Factors influencing self-perception of health status

Awareness of Healthy Lifestyle Among Elderly Population During Aging in Al-Ahsa, Saudi Arabia

INTRODUCTION

The research explores healthy aging among elderly individuals globally and in Saudi Arabia. Factors like health services, lifestyle, and chronic diseases affecting seniors are examined. However, there is a gap in culturally relevant research, particularly in Arabic-speaking countries. This study aims to understand elderly individuals' knowledge, attitudes, and practices regarding healthy lifestyles for effective functional preservation in aging.

METHODOLOGY

A cross-sectional study was conducted in the eastern part of Saudi Arabia, specifically Al-Ahsa, from February to May 2023. The Raosoft calculator was employed to determine a sample size of at least 384 participants. The data was analyzed using SPSS.

RESULTS

Regarding the associations between knowledge levels and demographics, education significantly impacts knowledge (p=0.003). Retired respondents exhibit higher knowledge (50.4%) compared to those with jobs (10.4%) (p=0.002). Smoking has a significant impact on knowledge (p=0.012). Regarding the opinions on elderly care, respondents agree on the importance of fresh fruits and vegetables (52.2%), increased protein intake (64.3%), less fat (83.5%), and regular exercise (44.3%). Supplements' necessity is disagreed upon (95.7%). Living with family is favored (67.8%), and elderly self-management is recognized (60.9%). Significant differences are seen in fruit and vegetable consumption (p=0.001), less fat usage (p=0.000), exercise habits (p=0.000), smoking (p=0.000), and using just salt in cooking (p=0.000).

CONCLUSION

Study findings underscore the importance of education in influencing healthy behaviors and informed choices, with education levels significantly impacting knowledge levels. Respondents' preferences for balanced diets, exercise, and self-management reflect a positive trend toward embracing healthy aging principles. Notably, the study identifies disparities between knowledge groups in various lifestyle factors, highlighting the potential of education to drive positive changes in behaviors.

Does noncompliance with COVID-19 regulations impact the depressive symptoms of others?

Before vaccines became commonly available, compliance with nonpharmaceutical only preventive measures offered protection against COVID-19 infection. Compliance is therefore expected to have physical health implications for the individual and others. Moreover, in the context of the highly contagious coronavirus, perceived noncompliance can increase the subjective risk assessment of contracting the virus and, as a result, increase psychological distress. However, the implications of (public) noncompliance on the psychological health of others have not been sufficiently explored in the literature. Examining this is of utmost importance in light of the pandemic's elevated prevalence of depressive symptoms across countries. Using nationally representative data from South Africa, we explore the relationship between depressive symptoms and perceived noncompliance. We examine this relationship using a double machine learning approach while controlling for observable selection. Our result shows that the perception that neighbors are noncompliant is correlated with self-reported depressive symptoms. Therefore, in the context of a highly infectious virus, noncompliance has detrimental effects on the wellbeing of others.

Effect of ethnicity, country of origin and workplace on health behaviors and health perception among nurses: Cross-sectional study

PURPOSE

The study aimed to (1) examine health behaviors and perceived health among nurses; (2) analyze the effect of nurses' personal and work characteristics on these variables; and (3) explore the relationship between health behaviors and nurses' health perception.

DESIGN AND METHODS

A cross-sectional study was conducted among nurses working in health care organizations (HCOs) across Israel. An email with the online questionnaire was sent to nurses working in 19 HCOs across Israel during September-December 2018.

FINDINGS

Of 18,120 nurses employed, 3542 completed the survey. Mean age was 44.8 years, 91% were female), 64.6% were hospital nurses and 52.8% were clinical staff nurses. Two-thirds of nurses did not achieve the physical activity (PA) target; the majority reported unfavorable eating habits; 66% slept less than 7 h at night and 15% smoke. Hospital nurses working night shifts reported the least favorable health behaviors. Non-Jewish nurses had less eating habits compared with Jewish nurses. Nurses born in the Former Soviet Union perceived their health as significantly worse than that of the other respondents. Binomial logistic regression demonstrated that, age, Israeli origin, achieving the PA target, having food breaks during work, consuming a Mediterranean diet, sleeping at least 7 h, undergoing screening tests as recommended, and not smoking predicted better health perception among nurses.

CONCLUSIONS

Nurses, particularly hospital-based, non-Jewish and immigrants from the Soviet Union, demonstrated unfavorable health behaviors that may negatively affect their wellbeing and health perception.

CLINICAL RELEVANCE

Interventions aimed at improving the health promoting mindset of nurses have the potential to improve their health and wellbeing and to enable them to become role models and health educators for patients and their families.

Barriers and strategies to successful tuberculosis treatment in a high-burden tuberculosis setting: a qualitative study from the patient's perspective

Background

Previously treated tuberculosis (TB) patients are a widely reported risk factor for multidrug-resistant tuberculosis. Identifying patients’ problems during treatment is necessary to control TB, especially in a high-burden setting. We therefore explored barriers to successful TB treatment from the patients’ perspective, aiming to identify potential patient-centred care strategies to improve TB treatment outcome in Indonesia.

Methods

A qualitative study was conducted in a province of Indonesia with high TB prevalence. Participants from various backgrounds (i.e., TB patients, physicians, nurses, pharmacists, TB activist, TB programmers at the district and primary care levels) were subject to in-depth interviews and focus group discussions (FGDs). All interviews and FGDs were transcribed verbatim from audio and visual recordings and the respective transcriptions were used for data analysis. Barriers were constructed by interpreting the codes’ pattern and co-occurrence. The information’s trustworthiness and credibility were established using information saturation, participant validation and triangulation approaches. Data were inductively analysed using the Atlas.ti 8.4 software and reported following the COREQ 32-items.

Results

We interviewed 63 of the 66 pre-defined participants and identified 15 barriers. The barriers were classified into three themes, i.e., socio-demography and economy; knowledge and perception and TB treatment. Since the barriers can be interrelated, we determined five main barriers across all barrier themes, i.e., lack of TB knowledge, stigmatisation, long distance to the health facility, adverse drug reaction and loss of household income.

Conclusion

The main treatment barriers can be considered to strengthen patient-centred care for TB patients in Indonesia. A multi-component approach including TB patients, healthcare providers, broad community and policy makers is required to improve TB treatment success.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12005-y.

Do overweight/obesity and low levels of leisure-time vigorous physical activity moderate the effect of occupational physical activity on self-rated health of construction workers?

Purpose

To investigate the combined effects of occupational physical activity (OPA) and either overweight/obesity or low levels of leisure-time vigorous physical activity (LTVPA) on self-rated health.

Methods

A longitudinal study was performed among 29,987 construction workers with complete data on 2 Workers’ Health Surveillance Programs during 2010–2018. Self-reported OPA involved strenuous work postures and manual material handling. Low level of LTVPA was defined as self-reported vigorous activity for less than three times per week lasting at least 20 min per session. Overweight and obesity were based on Body Mass Index (BMI) (25.0 ≤ BMI < 30.0 kg/m² and BMI ≥ 30.0 kg/m², respectively) using measured body height and weight. Self-rated health was measured using a single item question. Logistic regression analysis was used to investigate the associations between the separate risk factors at baseline and self-rated health at follow-up. The combined effects of demanding OPA and either overweight/obesity or low level of LTVPA on self-rated health were analyzed using the relative excess risk due to interaction (RERI).

Results

Mean follow-up duration was 31.7 (SD = 14.9) months. Construction workers with strenuous work postures (OR 1.35 95% CI 1.25–1.46), manual material handling (OR 1.29 95% CI 1.19–1.40), obesity (OR 1.31 95% CI 1.17–1.47) and low LTVPA (OR 1.13 95% CI 1.01–1.25) were more likely to report poor self-rated health at follow-up. No statistically significant interaction effects were found for OPA and obesity or low LTVPA.

Conclusions

OPA, obesity and low level of LTVPA were separate risk factors for poor self-rated health, but did not appear to have a synergistic effect.

Behavioral impact of national health campaigns on healthy lifestyle practices among young adults in Singapore: a cross-sectional study

Background

National health campaigns are often used to improve lifestyle behaviors in the general population. However, evidence specifically in the young adult population is scarce. Given the general deterioration of healthy lifestyle practices from adolescence to young adulthood, it is imperative to study this age group. This study aimed to investigate the behavioral impact of a national health campaign in Singapore on the lifestyle practices of young adults, and whether sex or full-time working and schooling status affected lifestyle practices.

Methods

A total of 594 Singaporean respondents aged 18–39 years old were interviewed via a cross-sectional study in December 2019. Lifestyle practices assessed were diet, exercise, alcohol consumption, current tobacco use, and participation in health screening programs. Other factors investigated included exposure to the national health campaign “War on Diabetes” (WoD), sex, ethnicity, and working/schooling status. Multivariable modified Breslow-Cox proportional hazards models were used to estimate prevalence risk ratios (PRRs) as measures for the associations in this study, after adjusting for potential confounders.

Results

Exposure to the WoD campaign had a significant association with meeting dietary recommendations (PRR = 1.6, 95% CI: 1.0–2.5, p = 0.037), participation in screening (PRR = 1.2, 95% CI: 1.0–1.5, p = 0.028), and current tobacco use (PRR = 0.5, 95% CI: 0.3–0.8, p = 0.003). Males were significantly more likely to meet exercise recommendations (PRR = 2.0, 95% CI: 1.5–2.7, p < 0.001), currently use tobacco (PRR = 3.9, 95% CI: 2.2–6.9, p < 0.001), and consume alcohol excessively (PRR = 1.5, 95% CI: 1.0–2.3, p = 0.046), as compared to females. Working young adults were significantly less likely to meet exercise recommendations (PRR = 0.7, 95% CI: 0.5–0.9, p = 0.019) but significantly more likely to be current tobacco users (PRR = 1.8, 95% CI: 1.1–3.1, p = 0.024), as compared to those who were in school.

Conclusions

While this paper affirms that national health campaigns have significant beneficial associations in diet, health screenings and current tobacco use, policymakers should acknowledge that young adults are an age group with different influences that impact their healthy lifestyle habits. Specific interventions that target these subgroups may be required for better health outcomes. Future studies should evaluate other socio-environmental factors that could play a role in modifying the effect of health campaigns among young adults.

Hierarchical Regression of Wellbeing and Self-Rated Health among Older Adults in Abu Dhabi

This study investigates the wellbeing factors related to self-rated health for older adults in Abu Dhabi (≥55 years). The purpose is to provide a comprehensive analysis of the determinants of self-rated health, considering various wellbeing factors, controlling for factors such as gender, nationality and long-standing illness if present. This research drew from a sample of 2375 older adults who participated in the Abu Dhabi Quality-of-Life Survey (QoL) conducted in 2018. Hierarchical multiple regression analysis was employed where the first two models corresponded to gender, nationality and having a long-standing illness or not. The third model focused on the wellbeing factors of Abu Dhabi citizens (i.e., social networks and connection, income and housing, sports and activities, mental feelings). The analysis revealed the insignificance of gender and nationality as controlled variables while having a long-standing illness showed significant adverse effects. The most significant variables were social support networks, family and social arrangements and connections. Other variables of significance included housing satisfaction, household income satisfaction, frequency of practicing sports, current mental status and life satisfaction. Policymakers could use the outcomes as insider intelligence for policymakers and social work professionals to create policies, programs and services to enhance the lives of older people in Abu Dhabi.

Questionnaires for assessing self-perceived physical fitness: A systematic review

This systematic review aimed to identify and summarize the reliability and validity of the questionnaires that have been designed for assessing self-perceived physical fitness (PF) in elderly people. Three electronic databases (MEDLINE/PubMed, SPORTDiscuss and Scopus) were searched systematically from their inception until March 2021 in order to find investigations that provided information on the reliability and/or validity of questionnaires used for identifying self-perceived PF in this population. Nine studies fulfilled these criteria, and seven questionnaires were found, five of them being specifically designed for the elderly. Concurrent validity was mostly obtained by correlating the items of the questionnaires with PF field-based tests, and poor to moderately strong associations were obtained. Test-retest reliability was informed in five questionnaires, and high values were generally observed. The SRFit questionnaire showed the best rates of concurrent validity and test-retest reliability, although these results were partially affected by the mean age of the sample. The lack of a rigorous methodological approach when designing these questionnaires detected in this review, asks for further studies using quantitative and qualitative approaches in order to create more solid and valid measurement tools.

Thinking of future as an older individual increases perceived risks for age-related diseases but not for COVID-19

Actively thinking of one's future as an older individual could increase perceived risk and risk aversion. This could be particularly relevant for COVID‐19, if we consider the common representation of the risk of being infected by COVID‐19 as associated with being older. Increased perceived risk could bear consequences on the adoption of preventive behaviours. Thus, we investigated whether increasing the salience of individuals' future as an older adult would impact on their perceived risk for COVID‐19 and medical conditions varying for age‐relatedness. One hundred and forty‐four Italian adults (M_age = 27.72, range: 18–56) were randomly assigned to either a future as older adult thinking or control condition. Perceived risk for COVID‐19 and other strongly, and weakly age‐related medical conditions during the lifetime was measured. Results showed that thinking about the future as an older adult increased perceived risk for strongly and weakly age‐related diseases, but not for COVID‐19. The salience of the COVID‐19 outbreak may have raised the perceived risks in both experimental conditions, making the manipulation ineffective. In conclusion, manipulating future‐oriented thinking might be a successful communication strategy to increase people's perceived risk of common diseases, but it might not work for highly salient pathologies such as COVID‐19.

Health literacy, health perception and related factors among different ethnic groups: a cross-sectional study in southeastern Turkey

BACKGROUND

Low levels of health literacy are associated with increased hospitalization rates, problems regarding the proper intake of medications, poor general health and increased mortality rates. It is a well-known fact that health literacy differs among ethnic groups and ethnic minorities, in particular, are known to have a low level of health literacy. The present study aimed to reveal the levels of health literacy among different ethnic groups and the affecting factors as well as the relationship between health literacy and health perceptions.

METHODS

This cross-sectional study was carried out with different ethnic groups (Kurdish, Arab, Turkish and Assyrian origin), between 18 and 65 years old in the province of Mardin in Turkey. The study was conducted with a total of 600 people. The European Health Literacy Scale-Turkish Adaptation (EHLS-TR) and Health Perception Scale (HPS) were used for measurement. Descriptive analysis, Mann Whitney U Test, Kruskal Wallis Test and Spearman correlation were used in the data analysis.

RESULTS

It was found that 80.7% of the participants had relatively low levels of health literacy. The lowest levels of health literacy were among those of Kurdish origin. There were correlations between sufficient levels of health literacy and several factors including being of Assyrian origin, being 50-65 years old, living in a nuclear family, being a secondary school graduate, having a high financial status, being retired, evaluating one's own health status as good, obtaining health information from healthcare professionals, preferring to visit a state hospital to seek medical assistance first, smoking and drinking alcohol. A positive correlation was also identified between the levels of health literacy and health perception.

CONCLUSIONS

It is essential to develop programs to increase health literacy for the public and, in particular, for the ethnic groups that are disadvantaged in many aspects in the context of health literacy.

Primary dysmenorrhea and postural control: Is it a problem only during menstruation?

BACKGROUND

The effects of the menstrual cycle and primary dysmenorrhea (PD) on phase-related cognitive and physical functions are controversial. This study was carried out to examine whether women with PD showed a different physical function or dual-tasking response than women without PD at times other than menstruation.

METHODS

Women with or without PD were recruited for the study. Individuals assessed on the first day of the menstruation and the day they reported themselves as well being (feeling good day-FGD). Zebris © FDM Type Force Platform was used to evaluate postural stability. Individuals have were asked to perform to a 3-step balance test protocol; the first session: comfortable upright standing; the second session: standing with a motor task; the third session: standing with a cognitive task (counting backward). Correctly calculated numbers were also recorded.

RESULTS

The number of correct answers given by individuals during the cognitive dual-task was similar on the first day of menstruation and FGD (p > 0.05). In the control group, no difference was observed between the first days of menstruation and the evaluations on FGD days with dual-task (p > 0.05). In individuals with PD, there was no difference between the measurements at different times (p > 0.05). However, in the assessment with the motor dual-task on the first day of menstruation; postural sway increased (p < 0,05). In FDG measurement; distortion in postural stability was observed with the cognitive task (p < 0,05). In the assessments performed on the first day of menstruation, there was no difference in any parameters between the groups (p > 0.05). In the measurements made on FGD day with the cognitive task; there was a difference between the groups (p < 0,05). Individuals with PD had higher postural sway.

SIGNIFICANCE

This study showed that the primary dysmenorrhea is not only a problem for females during menstruation, primary dysmenorrhea causes impaired ability of the individual to perform dual-tasking and continuously affects postural stability.

Age-specific differences in patient reported outcomes among adults with atherosclerotic cardiovascular disease: Medical expenditure panel survey 2006-2015

Objective

The prevalence of atherosclerotic cardiovascular disease (ASCVD) in younger adults has increased over the past decade. However, it is less well established whether patient reported outcomes differ between younger and older adults with ASCVD. We sought to evaluate age-specific differences in patient reported outcomes among adults with ASCVD.

Methods

This was a retrospective cross-sectional survey study. We used data from the 2006–2015 Medical Expenditure Panel Survey (MEPS), a nationally representative sample of the United States population. Adults ≥18 years with a diagnosis of ASCVD, ascertained by ICD9 codes or self-reported data, were included. Logistic regression was used to compare self-reported patient-clinician communication, patient satisfaction, perception of health, emergency department (ED) visits, and use of preventive medications (aspirin and statins) by age category [Young: 18–44, Middle: 45–64, Older: ≥65 years]. We used two-part econometric modeling to evaluate age-specific annual healthcare expenditure.

Results

There were 21,353 participants included. Over 9000 (42.6%-weighted) of the participants were young or middle aged, representing ~9.9 million adults aged <65 years with ASCVD nationwide. Compared with older adults, middle-aged and young adults with ASCVD were more likely to report poor patient-clinician communication [OR 1.73 (95% CI 1.28–2.33) and 2.49 (1.76–3.51), respectively], poor healthcare satisfaction, and poor perception of health status, have increased ED utilization and were also less likely to be using aspirin and statins. The mean annual healthcare expenditure was highest among middle-aged adults [$10,798 (95% CI, $10,012 to $11,583)].

Conclusion

Compared with older adults, younger adults with ASCVD were more likely to report poor patient experience and poor health status and less likely to be using preventive medications. More effort needs to be geared towards understanding the age-specific differences in healthcare quality and delivery to improve outcomes among high-risk young adults with ASCVD.

1

In a sample of US adults with ASCVD we compared young & middle-age to older adults.

2

Young adults were more likely to report poor healthcare communication & satisfaction.

3

Young adults at a higher risk for depression and have poorer health perception.

4

Young adults with ASCVD were less likely to be using aspirin and statins.

5

More effort needed to understanding age-specific differences in patient experience.

Clinical and Psychological Impact of COVID-19 Infection in Adult Patients with Eosinophilic Gastrointestinal Disorders during the SARS-CoV-2 Outbreak

Eosinophilic gastrointestinal diseases (EGIDs) are chronic gastrointestinal conditions requiring corticosteroid and immunosuppressive therapy for disease control. Patients with EGIDs usually report impaired quality of life. We aimed to report the clinical and psychological impact of COVID-19 infection in EGID patients. In this prospective web-based study we invited all consecutive EGID patients attending the University Hospital of Salerno (Campania) and Padua (Veneto) to fill an ad hoc COVID-19 survey. Moreover, a telemedicine service for direct consultation was organized. Data regarding the occurrence and perception of COVID-19 infection as well as clinical information were recorded. The study population included 102 EGID patients (mean age 36.6 years, 34 females), of whom 89 had eosinophilic esophagitis, nine had gastroenteritis, and four had colitis. No patient was diagnosed with COVID-19 or had recurrence of his/her primary disease. All of them were adherent to therapy and preventive measures adoption. Most patients were worried because of COVID-19 and social preventing measures but did not consider themselves at major risk or susceptible to COVID-19 or other infections due to their chronic condition or therapy. Female gender and low education level were associated to a higher psychological perception of COVID-19 compared to lockdown status or other demographic and clinical factors (p < 0.05). Overall, COVID-19 had a limited clinical impact on patients with EGIDs. The degree of education and sex, but not the fact of living in a lockdown area, influenced the perception of SARS-CoV-2 infection.

Clinical and Psychological Impact of COVID-19 Infection in Adult Patients with Eosinophilic Gastrointestinal Disorders during the SARS-CoV-2 Outbreak

Eosinophilic gastrointestinal diseases (EGIDs) are chronic gastrointestinal conditions requiring corticosteroid and immunosuppressive therapy for disease control. Patients with EGIDs usually report impaired quality of life. We aimed to report the clinical and psychological impact of COVID-19 infection in EGID patients. In this prospective web-based study we invited all consecutive EGID patients attending the University Hospital of Salerno (Campania) and Padua (Veneto) to fill an ad hoc COVID-19 survey. Moreover, a telemedicine service for direct consultation was organized. Data regarding the occurrence and perception of COVID-19 infection as well as clinical information were recorded. The study population included 102 EGID patients (mean age 36.6 years, 34 females), of whom 89 had eosinophilic esophagitis, nine had gastroenteritis, and four had colitis. No patient was diagnosed with COVID-19 or had recurrence of his/her primary disease. All of them were adherent to therapy and preventive measures adoption. Most patients were worried because of COVID-19 and social preventing measures but did not consider themselves at major risk or susceptible to COVID-19 or other infections due to their chronic condition or therapy. Female gender and low education level were associated to a higher psychological perception of COVID-19 compared to lockdown status or other demographic and clinical factors (p < 0.05). Overall, COVID-19 had a limited clinical impact on patients with EGIDs. The degree of education and sex, but not the fact of living in a lockdown area, influenced the perception of SARS-CoV-2 infection.

The effect of facilities management of common areas on the environment domain of quality of life or older people in private buildings

Purpose

The world was facing significant aging challenges. Aging in place has long been advocated which reflected the preference of older people to stay in their own home as long as possible. A huge amount of older people resided in private buildings that consist of both indoor settings (i.e. individual unit flats) and outdoor settings (i.e. common areas like lobby and corridor). The effect of indoor environment on the quality of life of the older people has been investigated, while this paper aims to examine the different effect of common areas environment for the older people.

Design/methodology/approach

A questionnaire survey was administered among over 300 older people living in private buildings. Multiple statistical techniques, including reliability test, correlation coefficient and multiple regression models, were used to analyze the collected data to determine the interactions between facilities management of the common areas in private buildings and the environment domain of quality of life for older people.

Findings

The final results were concluded based on the congruence of all the statistical results, which covered the identification of facilities management factors in common areas of private buildings that could influence the environment domain of quality of life for older people, including overall environment, health-care accessibility, information acquisition and transportation aspects; the overall environment was positively predicted by space and security in common areas of private building; health-care accessibility was positively affected by space, barrier-free facilities and recreational facilities; the information acquisition was only positively predicted by security; transportation was positively predicted by distance and recreational facilities; and building services of common areas in private buildings had no effect on the environment domain of quality of life for older people.

Originality/value

Practical recommendations have been made to improve the facilities management of common areas in private buildings to ensure the quality of life for older people, including provision of walking assistance, motion or infrared controlled systems and so on. This study contributed to enhance current understanding of the interactions between the older people and their living environment.

New Integrated Model Approach to Understand the Factors That Drive Electronic Health Record Portal Adoption: Cross-Sectional National Survey

Background

The future of health care delivery is becoming more patient-focused, and electronic health record (EHR) portals are gaining more attention from worldwide governments that consider this technology as a valuable asset for the future sustainability of the national health care systems. Overall, this makes the adoption of EHR portals an important field to study.

Objective

The aim of this study is to understand the factors that drive individuals to adopt EHR portals.

Methods

We applied a new adoption model that combines 3 different theories, namely, extended unified theory of acceptance and use of technology, health belief model, and the diffusion of innovation; all the 3 theories provided relevant contributions for the understanding of EHR portals. To test the research model, we used the partial least squares causal modeling approach. We executed a national survey based on randomly generated mobile phone numbers. We collected 139 questionnaires.

Results

Performance expectancy (beta=.203; t=2.699), compatibility (beta=.530; t=6.189), and habit (beta=.251; t=2.660) have a statistically significant impact on behavior intention (R²=76.0%). Habit (beta=.378; t=3.821), self-perception (beta=.233; t=2.971), and behavior intention (beta=.263; t=2.379) have a statistically significant impact on use behavior (R²=61.8%). In addition, behavior intention (beta=.747; t=10.737) has a statistically significant impact on intention to recommend (R²=69.0%), results demonstrability (beta=.403; t=2.888) and compatibility (beta=.337; t=2.243) have a statistically significant impact on effort expectancy (R²=48.3%), and compatibility (beta=.594; t=6.141) has a statistically significant impact on performance expectancy (R²=42.7%).

Conclusions

Our research model yields very good results, with relevant R² in the most important dependent variables that help explain the adoption of EHR portals, behavior intention, and use behavior.

Determinants of self-rated health in elderly populations in urban areas in Slovenia, Lithuania and UK: findings of the EURO-URHIS 2 survey

Background

Ageing imposes extra financial burdens on social and health services in developed countries. Self-rated health (SRH) is considered to be both a reliable measurement of overall health status including morbidity and mortality and an important predictor of hospitalization, functional impairment and greater demand for health-care services in the elderly. Our aim was to identify factors associated with poor SRH in elderly populations and investigate possible differences between urban areas in Slovenia, Lithuania and UK. Data were obtained from population-based surveys from the European Urban Health Indicator System Part 2 project. The stratified representative sample (41% men and 59% women) consisted of a total of 2547 respondents aged ≥65 from the urban areas in the three countries. The prevalence of poor SRH was highest in Lithuanian urban areas. The strongest factors associated with poor SRH were low education [OR (odds ratio) 4.3, 95% CI (confidence interval) 2.5-7.3, P < 0.001], restriction of activities attributable to a chronic disease (OR 2.6, 95% CI 2.2-3.0, P < 0.001), inadequate physical activity (OR 1.7, 95% CI 1.2-2.5, P = 0.007) and poor mental health (OR 1.1, 95% CI 1.1-1.2, P < 0.001). The main factors associated with poor SRH by country included the following: living alone (Slovenia) (OR 2.0, 95% CI 1.1-3.7, P = 0,023), female sex (Lithuania) (OR 2.0, 95% CI 1.0-4.2, P = 0.058) and inadequate physical activity (UK) (OR 2.2, 95% CI 1.3-3.6, P = 0,003). Despite different levels of poor SRH, the factors associated with poor SRH were similar for the urban areas of the three countries. Factors associated with poor SRH in the urban areas could also reflect either cultural differences or specific situations for elderly in that country, which need further research.

Gender differences in psychosocial predictors of self-perceived health status in the elderly: Evidence from a Brazilian community study

This article aims to identify the psychosocial factors associated with self-perceived health status in the Brazilian elderly population and to present differences related to gender. The data were collected by questionnaire, including sociodemographic and behavioral questions, and scales for psychological dimensions. Self-perceived health status is related to level of education, physical activity, and self-efficacy in the total population. Regarding gender differences, self-rated health status among men is related to education level and self-efficacy and in women to level of education, physical activity, social support, and self-efficacy. These results can inform future health promotion interventions.

Association between working time quality and self-perceived health: analysis of the 3rd Korean working conditions survey (2011)

Background

Self-perceived health, a subjective assessment of one’s health condition, is an important health indicator at the level of quality of life. In this study, working time quality refer to job factors with qualitative aspects of working time. This study was conducted to investigate the association between working time quality and self-perceived health in paid workers in Korea.

Methods

In this study, 35,902 paid workers were analyzed based on the 3rd Korean working conditions survey. For independent variables, working time quality (working at night, working in the evenings, working on Sundays, working on Saturdays, and working more than 10 h a day) were set as major job-related variables. Other occupational characteristics were divided into 6 groups and general characteristics were divided into 6 groups, and univariate analysis was conducted with self-perceived health, a dependent variable. Variables that had significance in the univariate analysis were used for multivariate logistic regression analysis.

Results

In the univariate analysis using Chi-square test, variables showing significance in self-perceived health were age, income, education, occupation, employment type, work hours per week, and shift work. Working time quality showed a significant association with self-perceived health. After adjusting for these variables using logistic regression analysis, working at night, working in the evening, working on Sundays, and working more than 10 h a day showed significant association with self-perceived health.

Conclusions

This study showed a statistically significant association between working time quality of employees with self-perceived health.

Self-perceived health among workers at a University Hospital and associations with indicators of adiposity, arterial blood pressure and physical activity habits

It has been shown that self-perceived health has a close relationship with indicators of morbidity and mortality. Since there is a lack of information on the self-perceived health status of hospital workers, the objective of this study was to determine the prevalence of satisfaction with health among people working at a University Hospital (UH) and its associations with indicators of adiposity, arterial blood pressure (BP) and physical activity (PA). A total of 380 adults took part in the study, with ages ranging from 20 to 59 and a mean age of 43.92 (SD = 8.46) years. Self-perceived health was assessed using a question from the "WHOQOL-bref" questionnaire. Overall satisfaction with health was 60.8%, and women reported lower satisfaction than men. An analysis adjusted for sex showed that having a healthy BMI was associated with the highest rate of satisfaction with health (PR = 1.478 [95%CI: 1.272 - 1.717]), followed by WC (PR = 1.323 [95%CI: 1.135 - 1.541]). Neither BP nor PA were associated with self-perceived health. It was concluded that the UH workers are aware of risks to their health, but that they do not recognize the importance of maintaining healthy blood pressure or of engaging in regular PA in order to delay onset of chronic conditions that could be harmful to them.

Economic shocks and health resilience: lessons from the Russian Federation

Background

Despite extensive research on determinants of health, there is much less information on factors protecting health among those exposed to economic shocks. Using longitudinal data from the Russian Federation in the post-Soviet period, we examined individual-level factors that enhance resilience of health to economic shocks.

Methods

Logistic regression analysed factors associated with good self-assessed health (SAH) and health resilience, using pooled samples from the Russia Longitudinal Monitoring Survey-Higher School of Economics (1994–2012).

Results

The general population consistently reported ‘average’ SAH, indicating almost invariant trends over the years. Male gender was the strongest predictor of good SAH and health resilience. Other factors positively associated with good SAH were age, higher education, employment, residing in rural areas, living in a larger and/or non-poor household. Among unemployed and those remaining unemployed, residing in rural areas, living in a larger and/or non-poor household remained the strongest predictors of good SAH and health resilience. These same factors were also important for males with recent job loss.

Conclusions

Several factors predicting good SAH in the general population also influence health resilience factors among those remaining unemployed and experiencing a job loss. Such factors help to identify those most vulnerable and aid targeting assistance during economic crises.

Going beyond life expectancy in assessments of health systems' performance: life expectancy adjusted by perceived health status

International comparisons of health systems data have been used to guide health policy. Health systems performance is generally evaluated on how different factors contribute to mortality and longevity. Fewer studies scrutinize the factors that determine morbidity in different countries, partly because indicators that assess morbidity on a country level are not as widely available as mortality and longevity data. We introduce a new health status indicator able to combine mortality and morbidity in a single composite measure for each country and gender at a point in time (LEAPHS), yielding the average number of years that men (women) can expect to live in "good" (or better) health. Using the Sullivan method we combine the mortality risk, calculated for specific age and gender groups, with perceived health status for the same age and gender groups, and we estimate how medical care and various socio-economic, environmental and structural, lifestyle, and technological factors affect LEAPHS and life expectancy at birth for a large panel of thirty OECD countries. We find that some variables (alcohol consumption, urbanization) have a significant effect on both LEAPHS and life expectancy, while one variable (the number of hospitals) has a significant effect for both genders on life expectancy only. However, the effects of many other variables (health expenditure per capita, health expenditure per capita squared, GDP growth, and technology) were only significant predictors for LEAPHS. This leads us to conclude that LEAPHS is able to capture the impact of some health determinants not captured by life expectancy at birth. While we believe this new measure may be useful for health economists and statisticians doing cross-country analyses, further comparisons with other measures may be useful.

Electronic Health Record Patient Portal Adoption by Health Care Consumers: An Acceptance Model and Survey

Background

The future of health care delivery is becoming more citizen centered, as today’s user is more active, better informed, and more demanding. Worldwide governments are promoting online health services, such as electronic health record (EHR) patient portals and, as a result, the deployment and use of these services. Overall, this makes the adoption of patient-accessible EHR portals an important field to study and understand.

Objective

The aim of this study is to understand the factors that drive individuals to adopt EHR portals.

Methods

We applied a new adoption model using, as a starting point, Ventkatesh's Unified Theory of Acceptance and Use of Technology in a consumer context (UTAUT2) by integrating a new construct specific to health care, a new moderator, and new relationships. To test the research model, we used the partial least squares (PLS) causal modelling approach. An online questionnaire was administrated. We collected 360 valid responses.

Results

The statistically significant drivers of behavioral intention are performance expectancy (beta=.200; t=3.619), effort expectancy (beta=.185; t=2.907), habit (beta=.388; t=7.320), and self-perception (beta=.098; t=2.285). The predictors of use behavior are habit (beta=0.206; t=2.752) and behavioral intention (beta=0.258; t=4.036). The model explained 49.7% of the variance in behavioral intention and 26.8% of the variance in use behavior.

Conclusions

Our research helps to understand the desired technology characteristics of EHR portals. By testing an information technology acceptance model, we are able to determine what is more valued by patients when it comes to deciding whether to adopt EHR portals or not. The inclusion of specific constructs and relationships related to the health care consumer area also had a significant impact on understanding the adoption of EHR portals.

Physical activity level of postmenopausal women in Nigeria: Association with self-rated health status, overall obesity, and abdominal obesity

Regular physical activity (PA) has been shown to have many health benefits in various populations, including postmenopausal women (n = 310). Self-rated health has been positively associated with PA. This cross-sectional survey of postmenopausal women in Nigeria was conducted from April to September 2012 to investigate associations among PA level, self-rated health, overall obesity (body mass index [BMI]), and abdominal obesity (waist-height ratio, waist-hip ratio, and waist circumference). The International Physical Activity Questionnaire was used to classify PA. Chi-square and logistic regression were used for analyses with level of significance set at .05. Participants were aged 53.0 ± 4.2 years; moderate to vigorous PA was reported by 188 (60.0%), while 26 (8.4%) self-rated their health as poor/fair, and 242 (78.1%) were either predominantly overweight or obese when classified according to BMI. Participants with fair/poor self-rated health had less odds of involvement in moderate to vigorous PA. Obese postmenopausal women had greater odds of reporting lower PA. PA was positively related to self-rated health, which was negatively associated with overall obesity but not abdominal obesity. Measures to control obesity among postmenopausal women are essential in view of its direct association with poor self-rated health and low PA in this group of women.

Factors Influencing the Successful Aging of Iranian Old Adult Women

Background:

Aging is an irreversible natural process characterized by a decline in both the physical and mental status of individuals. Because of multiple factors, this process and its consequences vary greatly between individuals. A successful aging (SA) is the target of current health policies and well-being of individuals. Knowing the factors that contribute to SA and its barriers would translate in measurements that increase the quality of life of elderly and reduce health costs.

Objectives:

The aim of this study was to explore barriers and facilitators to Iranian elderly women’s SA.

Patients and Methods:

A purposive sample of 16 elderly women, aged 61 - 96 years, was recruited for this qualitative content analysis study. Study data were collected during 2012 -.2013 by conducting 16 face-to-face semi-structured in-depth interviews. We continued the data collection until reaching saturation. Study data were analyzed concurrently with data collection, by using the conventional qualitative content analysis approach.

Results:

Barriers and facilitators to Iranian elderly women’s SA fell into five main categories, including availability of support systems, state of health, personal capabilities, personality characteristics, and lifestyle.

Conclusions:

Availability of support systems, state of health, personal capabilities, personality characteristics, and lifestyle were the main interrelated factors affecting Iranian elderly women’s SA. Accordingly, providing elderly women with strong educational, emotional, financial, cultural, and social supports can help facilitate their SA.

[Self-perceived health and clinical characteristics in young adult students from the Brazilian northeast]

OBJECTIVE

To analyze the association between socioeconomic situation, clinical characteristics referred and the family history of cardiovascular disease, with the Self-perceived health of young adults education and their implications for clinical characteristics observed.

METHOD

Analytical study conducted with 501 young adults who are students in countryside city in the Brazilian Northeast. We used binary logistic regression.

RESULTS

The final model explained 83.3% of the self-perceived positive health, confirming the association of Self-perceived health with male, residence in the community, have excellent/very good lifestyle and does not have or do not know that there are cases of stroke in the family.

CONCLUSION

Health perception was often optimistic, being important to identify devices to be worked closer to their perception of their actual health condition, increasing the effectiveness of health promotion activities undertaken by professionals.

Condiciones de vida, estado nutricional y estado de salud en adultos mayores, Córdoba, Argentina

OBJETIVO: Describir y comparar el estado nutricional y el estado de salud en dos grupos de adultos mayores de diferentes condiciones de vida, residentes en la ciudad de Córdoba, Argentina. MATERIAL Y MÉTODOS: Estudio transversal, llevado a cabo en dos grupos: adultos mayores concurrentes a Comedores Sociales de la Provincia de Córdoba CSPC; n=308 y adultos mayores afiliados a la obra social universitaria Dirección de Asistencia Social del Personal Universitario DASPU; n=134. Se determinaron parámetros antropométricos: índice de masa corporal IMC, circunferencia de cintura CC e índice cintura cadera ICC. Para la determinación del estado de salud se utilizaron indicadores subjetivos autopercepción de salud, autoinforme de enfermedades crónicas, obtenidos a través de encuesta. Para la corroboración de hipótesis se utilizó Test de X2, cálculo de Odds Ratio OR, y Prueba T. RESULTADOS: En hombres, se observó mayor sobrepeso y obesidad en el grupo DASPU; mientras que en las mujeres no se encontraron mayores diferencias entre ambas instituciones, salvo un promedio menor de IMC en el grupo DASPU. En relación a los indicadores del estado de salud, se observó en ambos sexos, una mejor percepción de la salud en el grupo DASPU, mayor prevalencia de diabetes en hombres del grupo CSPC, hipertensión en mujeres de CSPC y tumor maligno en hombres del grupo DASPU. CONCLUSIONES: Se observa que las condiciones sociales de vida influyen en el estado nutricional y de salud de los adultos mayores, en especial en hombres. Esto implica riesgos diferentes para ambos grupos.

Ethnic and gender differentials in non-communicable diseases and self-rated health in Malaysia

Objectives

This paper examines the ethnic and gender differentials in high blood pressure (HBP), diabetes, coronary heart disease (CHD), arthritis and asthma among older people in Malaysia, and how these diseases along with other factors affect self-rated health. Differentials in the prevalence of non-communicable diseases among older people are examined in the context of socio-cultural perspectives in multi-ethnic Malaysia.

Methods

Data for this paper are obtained from the 2004 Malaysian Population and Family Survey. The survey covered a nationally representative sample of 3,406 persons aged 50 and over, comprising three main ethnic groups (Malays, Chinese and Indians) and all other indigenous groups. Bivariate analyses and hierarchical logistic regression were used in the analyses.

Results

Arthritis was the most common non-communicable disease (NCD), followed by HBP, diabetes, asthma and CHD. Older females were more likely than males to have arthritis and HBP, but males were more likely to have asthma. Diabetes and CHD were most prevalent among Indians, while arthritis and HBP were most prevalent among the Indigenous groups. Older people were more likely to report poor health if they suffered from NCD, especially CHD. Controlling for socio-economic, health and lifestyle factors, Chinese were least likely to report poor health, whereas Indians and Indigenous people were more likely to do so. Chinese that had HBP were more likely to report poor health compared to other ethnic groups with the same disease. Among those with arthritis, Indians were more likely to report poor health.

Conclusion

Perceived health status and prevalence of arthritis, HBP, diabetes, asthma and CHD varied widely across ethnic groups. Promotion of healthy lifestyle, early detection and timely intervention of NCDs affecting different ethnic groups and gender with socio-cultural orientations would go a long way in alleviating the debilitating effects of the common NCDs among older people.

Physical and leisure activity in older community-dwelling canadians who use wheelchairs: a population study

Background. Physical and leisure activities are proven health promotion modalities and have not been examined in older wheelchair users. Main Objectives. Examine physical and leisure activity in older wheelchair users and explore associations between wheelchair use and participation in physical and leisure activity, and wheelchair use, physical and leisure activity, and perceived health. Methods. 8301 Canadians ≥60 years of age were selected from the Canadian Community Health Survey. Sociodemographic, health-related, mobility-related, and physical and leisure activity variables were analysed using logistic regression to determine, the likelihood of participation in physical and leisure activity, and whether participation in physical and leisure activities mediates the relationship between wheelchair use and perceived health. Results. 8.3% and 41.3% older wheelchair users were physically and leisurely active. Wheelchair use was a risk factor for reduced participation in physical (OR = 44.71) and leisure activity (OR = 10.83). Wheelchair use was a risk factor for poor perceived health (OR = 10.56) and physical and leisure activity negatively mediated the relationship between wheelchair user and perceived health. Conclusion. There is a need for the development of suitable physical and leisure activity interventions for older wheelchair users. Participation in such interventions may have associations with health benefits.

Functional independence, diagnostic groups, hospital stay, and modality of payment in three Croatian seaside inpatient rehabilitation centers

AIM

To determine patients' functional independence, diagnostic groups, duration of hospital stay, and modality of payment of rehabilitation in major special hospitals for rheumatology and medical rehabilitation on the Croatian seaside.

METHODS

In a cross-sectional study conducted from October 2006 until January 2009, we surveyed 400 patients treated at 3 special hospitals for medical rehabilitation. Their functional independence was assessed by modified Barthel index and they self-evaluated their health using the first item from the 36-Item Short-Form Health Survey questionnaire.

RESULTS

On admission, almost half of the patients (46%) were fully functionally independent, 33% were slightly dependent, while 21% were moderately or severely dependent. At the end of the hospitalization, significant predictors for the increase in Barthel index were longer hospital stay (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.06-1.22), diagnosis of post-procedural musculoskeletal disorders (OR, 4.84; 95% CI, 1.90-10.57), diagnosis of conditions following acute ischemic heart disease (OR, 9.71; 95% CI, 3.40-27.75), and lower Barthel index at admission (OR, 0.96; 95% CI, 0.94-0.97). Of the 97 patients with dorsopathy, 73 (75%) were fully functionally independent and 57 (59%) paid for the treatment either themselves or contributed substantially to the total cost.

CONCLUSION

Assessment of patients' functional status is important for the organization of inpatient rehabilitation. Patients with dorsopathy could be targeted as a population for medical tourism in rehabilitation medicine in order to maximize the use of rehabilitation hospitals.