Relationships between felt age and perceived disability, satisfaction with recovery, self-efficacy beliefs and coping strategies

Subjective age is related to health and to life satisfaction, and adaptation to stressful life events is associated with self-efficacy beliefs and coping. The present study on cancer survivors addressed two objectives: the relationship between felt age and perceived disability and satisfaction with recovery, and the feeding back of felt age on general self-efficacy beliefs and coping strategies. Data were collected one and six months after surgery. Individuals with younger age identities reported lower levels of perceived disability and avoidance-oriented coping and higher levels of satisfaction with recovery, self-efficacy and meaning-focused coping than individuals with older age identities. Individuals with decreased or stable felt age indicated increased meaning-focused coping or avoidance-oriented coping, respectively. Explanations for these associations are discussed.     

The paradox of health

Although the collective health of the nation has improved dramatically in the past 30 years, surveys reveal declining satisfaction with personal health during the same period. Increasingly, respondents report greater numbers of disturbing somatic symptoms, more disability, and more feelings of general illness. Four factors contribute to the discrepancy between the objective and subjective states of health. First, advances in medical care have lowered the mortality rate of acute infectious diseases, resulting in a comparatively increased prevalence of chronic and degenerative disorders. Second, society's heightened consciousness of health has led to greater self-scrutiny and an amplified awareness of bodily symptoms and feelings of illness. Third, the widespread commercialization of health and the increasing focus on health issues in the media have created a climate of apprehension, insecurity, and alarm about disease. Finally, the progressive medicalization of daily life has brought unrealistic expectations of cure that make untreatable infirmities and unavoidable ailments seem even worse. Physicians should become more aware of these paradoxical consequences of medical progress so that they do not inadvertently contribute to a rising public dissatisfaction with medicine and medical care.     

God's will,God's punishment,or God's limitations? Religious coping strategies reported by young adults living with serious mental illness

Qualitative research has demonstrated that religious meaning-making coping, defined as attributions of a stressful life event that involve the sacred, is particularly relevant to persons with serious mental illness. However, recent research advances in the study of religious coping have yet to be employed in clinical samples. This longitudinal study examines religious meaning-making coping in a sample of 48 young adults diagnosed with schizophrenia or bipolar disorder over a one-year period. Young adults with mental illness generally reported using religious meaning-making coping in levels comparable to nonpsychiatric samples. Reports of benevolent religious reappraisals were associated with perceptions of positive mental health, whereas punishing God reappraisals and reappraisals of God's power were associated with self-reported distress and personal loss. Religious coping variables accounted for variation in adults' reports of psychiatric symptoms and personal loss one year later over and above demographic and global religious variables. Implications of findings for clinical practice are discussed.     

老人主观幸福感的社会性因素

目的：在于探讨香港高龄老人主观幸福感的社会性因素。方法：受访者（Ｎ＝５５４）均龄为７７０岁,教育水平偏低,曾受小学或以上教育的不超过１７％。男性占总样本量的４８％。资料的收集过程以个别面谈和问卷的方式进行,并以自评的生活满足感、抑郁症状、以及身体健康作为主观幸福感的指标,采用多元回归分析。结果：自评身体健康状况与人口特征（性别、教育）有较显著的关系。相对的,生活满足感以及抑郁症状则与社会网络,尤其是家庭网络和互依关系有更显著的相关。研究结果的讨论与西方学者的发现作了比较     

Consequences of anxiety in older persons: its effect on disability, well-being and use of health services.

BACKGROUND: Although anxiety is quite prevalent in late life, its impact on disability, well-being, and health care utilization of older persons has not been studied. Older persons are a highly relevant age group for studying the consequences of anxiety, since their increasing numbers put an extra strain on already limited health care resources. METHODS: Data of a large community-based random probability sample (N = 659) of older subjects (55-85 year) in the Netherlands were used to select three groups: subjects with a diagnosed anxiety disorder, subjects with merely anxiety symptoms and a reference group without anxiety. These groups were compared with regard to their functioning, subjective well-being, and use of health care services, while controlling for potentially confounding variables. RESULTS: Anxiety was associated with increased disability and diminished well-being. Older persons with a diagnosed anxiety disorder were equally affected in their functioning as those with merely anxiety symptoms. Although use of health services was increased in anxiety sufferers, their use of appropriate care was generally low. CONCLUSIONS: Anxiety has a clear negative impact on the functioning and well-being of older subjects. The similarity of participants with an anxiety disorder and those having merely anxiety symptoms regarding quality of life variables and health care use was quite striking. Finally, in spite of its grave consequences for the quality of life, appropriate care for anxiety is seldom received. Efforts to improve recognition, disseminate effective treatments in primary care, and referring to specialized care may have positive effects on the management of anxiety in late life.     

Quality of life in first-admitted schizophrenia patients: a follow-up study

BACKGROUND: While most studies of quality of life (QoL) in schizophrenia have investigated long-term patients, relatively little is known about QoL early in the illness and how it changes over time. This study was conducted to investigate objective and subjective quality of life in first-admitted schizophrenia patients as compared to patients with long-term schizophrenia, changes between first admission and 9-month follow-up and predictors of changes. METHOD: Eighty-six patients were examined after first admission and 51 were re-interviewed at follow-up. Results were compared with samples of in-patients and out-patients with long-term schizophrenia. QoL was assessed using a German version of the Lancashire Quality of Life Profile. RESULTS: Although some objective QoL data were more favourable in first-admitted patients, subjective QoL was lower than in each of the other two groups, even when psychopathology and age were controlled for. On a group level, patients showed a slight improvement in subjective QoL, which was not statistically significant. Individual changes over time were not predicted by initial data, but were correlated with changes in anxiety/depression. CONCLUSION: Subjective QoL appears to be lower in first-admitted schizophrenics than in groups with long-term illness and, on a group level, it changes little within 9 months. On an individual level, changes in depressive symptoms need to be considered when interpreting changes in satisfaction with life.     

Self-attention, life stress, and illness: a prospective study

Using a prospective design, this study examined the hypothesis that a predisposition to focus on internal aspects of the self serves as a stress resistance resource. One hundred and twenty subjects filled out the Private Self-Consciousness inventory, a schedule of recent life events and a symptom checklist. Two months later they were asked again to report life events and symptoms that had occurred in the interval. Data were analyzed by means of hierarchical panel analysis. The results showed, consistent with the hypothesis, that incidence of stressful life events predicted subsequent illness among persons low in private self-consciousness but not in persons high in private self-consciousness. It is proposed that the tendency on the part of persons low in private self-consciousness to disattend to their psychologic and somatic reactions to stressful life events and to fail to take corrective actions may lead to lowered body resistance over time and hence increase their susceptibility to physical illness. The results are interpreted as consistent with Schwartz's concept of disregulation and control systems analysis of health behavior and Leventhal's work on the role of internal monitoring for coping with stress.     

Definite involuntary childlessness: associations between coping, social support and psychological distress

BACKGROUND: Around 4% of all couples remain involuntarily childless. These people often experience insufficient social support, which further aggravates the distress symptoms such as physical health problems, anxiety, depression and complicated grief. This study investigates the association of coping style and the degree of satisfaction regarding social support from primary support groups with distress symptoms of involuntarily childless individuals. MATERIALS AND METHODS: Subjects in this cross-sectional study were people who wanted to have children with their partner but were unable to conceive and had acknowledged their involuntary childlessness. The sample consisted of 116 persons (response 88%) with an average age of 39 years (SD = 6.0), with 75% women. The sample group completed a questionnaire consisting of passive and active coping styles from the Utrecht Coping List (UCL), the discrepancy variant of the Social Support List (SSL-D), the short version of the Questionnaire on Experienced Health Complaints (VOEG-21), the Hospital Anxiety and Depression Scale (HADS) and the Inventory of Complicated Grief-Revised (ICG-R), adapted for this study. RESULTS: Women especially experienced more health complaints, more anxiety and depression symptoms and more complicated grief than the general population. Regression analysis shows that when controlled for sex and the duration of involuntary childlessness, the concepts passive coping style and dissatisfaction with social support were positively associated with health complaints, depression, anxiety and complicated grief. The concept active coping style was negatively associated with depression, anxiety and complicated grief. Explained variance of the different distress symptoms varied from 30 to 65%. A moderating association of perceived social support is only found between a passive coping style and health complaints. CONCLUSIONS: Psychosocial interventions should be continued after the childlessness has become definite. By teaching couples how to cope actively with their childlessness and how to ask for support, the negative consequences of their childlessness may be decreased.     

Quality of life and patients' satisfaction in chronic urticaria and respiratory allergy

BACKGROUND: Few articles are available about chronic urticaria (CU) impact on patients' quality of life (QoL). The aim of our study was to evaluate QoL in CU patients both focusing on health status and subjective satisfaction. We adopted two generic tools: SF-36 (an health status questionnaire) and SAT-P (a satisfaction profile). METHODS: Twenty-one untreated patients (five males, 16 females; aged 46.3 +/- 12.4) affected by CU, were enrolled. SF-36 and SAT-P scores of CU patients were compared with scores of a group of 27 patients with respiratory allergy. Published reference values of 608 and 241 Italian healthy subjects were used as controls, respectively, for SF-36 and SAT-P. RESULTS: Patients with CU compared with allergic patients referred significantly lower scores in physical functioning (P = 0.046), role physical (P = 0.01), bodily pain (P = 0.0001), general health (P = 0.0043) and role emotional (P = 0.04), and compared with reference sample reported lower scores in all SF-36 domains (P < 0.0001). SAT-P scores of CU patients compared with patients with respiratory allergy and with reference sample were significantly lower in many aspects of daily life. CONCLUSIONS: These results show a significant impact on health status and on subjective satisfaction in patients with CU: the symptoms affect everyday life, limiting and impairing physical and emotional functioning, and acts as an indirect burden on life satisfaction.     

Provider and patient perspectives regarding health care for war-related health concerns

OBJECTIVE: To gain insight about Department of Defense providers' and health care beneficiaries' opinions regarding provider-patient communication of health care for post-deployment health concerns. METHODS: Thirty-five Department of Defense primary care providers and 14 military beneficiaries participated in focus groups at five military medical treatment facilities. We audiotaped, transcribed, and qualitatively analyzed semi-structured focus group interviews to determine attitudes and beliefs about war-related health concerns, symptoms, and health care quality. RESULTS: Focus groups revealed important insights about provider and patient perspectives of communication and care in four general areas: physician-patient trust, validity of symptoms and concerns, exchange of health information, and barriers to care. CONCLUSION: Provider-patient communication contributes to patient satisfaction with medical care; poor communication may contribute to decreased patient satisfaction and provider effectiveness. The military health care system poses several challenges to provider-patient communication: the dual nature of the provider's role, the occupational relationship between illness and health care, pre- and post-deployment issues, and continuity of care impact patient and provider perspectives. The prevalence of various beneficiary and provider concerns regarding health care communication requires further study, particularly for the severely wounded. PRACTICE IMPLICATIONS: The quality of information exchanged and of the interpersonal relationship impact medical decision making, particularly in occupational health settings such as the military. Attention to these issues may improve patient outcomes including satisfaction, adherence, trust, health status, and quality of life.     

Quality of life in individuals with serious mental illness and type 2 diabetes

Diabetes is a pervasive metabolic disease that disproportionately affects persons with serious mental illness. The authors studied the effect of diabetes on quality of life in a sample of 369 adult outpatients with schizophrenia or major mood disorder, 201 of whom had type 2 diabetes. Patients with diabetes reported greater impairment in both physical and mental-health quality of life than those without diabetes. The diabetes patients also reported less satisfaction with health but not with other life domains. Medical providers need to be attentive to the burden of disease experienced by patients with both serious mental illness and diabetes.     

Prevalence and burden of illness for asthma and related symptoms among kindergartners in Chicago public schools.

BACKGROUND: Asthma mortality rates in poor communities of Chicago are among the highest in the country. Possible explanations include increased asthma prevalence, increased severity, and suboptimal health care. OBJECTIVE: To estimate the prevalence of asthma and asthma-related symptoms among inner-city kindergarten children, and to characterize their burden of illness, asthma-related health care access, and pharmacologic treatment. METHODS: Cross-sectional survey of parents of kindergartners was conducted in 11 randomly selected Chicago elementary schools. A self-administered 16-item questionnaire was given to parents of kindergartners. Parents who reported doctor-diagnosed asthma or at least one of several key asthma-related symptoms were then interviewed with a supplemental questionnaire examining asthma-related health care and medication use. RESULTS: Based on data from 638 children [mean age 5.7 (SD = 0.6) years], the prevalence of diagnosed asthma was 10.8%. Sixteen percent of the respondents reported that their child had wheezed in the past year. The prevalence of asthma-related symptoms unassociated with a diagnosis of asthma was 30.1%. The children with diagnosed asthma had evidence of a high burden of illness: over 40% were reported to have had sleep disturbance due to wheezing > or =1 to 2 nights/week and 86.6% reported acute care visits for respiratory symptoms in the past year. Self-reported access to medical care was high. Over 40% of the children with doctor diagnosed asthma were reported to have used a beta2-agonist in the preceding 2 weeks, and 12.2% used an inhaled anti-inflammatory. CONCLUSIONS: These data suggest that asthma prevalence in school-aged children in inner-city communities may be higher than US estimates. The burden of illness experienced by these children is substantial. Also, a large proportion of children were reported to have respiratory symptoms consistent with asthma, and no asthma diagnosis, suggesting possible undiagnosed asthma. While measures of health care access appear to indicate that the majority of children with asthma experience no identified barriers to health care, there is evidence to suggest undertreatment.     

Adjustment of children and their mothers with breast cancer

OBJECTIVE: To examine the adjustment of children of mothers with both active and nonactive breast cancers in comparison with a healthy community control sample. METHODS: Participants included 80 mothers and their children. Half of the mothers had breast cancer or a history of breast cancer. Children in both groups ranged in age from 8 to 19 years. Assessments included measures of maternal stressors and resources, maternal and child adjustment and posttraumatic stress, and maternal coping and illness uncertainty reported by both mothers and their children. RESULTS: Few differences were found between the groups, although there was a trend for girls of mothers with breast cancer to have a higher frequency of depressive symptoms. Children of mothers who perceived support from friends and family had fewer depressive symptoms, after we controlled for child gender. CONCLUSIONS: The social support perceived by mothers with breast cancer may serve as a protective factor for their children's psychological adjustment.     

Life dissatisfaction and subsequent work disability in an 11-year follow-up

BACKGROUND: Mental disorders are associated with disability, but the long-term effects of low subjective well-being on work ability in general population are not known. In this study we investigated whether self-reported life dissatisfaction predicts work disability. METHOD: A nationwide sample of Finnish twins aged 18-54 years (N = 22,136), unselected for health status responded to a health questionnaire with a four-item life satisfaction scale (range 4-20) covering interest, happiness, easiness and loneliness of life in 1975 and 1981. Cox regression for all subjects and conditional logistic regression for discordant twin pairs were used to compare the risk of subsequent work disability (N = 1200) (Nationwide Disability Register) between the dissatisfied and satisfied. RESULTS: Life dissatisfaction predicted subsequent (1977-87) work disability pension due to psychiatric and non-psychiatric causes among the healthy at baseline, and that due to psychiatric causes among the ill. After controlling for age, marital status, social class and health behaviour, these risks remained significant. Repeatedly reported (1975 and 1981) life dissatisfaction was strongly associated with increased (age-adjusted) risk of subsequent (1982-87) work disability due to psychiatric and also that due to non-psychiatric causes among the healthy. When twin pairs discordant for end-point disability status were analysed, risk differences related to life satisfaction were only slightly decreased, but they did not differ significantly between monozygotic and dizygotic pairs. CONCLUSION: Life dissatisfaction predicts subsequent work disability especially among the healthy.     

慢性乙肝和肝硬变病人的心理健康状况调查

慢性乙型肝炎是临床上一种常见而多发的疾病 ,它具有传染性强 ,慢性病程 ,预后较差的特点 ,病人可能发展为肝硬变、肝癌、肝衰竭等危及生命的疾病。在我国肝硬变的主要病因是慢性乙肝。对慢性肝病的研究多从生物医学角度来探讨 ,从心理社会角度的研究甚少 ,尤其关于在乙肝转变为肝硬化的过程中心理因素是否起一定作用。为了了解慢性乙肝和肝硬变病人的心理问题 ,我们对住院慢性乙肝和乙型肝炎肝硬变病人各 30例进行了问卷式心理调查 ,并观察其心理问题与病人个性、应对方式等因素的关系 ,以期对慢性肝病临床工作中的心理治疗提供指导依据。1…     

Subjective life satisfaction and objective functional outcome in bipolar and unipolar mood disorders: a longitudinal analysis

BACKGROUND: Quality of life (QOL) has gained increasing attention as an important yet underappreciated component of functional outcome in mood disorders. In particular, the relationship between subjective life satisfaction and objective measures of psychosocial adjustment has not been well-studied. The goal of the present study was to examine the longitudinal associations between subjective life satisfaction and objective functional outcome among individuals with bipolar and unipolar mood disorders. METHOD: One hundred fifty-seven mood disordered subjects were assessed at index hospitalization for bipolar mania (n=35), unipolar psychotic depression (n=27), or unipolar nonpsychotic depression (n=95). All were prospectively followed up three times, at approximately 2, 4.5 and 7-8 years. Global outcome, work performance, social adjustment, recurrent depressive episodes, and dimensions of life satisfaction were assessed by semi-structured interviews using standardized ratings. RESULTS: Subjective life satisfaction strongly paralleled global functioning, work performance and social adjustment at each follow-up for patients with unipolar nonpsychotic depression, but not bipolar disorder or unipolar psychotic depression. Depressive symptoms and objective functional impairment contributed to poor QOL in most domains, independent of illness chronicity, medication use, or affective disorder subtype. LIMITATIONS: Findings might have differed had a different QOL measure been used, although the present measure showed concurrent validity with a previously used instrument. Sample sizes for the bipolar and psychotic depression groups were sufficient to detect moderate, but not small, correlations between objective functioning and subjective QOL. CONCLUSIONS: Recurrent depression remains a substantial contributor to poor life satisfaction across affective disorder subtypes. Subjective QOL in bipolar and unipolar psychotic depression patients may not accurately reflect objective functional outcome status, potentially due to diminished insight, demoralization, or altered life expectations over time.     

青少年家庭教养方式、应对方式对主观幸福感的影响

目的:探讨青少年家庭教养方式、应对方式对主观幸福感的影响。方法:采用父母教养方式评价量表、总体幸福感量表、简易应对方式问卷对沧州市400名青少年进行问卷调查。结果:1青少年主观幸福感得分79.77分,其中男生的主观幸福感总分为80.97分,女生的主观幸福感总分为78.24分,均显著高于全国常模(75,71,P0.05);2男生在对生活的满足和兴趣、精力、对感情和行为的控制的3个维度以及幸福感总分上显著高于女生(t=2.345,2.251,2.989,2.191;P0.05);3家庭教养方式和应对方式是影响主观幸福感的重要因素;青少年的积极应对方式与主观幸福感的5个维度有显著的相关(r=0.288,-0.137,0.290,0.241,0.113;P0.05),消极应对方式与主观幸福感的4个维度也呈显著相关(r=-0.052,0.102,-0.143,-0.158;P0.05)。家庭教养方式中拒绝、过度保护维度与主观幸福感的4个维度存在显著负相关(r=-0.279,-0.157,-0.218,-0.178;P0.05),情感温暖与其则存在显著正相关(r=0.312,0.194,0.252,0.185;P0.05);4父亲拒绝、母亲过度保护、积极应对和消极应对4个因子对主观幸福感有显著预测作用。结论:1青少年的主观幸福感处于中等偏上水平,男生的主观幸福感显著高于女生;2总体来说,青少年中男生在对生活的满足和兴趣、精力与对感情和行为的控制3个维度上的幸福感高于女生;3家庭教养方式与应对方式是影响青少年主观幸福感的重要因素,它们对主观幸福感具有良好的预测作用。     

消化系统疾病患者生活满意度状况调查探究

目的 探讨消化系统疾病患者生活状况和生活满意度水平与疾病的相关性.方法 对130例消化系统疾病患者及98例正常人做基本问卷调查和生活满意度测量.结果 显示患病组的受困率显著高于对照组(χ2=7.52,P<0.05),患病组的总体生活满意度水平显著低于对照组(t=2.3486,P<0.05),在不同年龄组中,2组的生活满...     

城市居民生活满意感与心理健康的相关研究

目的探讨生活满意感对心理健康的影响。方法对286名宁波市民,采用自编的生活满意感量表、SCL-90症状自评量表进行问卷调查。结果①在不同群体总体生活满意感的比较中,不同职业状况、个人月收入、家庭月收入的群体闻存在极显著的差异,而不同性别、年龄、教育程度、婚姻状况的群体闻没有显著差异。②城市居民的总体满意感处在一般和较满意之间,在3个生活满意度因子中．满意度最高的是人际关系和健康状况因子。③社会物质生活条件和社会地位因子与SCL-90大部分因子的相关达到显著水平。④生活满意感水平高、低两组被试在SCL-90的绝大部分因子上的差异达到显著水平。结论个体的主观满意感水平能够影响个体的心理健康感。     

Stress and coping styles in guangzhou families with hepatitis B virus children

This study was conducted in Guangzhou, China. The study compared the stress coping styles of three groups of parents: (1) parents of children who are carriers of the hepatitis B virus (HBV) who attend a special health kindergarten; (2) parents of children with HBV who stay at home; and (3) parents of healthy children attending ordinary kindergarten. Parents of HBV children who stayed at home reported greater problems due to stress. The groups did not differ in reports of stress arising from life events other than their child's illness and the fact that their HBV-carrying children were prohibited from the kindergarten. Content analyses of the mothers' reported styles revealed five patterns of coping styles, which are explained with reference to the Chinese cultural context.