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Mossman B, Perry LM, Voss HM, Maciejewski PK, Gramling R, Duberstein P, Prigerson HG, Epstein RM, Hoerger M. Patient-Caregiver Dyads & End-of-Life Care: Caregiver Personality Disrupts Gender-Based Norms. J Pain Symptom Manage 2024; 67:e393-e398. [PMID: 38278189 PMCID: PMC11032258 DOI: 10.1016/j.jpainsymman.2024.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/28/2024]
Abstract
CONTEXT Gender and personality may individually impact end-of-life care. Men often receive more aggressive treatments than women near death, and personality - particularly openness - may be associated with increased care utilization when it diverges from traditional treatment norms. However, research has not examined the interaction of these variables in a dyadic context. OBJECTIVES This study examined the dyadic effects of patient gender and caregiver personality on end-of-life care. METHODS Using data from the VOICE randomized clinical trial, the present sample consisted of patient-caregiver dyads receiving outpatient care for advanced cancer in Sacramento and Western New York. Analyses assessed whether caregiver personality was associated with gender-based differences in patient chemotherapy or emergency department/inpatient visits in the 30 days before death. Logistic regression examined the interaction between caregivers' Big Five personality dimensions and patient gender while accounting for patient and caregiver demographic and health characteristics. RESULTS Of a total of 134 patient-caregiver dyads, 19.4% (n = 26) of patients received chemotherapy and 47.8% (n = 64) had an emergency department/inpatient visit in the 30 days before death. Results demonstrated a significant interaction between caregiver openness and patient gender on receipt of chemotherapy (odds ratio = 0.07, p = 0.006). When caregivers were less open, men were more likely to receive chemotherapy near death, whereas when caregivers were more open, women were more likely to receive chemotherapy near death. CONCLUSION Results suggest caregiver personality characteristics, particularly openness, might disrupt gender-based treatment norms at end-of-life. Findings demonstrate that patient and caregiver factors can interact to explain patient healthcare utilization.
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Affiliation(s)
- Brenna Mossman
- Department of Psychology (B.M., H.M.V., M.H.), Tulane University, New Orleans, LA, USA
| | - Laura M Perry
- Department of Medical Social Sciences (L.M.P.), Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Medicine (L.M.P.), Tulane University School of Medicine, New Orleans, LA, USA
| | - Hallie M Voss
- Department of Psychology (B.M., H.M.V., M.H.), Tulane University, New Orleans, LA, USA
| | - Paul K Maciejewski
- Cornell Center for Research on End-of-Life Care (P.K.M., H.G.P.), Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Robert Gramling
- Department of Family Medicine (R.G.), University of Vermont, Burlington, VT, USA
| | - Paul Duberstein
- Department of Health Behavior (P.D.), Society, and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Holly G Prigerson
- Cornell Center for Research on End-of-Life Care (P.K.M., H.G.P.), Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Ronald M Epstein
- Departments of Family Medicine (R.M.E.), Medicine and Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael Hoerger
- Department of Psychology (B.M., H.M.V., M.H.), Tulane University, New Orleans, LA, USA; Departments of Psychiatry and Medicine (M.H.), Tulane Cancer Center, and Freeman School of Business, Tulane University, New Orleans, LA, USA.
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Bethell J, Andrew MK, Hothi S, Mick P, Morgan D, O'Connell ME, Phillips NA, Stewart S, Walker JD, Wittich W, McGilton KS. Does social connection mediate the association between neuroticism and cognition? Cross-sectional analysis of the Canadian Longitudinal Study on Aging. Aging Ment Health 2024; 28:482-490. [PMID: 37667914 DOI: 10.1080/13607863.2023.2252369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/18/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVES This study tested the association between neuroticism and six cognitive measures, and examined the potential mediating roles of social connection (social isolation and loneliness) among middle-aged and older adults. METHODS This cross-sectional study was a secondary analysis of the Canadian Longitudinal Study on Aging (CLSA) Comprehensive Cohort, a sample of Canadians aged 45-85 years at baseline. Respondents with data collected at the first follow-up, between 2015 and 2018, were included (n = 27,765). Structural equation modelling was used to assess the association between neuroticism and six cognitive measures (Rey Auditory Verbal Learning Test immediate recall and delayed recall, Animal Fluency Test, Mental Alternation Test, Controlled Oral Word Association Test and Stroop Test interference ratio), with direct and indirect effects (through social isolation and loneliness). All analyses were stratified by sex, including females (n = 14,133) and males (n = 13,632). RESULTS In unadjusted models, there was evidence of associations between neuroticism and all cognitive measures, except the Stroop Test interference ratio, suggesting higher neuroticism was associated with lower scores on memory and executive function tests. In the models of these other five outcomes, there was consistent evidence of indirect effects (through social isolation and loneliness) and, in some cases, direct effects. The results are discussed in context with limitations, including the use of cross-sectional design and alternative hypotheses to explain the association between personality and cognition. CONCLUSION Among middle-aged and older adults, for both males and females, the findings suggest that the association between neuroticism and cognitive outcomes may be mediated by aspects of social connection.
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Affiliation(s)
- Jennifer Bethell
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Melissa K Andrew
- Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, Canada
| | - Sobhneek Hothi
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Department of Health Studies, University College, University of Toronto, Toronto, Canada
| | - Paul Mick
- Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Debra Morgan
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
| | - Natalie A Phillips
- Department of Psychology, Centre for Research in Human Development, Concordia University, Montreal, Canada
| | - Steven Stewart
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Jennifer D Walker
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Walter Wittich
- School of Optometry, Université de Montréal, Montreal, Canada
| | - Katherine S McGilton
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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Atherton OE, Willroth EC, Weston SJ, Mroczek DK, Graham EK. Longitudinal associations among the Big Five personality traits and healthcare utilization in the U.S. Soc Sci Med 2024; 340:116494. [PMID: 38101170 PMCID: PMC11065195 DOI: 10.1016/j.socscimed.2023.116494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE One critical component of individual and public health is healthcare utilization, or the extent to which individuals have routine check-ups, schedule treatments, or use emergency services. However, we know little about who uses healthcare services and what types, the conditions that exacerbate utilization, or the factors that explain why people seek out services. The present study fills these gaps in the literature by investigating the role of personality factors in predicting various forms of healthcare utilization, how these associations vary by age, socioeconomic resources, and chronic conditions, as well as one potential psychological mediating mechanism (i.e., sense of control). METHODS We use data from a large longitudinal sample of Americans (N = 7108), with three assessments spanning 20 years. Participants reported on their Big Five personality traits using the Midlife Development Inventory, healthcare utilization across three domains (routine visits, scheduled treatment, urgent care), age, income, insurance, chronic conditions, and sense of control. RESULTS Multilevel models showed that people who were more agreeable and neurotic tended to use more healthcare services. Moreover, on occasions when people were more extraverted and open, they tended to use more healthcare services. There were several nuances in personality-healthcare utilization associations depending on the type of healthcare service, age, and socioeconomic resources. Longitudinal mediation analyses demonstrated sense of control as one mechanism linking personality traits to healthcare utilization in the U.S. CONCLUSIONS We discuss the theoretical and practical implications of interactions between individuals and structural systems for promoting the health of aging U.S. Americans.
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Affiliation(s)
- Olivia E Atherton
- Department of Psychology, University of Houston, Houston, TX, USA; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - Emily C Willroth
- Department of Psychological and Brain Sciences, Washington University in St. Louis, MO, USA
| | - Sara J Weston
- Department of Psychology, University of Oregon, Eugene, OR, USA
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Psychology, Northwestern University, Chicago, IL, USA
| | - Eileen K Graham
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Delle Fave A, Wissing MP, Brdar I. Beyond polarization towards dynamic balance: harmony as the core of mental health. Front Psychol 2023; 14:1177657. [PMID: 37771812 PMCID: PMC10525342 DOI: 10.3389/fpsyg.2023.1177657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
Worldviews are culturally derived assumptions that influence individual and collective behaviors, values, and representations of reality. The study of mental functions is not exempt from this influence, as reflected in scientific theories, methodological approaches, and empirical studies. Despite acknowledging the interplay of mental processes with developmental, environmental, and cultural dimensions, psychological research is still primarily based on quantitative methods, and on the conceptualization of mental phenomena as unfolding along polarized continua. A lively epistemological debate surrounds this approach, especially underscoring the risk of blurring the distinction between constructs derived from statistical models and real-life processes and experiences. Based on this debate and on recent empirical evidence derived from the positive psychology literature, this paper is aimed at proposing an integrated view of mental health, as a holistically patterned, contextually imbedded, and dynamic phenomenon changing over time and across life events, with harmony, harmonization and dynamic balance as core qualities. The heuristic potential of investigating the qualitative configuration patterns of mental health dimensions across individuals and groups, beyond their position along a quantitative continuum, is outlined. The development of more integrated approaches and methodologies to investigate mental health as a harmonization process, taking into account personal, contextual and developmental features, would be aligned with evidence derived from the integration of traditional nomothetic and ideographic approaches, and other life sciences. However, the development of a transdisciplinary line of research requires further inputs from different epistemological views, as well as higher attention to the potential contribution of different philosophical traditions.
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Affiliation(s)
- Antonella Delle Fave
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Marié Philipina Wissing
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, North West, South Africa
| | - Ingrid Brdar
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Rijeka, Rijeka, Croatia
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Willroth EC, Luo J, Atherton OE, Weston SJ, Drewelies J, Batterham PJ, Condon DM, Gerstorf D, Huisman M, Spiro A, Mroczek DK, Graham EK. Personality traits and health care use: A coordinated analysis of 15 international samples. J Pers Soc Psychol 2023; 125:629-648. [PMID: 37338439 PMCID: PMC10524692 DOI: 10.1037/pspp0000465] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Some people use health care services more than others. Identifying factors associated with health care use has the potential to improve the effectiveness, efficiency, and equity of health care. In line with the Andersen behavioral model of health care utilization and initial empirical findings, personality traits may be key predisposing factors associated with health care use. Across 15 samples, the present study examined cross-sectional and prospective associations between Big Five personality traits and the likelihood of dental visits, general medical practitioner visits, and hospitalizations. Using coordinated data analysis, we estimated models within each of 15 samples individually (sample Ns ranged from 516 to 305,762), and then calculated weighted mean effect sizes using random-effects meta-analysis across samples (total N = 358,803). According to the synthesized results, people higher in conscientiousness, agreeableness, extraversion, and openness, and lower in neuroticism were more likely to visit the dentist; people higher in neuroticism were more likely to visit general medical practitioners; and people lower in conscientiousness and agreeableness and higher in neuroticism were more likely to be hospitalized. Associations tended to be small with odds ratios around 1.20 (rs ≈ .05). These findings provide evidence across 15 international samples for small but consistent associations between personality traits and health care use and demonstrate that personality-health care associations differ by type of care. We discuss directions for future research, including examining more specific personality facets (e.g., productiveness vs. responsibility) as well as important dimensions of health care (e.g., preventative vs. reactive care; acute vs. chronic care). (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Emily C Willroth
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Jing Luo
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Olivia E Atherton
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | | | | | | | | | | | - Martijn Huisman
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Vrije Universiteit Amsterdam
| | - Avron Spiro
- Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Eileen K Graham
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
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Ryser VA, Meier C, Vilpert S, Maurer J. Health literacy across personality traits among older adults: cross-sectional evidence from Switzerland. Eur J Ageing 2023; 20:28. [PMID: 37369924 DOI: 10.1007/s10433-023-00774-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
This research aims to better understand the association of personality traits (PT)-Openness to Experience, Conscientiousness, Extraversion, Agreeableness, and Neuroticism-with health literacy (HL) skills of adults aged 58 years and older in a nationally representative sample from Switzerland. Analyses were conducted on a subsample (n = 1546) of respondents living in Switzerland from wave 8 (2019/2020) of the Survey of Health, Ageing, and Retirement in Europe (SHARE). PT were assessed with the Big-Five inventory ten (BFI-10). HL was measured using the short version of the European Health Literacy Survey questionnaire (HLS-EU-Q16). We used multivariable regressions to explore how respondents' PT are independently associated with (1) the HLS-EU-Q16 and (2) seven sub-indices derived from this HL scale. Results demonstrated that even when controlling for social, regional, and health characteristics, PT were significantly associated with HL among older adults in Switzerland. More open individuals showed better HL competencies. By contrast, individuals who scored higher on neuroticism expressed more difficulties regarding concrete health-relevant tasks or situations. These findings call for public health policies targeting older adults with lower levels of openness who are less likely to engage in self-examination, and individuals with higher levels of neuroticism who tend to experience more negative emotions. Moreover, health information and communication strategies content development that accounts for different personality types and addresses the needs of individuals with low levels of openness and high neuroticism may help improve HL among older adults whose personalities may otherwise put them at a disadvantage in handling health information.
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Affiliation(s)
- Valérie-Anne Ryser
- Swiss Centre of Expertise in the Social Sciences (FORS), c/o University of Lausanne, Lausanne, Switzerland.
| | - Clément Meier
- Swiss Centre of Expertise in the Social Sciences (FORS), Faculty of Biology and Medicine (FBM) & The Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland.
| | - Sarah Vilpert
- Swiss Centre of Expertise in the Social Sciences (FORS), Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
| | - Jürgen Maurer
- Faculty of Business and Economics (HEC), Lausanne Center for Health Economics, Behavior and Policy (LCHE), Interdisciplinary Centre of Life Course Research (LIVES-UNIL), University of Lausanne, Lausanne, Switzerland
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7
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Sugawara Y, Kanemura S, Fukao A, Tsuji I. Association between personality and the risk of ischemic heart disease mortality before and after the Great East Japan Earthquake: Data from the Miyagi Cohort Study. J Psychiatr Res 2023; 161:84-90. [PMID: 36907159 DOI: 10.1016/j.jpsychires.2023.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 02/13/2023] [Accepted: 02/22/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND The purpose of the present study was to investigate the association between personality and the risk of IHD mortality among Great East Japan Earthquake (GEJE) survivors, and to investigate whether personality traits affected the increase in IHD mortality observed after the GEJE. METHODS We analyzed data for 29,065 men and women in the Miyagi Cohort Study who were 40-64 years old at baseline. We divided the participants into quartiles based on scores for each of the four personality subscales (extraversion, neuroticism, psychoticism, and lie), using the Japanese version of the Eysenck Personality Questionnaire-Revised Short Form. We divided the eight years before and after the GEJE event (11 March 2011) into two period, and examined the relationship between personality traits and the risk of IHD mortality. Cox proportional hazards analysis was used to estimate the multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of IHD mortality according to each personality subscale category. RESULTS In the four years before the GEJE, neuroticism was significantly associated with an increased risk of IHD mortality. Compared with the lowest category for neuroticism, the multivariate-adjusted HR (95% CI) for IHD mortality in the highest category was 2.19 (1.03-4.67) (p-trend = 0.12). In contrast, no statistically significant association between neuroticism and IHD mortality was observed in the four years after the GEJE. CONCLUSION This finding suggests that the observed increase in IHD mortality after the GEJE can be attributed to risk factors other than personality.
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Affiliation(s)
- Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan.
| | - Seiki Kanemura
- Division of Epidemiology, Miyagi Prefectural Cancer Research Center, Natori, Japan
| | | | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
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8
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Lam SU, Riordan KM, Simonsson O, Davidson RJ, Goldberg SB. Who Sticks with Meditation? Rates and Predictors of Persistence in a Population-based Sample in the USA. Mindfulness (N Y) 2023; 14:66-78. [PMID: 36777474 PMCID: PMC9910079 DOI: 10.1007/s12671-022-02061-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 01/07/2023]
Abstract
Objectives Despite the well-documented psychological benefits of meditation practice, limited research has examined factors associated with meditation practice persistence. Like other health behaviors (e.g., exercise), non-persistence may undermine the effectiveness of meditation. Methods We examined rates and correlates of meditation persistence using a population-based sample (n = 953) in the United States. Persistence was operationalized in two ways: number of lifetime practice sessions (i.e., lifetime persistence) and current practice frequency (i.e., current persistence). Consistent with the National Health Interview Survey, we defined meditation as mindfulness meditation, mantra meditation, and spiritual meditation. We examined factors related to the Reasoned Action Approach (RAA), a theory that has been used to explain adherence to health behaviors. Results Almost half of the sample (49.3%) indicated lifetime exposure to meditation and a third (35.0%) indicated practice in the past year. Factors positively associated with persistence (lifetime and/or current) included having spoken with a meditation teacher, higher perceived effectiveness of meditation, higher meditation-positive subjective norms, lower perceived barriers, higher conscientiousness, higher wellbeing growth mindset, and retreat experience. Factors negatively associated with persistence included first exposure through various forms of technology and having a mental health motivation for practice. First exposure through a smartphone app and first exposure through friends and family were not associated with lifetime or current persistence. Findings were unchanged after controlling for demographics and applying a false discovery rate p-value adjustment. Conclusions These findings provide insights into factors that may promote persistence with meditation which can guide the delivery of meditation training. Preregistration This study was preregistered at the Open Science Framework (https://osf.io/4h86s).
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Affiliation(s)
- Sin U Lam
- Department of Counseling Psychology, University of Wisconsin – Madison
- Center for Healthy Minds, University of Wisconsin - Madison
| | - Kevin M. Riordan
- Department of Counseling Psychology, University of Wisconsin – Madison
- Center for Healthy Minds, University of Wisconsin - Madison
| | - Otto Simonsson
- Center for Healthy Minds, University of Wisconsin - Madison
| | - Richard, J. Davidson
- Center for Healthy Minds, University of Wisconsin - Madison
- Department of Psychology, University of Wisconsin – Madison
- Department of Psychiatry, University of Wisconsin – Madison
| | - Simon B. Goldberg
- Department of Counseling Psychology, University of Wisconsin – Madison
- Center for Healthy Minds, University of Wisconsin - Madison
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Hongmei Z, Jingwei Y. Investigating the Role of Personality Traits on the Mental Health of the Residents of China: How Effective is the BIG Five? Am J Health Behav 2022; 46:706-715. [PMID: 36721288 DOI: 10.5993/ajhb.46.6.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objectives: This study aims to investigate the influence of personality traits in determining the mental health of Chinese residents. To reflect the personality characteristic, a questionnaire survey has been designed with the components of agreeableness, conscientiousness, openness to experience, extraversion, and emotional stability. In addition, anxiety and depression have been mirrored in anxiety and depression items. China's diverse community members were surveyed through an online questionnaire.Methods: Smart PLS has been used to apply both measurement and structural models to empirical estimations. The measurement model's results demonstrate its reliability, convergent validity, and discriminant validity. On the other hand, the SEM method yields fruitful results. Results: It is noticed that agreeableness, consciousness, emotional stability, and openness to experience have a considerable effect on responders' mental health. Nevertheless, the negative and significant coefficients of agreeableness, emotional stability, and openness to experience indicate that they lessen mental distress and sadness. Still, conscientiousness harms these cognitive difficulties. Conclusion: These findings imply that an environment of openness to experience, emotional stability, and agreeableness must be fostered to reduce mental tension and anxiety. In addition, this work addresses a few constraints and future initiatives.
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Affiliation(s)
- Zhang Hongmei
- Zhang hongmei. Xinyang College, Xinyang Henan, 464000, P. R. China. & Graduate School & University of Perpetual Help System DALTA, Las Pinas, 1740 Philippines
| | - Yang Jingwei
- Yang Jingwei, Xinyang Normal University, Xinyang 464000, P. R. China;,
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10
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Gaggero G, Dellantonio S, Pastore L, Sng KHL, Esposito G. Shared and unique interoceptive deficits in high alexithymia and neuroticism. PLoS One 2022; 17:e0273922. [PMID: 36044535 PMCID: PMC9432684 DOI: 10.1371/journal.pone.0273922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/17/2022] [Indexed: 11/18/2022] Open
Abstract
Interoception is the perception of internal bodily signals. It is considered fundamental to developing emotional awareness. For this reason, interoceptive deficits are often associated with alexithymia, a condition characterized by difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and an externally-oriented style of thinking (EOT). Yet, the atypical interoception found in alexithymia might be of a similar type and/or more serious than those found in other partially overlapping constructs that entail emotional difficulties and behavioural patterns associated with specific emotional styles. Our study explores this issue by examining the relationship between the interoceptive deficits associated with alexithymia and the Big Five personality traits. A non-clinical sample (N = 504) completed the Toronto Alexithymia Scale, the Big Five Inventory and the Multidimensional Assessment of Interoceptive Awareness. Data were analysed using a network analytic approach that conceives psychological traits as networks of interacting symptoms. The estimated network highlighted that EOT is the alexithymia component least associated with interoception and most associated with lower Openness to Experience. Conversely, DIF and Neuroticism are, respectively, the dimensions of alexithymia and the Big Five most highly associated with interoception. We also compared interoceptive abilities in the four groups of participants whose scores were a) high for both alexithymia and neuroticism, b) high only for alexithymia c), high only for neuroticism, and d) low for both. High alexithymia was especially associated with the tendency to ignore sensations of pain or discomfort, while neuroticism was more indicative of the tendency to worry about these sensations. These results suggest that while high alexithymia and neuroticism share some interoceptive deficits, others are unique to alexithymia and contribute to overall lower interoceptive ability in this condition. Our findings suggest that interventions to enhance awareness of bodily sensations can be beneficial especially for profiles who present high neuroticism and alexithymia.
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Affiliation(s)
- Giulia Gaggero
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
- * E-mail:
| | - Sara Dellantonio
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
| | - Luigi Pastore
- Department of Education, Psychology, Communication, University of Bari, Bari, Italy
| | - Kelly H. L. Sng
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Gianluca Esposito
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
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11
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Personality traits and mental health care utilization: Longitudinal findings from the MIDUS. JOURNAL OF RESEARCH IN PERSONALITY 2022; 99:104260. [PMID: 36793507 PMCID: PMC9928170 DOI: 10.1016/j.jrp.2022.104260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Underutilization of mental health services is prevalent in the U.S., and an understanding of utilization patterns can inform interventions to enhance treatment use. The current study investigated longitudinal associations between changes in mental health care utilization (MHCU) and Big Five personality traits. Data included three waves (4,658 adult participants) of the Midlife Development in the United States (MIDUS) study. 1,632 participants provided data at all three waves. Second-order latent growth curve models showed that MHCU level predicted an increase in emotional stability, and emotional stability level predicted a decrease in MHCU. Increases in emotional stability, extraversion, and conscientiousness predicted decreases in MHCU. These results indicate that personality is associated with MHCU over time and may inform interventions to increase MHCU.
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12
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Golgelioglu F, Oguzkaya S, Uzun E, Uzun MF, Yoca G, Guney A. The impact of the level of anxiety and temperament in asymptomatic or mildly symptomatic patients requesting implant removal surgery after tibia intramedullary nailing. J Orthop Sci 2022; 27:887-891. [PMID: 34144881 DOI: 10.1016/j.jos.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/19/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
BACKROUND Implant removal (IR) surgery is one of the most frequent procedures in orthopedic practice. Many of the IR surgeries result from patient request rather than a medical necessity. The purpose of the study was to investigate the association between the level of anxiety, type of temperament and psychopathological status, and the willingness to receive IR surgery in asymptomatic or mildly symptomatic patients. We also aimed to compare pre- and postoperative pain scores and document the complication rates after IR surgery. METHODS The patients who received tibia intramedullary nailing after tibia diaphyseal fracture with a minimum of 18 months follow-up were included in the study. A total of 246 asymptomatic or mildly symptomatic patients were evaluated, and all patients received detailed oral and written information about the risks of IR surgery. The patients who wished to receive IR surgery were called Group 1 (N = 104), and the patients who did not wish to have surgery were called Group 2 (N = 146). All patients were referred to a psychologist to complete the Beck anxiety inventory (BAI), Symptom checklist-90-R (SCL-R-90), and the Temperament Evaluation of Memphis, Pisa, and San Diego Autoquestionnaire (TEMPS-A). RESULTS The mean age of the patients was 32.31 ± 9.56. One hundred thirteen (45.9%) of the patients were male, and 133 were female (54%). Mean BAI and SCL-90-R were higher in Group 1 than Group 2 (P = 0.001). Anxious and irritable temperament was higher in Group 1 (P = 0.045 and P = 0.035 respectively), and non-dominant and hyperthymic temperament was higher in Group 2 (P = 0.02 and P = 0.04 respectively). CONCLUSIONS The level of anxiety and type of temperament is associated with the willingness to receive implant removal surgery in asymptomatic or mildly symptomatic patients. Measures to reduce anxiety levels may reduce the rate of unnecessary implant removal surgeries, associated patient care costs, and potential complications.
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Affiliation(s)
- Fatih Golgelioglu
- Department of Orthopedics and Traumatology, Tunceli State Hospital, Tunceli, Turkey
| | - Sinan Oguzkaya
- Department of Orthopedics and Traumatology, Sarkisla State Hospital, Sivas, Turkey.
| | - Erdal Uzun
- Department of Orthopedics and Traumatology, Department of Orthopaedics and Traumatology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mehmet Fatih Uzun
- Department of Orthopedics and Traumatology, Department of Orthopaedics and Traumatology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Gokhan Yoca
- Department of Psychiatry and Behavioral Sciences, Sarkisla State Hospital, Sivas, Turkey
| | - Ahmet Guney
- Department of Orthopedics and Traumatology, Department of Orthopaedics and Traumatology, Erciyes University School of Medicine, Kayseri, Turkey
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Emergency department utilisation among older adults—Protocol for a systematic review of determinants and conceptual frameworks. PLoS One 2022; 17:e0265423. [PMID: 35661153 PMCID: PMC9166351 DOI: 10.1371/journal.pone.0265423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 03/01/2022] [Indexed: 11/19/2022] Open
Abstract
Background Older adults aged 65 years and above have a disproportionately higher utilization of emergency healthcare, of which Emergency Department (ED) visits are a key component. They experience higher degree of multimorbidity and mobility issues compared to younger patients, and are consequently more likely to experience a health event which requires an ED visit. During their visit, older adults tend to require more extensive workup, therefore spending a greater amount of time in the ED. Compared to the younger population, older adults are more susceptible to adverse events following discharge. Considering these factors, investigating the determinants of ED utilisation would be valuable. In this paper, we present a protocol for a systematic review of the determinants of ED utilisation among communitydwelling older adults aged 65 years and above, applying Andersen and Newman’s model of healthcare utilisation. Furthermore, we aim to present other conceptual frameworks for healthcare utilisation and propose a holistic approach for understanding the determinants of ED utilisation by older persons. Methods The protocol is developed in accordance with the standards of Campbell Collaboration guidelines for systematic reviews, with reference to the Cochrane Handbook for Systematic Review of Interventions. Medline, Embase and Scopus will be searched for studies published from 2000 to 2020. Studies evaluating more than one determinant for ED utilisation among older adults aged 65 years and above will be included. Search process and selection of studies will be presented in a PRISMA flow chart. Statistically significant (p < 0.05) determinants of ED utilisation will be grouped according to individual and societal determinants. Quality of the studies will be assessed using Newcastle Ottawa Scale (NOS). Discussion In Andersen and Newman’s model, individual determinants include predisposing factors, enabling and illness factors, and societal determinants include technology and social norms. Additional conceptual frameworks for healthcare utilisation include Health Belief Model, Social Determinants of Health and Big Five personality traits. By incorporating the concepts of these models, we hope to develop a holistic approach of conceptualizing the factors that influence ED utilisation among older people. Systematic review registration This protocol is registered on 8 May 2021 with PROSPERO’s International Prospective Register of Systematic Reviews (CRD42021253770).
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The Big Five personality traits and regularity of lifetime dental visit attendance: evidence of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Aging Clin Exp Res 2022; 34:1439-1445. [PMID: 34964080 PMCID: PMC9151578 DOI: 10.1007/s40520-021-02051-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/07/2021] [Indexed: 01/22/2023]
Abstract
Background Regular dental visits are essential for the prevention, early detection and treatment of worldwide highly prevalent oral diseases. Personality traits were previously associated with treatment compliance, medication adherence and regular doctor visits, however, the link between personality traits and regular dental visit attendance remains largely unexplored. Thus, the objective of this study is to clarify this link. Methods Data (wave 7) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used, focusing on Germany (n = 2822). Personality was assessed using the 10-item Big Five Inventory (BFI-10). Regular dental visits were assessed. Multiple logistic regressions were used, adjusting for various covariates. Results Majority of the participants (84%) reported to attend regular dental visits during lifetime. Regularity of lifetime dental visit attendance was positively and significantly associated with increased extraversion [OR 1.13, 95% CI (1.01–1.26)], increased conscientiousness [OR 1.26, 95% CI (1.10–1.44)], and increased openness to experience [OR 1.12, 95% CI (1.01–1.26)]. However, there was a lack of association with agreeableness and neuroticism. Moreover, the outcome measure was positively associated with younger age, being female, born in Germany, being married, higher education, being retired (compared to being homemaker), whereas it was not associated with obesity or chronic diseases. Conclusions Identification of personality traits that are associated with regular dental visits can support prevention, screening and clinical management of oral diseases. Further research in this field may facilitate the development and increase the incorporation of individualized concepts to enhance patient compliance and attendance, and thus the provision of oral and dental care services. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-02051-2.
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15
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Liu Y, Boes S. On the Relative Importance of Different Factors Explaining Health Plan Choices: Evidence From Mandatory Health Insurance in Switzerland. FRONTIERS IN HEALTH SERVICES 2022; 2:847486. [PMID: 36925810 PMCID: PMC10012804 DOI: 10.3389/frhs.2022.847486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 02/16/2022] [Indexed: 11/13/2022]
Abstract
Many factors influence health plan choices. Classical individual-level determinants include socioeconomic and health-related characteristics, and risk attitudes. However, little is known to what extent personality traits can determine insurance choices. Using representative survey data from Switzerland, we investigate the associations between choices of health plans and traditional individual factors as well as personality traits. We employ dominance analysis to explore the relative importance of the different predictors. We find that personality traits play an at least equally important role in predicting health plan choices as common factors like age, health status, and income. Our results have implications regarding recent efforts to empower people in making better health plan choices and support theoretical models that integrate insights from behavioral sciences.
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Affiliation(s)
- Yanmei Liu
- Department of Health Sciences and Medicine and Center for Health, Policy and Economics, University of Lucerne, Lucerne, Switzerland
| | - Stefan Boes
- Department of Health Sciences and Medicine and Center for Health, Policy and Economics, University of Lucerne, Lucerne, Switzerland
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16
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Atherton OE, Willroth EC, Schwaba T, Goktan AJ, Graham EK, Condon DM, Rao MB, Mroczek DK. Personality predictors of emergency department post-discharge outcomes. PERSONALITY SCIENCE 2021; 2. [PMID: 35356090 PMCID: PMC8963191 DOI: 10.5964/ps.7193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Personality traits are important predictors of health behaviors, healthcare utilization, and health outcomes. However, we know little about the role of personality traits for emergency department outcomes. The present study used data from 200 patients (effective Ns range from 84 to 191), who were being discharged from the emergency department at an urban hospital, to investigate whether the Big Five personality traits were associated with post-discharge outcomes (i.e., filling prescriptions, following up with primary care physician, making an unscheduled return to the emergency department). Using logistic regression, we found few associations among the broad Big Five domains and post-discharge outcomes. However, results showed statistically significant associations between specific Big Five items (e.g., “responsible”) and the three post-discharge outcomes. This study demonstrates the feasibility of assessing personality traits in an emergency medicine setting and highlights the utility of having information about patients’ personality tendencies for predicting post-discharge compliance.
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Affiliation(s)
- Olivia E. Atherton
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Emily C. Willroth
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ted Schwaba
- Department of Psychology, University of Texas Austin, Austin, TX, USA
| | - Ayla J. Goktan
- College of Education and Human Development, University of Louisville, Louisville, KY, USA
| | - Eileen K. Graham
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - David M. Condon
- Department of Psychology, University of Oregon, Eugene, OR, USA
| | - Mitesh B. Rao
- Department of Emergency Medicine, Stanford University, Palo Alto, CA, USA
| | - Daniel K. Mroczek
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
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17
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Miranda R, Smets T, De Schreye R, Faes K, Van Den Noortgate N, Cohen J, Van den Block L. Improved quality of care and reduced healthcare costs at the end-of-life among older people with dementia who received palliative home care: A nationwide propensity score-matched decedent cohort study. Palliat Med 2021; 35:1701-1712. [PMID: 34109861 DOI: 10.1177/02692163211019321] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND While palliative home care is advocated for people with dementia, evidence of its effectiveness is lacking. AIM To evaluate the effects of palliative home care on quality and costs of end-of-life care for older people with dementia. DESIGN Decedent cohort study using linked nationwide administrative databases and propensity score matching. SETTING/PARTICIPANTS All home-dwelling older people who died with dementia between 2010 and 2015 in Belgium (N = 23,670). EXPOSURE Receiving palliative home care support for the first time between 360 and 15 days before death. RESULTS Five thousand six hundred and thirty-seven (23.8%) received palliative home care support in the last 2 years of life, of whom 2918 received it for the first time between 360 and 15 days before death. Two thousand eight hundred and thirty-nine people who received support were matched to 2839 people who received usual care. After matching, those using palliative home care support, in the last 14 days of life, had lower risk of hospital admission (17.5% vs 50.5%; relative risk (RR) = 0.21), undergoing diagnostic testing (17.0% vs 53.6%; RR = 0.20) and receiving inappropriate medications, but were more likely to die at home (75.7% vs 32.6%; RR = 6.45) and to have primary care professional contacts (mean 11.7 vs mean 5.2), compared with those who did not. Further, they had lower mean total costs of care in the last 30 days of life (incremental cost:-€2129). CONCLUSIONS Palliative home care use by home-dwelling older people with dementia is associated with improved quality and reduced costs of end-of-life care. Access remains low and should be increased.
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Affiliation(s)
- Rose Miranda
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Tinne Smets
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Robrecht De Schreye
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Kristof Faes
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Lieve Van den Block
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Minvielle E, Fourcade A, Ricketts T, Waelli M. Current developments in delivering customized care: a scoping review. BMC Health Serv Res 2021; 21:575. [PMID: 34120603 PMCID: PMC8201906 DOI: 10.1186/s12913-021-06576-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 05/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, there has been a growing interest in health care personalization and customization (i.e. personalized medicine and patient-centered care). While some positive impacts of these approaches have been reported, there has been a dearth of research on how these approaches are implemented and combined for health care delivery systems. The present study undertakes a scoping review of articles on customized care to describe which patient characteristics are used for segmenting care, and to identify the challenges face to implement customized intervention in routine care. METHODS Article searches were initially conducted in November 2018, and updated in January 2019 and March 2019, according to Prisma guidelines. Two investigators independently searched MEDLINE, PubMed, PsycINFO, Web of Science, Science Direct and JSTOR, The search was focused on articles that included "care customization", "personalized service and health care", individualized care" and "targeting population" in the title or abstract. Inclusion and exclusion criteria were defined. Disagreements on study selection and data extraction were resolved by consensus and discussion between two reviewers. RESULTS We identified 70 articles published between 2008 and 2019. Most of the articles (n = 43) were published from 2016 to 2019. Four categories of patient characteristics used for segmentation analysis emerged: clinical, psychosocial, service and costs. We observed these characteristics often coexisted with the most commonly described combinations, namely clinical, psychosocial and service. A small number of articles (n = 18) reported assessments on quality of care, experiences and costs. Finally, few articles (n = 6) formally defined a conceptual basis related to mass customization, whereas only half of articles used existing theories to guide their analysis or interpretation. CONCLUSIONS There is no common theory based strategy for providing customized care. In response, we have highlighted three areas for researchers and managers to advance the customization in health care delivery systems: better define the content of the segmentation analysis and the intervention steps, demonstrate its added value, in particular its economic viability, and align the logics of action that underpin current efforts of customization. These steps would allow them to use customization to reduce costs and improve quality of care.
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Affiliation(s)
- Etienne Minvielle
- i3-Centre de Recherche en Gestion, Institut Interdisciplinaire de l’Innovation (UMR 9217), École polytechnique, Batiment Ensta, 828, Boulevard des Maréchaux, 91762 Palaiseau Cedex, France
- Institut Gustave Roussy, 114, rue Edouard Vaillant, 94800 Villejuif, France
| | - Aude Fourcade
- Institut Gustave Roussy, 114, rue Edouard Vaillant, 94800 Villejuif, France
| | - Thomas Ricketts
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina USA
| | - Mathias Waelli
- MOS (EA 7418), French School of Public Health, Rennes, France
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19
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Bahat E. The Big Five personality traits and adherence to breast cancer early detection and prevention. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2020.110574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Nguyen-Feng VN, Frazier PA, Roy N, Cohen S, Misono S. Perceived Control, Voice Handicap, and Barriers to Voice Therapy. J Voice 2021; 35:326.e13-326.e19. [PMID: 31604609 PMCID: PMC7138698 DOI: 10.1016/j.jvoice.2019.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To characterize the associations of perceived control with voice outcomes and self-reported likelihood of attending voice therapy using a national practice-based research network. STUDY DESIGN Cross-sectional study of prospectively enrolled adult patients seen for dysphonia. SETTING Creating Healthcare Excellence through Education and Research (CHEER) network of community and academic practice sites. SUBJECTS AND METHODS Data collected included patient-reported demographics, outcome measures of voice (Voice Handicap Index-10), perceived control (present control subscale of voice-specific Perceived Control over Stressful Events Scale), personality (Ten Item Personality Inventory), likelihood of attending voice therapy if recommended, and barriers to attending voice therapy. RESULTS Patients (N = 247) were enrolled over 12 months from 10 sites, of whom 170 received a recommendation for voice therapy. The majority (85%) of this group planned to attend voice therapy. Voice-specific perceived control and VHI-10 were inversely related (r = -0.31, P < 0.001), even when controlling for personality. No study variables were associated with self-reported likelihood of attending voice therapy, but perceived control was the most consistent correlate of specific barriers to attending voice therapy (eg, "hard to translate into everyday use") and was inversely related to these barriers. CONCLUSIONS Patients scoring higher on a voice-specific measure of perceived control reported less voice handicap, independent of personality, and higher perceived control was associated with having fewer concerns about voice therapy goals and process. Perceived control is a potential target for intervention in patients with voice disorders.
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Affiliation(s)
| | - Patricia A Frazier
- Department of Psychology, College of Liberal Arts, University of Minnesota Twin Cities, Minneapolis, Minnesota
| | - Nelson Roy
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah
| | - Seth Cohen
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina
| | - Stephanie Misono
- Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota.
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21
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Mah JC, Stevens SJ, Keefe JM, Rockwood K, Andrew MK. Social factors influencing utilization of home care in community-dwelling older adults: a scoping review. BMC Geriatr 2021; 21:145. [PMID: 33639856 PMCID: PMC7912889 DOI: 10.1186/s12877-021-02069-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/01/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Older adults want to live at home as long as possible, even in the face of circumstances that limit their autonomy. Home care services reflect this emergent preference, allowing older adults to 'age in place' in familiar settings rather than receiving care for chronic health conditions or ageing needs in an institutionalized setting. Numerous social factors, generally studied in isolation, have been associated with home care utilization. Even so, social circumstances are complex and how these factors collectively influence home care use patterns remains unclear. OBJECTIVES To provide a broad and comprehensive overview of the social factors influencing home care utilization; and to evaluate the influence of discrete social factors on patterns of home care utilization in community-dwelling older adults in high-income countries. METHODS A scoping review was conducted of six electronic databases for records published between 2010 and 2020; additional records were obtained from hand searching review articles, reference lists of included studies and documents from international organisations. A narrative synthesis was presented, complemented by vote counting per social factor, harvest plots and an evaluation of aggregated findings to determine consistency across studies. RESULTS A total of 2,365 records were identified, of which 66 met inclusion criteria. There were 35 discrete social factors grouped into four levels of influence using a socio-ecological model (individual, relationship, community and societal levels) and grouped according to outcome of interest (home care propensity and intensity). Across all studies, social factors consistently showing any association (positive, negative, or equivocal in pattern) with home care propensity were: age, ethnicity/race, self-assessed health, insurance, housing ownership, housing problems, marital status, household income, children, informal caregiving, social networks and urban/rural area. Age, education, personal finances, living arrangements and housing ownership were associated with home care intensity, also with variable patterns in utilization. Additional community and societal level factors were identified as relevant but lacking consistency across the literature; these included rurality, availability of community services, methods of financing home care systems, and cultural determinants. CONCLUSION This is the first literature review bringing together a wide range of reported social factors that influence home care utilization. It confirms social factors do influence home care utilization in complex interactions, distinguishes level of influences at which these factors affect patterns of use and discusses policy implications for home care reform.
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Affiliation(s)
- Jasmine C Mah
- Department of Health Policy, London School of Economics and Political Sciences, London, UK.
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
- Department of Medicine, Dalhousie University, Halifax, NS, Canada.
| | - Susan J Stevens
- Faculty of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, NS, Canada
- Continuing Care, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Janice M Keefe
- Faculty of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Kenneth Rockwood
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Melissa K Andrew
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
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Hajek A, Kretzler B, König HH. Determinants of Frequent Attendance in Primary Care. A Systematic Review of Longitudinal Studies. Front Med (Lausanne) 2021; 8:595674. [PMID: 33634146 PMCID: PMC7901229 DOI: 10.3389/fmed.2021.595674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/19/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: There is a lack of a systematic review synthesizing longitudinal studies investigating the determinants of frequent attendance in primary care. The goal of our systematic review was to fill this gap in knowledge. Methods: Three electronic databases (Medline, PsycINFO, and CINAHL) were searched. Longitudinal observational studies analyzing the predictors of frequent attendance in primary care were included. Data extraction covered methods, sample characteristics, and main findings. Selection of the studies, extracting the data and evaluation of study quality was performed by two reviewers. In the results section, the determinants of frequent attendance were presented based on the (extended) Andersen model. Results: In total, 11 longitudinal studies have been included in our systematic review. The majority of studies showed that frequent attendance was positively associated with the predisposing characteristics lower age, and unemployment. Moreover, it was mainly not associated with enabling resources. Most of the studies showed that need factors, and in particular worse self-rated health, lower physical functioning and physical illnesses were associated with an increased likelihood of frequent attendance. While most studies were of good quality, several of the included studies did not perform sensitivity analysis or described how they dealt with missing data. Discussion: Our systematic review showed that particularly lower age, unemployment and need factors are associated with the likelihood of becoming a frequent attender. Enabling resources are mainly not associated with the outcome measure. Future research should concentrate on the determinants of persistent frequent attendance due to the high economic burden associated with it.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hajek A, Kretzler B, König HH. Personality and the use of cancer screenings. A systematic review. PLoS One 2020; 15:e0244655. [PMID: 33370379 PMCID: PMC7769487 DOI: 10.1371/journal.pone.0244655] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/14/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND No systematic review exists synthesizing studies examining the association between personality factors and use of cancer screenings. Hence, the aim of this systematic review is to provide an overview of empirical findings from observational studies investigating the link between personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism and openness to experience) and use of cancer screenings. METHODS Medline, PsycInfo and CINAHL were searched using predefined search terms. Observational studies examining the link between personality factors and use of cancer screenings using validated tools were included. Study selection, data extraction, and quality assessment were performed by two reviewers. RESULTS In total, n = 11 studies were included in our systematic review. There is mostly inconclusive evidence regarding the link between agreeableness, neuroticism, openness to experience and the use of cancer screenings. Clearer evidence was identified for an association between increased extraversion and an increased use of cancer screenings. Moreover, the majority of studies identified a link between increased conscientiousness and an increased use of cancer screenings. DISCUSSION Studies indicate that personality factors, particularly an increased extraversion and increased conscientiousness, are associated with an increased use of cancer screenings. This knowledge may be beneficial to address individuals at risk for underuse. PROSPERO REGISTRATION NUMBER CRD42020176830.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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The Association of Post-Materialism with Health Care Use. Findings of a General Population Survey in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238869. [PMID: 33260640 PMCID: PMC7730980 DOI: 10.3390/ijerph17238869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/22/2022]
Abstract
(1) The aim of this study was to identify the association between post-materialism and health care use (in terms of the frequency of doctor visits and the reason for doctor visits). (2) Data were taken from the German General Social Survey (a representative sample of individuals aged 18 years and over, n = 3338). The Inglehart's post-materialist index was used to quantify post-materialism. The doctor visits (self-reported) in the past three months served as an outcome measure. The reasons for seeing a doctor served as an additional outcome measure (acute illness; chronic illness; feeling unwell; requesting advice; visit to the doctor's office without consulting the doctor (e.g., need to get a prescription); preventive medical check-up/vaccination). (3) After adjusting for several covariates, negative binomial regressions revealed that compared with materialism, post-materialism was associated with decreased doctor visits (total sample; women). Moreover, the likelihood of visiting the doctor for reasons of chronic illnesses was lower in post-materialistic women, whereas the likelihood of visiting the doctor for reasons of preventive medical check-up/vaccination was higher in post-materialistic women. (4) Study findings identify an unexplored link between post-materialism and doctor visits in women. One may conclude that in the long-term, the increased likelihood of preventive medical check-ups in post-materialistic women will be beneficial in decreasing the need for doctor visits for reasons of chronic illnesses. However, future research is required to elucidate the underlying mechanisms.
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Hajek A, Kretzler B, König HH. Personality, Healthcare Use and Costs-A Systematic Review. Healthcare (Basel) 2020; 8:healthcare8030329. [PMID: 32916927 PMCID: PMC7551177 DOI: 10.3390/healthcare8030329] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/31/2020] [Accepted: 09/07/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Thus far, there is a lack of a systematic review synthesizing empirical studies that analyze the link between personality factors and healthcare use (HCU) or costs. Consequently, the purpose of our systematic review is to give an overview of empirical findings from observational studies examining the association between personality factors and HCU or costs. METHODS PubMed, PsycINFO, and NHS EED (NHS Economic Evaluation Database) were searched. Observational studies examining the association between personality factors and HCU costs by using validated tools were included. Two reviewers performed study selection and data extraction and evaluated the study quality. Findings were synthesized qualitatively. RESULTS In total, n = 15 studies (HCU, n = 14; cost studies, n = 1) were included in the final synthesis. A few studies point to an association between conscientiousness and HCU (with mixed evidence). Some more evidence was found for an association between higher agreeableness, higher extraversion, and higher openness to experience and increased HCU. The majority of studies analyzed found a link between higher neuroticism and increased HCU. CONCLUSION Personality factors, and particularly neuroticism, are associated with HCU. This knowledge is important to manage healthcare use. However, future research based on longitudinal data and studies investigating the link between personality characteristics and costs are required.
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Hajek A, Enzenbach C, Stengler K, Glaesmer H, Hinz A, Röhr S, Stein J, Riedel-Heller SG, König HH. Determinants of Willingness to Pay for Health Insurance in Germany-Results of the Population-Based Health Study of the Leipzig Research Centre for Civilization Diseases (LIFE-Adult-Study). Front Public Health 2020; 8:456. [PMID: 32984246 PMCID: PMC7485392 DOI: 10.3389/fpubh.2020.00456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/22/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate which factors are associated with the willingness to pay (WTP) for health insurance. Methods: The analysis (n = 1,248 individuals) is based on data of a large population-based study—the Health Study of the Leipzig Research Centre for Civilization Diseases (LIFE-Adult-Study). With regard to WTP for health insurance, a contingent valuation method with a payment card was used. Several explanatory variables were included. For example, personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism, and openness to experience) were assessed using the NEO-16 Adjective Measure. Results: Average WTP for health insurance per month equaled about €240 which corresponds to ~14% of household net equivalent income. Multiple regressions showed that an increased WTP was associated with lower age (β = −1.7, p < 0.001), higher (log) household net equivalent income (β = 153.6, p < 0.001), higher social support (β = 2.0, p < 0.05), and private health insurance (β = 131.1, p < 0.001). Furthermore, an increased WTP for health insurance was associated with higher openness to experience (β = 10.1, p < 0.05), whereas it was not associated with agreeableness, conscientiousness, extraversion, and neuroticism. Conclusion: The quite large amount of average WTP for health insurance may suggest that individuals accept current contributions to health insurances and would probably accept higher contributions. While previous studies mainly focused on individuals in late life, we identified a link between socioeconomic, health-related factors, and personality factors (in terms of openness to experience) and WTP in the general adult population.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Cornelia Enzenbach
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Katarina Stengler
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Helios Park Hospital Leipzig, Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Sociology, University of Leipzig, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Sociology, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Personality, Health Care Use, and Costs: A Study Protocol for a Systematic Review. Healthcare (Basel) 2020; 8:healthcare8030263. [PMID: 32806553 PMCID: PMC7551013 DOI: 10.3390/healthcare8030263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 11/17/2022] Open
Abstract
Recent empirical studies have shown that personality factors are associated with health care use (HCU). However, to date, a systematic review is lacking summarizing evidence regarding the link between personality factors and health care use or costs (i.e., monetarily valued health care use). Therefore, the objective of this systematic review is to provide an overview of evidence from observational studies investigating the link between personality characteristics and health care use or costs. Electronic databases (PubMed, PsycINFO, NHS EED) will be searched using predefined search terms. In an additional step, the reference lists of included studies will be searched (manually). No restrictions will be applied regarding the time of publication. Observational studies (both cross-sectional and longitudinal) assessing the link between personality characteristics and health care use/costs across all age categories will be included. Only studies using validated tools to quantify personality characteristics will be included. Among others, studies only focusing on mental HCU or studies only analyzing samples with a specific disorder (e.g., individuals with personality disorders) will be excluded. Mainly, data on methods (study design, measures, and statistical analysis), sample characteristics, and results regarding the link between personality and HCU/costs will be extracted. A quality assessment will be conducted. Two reviewers will perform the study selection, data extraction, and assessment of the study quality. If disagreements occur, they will be resolved through discussion to reach a consensus or by inclusion of a third party. Results will be presented narratively (text and tables). Depending on the number and heterogeneity of the studies included, a meta-analysis will be conducted. Results will be disseminated through publication in a peer-reviewed, scientific journal.
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Beyond symptoms: why do patients see the doctor? BJGP Open 2020; 4:bjgpopen20X101088. [PMID: 32430301 PMCID: PMC7330227 DOI: 10.3399/bjgpopen20x101088] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 11/01/2022] Open
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Martin P, Kim J, Jasper A, Baek Y, Russell D. The development of a brief measure of health personality. J Health Psychol 2020; 26:2768-2780. [PMID: 32529852 DOI: 10.1177/1359105320931179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this research was to develop a brief assessment of health personality, defined as a set of individual dispositions that are directly related to health. In Study 1, an initial pool of items was developed with 615 older adults, 65 years of age and older. The scale was reduced to a 15-item version for use in applied health care settings. Results indicated that the 'Health Personality Assessment scale' has good internal consistency, and the five-factors correlated significantly with self-reported measures of physical health and well-being. In Study 2, the scale was cross-validated with 254 older adults from the Health Literacy and Cognitive Function among Older Adults Study. The scale was refined and a third study consisted of 3,907 older adults. Reliability and validity of the scale were confirmed. Future research should evaluate the usefulness of this scale in applied healthcare settings.
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van Reijswoud BE, Debast I, Videler AC, Rossi G, Lobbestael J, Segal DL, van Alphen SPJ. Severity Indices of Personality Problems-Short Form in Old-Age Psychiatry: Reliability and Validity. J Pers Assess 2020; 103:174-182. [PMID: 32267173 DOI: 10.1080/00223891.2020.1743710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The Severity Indices of Personality Problems (SIPP; Verheul et al., 2008) is a popular self-report questionnaire that measures severity of maladaptive personality functioning. Two studies demonstrated the utility of the short form (SIPP-SF) among older adults but validation in clinical settings is lacking. Therefore, we examined the psychometric properties of the SIPP-SF in a large sample of older adult Dutch outpatients (N = 124; age range = 60-85 years, M = 69.8, SD = 5.3). The SIPP-SF domains showed good to excellent internal reliability (Cronbach's α = .75-.91) and effectively discriminated between participants with and without a personality disorder, as assessed with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Convergent validity of the SIPP-SF was examined with instruments for measuring personality pathology among older adults (Informant Personality questionnaire [HAP]; Gerontological Personality Disorders Scale [GPS]). The GPS generally correlated with the SIPP-SF domains in expected directions, with small to large effect sizes. For the HAP, only 1 scale correlated with all SIPP-SF domains. No associations were found between the SIPP-SF and psychiatric symptomatology as measured by the Brief Symptom Inventory (BSI). The SIPP-SF appears to be a promising instrument for assessing maladaptive personality functioning among older adult outpatients.
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Affiliation(s)
| | - Inge Debast
- Department of Clinical and Lifespan Psychology, Free University Brussels, Brussels, Belgium
| | - Arjan C Videler
- Breburg Institute for Mental Health Care, Breda, The Netherlands
| | - Gina Rossi
- Department of Clinical and Lifespan Psychology, Free University Brussels, Brussels, Belgium
| | - Jill Lobbestael
- Department of Clinical Psychology Sciences, Maastricht University, Maastricht, The Netherlands
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Hajek A, König HH. Meaning in life and health care use: findings from a nationally representative study of older adults in Germany. BMC Geriatr 2019; 19:368. [PMID: 31870312 PMCID: PMC6929414 DOI: 10.1186/s12877-019-1389-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 12/16/2019] [Indexed: 12/13/2022] Open
Abstract
Background There is a lack of studies examining the link between meaning in life and health care use. Meaning in life refers to a sense of comprehension and significance in life. Consequently, the purpose of this study was to investigate the association between meaning in life and health care use. Methods Cross-sectional data from the German Ageing Survey, a nationally representative sample of older adults, was used for this study (in the analytical sample: n = 3850; year 2002). The frequency of GP and specialist visits in the past 12 months were used as outcome measures. Meaning in life was assessed using a single item measure. Based on Andersen’s model, covariates were selected. Sex, age, family status, occupational status, income, self-rated health, physical functioning, depressive symptoms, and the number of physical illnesses were adjusted for in a multiple regression analysis. Results After adjusting for various potential confounders, there was a positive association between meaning in life and GP (IRR: 1.04, 95%-CI: 1.01–1.08) as well as specialist visits (IRR: 1.07, 95%-CI: 1.02–1.12) in a multiple regression analysis. With the exception of employment status (retired vs. employed), income and need factors, no covariates were consistently associated with both outcome measures. Conclusions This study highlighted the association between meaning in life and health care use. Our results indicate that there are other factors that are associated with health care use, beyond need-variables. This might help to identify individuals at risk for under- or overuse of health care services.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany
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Weiss A, Deary IJ. A New Look at Neuroticism: Should We Worry So Much About Worrying? CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2019. [DOI: 10.1177/0963721419887184] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
People with higher levels of neuroticism seem to have drawn the short straw of personality. However, there are multiple ways to score highly in neuroticism. Analyses of the short scale of the Eysenck Personality Questionnaire-Revised in three large data sets have revealed that higher neuroticism can mean having elevated scores on all items, elevated scores mainly on items related to anxiety and tension, or elevated scores mainly on items related to worry and vulnerability. Epidemiological and molecular genetic studies have revealed that people in the first group are at greater risk for poorer mental and physical health but that people in the latter two groups, especially those beset by worry and feelings of vulnerability, have better physical health. These findings suggest that future research on neuroticism and health should focus on different ways that people can exhibit high neuroticism.
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Affiliation(s)
- Alexander Weiss
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, The University of Edinburgh
| | - Ian J. Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, The University of Edinburgh
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Perry LM, Hoerger M, Molix LA, Duberstein PR. A Validation Study of the Mini-IPIP Five-Factor Personality Scale in Adults With Cancer. J Pers Assess 2019; 102:153-163. [PMID: 31403328 DOI: 10.1080/00223891.2019.1644341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The Mini International Personality Item Pool (Mini-IPIP) is a brief measure of the Five-Factor Model of personality with documented validity in healthy samples of adults and could be useful for assessing personality in patient populations such as individuals with cancer. The purpose of this study was to examine the psychometric properties of the Mini-IPIP in 2 samples of adults with cancer. A sample of 369 (Sample 1) and a sample of 459 (Sample 2) adults with cancer completed an online survey including the Mini-IPIP. To assess criterion validity, Sample 2 completed measures of emotional distress. Analyses included internal consistency (Samples 1 and 2), confirmatory factor analyses (CFAs; Samples 1 and 2), and correlations and a structural regression model to examine the associations between the 5 personality factors and emotional distress (Sample 2 only). Results showed that the Mini-IPIP demonstrated levels of internal consistency and CFA model fit that were similar to previous validation studies conducted in the general population. Consistent with prior research and theory, this study also found that personality factors measured by the Mini-IPIP were associated with measures of emotional distress in Sample 2. These findings suggest the potential utility of the Mini-IPIP in both research and clinical settings involving individuals with cancer.
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Affiliation(s)
| | - Michael Hoerger
- Department of Psychology, Tulane University.,Department of Medicine, Section of Hematology and Medical Oncology, Tulane University
| | | | - Paul R Duberstein
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health
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Gibney S, Moore T. Older Patients' Views of Health Care Interactions in Ireland. Health Lit Res Pract 2019; 2:e180-e191. [PMID: 31294294 PMCID: PMC6608904 DOI: 10.3928/24748307-20180831-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 06/12/2018] [Indexed: 01/07/2023] Open
Abstract
Background Chronic and sensitive health conditions such as pain, urinary incontinence, and hearing loss are common but often untreated among older adults in Ireland, and many patients do not disclose these and other sensitive health issues to their health care provider. Objective This study investigates the link between provider communication and older patients' perceived encouragement to talk about physical, social, sensitive, and emotional problems with their usual source of care (USC), be it a doctor or nurse. Methods Data were from the Irish sample of the Survey of Health, Ageing and Retirement in Europe (SHARE; N = 720). Logistic regression models were used to estimate the association among (1) patient characteristics, (2) health care use, and (3) USC communication characteristics and the likelihood of feeling encouraged to talk about each health problem. Results are reported as odds ratios (OR) with confidence intervals at the 95% level. Key Results More patients felt discouraged to talk about social (39%) and sensitive (42%) health problems with their USC compared with physical (18%) and emotional (29%) health problems. Many participants reported that their USC rarely or never explained the results of medical examinations (23.6%), explained different treatment options (26.2%), or listened to their opinions or preferences when making treatment decisions (29.1%). A USC "explaining test results" was associated with increased odds of feeling encouraged to discuss physical (OR = 2.82, 95% confidence interval [CI; 1.15, 6.91]) and social (OR = 2.02, 95% CI [1.01, 4.04]) problems. "Listening to patient preferences" was associated with increased odds of feeling encouraged to discuss physical (OR = 4.49; 95% CI [2.24-9.01]), emotional (OR = 2.31, 95% CI [1.27, 4.21]), and social (OR = 2.88, 95% CI [1.60, 5.18]) problems. Controlling for USC communication characteristics attenuated the association between lower educational attainment and perceived encouragement. Conclusions An open and patient-centered communication style was associated with a greater sense of encouragement to discuss physical, emotional, and social health problems, particularly among older patients with lower levels of education. [HLRP: Health Literacy Research and Practice. 2018;2(4):e180-e191.]. Plain Language Summary This is the first study in Ireland to investigate the link between the communication styles used by health care providers and to what extent older patients felt encouraged to talk about physical, emotional, social, or sensitive health problems. When providers took a more patient-centered approach, these patients felt more encouraged to disclose physical, social, and emotional health problems.
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Affiliation(s)
- Sarah Gibney
- Address correspondence to Sarah Gibney, PhD, Healthy and Positive Ageing Initiative, Department of Health, Hawkins House, Dublin, Ireland D02 VW90;
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Kannan VD, Brown TM, Kunitz SJ, Chapman BP. Political parties and mortality: The role of social status and personal responsibility. Soc Sci Med 2019; 223:1-7. [PMID: 30684874 DOI: 10.1016/j.socscimed.2019.01.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/13/2019] [Accepted: 01/16/2019] [Indexed: 01/21/2023]
Abstract
Previous research findings across a variety of nations show that affiliation with the conservative party is associated with greater longevity; however, it is thus far unclear what characteristics contribute to this relationship. We examine the political party/mortality relationship in the United States context. The goal of this paper is two-fold: first, we seek to replicate the mortality difference between Republicans and Democrats in two samples, controlling for demographic confounders. Second, we attempt to isolate and test two potential contributors to the relationship between political party affiliation and mortality: (1) socioeconomic status and (2) dispositional traits reflecting a personal responsibility ethos, as described by the Republican party. Graduate and sibling cohorts from the Wisconsin Longitudinal Study were used to estimate mortality risk from 2004 to 2014. In separate Cox proportional hazards models controlling for age and sex, we adjusted first for markers of socioeconomic status (such as wealth and education), then for dispositional traits (such as conscientiousness and active coping), and finally for both socioeconomic status and dispositional traits together. Clogg's method was used to test the statistical significance of attenuation in hazard ratios for each model. In both cohorts, Republicans exhibited lower mortality risk compared to Democrats (Hazard Ratios = 0.79 and 0.73 in graduate and sibling cohorts, respectively [p < 0.05]). This relationship was explained, in part, by socioeconomic status and traits reflecting personal responsibility. Together, socioeconomic factors and dispositional traits account for about 52% (graduates) and 44% (siblings) of Republicans' survival advantage. This study suggests that mortality differences between political parties in the US may be linked to structural and individual determinants of health. These findings highlight the need for better understanding of political party divides in mortality rates.
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Affiliation(s)
- Viji Diane Kannan
- Department of Psychiatry, University of Rochester, 300 Crittenden Boulevard, Rochester, NY, 14642, USA.
| | - Theodore M Brown
- Department of History, University of Rochester, Rochester, NY, USA; Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
| | - Stephen J Kunitz
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
| | - Benjamin P Chapman
- Department of Psychiatry, University of Rochester, 300 Crittenden Boulevard, Rochester, NY, 14642, USA
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van Dijk SDM, Veenstra MS, Bouman R, Peekel J, Veenstra DH, van Dalen PJ, van Asselt ADI, Boshuisen ML, van Alphen SPJ, van den Brink RHS, Oude Voshaar RC. Group schema-focused therapy enriched with psychomotor therapy versus treatment as usual for older adults with cluster B and/or C personality disorders: a randomized trial. BMC Psychiatry 2019; 19:26. [PMID: 30646879 PMCID: PMC6334382 DOI: 10.1186/s12888-018-2004-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 12/26/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Several types of psychotherapy have been proven successful in the treatment of personality disorders in younger age groups, however studies among older patients are lacking. We developed a group schema-focused therapy (SFT) enriched with psychomotor therapy (PMT) for older adults with cluster B and/or C personality disorders. This paper describes the design of a randomized controlled trial (RCT). We will evaluate the (cost-)effectiveness of this therapy protocol in specialized mental health care. We hypothesize that our treatment program is cost-effective and superior to treatment as usual (TAU) in reducing psychological distress and improving quality of life in older adults treated to specialized mental healthcare. METHODS A multicenter RCT with a one-year follow-up comparing group schema-focused therapy enriched with psychomotor therapy (group SFT + PMT) and TAU for adults aged 60 years and older who suffer from either a cluster B and/or C personality disorder. The primary outcome is general psychological distress measured with the 53-item Brief Symptom Inventory. Secondary outcomes are the Schema Mode Inventory (118-item version) and the Young Schema Questionnaire. Cost-effectiveness analysis will be performed from a societal perspective with the EuroQol five dimensions questionnaire and structured cost-interviews. DISCUSSION This study will add to the knowledge of psychotherapy in later life. The study specifically contributes to the evidence on (cost-) effectiveness of group SFT enriched with PMT adapted to the needs of for older adults with cluster b and/or c personality. TRIAL REGISTRATION Netherlands Trial Register NTR 6621 . Registered on 20 August 2017.
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Affiliation(s)
- S. D. M. van Dijk
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Post office box 30.001, 9700 RB Groningen, The Netherlands
| | - M. S. Veenstra
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Post office box 30.001, 9700 RB Groningen, The Netherlands
| | - R. Bouman
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Post office box 30.001, 9700 RB Groningen, The Netherlands
| | - J. Peekel
- Mediant Geestelijke Gezondheidszorg, Enschede, The Netherlands
| | - D. H. Veenstra
- Van Andel Ouderenpsychiatrie (GGZ Friesland), Leeuwarden, The Netherlands
| | - P. J. van Dalen
- Dimence, Mental Health Organization, Deventer, The Netherlands
| | - A. D. I. van Asselt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M. L. Boshuisen
- Lentis, Mental Health Organization, Groningen, The Netherlands
| | | | - R. H. S. van den Brink
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Post office box 30.001, 9700 RB Groningen, The Netherlands
| | - R. C. Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Post office box 30.001, 9700 RB Groningen, The Netherlands
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Axfors C, Hellgren C, Volgsten H, Skoog Svanberg A, Ekselius L, Wikström AK, Ramklint M, Skalkidou A, Sundström-Poromaa I. Neuroticism is associated with higher antenatal care utilization in obstetric low-risk women. Acta Obstet Gynecol Scand 2018; 98:470-478. [PMID: 30457176 DOI: 10.1111/aogs.13506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 11/13/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Elevated neuroticism is associated with higher health care utilization in the general population. This study aimed to investigate the association between neuroticism and the use of publicly financed antenatal care in obstetric low-risk women, taking predisposing and need factors for health care utilization into consideration. MATERIAL AND METHODS Participants comprised 1052 obstetric low-risk women (no chronic diseases or adverse pregnancy conditions) included in several obstetrics/gynecology studies in Uppsala, Sweden. Neuroticism was self-rated on the Swedish universities Scales of Personality. Medical records of their first subsequent pregnancy were scanned for antenatal care use. Associations between antenatal care use and neuroticism were analyzed with logistic regression (binary outcomes) or negative binomial regression (count outcomes) comparing the 75th and 25th neuroticism percentiles. Depending on the Akaike information criterion the exposure was modeled as either linear or with restricted cubic splines. Analyses were adjusted for predisposing (sociodemographic and parity) and need factors (body mass index and psychiatric morbidity). RESULTS After adjustment, women with higher neuroticism had more fetal ultrasounds (incidence rate ratio = 1.09, 95% confidence interval (CI) 1.02-1.16), more emergency visits to an obstetrician/gynecologist (incidence rate ratio = 1.22, 95% CI 1.03-1.45) and were more likely to visit a fear-of-childbirth clinic (odds ratio = 2.71, 95% CI 1.71-4.29). Moreover, they more often consulted midwives in specialized antenatal care facilities (significant J-shaped association). CONCLUSIONS Neuroticism was associated with higher utilization of publicly financed antenatal care in obstetric low-risk women, even after adjusting for predisposing and need factors. Future studies should address the benefits of interventions as a complement to routine antenatal care programs to reduce subclinical anxiety.
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Affiliation(s)
- Cathrine Axfors
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Charlotte Hellgren
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Helena Volgsten
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Lisa Ekselius
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Anna-Karin Wikström
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Mia Ramklint
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Alkistis Skalkidou
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Abstract
Trait stability and maturation are fundamental principles of contemporary personality psychology and have been shown to hold across many cultures. However, it has proven difficult to move beyond these general findings to a detailed account of trait development. There are pervasive and unexplained inconsistencies across studies that may be due to ( a) insufficient attention to measurement error, ( b) subtle but age-sensitive differences in alternative measures of the same trait, or ( c) different perspectives reflected in self-reports and observer ratings. Multiscale, multimethod-and ideally multinational-studies are needed. Several hypotheses have been proposed to account for trait stability and change, but supporting evidence is currently weak or indirect; trait development is a fertile if sometimes frustrating field for theory and research. Beyond traits, there are approaches to personality development that are of interest to students of adult development, and these may be fruitfully addressed from a trait perspective.
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Affiliation(s)
- Paul T Costa
- Behavioral Medicine Research Center and Department of Psychiatry and Behavioral Science, Duke University School of Medicine, Durham, North Carolina 27710, USA;
| | | | - Corinna E Löckenhoff
- Department of Human Development, Cornell University, Ithaca, New York 14850, USA;
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The Thick of It: Freely Wandering in Academic Medicine. Am J Geriatr Psychiatry 2018; 26:603-609. [PMID: 29433846 DOI: 10.1016/j.jagp.2017.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 12/04/2017] [Indexed: 11/22/2022]
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Hajek A, Bock JO, König HH. The role of general psychosocial factors for the use of cancer screening-Findings of a population-based observational study among older adults in Germany. Cancer Med 2017; 6:3025-3039. [PMID: 29030910 PMCID: PMC5727314 DOI: 10.1002/cam4.1226] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/12/2017] [Accepted: 09/17/2017] [Indexed: 11/24/2022] Open
Abstract
Within the framework of the health‐belief model, some studies exist investigating the association between illness‐specific psychosocial factors and the use of cancer screenings. However, studies investigating the association between general psychosocial factors and the use of cancer screenings are missing. Thus, this study aimed at examining the association between well‐established general psychosocial factors and the use of cancer screenings. Data were gathered from a large, population‐based sample of community‐dwelling individuals aged 40 and above in Germany (n = 7673; in 2014). Loneliness, cognitive well‐being, affective well‐being (negative and positive affect), optimism, self‐efficacy, self‐esteem, self‐regulation, perceived autonomy, perceived stress, and perceived social exclusion were used as general psychosocial factors. Furthermore, individuals were asked whether they regularly underwent early cancer screening in the past years (yes; no). A total of 65.6% of the individuals used cancer screening. Adjusting for sociodemographic factors, self‐rated health, morbidity and lifestyle factors, multiple logistic regressions revealed that the use of cancer screening is positively associated with decreased loneliness, cognitive well‐being, optimism, self‐efficacy, self‐esteem, self‐regulation, perceived autonomy, decreased perceived stress, decreased perceived social exclusion, and positive affect, while it is not associated with negative affect. This study stresses the strong association between general psychosocial factors and the use of cancer screening. This knowledge might be fruitful to address individuals at risk for underuse.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens-Oliver Bock
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Henning-Smith C, Prasad S, Casey M, Kozhimannil K, Moscovice I. Rural-Urban Differences in Medicare Quality Scores Persist After Adjusting for Sociodemographic and Environmental Characteristics. J Rural Health 2017; 35:58-67. [DOI: 10.1111/jrh.12261] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/21/2017] [Accepted: 07/17/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Carrie Henning-Smith
- Division of Health Policy and Management, Rural Health Research Center; University of Minnesota School of Public Health; Minneapolis Minnesota
| | - Shailendra Prasad
- Department of Family Medicine and Community Health; University of Minnesota School of Medicine; Minneapolis Minnesota
| | - Michelle Casey
- Division of Health Policy and Management, Rural Health Research Center; University of Minnesota School of Public Health; Minneapolis Minnesota
| | - Katy Kozhimannil
- Division of Health Policy and Management, Rural Health Research Center; University of Minnesota School of Public Health; Minneapolis Minnesota
| | - Ira Moscovice
- Division of Health Policy and Management, Rural Health Research Center; University of Minnesota School of Public Health; Minneapolis Minnesota
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Hajek A, Bock JO, König HH. The role of personality in health care use: Results of a population-based longitudinal study in Germany. PLoS One 2017; 12:e0181716. [PMID: 28746388 PMCID: PMC5528826 DOI: 10.1371/journal.pone.0181716] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 05/04/2017] [Indexed: 11/19/2022] Open
Abstract
Objective To determine the role of personality in health care use longitudinally. Methods Data were derived from the German Socio-Economic Panel (GSOEP), a nationally representative, longitudinal cohort study of German households starting in 1984. Concentrating on the role of personality, we used data from the years 2005, 2009 and 2013. Personality was measured by using the GSOEP Big Five Inventory (BFI-S). Number of physician visits in the last 3 months and hospital stays in the last year were used as measures of health care use. Results Adjusting for predisposing factors, enabling resources, and need factors, fixed effects regressions revealed that physician visits increased with increasing neuroticism, whereas extraversion, openness to experience, agreeableness and conscientiousness did not affect physician visits in a significant way. The effect of self-rated health on physician visits was significantly moderated by neuroticism. Moreover, fixed effects regressions revealed that the probability of hospitalization in the past year increased with increasing extraversion, whereas the other personality factors did not affect this outcome measure significantly. Conclusion Our findings suggest that changes in neuroticism are associated with changes in physician visits and that changes in extraversion are associated with the probability of hospitalization. Since recent studies have shown that treatments can modify personality traits, developing interventional strategies should take into account personality factors. For example, efforts to intervene in changing neuroticism might have beneficial effects for the healthcare system.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | - Jens-Oliver Bock
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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S Durvasula R, Halkitis PN. Delineating the Interplay of Personality Disorders and Health. Behav Med 2017; 43:151-155. [PMID: 28767019 PMCID: PMC6134178 DOI: 10.1080/08964289.2017.1337400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Perry N Halkitis
- b School of Public Health , Rutgers University
- c Center for Health, Identity, Behavior & Prevention Studies, New York University
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Hajek A, König HH. Locus of control and frequency of physician visits: Results of a population-based longitudinal study in Germany. Br J Health Psychol 2017; 22:414-428. [DOI: 10.1111/bjhp.12236] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 02/13/2017] [Indexed: 11/28/2022]
Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research; Hamburg Center for Health Economics; University Medical Center Hamburg-Eppendorf; Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research; Hamburg Center for Health Economics; University Medical Center Hamburg-Eppendorf; Germany
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Hajek A, Bock JO, König HH. Association of general psychological factors with frequent attendance in primary care: a population-based cross-sectional observational study. BMC FAMILY PRACTICE 2017; 18:48. [PMID: 28340559 PMCID: PMC5366110 DOI: 10.1186/s12875-017-0621-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 03/20/2017] [Indexed: 11/30/2022]
Abstract
Background Whereas several studies have examined the association between frequent attendance in primary care and illness-specific psychological factors, little is known about the relation between frequent attendance and general psychological factors. Thus, the aim of this study was to investigate the association between being a frequent attender in primary care and general psychological factors. Methods Data were used from a large, population-based sample of community-dwelling individuals aged 40 and above in Germany in 2014 (n = 7,446). Positive and negative affect, life satisfaction, optimism, self-esteem, self-efficacy, and self-regulation were included as general psychological factors. The number of self-reported GP visits in the past twelve months was used to quantify frequency of attendance; individuals with more than 9 visits (highest decile) were defined as frequent attenders. Results Multiple logistic regressions showed that being a frequent attender was positively associated with less life satisfaction [OR: 0.79 (0.70–0.89)], higher negative affect [OR: 1.38 (1.17–1.62)], less self-efficacy [OR: 0.74 (0.63–0.86)], less self-esteem [OR: 0.65 (0.54–0.79)], less self-regulation [OR: 0.74 (0.60–0.91)], and higher perceived stress [OR: 1.46 (1.28–1.66)], after adjusting for sociodemographic factors, morbidity and lifestyle factors. However, frequent attendance was not significantly associated with positive affect and self-regulation. Conclusions The present study highlights the association between general psychological factors and frequent attendance. As frequent GP visits produce high health care costs and are potentially associated with increased referrals and use of secondary health care services, this knowledge might help to address these individuals with high needs. Electronic supplementary material The online version of this article (doi:10.1186/s12875-017-0621-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Jens-Oliver Bock
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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46
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Fluegge K. The new frontier in health services research: a behavioural paradigm guided by genetics. J Health Serv Res Policy 2017; 22:68-71. [PMID: 27810890 PMCID: PMC5400703 DOI: 10.1177/1355819616664374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The incorporation of genetics into health services research has largely floundered, despite the rapidly accelerating availability of, and access to, such data. This is expected given the ethical questions involved. However, using these new resources robustly to examine population choices when it comes to health insurer selection, coverage therein and especially the subsequent use of health services is a necessary step forward, especially given the increasing prevalence of multimorbidity. Such a novel advancement in health services research may eventually propel public and private insurers to redesign their infrastructure to more accurately reflect the behavioural inclinations of their beneficiary populations. Using this resource will likely provide equally important insight for countries with extensive mixed insurer systems (like the United States) or nations with a greater emphasis on single-payer systems (such as various European models).
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Affiliation(s)
- Kyle Fluegge
- 1 Co-Director, Division of Disease Control, New York City Department of Health and Mental Hygiene, USA
- 2 Postdoctoral Fellow, Department of Epidemiology & Biostatistics, Case Western Reserve University School of Medicine, USA
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Hallgren J, Fransson EI, Kåreholt I, Reynolds CA, Pedersen NL, Dahl Aslan AK. Factors associated with hospitalization risk among community living middle aged and older persons: Results from the Swedish Adoption/Twin Study of Aging (SATSA). Arch Gerontol Geriatr 2016; 66:102-8. [PMID: 27281475 DOI: 10.1016/j.archger.2016.05.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 04/01/2016] [Accepted: 05/12/2016] [Indexed: 11/30/2022]
Abstract
The aims of the present study were to: (1) describe and compare individual characteristics of hospitalized and not hospitalized community living persons, and (2) to determine factors that are associated with hospitalization risk over time. We conducted a prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/Twin Study of Aging (SATSA). A total of 772 Swedes (mean age at baseline 69.7 years, range 46-103, 59.8% females) answered a postal questionnaire about physical and psychological health, personality and socioeconomic factors. During nine years of follow-up, information on hospitalizations and associated diagnoses were obtained from national registers. Results show that 484 persons (63%) had at least one hospital admission during the follow-up period. The most common causes of admission were cardiovascular diseases (25%) and tumors (22%). Cox proportional hazard regression models controlling for age, sex and dependency within twin pairs, showed that higher age (HR=1.02, p<0.001) and more support from relatives (HR=1.09, p=0.028) were associated with increased risk of hospitalization, while marital status (unmarried (HR=0.75, p=0.033) and widow/widower (HR=0.69, p<0.001)) and support from friends (HR=0.93, p=0.029) were associated with lower risk of hospitalization. Social factors were important for hospitalization risk even when medical factors were controlled for in the analyses. Number of diseases was not a risk in the final regression model. Hospitalization risk was also different for women and men and within different age groups. We believe that these results might be used in future interventions targeting health care utilization.
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Affiliation(s)
- Jenny Hallgren
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Eleonor I Fransson
- Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm 551 11, Sweden
| | - Ingemar Kåreholt
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Chandra A Reynolds
- Department of Psychology, University of Southern California, Riverside, USA
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna K Dahl Aslan
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Barkan T, Hoerger M, Gallegos AM, Turiano NA, Duberstein PR, Moynihan JA. Personality Predicts Utilization of Mindfulness-Based Stress Reduction During and Post-Intervention in a Community Sample of Older Adults. J Altern Complement Med 2016; 22:390-5. [PMID: 27031734 PMCID: PMC4860670 DOI: 10.1089/acm.2015.0177] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Mindfulness-based stress reduction (MBSR) is a promising intervention for older adults seeking to improve quality of life. More research is needed, however, to determine who is most willing to use the four techniques taught in the program (yoga, sitting meditation, informal meditation, and body scanning). This study evaluated the relationship between the Big Five personality dimensions (neuroticism, extraversion, openness to experience, conscientiousness, and agreeableness) and use of MBSR techniques both during the intervention and at a 6-month follow-up. The hypothesis was that those with higher levels of openness and agreeableness would be more likely to use the techniques. METHODS Participants were a community sample of 100 older adults who received an 8-week manualized MBSR intervention. Personality was assessed at baseline by using the 60-item NEO Five-Factor Inventory. Use of MBSR techniques was assessed through weekly practice logs during the intervention and a 6-month follow-up survey. Regression analyses were used to examine the association between each personality dimension and each indicator of MBSR use both during and after the intervention. RESULTS As hypothesized, openness and agreeableness predicted greater use of MBSR both during and after the intervention, while controlling for demographic differences in age, educational level, and sex. Openness was related to use of a variety of MBSR techniques during and after the intervention, while agreeableness was related to use of meditation techniques during the intervention. Mediation analysis suggested that personality explained postintervention MBSR use, both directly and by fostering initial uptake of MBSR during treatment. CONCLUSIONS Personality dimensions accounted for individual differences in the use of MBSR techniques during and 6 months after the intervention. Future studies should consider how mental health practitioners would use these findings to target and tailor MBSR interventions to appeal to broader segments of the population.
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Personality and coping in first episode psychosis linked to mental health care use. Psychiatry Res 2016; 238:218-224. [PMID: 27086236 DOI: 10.1016/j.psychres.2016.02.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 02/03/2016] [Accepted: 02/16/2016] [Indexed: 12/24/2022]
Abstract
A body of literature focuses on associations of neuroticism, extraversion, passive coping and active coping with the course of psychotic illness. Less is known about other personality and coping variables - and underlying causal mechanisms between variables remain unclear. We explored causal effects from personality, coping and symptoms on mental health care consumption over two years in 208 first episode patients. Causal inference search algorithms lead to formation of a hypothetical causal model based on presumptions on (non-)mutuality between variables and consistent with data. Structural equation modelling estimated effect sizes conditionally on the causal model. Our observed model implies that none of the coping or personality variables have any effect on the number of days of hospitalisation, whereas general psychopathology symptoms do have a direct positive effect. For ambulatory care it is proposed that openness to experience, depressive symptoms and age have direct positive effects. Reassuring thoughts as a coping strategy seems to have a direct negative effect on the use of ambulatory care and mediates indirect effects of other personality and coping variables on ambulatory care. Furthermore, while previously established relations between personality and symptoms are confirmed by our model, it challenges traditional ideas about causation between personality and symptoms.
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Lattie EG, Asvat Y, Shivpuri S, Gerhart J, O'Mahony S, Duberstein P, Hoerger M. Associations Between Personality and End-of-Life Care Preferences Among Men With Prostate Cancer: A Clustering Approach. J Pain Symptom Manage 2016; 51:52-9. [PMID: 26344553 PMCID: PMC4698197 DOI: 10.1016/j.jpainsymman.2015.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/13/2015] [Accepted: 08/21/2015] [Indexed: 10/23/2022]
Abstract
CONTEXT Increased focus on patient-centered care models has contributed to greater emphasis on improving quality of life at the end of life through personalized medicine. However, little is known about individual-level factors impacting end-of-life care preferences. OBJECTIVES To examine whether the five-factor model of personality explains variation in preferences for end-of-life care in men with prostate cancer. METHODS Two hundred twelve men with a prostate cancer diagnosis (mean age = 62 years) completed a measure of the five-factor model of personality--spanning the personality dimensions of neuroticism, agreeableness, extraversion, openness, and conscientiousness--and reported on end-of-life care preferences. Cluster analyses were used to partition the sample into groups with similar care preferences. Analyses of variance and Chi-square tests were used to evaluate differences in care preferences among the groups. RESULTS Cluster analyses revealed three groups of participants: "comfort-oriented patients," "service-accepting patients," and "service-reluctant patients." Most (67%) were comfort oriented, preferring palliative care and opposing life support services. A subset of patients were service accepting (17%), preferring both palliative care and life support, or were service reluctant (16%), preferring neither. Service-reluctant patients endorsed significantly higher levels of neuroticism (emotional instability and negativity) than comfort-oriented patients. Comfort-oriented patients endorsed significantly higher levels of agreeableness than service-accepting patients and service-reluctant patients. CONCLUSION Findings suggest that personality traits are associated with specific health care preferences. Individuals high on neuroticism are likely to report reluctance toward all forms of end-of-life care and may benefit from in-depth information about the process and likely outcomes of receiving life support and palliative care services.
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Affiliation(s)
- Emily G Lattie
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
| | - Yasmin Asvat
- Siteman Cancer Center, Barnes-Jewish Hospital, St. Louis, Missouri, USA
| | - Smriti Shivpuri
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - James Gerhart
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Sean O'Mahony
- Department of Palliative Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Paul Duberstein
- Departments of Psychiatry and Family Medicine, University of Rochester, Rochester, New York, USA
| | - Michael Hoerger
- Departments of Psychology, Psychiatry, and Medicine, Tulane University, New Orleans, Louisiana, USA
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