关系影响幼儿教师的心理状况、社会关系、满意度和确定控制感,工作强度影响幼儿教师对社会关系的满意度和安全感。劳动合同关系和工作强度对环境状况满意度表现出交互作用。     

Sources of social support as predictors of health, psychological well-being and life satisfaction among Dutch male and female dual-earners

We examined whether gender differences in health, psychological well-being, and life satisfaction, can be explained by effects of work-related and nonwork-related sources of social support. The sample consisted of 459 men and women from dual earner families. Men report better health and psychological well-being than women, whereas women report higher life satisfaction than men. Contrary to our expectations, women receive more social support from colleagues than men, while men and women equally receive support from their supervisor. As for the nonwork-related sources of social support, men receive more social support from their spouse, while women receive more social support from relatives and friends. No gender differences exist in the effects of social support. Although men and women differ with respect to the social support they receive from different sources, these differences cannot explain gender differences in health, psychological well-being and life satisfaction.     

Soziale Lebenssituation und Gesundheit von M��ttern in Deutschland

This paper reports findings from a population sample of mothers with underage children living in Germany (n=3,129). The objective of the study was to analyze whether social and familiar living conditions are associated with enhanced health risks for mothers. The sample is representative with respect to German federal states, school education, marital status, age of mothers, and number of children. Health problems were assessed in terms of physical disabilities and discomforts, anxiety and depression, and self-rated health. About 27% of mothers perceived physical disabilities and discomfort, 21% reported high levels of anxiety, and 22% high levels of depression. About 6% assessed their health as poor or very poor. Particularly single motherhood, unemployment, sole responsibility for household and family as well as low income and low school education increased the risk of poor health. The findings suggest that for specific subgroups of mothers parenting may be a vulnerable phase of life reflecting the need for a life stage orientation in health inequality research.     

Cut-off point for WHOQOL-bref as a measure of quality of life of older adults

OBJECTIVE

To propose a cut-off for the World Health Organization Quality of Life-Bref (WHOQOL-bref) as a predictor of quality of life in older adults.

METHODS

Cross-sectional study with 391 older adults registered in the Northwest Health District in Belo Horizonte, MG, Southeastern Brazil, between October 8, 2010 and May 23, 2011. The older adults’ quality of life was measured using the WHOQOL-bref. The analysis was rationalized by outlining two extreme and simultaneous groups according to perceived quality of life and satisfaction with health (quality of life good/satisfactory – good or very good self-reported quality of life and being satisfied or very satisfied with health – G5; and poor/very poor quality of life – poor or very poor self-reported quality of life and feeling dissatisfied or very dissatisfied with health – G6). A Receiver-Operating Characteristic curve (ROC) was created to assess the diagnostic ability of different cut-off points of the WHOQOL-bref.

RESULTS

ROC curve analysis indicated a critical value 60 as the optimal cut-off point for assessing perceived quality of life and satisfaction with health. The area under the curve was 0.758, with a sensitivity of 76.8% and specificity of 63.8% for a cut-off of ≥ 60 for overall quality of life (G5) and sensitivity 95.0% and specificity of 54.4% for a cut-off of < 60 for overall quality of life (G6).

CONCLUSIONS

Diagnostic interpretation of the ROC curve revealed that cut-off < 60 for overall quality of life obtained excellent sensitivity and negative predictive value for tracking older adults with probable worse quality of life and dissatisfied with health.     

邯郸市社区卫生服务满意度调查及其影响因素

目的了解邯郸市社区居民的健康状况以及其在就医方面的切实困难和需求。方法查阅相关资料,并进行问卷调查,采用研究者自行设计的社区卫生服务满意度调查表,调查社区居民和前来社区卫生服务机构就诊的患者,并分析其影响因素。结果居民、患者对社区卫生服务的就医方便性满意度最高(75.7%),其次是服务态度(59.7%);而最不满意的是服务质量(43.8%),其次是设备配置(38.9%)。结论邯郸市实施社区卫生服务取得了一定的社会效益和经济效益,同时也存在一些弊端,建议政府给予适当的经费保障,提高医疗队伍整体素质,以利于社区卫生服务的可持续性发展。