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Wu W, Shang Y, Calderón-Larrañaga A, Rizzuto D, Saadeh M, Dove A, Pan KY, Xu W. Association of life satisfaction with disability-free survival: role of chronic diseases and healthy lifestyle. Age Ageing 2021; 50:1657-1665. [PMID: 34120170 DOI: 10.1093/ageing/afab086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND this article investigates the association between life satisfaction and disability-free survival, and explores the roles of chronic diseases and healthy lifestyle in this association. METHOD a cohort of 2,116 functionally independent adults aged ≥60 was followed up to 12 years. At baseline, life satisfaction was assessed with the Life Satisfaction Index A (LSI-A). Disability-free survival was defined as the survival till the first occurrence of either death, dementia or physical disability. Information on lifestyle factors was collected via questionnaire. Chronic diseases were ascertained through clinical examinations at baseline and each follow-up. Data were analysed using Cox proportional hazard regression models and Laplace regression. RESULTS over follow-up, 1,121 participants died, developed dementia, or became disabled. High LSI-A versus Low LSI-A had a lower risk of death, dementia and physical disability (hazard ratio [HR] 0.79, 95% confidence intervals [CI] 0.67-0.94), and had a longer disability-free period by 1.73 (95% CI 0.18-3.32) years. In mediation analysis, accumulation of chronic diseases mediated 17.8% of the association between LSI-A and disability-free survival. In joint effect analysis, participants with high LSI-A and a favourable lifestyle profile had a HR of 0.53 (95% CI 0.41-0.69) for the composite endpoint, and lived 3.2 (95% CI 1.35-5.11) disability-free years longer than those with low life satisfaction and an unfavourable lifestyle profile. DISCUSSION high life satisfaction is independently associated with longer disability-free survival. This association is partially mediated by a lower burden of chronic diseases and is reinforced by healthy lifestyle.
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Affiliation(s)
- Wei Wu
- School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan 430065, China
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
| | - Ying Shang
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
| | - Amaia Calderón-Larrañaga
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
| | - Debora Rizzuto
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
- Stockholm Gerontology Research Center, Stockholm 11330, Sweden
| | - Marguerita Saadeh
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
| | - Abigail Dove
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
| | - Kuan-Yu Pan
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
- Amsterdam University Medical Center, Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health Research Institute, 1081, The Netherlands
| | - Weili Xu
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
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Ironson G, Verhagen R, da Rosa B, Hylton E. Interview-Rated Meaning and Survival Over 17 Years in People Living With HIV. Psychosom Med 2021; 83:671-678. [PMID: 34267088 DOI: 10.1097/psy.0000000000000963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The primary purpose of this study was to determine whether meaning in life predicts survival in people living with HIV (PLWH) over 17 years. This study also examined whether interviewer- and transcript-rated meanings predict survival equivalently. A third purpose of the study was to investigate whether meaning in life adds to the prediction of survival over positive emotional expression. METHODS A diverse sample of people with HIV (n = 177) completed an interview on stress and coping at baseline and were followed up for survival up to 17 years. Meaning was measured by interviewer rating of four items (meaningful purpose, unfinished business, finding new meaning, and meaningful activities). Transcript-rated meaning was assessed by two independent raters. Cox proportional hazards regression was used to determine whether meaning predicted survival over 17 years. RESULTS Meaning in life predicted significantly greater survival, adjusting for biomedical and sociodemographic variables whether assessed by interviewer or by transcript raters. Hazard ratios suggest that the effect is moderate to large (2.66-3.45 for top versus bottom third; 2.05-2.49 for top versus bottom half). Significance was maintained after adjusting for positive emotion. CONCLUSIONS Meaning assessed by interview (by both interviewer and transcript ratings) predicted greater survival over 17 years in PLWH and did so above positive emotion. This adds to a literature that is primarily based on self-report questionnaires. Meaning may have beneficial effects for both psychological and physical health in PLWH.
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Affiliation(s)
- Gail Ironson
- From the Department of Psychology, University of Miami, Coral Gables, Florida
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Rediscovering Meaning and Purpose: An Approach to Burnout in the Time of COVID-19 and Beyond. Am J Med 2021; 134:1065-1067. [PMID: 33989605 PMCID: PMC9746258 DOI: 10.1016/j.amjmed.2021.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 12/16/2022]
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Shiba K, Kubzansky LD, Williams DR, VanderWeele TJ, Kim ES. Associations Between Purpose in Life and Mortality by SES. Am J Prev Med 2021; 61:e53-e61. [PMID: 34020851 PMCID: PMC8319073 DOI: 10.1016/j.amepre.2021.02.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/02/2021] [Accepted: 02/19/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Having a higher purpose in life has been linked to favorable health outcomes. However, little research has examined whether the purpose-health association persists across different levels of SES. This study assesses whether the association between higher purpose in life and lower mortality is similar across the levels of SES. METHODS A national sample of 13,159 U.S. adults aged >50 years from the Health and Retirement Study was analyzed. The baseline year was 2006‒2008. Purpose in life was assessed at baseline using Purpose in Life Subscale of the Ryff Psychological Well-being Scales. The risk of death during an 8-year follow-up was assessed. SES was measured using education, income, and wealth. Using multivariable Poisson regression, effect modification by SES was tested on both the additive and multiplicative scales. Analyses were done in 2020. RESULTS In analyses stratified by SES, people with the highest level of purpose consistently tended to have lower mortality risk across the levels of SES than those with the lowest level of purpose. However, people with middle-range purpose levels had lower mortality risk only if they also had mid-to-high education, income, and wealth. When formally testing the effect modification by SES, there was modest evidence that the associations between higher purpose and lower mortality were stronger among individuals with high education, income, and wealth. CONCLUSIONS The highest level of purpose appeared protective against all-cause mortality regardless of the levels of SES. By contrast, when levels of purpose were more modest, people with lower SES may benefit less health-wise from having a purpose.
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Affiliation(s)
- Koichiro Shiba
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; The Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts.
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Sociology, Harvard University, Cambridge, Massachusetts
| | - Tyler J VanderWeele
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; The Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Eric S Kim
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; The Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
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Tsuzishita S, Wakui T. The Effect of High and Low Life Purpose on Ikigai (a Meaning for Life) among Community-Dwelling Older People-A Cross-Sectional Study. Geriatrics (Basel) 2021; 6:geriatrics6030073. [PMID: 34449639 PMCID: PMC8395894 DOI: 10.3390/geriatrics6030073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study is to reveal how high or low life purpose is related to QOL and ikigai (a meaning for life). Ikigai is “a sense of purpose and motivation in the daily lives of older people, a sense that they are capable and meaningful to their families and others, and that they should be”. Eighty-one community-dwelling older people (23 male and 58 female, mean age 77 ± 5.2 years) participated of their own will. The following items were measured: dementia test, exercise habits, life purpose, ikigai, and QOL. In the multivariate analysis of high and low life purpose, only ikigai was found to be related. In the multivariate analysis of ikigai, life purpose was also the most relevant, indicating that life purpose and ikigai are strongly interrelated. To improve QOL, it is also necessary to take into account life purpose in addition to the current nursing care prevention.
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Affiliation(s)
- Souma Tsuzishita
- Department of Rehabilitation, Faculty of Health Science, Nara Gakuen University, Nara 631-8524, Japan
- Correspondence:
| | - Tadaaki Wakui
- Faculty of Health and Well-Being, Kansai University, Osaka 590-8515, Japan;
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Terry PE. "A Bowl of Vegetables With Someone You Love": Faith, Health and Workplace Well-Being. Am J Health Promot 2021; 35:893-896. [PMID: 34247543 DOI: 10.1177/08901171211030141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Worksite health and well-being initiatives will ideally be integrated with employers' efforts to address diversity, equity and inclusion issues. Social Determinants of Health (SDOH) include race, class, community health, income and other variables that companies can play a role in ameliorating. As much as spirituality is commonly espoused as a component of a holistic approach to health promotion, making space to discuss faith and health remains an uncommon strategy in the workplace wellness movement. Recognizing the value on investment (VOI) in wellness has eclipsed a return on investment as a driver of an employer's well-being strategy. This editorial argues that making space for learning about faith and health will intersect in vital ways with anti-racism work, diversity programs and similar efforts to eliminate health inequities, address SDOH and bolster the VOI of worksite well-being initiatives. A fictional dialogue between executives is used to review these issues and related literature.
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Affiliation(s)
- Paul E Terry
- Editor in Chief, American Journal of Health Promotion, Senior Fellow, HERO (The Health Enhancement Research Organization)
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Luster JE, Ratz D, Wei MY. Multimorbidity and Social Participation Is Moderated by Purpose in Life and Life Satisfaction. J Appl Gerontol 2021; 41:560-570. [PMID: 34225497 DOI: 10.1177/07334648211027691] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES We examined the association between multimorbidity and social participation and whether purpose in life and life satisfaction moderate this relationship. METHODS Participants were 12,825 Health and Retirement Study adults. We used multiple linear regression to examine the association between a cumulative-updated multimorbidity-weighted index (MWI) and social participation. RESULTS Among adults with average purpose in life or life satisfaction, MWI was associated with lower social participation. For those with above average purpose in life, each 1-point increase in MWI was associated with a 0.11-point (95% confidence interval [CI]: [0.07, 0.14]) better social participation score. Participants with above average life satisfaction experienced a 0.04-point (95% CI: [0.02, 0.07]) better social participation score with each 1-point increase in MWI. DISCUSSION Multimorbidity was associated with worse social participation, but this was reversed by above average purpose in life and life satisfaction. Interventions that improve well-being should be assessed to enhance social participation among older adults with any degree of multimorbidity.
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Affiliation(s)
| | | | - Melissa Y Wei
- University of Michigan, Ann Arbor, USA.,University of California, Los Angeles, USA
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Abadi M, Richard B, Shamblen S, Drake C, Schweinhart A, Bokhour B, Bauer R, Rychener D. Achieving Whole Health: A Preliminary Study of TCMLH, a Group-Based Program Promoting Self-Care and Empowerment Among Veterans. HEALTH EDUCATION & BEHAVIOR 2021; 49:347-357. [PMID: 34018443 DOI: 10.1177/10901981211011043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE An emerging literature suggests patients with chronic illnesses can benefit from integrated, person-centric approaches to health care, including group-based programs. However, much of the research in this area is disease specific. The objective of this study was to collect preliminary evidence on the efficacy of Taking Charge of My Life and Health (TCMLH), a Whole Health group-based program that emphasizes self-care and empowerment on the overall health and well-being of veterans, a population burdened with high rates of multiple chronic conditions. METHOD Self-reported outcomes, including standardized survey measures, were collected at pretest, posttest, and 2-month follow-up from 77 participants across 15 groups at four VA sites. Random intercept mixed-model regressions were used to analyze data. RESULTS Results from this initial study showed high satisfaction with the program and facilitators, and high attendance. There were significant pre-post gains in self-care attitudes and behaviors, patient motivation, meaning and purpose, mental health, perceived stress, goal progress, and goal-specific hope. Outcomes were maintained at 2-month follow-up for patient motivation, perceived stress, goal-specific hope, and goal progress. Significant gains were observed in health care empowerment and physical health from pretest to follow-up. CONCLUSIONS Preliminary findings support the efficacy of TCMLH, a Whole Health group-based program that emphasizes patient empowerment, self-care practices, and peer support. Future research priorities include a rigorous evaluation with a larger sample size and control group to assess effectiveness.
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Affiliation(s)
- Melissa Abadi
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
| | - Bonnie Richard
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
| | - Steve Shamblen
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
| | | | | | - Barbara Bokhour
- Center for Healthcare Organization and Implementation Research, Bedford, MA, USA.,Boston University School of Public Health, Boston, MA, USA
| | - Rachel Bauer
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
| | - David Rychener
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
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Does social capital influence purpose in life and life satisfaction among Japanese health-literate professionals? CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01851-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractA strong sense of purpose and satisfaction in life is associated with multiple health benefits. There is also evidence to suggest that social capital predicts better health indicators. While both social capital and purpose and satisfaction in life direct better health, the relationship between social capital and purpose and satisfaction in life in terms of health, remains unclear. A retrospective cohort study was conducted on Japanese health management professionals (N = 4820). We analyzed the cohort’s demographics and reported changes in social capital (social engagement and trust), purpose in life, and life satisfaction using self-reported questionnaires and the Ikigai-9 scale. The cohort was categorized into group 1 (neither changes), group 2 (one changes), and group 3 (both change), based on the number of changes reported in social capital. Purpose in life and life satisfaction scores were then compared among the three groups. The purpose in life score (SD [standard deviation]) for groups 1, 2, and 3 was 30.7 (6.0), 32.5 (5.6), and 35.6 (5.2), respectively. Life satisfaction scores (SD) for groups 1, 2 and 3 were 3.35 (0.8), 3.67 (0.8), and 4.26 (0.7), respectively. We found a statistically significant difference in purpose and satisfaction in life among the three groups (F(2) = 361.4, p < 0.001 and F(2) = 703.9, p < 0.001). Social capital was associated with purpose and satisfaction in life among health-literate professionals. Strengthening social capital may increase individual purpose and satisfaction in life and ultimately yield better health.
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Babulal GM, Torres VL, Acosta D, Agüero C, Aguilar-Navarro S, Amariglio R, Ussui JA, Baena A, Bocanegra Y, Brucki SMD, Bustin J, Cabrera DM, Custodio N, Diaz MM, Peñailillo LD, Franco I, Gatchel JR, Garza-Naveda AP, González Lara M, Gutiérrez-Gutiérrez L, Guzmán-Vélez E, Hanseeuw BJ, Jimenez-Velazquez IZ, Rodríguez TL, Llibre-Guerra J, Marquine MJ, Martinez J, Medina LD, Miranda-Castillo C, Morlett Paredes A, Munera D, Nuñez-Herrera A, de Oliveira MO, Palmer-Cancel SJ, Pardilla-Delgado E, Perales-Puchalt J, Pluim C, Ramirez-Gomez L, Rentz DM, Rivera-Fernández C, Rosselli M, Serrano CM, Suing-Ortega MJ, Slachevsky A, Soto-Añari M, Sperling RA, Torrente F, Thumala D, Vannini P, Vila-Castelar C, Yañez-Escalante T, Quiroz YT. The impact of COVID-19 on the well-being and cognition of older adults living in the United States and Latin America. EClinicalMedicine 2021; 35:100848. [PMID: 33997742 PMCID: PMC8100067 DOI: 10.1016/j.eclinm.2021.100848] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In the COVID-19 pandemic, older adults from vulnerable ethnoracial groups are at high risk of infection, hospitalization, and death. We aimed to explore the pandemic's impact on the well-being and cognition of older adults living in the United States (US), Argentina, Chile, Mexico, and Peru. METHODS 1,608 (646 White, 852 Latino, 77 Black, 33 Asian; 72% female) individuals from the US and four Latin American countries aged ≥ 55 years completed an online survey regarding well-being and cognition during the pandemic between May and September 2020. Outcome variables (pandemic impact, discrimination, loneliness, purpose of life, subjective cognitive concerns) were compared across four US ethnoracial groups and older adults living in Argentina, Chile, Mexico, and Peru. FINDINGS Mean age for all participants was 66.7 (SD = 7.7) years and mean education was 15.4 (SD = 2.7) years. Compared to Whites, Latinos living in the US reported greater economic impact (p < .001, ηp 2 = 0.031); while Blacks reported experiencing discrimination more often (p < .001, ηp 2 = 0.050). Blacks and Latinos reported more positive coping (p < .001, ηp 2 = 0.040). Compared to Latinos living in the US, Latinos in Chile, Mexico, and Peru reported greater pandemic impact, Latinos in Mexico and Peru reported more positive coping, Latinos in Argentina, Mexico, and Peru had greater economic impact, and Latinos in Argentina, Chile, and Peru reported less discrimination. INTERPRETATION The COVID-19 pandemic has differentially impacted the well-being of older ethnically diverse individuals in the US and Latin America. Future studies should examine how mediators like income and coping skills modify the pandemic's impact. FUNDING Massachusetts General Hospital Department of Psychiatry.
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Affiliation(s)
| | - Valeria L. Torres
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Daisy Acosta
- Universidad Nacional Pedro Henriquez Urena, Santo Domingo, Dominican Republic
| | - Cinthya Agüero
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Sara Aguilar-Navarro
- Department of Geriatrics. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubiran” Mexico City, Mexico
| | - Rebecca Amariglio
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Juliana Aya Ussui
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Ana Baena
- Washington University School of Medicine, St Louis, MO, USA
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin, Colombia
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin, Colombia
| | | | - Julian Bustin
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, CONICET, Buenos Aires, Argentina
| | | | - Nilton Custodio
- Unit Cognitive Impairment and Dementia Prevention, Peruvian Institute of Neurosciences, Lima, Peru
| | - Monica M. Diaz
- Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Idalid Franco
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Jennifer R. Gatchel
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Ana Paola Garza-Naveda
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | | | - Lidia Gutiérrez-Gutiérrez
- Department of Geriatrics. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubiran” Mexico City, Mexico
| | - Edmarie Guzmán-Vélez
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Bernard J. Hanseeuw
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
- Neurology Department, Cliniques Universitaires Saint-Luc, Belgium
| | - Ivonne Z. Jimenez-Velazquez
- Geriatrics Division, Internal Medicine Department, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Tomás León Rodríguez
- Memory and Neuropsychiatric Clinic (CMYN), Neurology Department, Del Salvador Hospital and University of Chile School of Medicine, Santiago, Chile
| | | | - María J. Marquine
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
| | - Jairo Martinez
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Luis D. Medina
- University of Houston, Department of Psychology, Houston, TX, USA
| | - Claudia Miranda-Castillo
- Faculty of Nursing Universidad Andres Bello, Millennium Institute for Research in Depression and Personality, Santiago, Chile
| | | | - Diana Munera
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | | | | | | | | | | | - Celina Pluim
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Liliana Ramirez-Gomez
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Dorene M. Rentz
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | | | | | - Cecilia M Serrano
- Neurology Department, Cesar Milstein Hospital, Buenos Aires, Argentina
| | - Maria Jose Suing-Ortega
- Department of Geriatrics. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubiran” Mexico City, Mexico
| | - Andrea Slachevsky
- Memory and Neuropsychiatric Clinic (CMYN), Neurology Department, Del Salvador Hospital and University of Chile School of Medicine, Santiago, Chile
| | | | - Reisa A. Sperling
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Fernando Torrente
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, CONICET, Buenos Aires, Argentina
| | - Daniela Thumala
- Psychology Department, Social Sciences Faculty, University of Chile, Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Patrizia Vannini
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Clara Vila-Castelar
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | | | - Yakeel T. Quiroz
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
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Hirooka N, Kusano T, Kinoshita S, Aoyagi R, Hidetomo N. Association between healthy lifestyle practices and life purpose among a highly health-literate cohort: a cross-sectional study. BMC Public Health 2021; 21:820. [PMID: 33926422 PMCID: PMC8082900 DOI: 10.1186/s12889-021-10905-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The national health promotion program in the twenty-first century Japan (HJ21) correlates life purpose with disease prevention, facilitating the adoption of healthy lifestyles. However, the influence of clustered healthy lifestyle practices on life purpose, within the context of this national health campaign remains uninvestigated. This study assessed the association between such practices and life purpose, in line with the HJ21. METHODS We performed a nationwide cross-sectional survey on certified specialists in health management. Participants' demographic information, lifestyle, and purpose in life were measured using a validated tool. The cohort was median-split into two groups based on their clustered health-related lifestyle score. The values for health-related lifestyle and purpose were compared between the two groups and the correlation between health-related lifestyle and purpose in life was measured. RESULTS Data from 4820 participants were analyzed. The higher-scoring health-related lifestyle group showed a significantly higher life purpose than the lower group (35.3 vs 31.4; t = 23.6, p < 0.001). There was a significant association between the scores of clustered healthy lifestyle practices and life purpose (r = 0.401, p < 0.001). The higher-scoring health-related lifestyle group achieved a higher life purpose than the lower-scoring group. This association between healthy lifestyle practices and life purpose denotes a positive and linear relationship. CONCLUSIONS Our results suggest that individuals who have a better health-related lifestyle gain a higher sense of life purpose. In other words, a healthy lifestyle predicts a purpose in life. Our findings posit that examining the causal relationship between healthy lifestyle and purpose in life may be a more efficient approach toward health promotion.
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Affiliation(s)
- Nobutaka Hirooka
- Department of General Internal Medicine, Saitama Medical University, Morohongo 38, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.
| | - Takeru Kusano
- Department of General Internal Medicine, Saitama Medical University, Morohongo 38, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Shunsuke Kinoshita
- Department of General Internal Medicine, Saitama Medical University, Morohongo 38, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Ryutaro Aoyagi
- Department of General Internal Medicine, Saitama Medical University, Morohongo 38, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Nakamoto Hidetomo
- Department of General Internal Medicine, Saitama Medical University, Morohongo 38, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
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Boehm JK. Positive psychological well‐being and cardiovascular disease: Exploring mechanistic and developmental pathways. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2021; 15:e12599. [PMID: 35860033 PMCID: PMC9285725 DOI: 10.1111/spc3.12599] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 01/15/2021] [Accepted: 03/18/2021] [Indexed: 12/29/2022]
Abstract
Empirical research regarding the health benefits of positive psychological well‐being (e.g., positive emotions, life satisfaction, purpose in life, and optimism) has flourished in recent years, particularly with regard to cardiovascular disease. This paper reviews the state of evidence for well‐being's association with cardiovascular disease in both healthy individuals and those diagnosed with a disease. Prospective studies consistently indicate well‐being reduces cardiovascular events in healthy and, to a lesser extent, patient populations. Potential pathways that link well‐being with cardiovascular disease are discussed (including health behaviors, physiological processes, and stress buffering), although the existing evidence is mostly cross‐sectional which limits conclusions about directionality. Issues related to development across the lifespan are considered and childhood is identified as a crucial period for establishing healthy cardiovascular trajectories. Outstanding questions for future research are provided with recommendations to focus on well‐powered and prospective study designs with rigorous assessment of both well‐being and cardiovascular‐related outcomes.
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Affiliation(s)
- Julia K. Boehm
- Department of Psychology Chapman University Orange California USA
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63
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McPeake J, Iwashyna TJ, Boehm LM, Hibbert E, Bakhru RN, Bastin AJ, Butcher BW, Eaton TL, Harris W, Hope AA, Jackson J, Johnson A, Kloos JA, Korzick KA, Meyer J, Montgomery-Yates A, Mikkelsen ME, Slack A, Wade D, Still M, Netzer G, Hopkins RO, Quasim T, Sevin CM, Haines KJ. Benefits of Peer Support for Intensive Care Unit Survivors: Sharing Experiences, Care Debriefing, and Altruism. Am J Crit Care 2021; 30:145-149. [PMID: 33566086 DOI: 10.4037/ajcc2021702] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND After critical illness, patients are often left with impairments in physical, social, emotional, and cognitive functioning. Peer support interventions have been implemented internationally to ameliorate these issues. OBJECTIVE To explore what patients believed to be the key mechanisms of effectiveness of peer support programs implemented during critical care recovery. METHODS In a secondary analysis of an international qualitative data set, 66 telephone interviews with patients were undertaken across 14 sites in Australia, the United Kingdom, and the United States to understand the effect of peer support during recovery from critical illness. Prevalent themes were documented with framework analysis. RESULTS Most patients who had been involved in peer support programs reported benefit. Patients described 3 primary mechanisms: (1) sharing experiences, (2) care debriefing, and (3) altruism. CONCLUSION Peer support is a relatively simple intervention that could be implemented to support patients during recovery from critical illness. However, more research is required into how these programs can be implemented in a safe and sustainable way in clinical practice.
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Affiliation(s)
- Joanne McPeake
- Joanne McPeake is a nurse consultant, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Scotland, United Kingdom and an honorary senior clinical lecturer, School of Medicine, Dentistry and Nursing, University of Glasgow, Scotland, United Kingdom, and a research fellow, THIS Institute, University of Cambridge, United Kingdom
| | - Theodore J. Iwashyna
- Theodore J. Iwashyna is a professor of internal medicine, Department of Medicine, Division of Pulmonary & Critical Care, University of Michigan, Ann Arbor and a research scientist, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Michigan
| | - Leanne M. Boehm
- Leanne M. Boehm is an assistant professor, School of Nursing, Vanderbilt University, Nashville, Tennessee
| | - Elizabeth Hibbert
- Elizabeth Hibbert is a physiotherapist, Department of Physiotherapy, Western Health, Melbourne, Australia
| | - Rita N. Bakhru
- Rita N. Bakhru is an assistant professor, Section of Pulmonary, Critical Care, Allergy and Immunology, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Anthony J. Bastin
- Anthony J. Bastin is a consultant in critical care, Department of Perioperative Medicine, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Brad W. Butcher
- Brad W. Butcher is an assistant professor, Department of Critical Care Medicine, University of Pittsburgh Medical Center (UPMC), Pennsylvania
| | - Tammy L. Eaton
- Tammy L. Eaton is a PhD candidate, University of Pittsburgh School of Nursing, and a founder of the Critical Illness Recovery Center at UPMC Mercy
| | - Wendy Harris
- Wendy Harris is a senior nurse, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Aluko A. Hope
- Aluko A. Hope is an associate professor, Division of Critical Care Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - James Jackson
- James Jackson is a research professor, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Annie Johnson
- Annie Johnson is a nurse practitioner, Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
| | - Janet A. Kloos
- Janet A. Kloos is a clinical nurse specialist, Department of Acute and Critical Care Nursing, University Hospitals Cleveland Medical Center, Ohio
| | - Karen A. Korzick
- Karen A. Korzick is codirector of critical care medicine and medical director, ICU Survivor Clinic, Department of Pulmonary and Critical Care Medicine, Geisinger Medical Center, Danville, Pennsylvania
| | - Joel Meyer
- Joel Meyer is critical care consultants, Guy’s & St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Ashley Montgomery-Yates
- Ashley Montgomery-Yates is an associate professor, Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington
| | - Mark E. Mikkelsen
- Mark E. Mikkelsen is an associate professor, Division of Pulmonary, Allergy, and Critical Care Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia
| | - Andrew Slack
- Andrew Slack is a critical care consultant, Guy’s & St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Dorothy Wade
- Dorothy Wade is principal health psychologist, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Mary Still
- Mary Still is a clinical nurse specialist in critical care, Emory University Hospital (Emory Healthcare), Atlanta, Georgia
| | - Giora Netzer
- Giora Netzer is a professor of medicine and epidemiology, Division of Pulmonary and Critical Care, University of Maryland School of Medicine, and vice president of patient experience, University of Maryland Medical Center
| | - Ramona O. Hopkins
- Ramona O. Hopkins is a senior research associate, Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, Utah; a founding member, Center for Humanizing Critical Care, Intermountain Health Care, Murray, Utah, and a professor, Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah
| | - Tara Quasim
- Tara Quasim is a critical care consultant, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde and a senior clinical lecturer, University of Glasgow
| | - Carla M. Sevin
- Carla M. Sevin is an associate professor, Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center
| | - Kimberley J. Haines
- Kimberley J. Haines is physiotherapy lead and senior ICU physiotherapist, Department of Physiotherapy, Western Health, Sunshine Hospital, St Albans, Australia and an associate professor, Centre for Integrated Critical Care, University of Melbourne, Australia
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64
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Mitic M, Woodcock KA, Amering M, Krammer I, Stiehl KAM, Zehetmayer S, Schrank B. Toward an Integrated Model of Supportive Peer Relationships in Early Adolescence: A Systematic Review and Exploratory Meta-Analysis. Front Psychol 2021; 12:589403. [PMID: 33716860 PMCID: PMC7947339 DOI: 10.3389/fpsyg.2021.589403] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/06/2021] [Indexed: 12/30/2022] Open
Abstract
Supportive peer relationships (SPR) are crucial for mental and physical health. Early adolescence is an especially important period in which peer influence and school environment strongly shape psychological development and maturation of core social-emotional regulatory functions. Yet, there is no integrated evidence based model of SPR in this age group to inform future research and practice. The current meta-analysis synthetizes evidence from 364 studies into an integrated model of potential determinants of SPR in early adolescence. The model encompasses links with 93 variables referring to individual (identity, skills/strengths, affect/well-being, and behavior/health) and environmental (peer group, school, family, community, and internet/technology) potential influences on SPR based on cross-sectional correlational data. Findings suggest the central importance of identity and social-emotional skills in SPR. School environment stands out as a compelling setting for future prevention programs. Finally, we underscore an alarming gap of research on the influence of the virtual and online environment on youth's social realm given its unquestionable importance as a globally expanding social interaction setting. Hence, we propose an integrated model that can serve as organizational framework, which may ultimately lead to the adoption of a more structured and integrated approach to understanding peer relationship processes in youth and contribute to overcoming marked fragmentation in the field.
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Affiliation(s)
- Marija Mitic
- D.O.T. Research Group for Mental Health of Children and Adolescents, Ludwig Boltzmann Society at Karl Landsteiner University of Health Sciences, Krems on the Danube, Austria
| | - Kate A. Woodcock
- Centre for Applied Psychology, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Michaela Amering
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Ina Krammer
- D.O.T. Research Group for Mental Health of Children and Adolescents, Ludwig Boltzmann Society at Karl Landsteiner University of Health Sciences, Krems on the Danube, Austria
| | - Katharina A. M. Stiehl
- D.O.T. Research Group for Mental Health of Children and Adolescents, Ludwig Boltzmann Society at Karl Landsteiner University of Health Sciences, Krems on the Danube, Austria
| | - Sonja Zehetmayer
- Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Beate Schrank
- D.O.T. Research Group for Mental Health of Children and Adolescents, Ludwig Boltzmann Society at Karl Landsteiner University of Health Sciences, Krems on the Danube, Austria
- Department of Psychiatry and Psychotherapy, University Hospital Tulln, Karl Landsteiner University of Health Sciences, Tulln, Austria
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65
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Murdock BJ, Goutman SA, Boss J, Kim S, Feldman EL. Amyotrophic Lateral Sclerosis Survival Associates With Neutrophils in a Sex-specific Manner. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2021; 8:8/2/e953. [PMID: 33531377 PMCID: PMC8057067 DOI: 10.1212/nxi.0000000000000953] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/13/2020] [Indexed: 12/11/2022]
Abstract
Objective To determine whether neutrophils contribute to amyotrophic lateral sclerosis
(ALS) progression, we tested the association of baseline neutrophil count on
ALS survival, whether the effect was sex specific, and whether neutrophils
accumulate in the spinal cord. Methods A prospective cohort study was conducted between June 22, 2011, and October
30, 2019. Blood leukocytes were isolated from ALS participants and
neutrophil levels assessed by flow cytometry. Participant survival outcomes
were analyzed by groups (<2 × 106, 2–4 ×
106, and >4 × 106 neutrophils/mL) with
adjustments for relevant ALS covariates and by sex. Neutrophil levels were
assessed from CNS tissue from a subset of participants. Results A total of 269 participants with ALS within 2 years of an ALS diagnosis were
included. Participants with baseline neutrophil counts over 4 ×
106/mL had a 2.1 times higher mortality rate than those with
a neutrophil count lower than 2 × 106/mL (95% CI:
1.3–3.5, p = 0.004) when adjusting for age,
sex, and other covariates. This effect was more pronounced in females, with
a hazard ratio of 3.8 (95% CI: 1.8–8.2, p =
0.001) in the >4 × 106/mL vs <2 ×
106/mL group. Furthermore, ALS participants (n = 8) had
increased neutrophils in cervical (p = 0.049) and
thoracic (p = 0.022) spinal cord segments compared
with control participants (n = 8). Conclusions Higher neutrophil counts early in ALS associate with a shorter survival in
female participants. Furthermore, neutrophils accumulate in ALS spinal cord
supporting a pathophysiologic correlate. These data justify the
consideration of immunity and sex for personalized therapeutic development
in ALS. Classification of Evidence This study provides Class III evidence that in female participants with ALS,
higher baseline neutrophil counts are associated with shorter survival.
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Affiliation(s)
- Benjamin J Murdock
- From the Department of Neurology (B.J.M., S.A.G., E.L.F.), and Department of Biostatistics (J.B., S.K.), School of Public Health, University of Michigan, Ann Arbor
| | - Stephen A Goutman
- From the Department of Neurology (B.J.M., S.A.G., E.L.F.), and Department of Biostatistics (J.B., S.K.), School of Public Health, University of Michigan, Ann Arbor.
| | - Jonathan Boss
- From the Department of Neurology (B.J.M., S.A.G., E.L.F.), and Department of Biostatistics (J.B., S.K.), School of Public Health, University of Michigan, Ann Arbor
| | - Sehee Kim
- From the Department of Neurology (B.J.M., S.A.G., E.L.F.), and Department of Biostatistics (J.B., S.K.), School of Public Health, University of Michigan, Ann Arbor
| | - Eva L Feldman
- From the Department of Neurology (B.J.M., S.A.G., E.L.F.), and Department of Biostatistics (J.B., S.K.), School of Public Health, University of Michigan, Ann Arbor
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66
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Dy CJ, Brogan DM, Rolf L, Ray WZ, Wolfe SW, James AS. A qualitative study of life satisfaction after surgery for adult traumatic brachial plexus injury. Bone Jt Open 2021; 2:9-15. [PMID: 33537671 PMCID: PMC7842160 DOI: 10.1302/2633-1462.21.bjo-2020-0175.r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Aims Brachial plexus injury (BPI) is an often devastating injury that affects patients physically and emotionally. The vast majority of the published literature is based on surgeon-graded assessment of motor outcomes, but the patient experience after BPI is not well understood. Our aim was to better understand overall life satisfaction after BPI, with the goal of identifying areas that can be addressed in future delivery of care. Methods We conducted semi-structured interviews with 15 BPI patients after initial nerve reconstruction. The interview guide was focused on the patient’s experience after BPI, beginning with the injury itself and extending beyond surgical reconstruction. Inductive and deductive thematic analysis was used according to standard qualitative methodology to better understand overall life satisfaction after BPI, contributors to life satisfaction, and opportunities for improvement. Results Among the 15 patients interviewed, the following themes emerged: 1) happiness and life satisfaction were noted despite limitations in physical function; 2) quality of social support influences life satisfaction during recovery from BPI; and 3) social participation and having a sense of purpose impact life satisfaction during recovery from BPI. Conclusion How patients perceive their BPI treatment and recovery varies widely, and is not directly linked to their self-reported functional outcome. Patients with stronger social circles and activities that give them a sense of fulfillment were more likely to be satisfied with their current status. Evaluating a patient’s social network, goals, and potential supportive adaptations early in the treatment timeline through coordinated multidisciplinary care may improve overall satisfaction during recovery from BPI. Cite this article: Bone Joint Open 2020;2(1):9–15.
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Affiliation(s)
- Christopher J Dy
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - David M Brogan
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Liz Rolf
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Wilson Z Ray
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Scott W Wolfe
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Aimee S James
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
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67
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Dahl CJ, Wilson-Mendenhall CD, Davidson RJ. The plasticity of well-being: A training-based framework for the cultivation of human flourishing. Proc Natl Acad Sci U S A 2020; 117:32197-32206. [PMID: 33288719 PMCID: PMC7768706 DOI: 10.1073/pnas.2014859117] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Research indicates that core dimensions of psychological well-being can be cultivated through intentional mental training. Despite growing research in this area and an increasing number of interventions designed to improve psychological well-being, the field lacks a unifying framework that clarifies the dimensions of human flourishing that can be cultivated. Here, we integrate evidence from well-being research, cognitive and affective neuroscience, and clinical psychology to highlight four core dimensions of well-being-awareness, connection, insight, and purpose. We discuss the importance of each dimension for psychological well-being, identify mechanisms that underlie their cultivation, and present evidence of their neural and psychological plasticity. This synthesis highlights key insights, as well as important gaps, in the scientific understanding of well-being and how it may be cultivated, thus highlighting future research directions.
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Affiliation(s)
- Cortland J Dahl
- Center for Healthy Minds, University of Wisconsin, Madison, WI 53703;
| | | | - Richard J Davidson
- Center for Healthy Minds, University of Wisconsin, Madison, WI 53703;
- Department of Psychology, University of Wisconsin, Madison, WI 53706
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin, Madison, WI 53705
- Department of Psychiatry, University of Wisconsin, Madison, WI 53719
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68
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Kinoshita S, Hirooka N, Kusano T, Saito K, Nakamoto H. Does Improvement in Health-Related Lifestyle Habits Increase Purpose in Life among a Health Literate Cohort? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238878. [PMID: 33260350 PMCID: PMC7730675 DOI: 10.3390/ijerph17238878] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 12/11/2022]
Abstract
A growing number of studies have revealed the association between health-related lifestyle habits and purpose in life. However, the mechanism linking the two has not been adequately understood. This study aims to examine the effect of changes in health-related lifestyle habits on purpose in life. A retrospective cohort study was conducted on certified professional specialists of health management. We analyzed the cohort’s demographic information, health-related lifestyle behaviors, reported changes in health-related lifestyle habits (exercise, diet, sleep, and other habits), and purpose in life using a validated tool (Ikigai-9). The cohort was divided into four groups based on the number of reported changes in health-related lifestyles. The purpose in life score was compared among the four groups with and without adjusting for lifestyle. In total, there were 4820 participants. The means (and SD) of the Ikigai-9 score for groups 1, 2, 3, and 4 were 31.4 (6.6), 32.2 (5.6), 32.8 (5.8), and 34.9 (5.4), respectively. There was a statistically significant difference in the Ikigai-9 score among the groups. Healthier changes in lifestyle habits increased perceptions of purpose in life. Both purpose in life and health-related lifestyle habits might be the target factors for disease prevention and health promotion.
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69
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Determinants of Multidimensional and Physical Frailty and Their Individual Components: Interactions between Frailty Deficits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228656. [PMID: 33233408 PMCID: PMC7700624 DOI: 10.3390/ijerph17228656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 11/17/2022]
Abstract
Purpose: To identify the interrelations among determinants of multidimensional frailty, physical frailty, and their individual components. Methods: A group of 1024 community-dwelling people older than 65 years completed questionnaires regarding: multidimensional frailty (Tilburg Frailty Indicator, TFI) and physical frailty (FRAIL scale), and common frailty risk factors. Results: Multidimensional frailty was recognized in 559 subjects (54.6%) and determined by 13 factors (R2 = 0.21 in logistic regression). After incorporating TFI components to the models, the majority of previous risk factors became non-essential, and the frailty deficits mainly determined each other with R2 ranging between 0.07-0.67. Physical frailty and non-robust status (i.e., either physical frailty or pre-frailty) were recognized in 64 (6.3%) and 542 (52.9%) participants, and were determined by 5 factors (R2 = 0.33) and 11 factors (R2 = 0.34), respectively. Associations between the frailty deficits were detected within and between different dimensions (i.e., physical, psychological and social); the physical domain was mainly related to the psychological one which in turn was additionally associated with the social one. Conclusion: Frailty is the accumulation of deficits and is determined by factors other than the determinants of the individual deficits. The associations between deficits coming from various dimensions of human functioning presumably amplify their effects and accelerate frailty development.
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70
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Zhang MX, Yang HM, Tong KK, Wu AMS. The prospective effect of purpose in life on gambling disorder and psychological flourishing among university students. J Behav Addict 2020; 9:756-765. [PMID: 32817587 PMCID: PMC8943680 DOI: 10.1556/jba-9-756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/22/2020] [Accepted: 06/30/2020] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND AND AIMS Gambling disorder (GD) is a mental disorder with a relatively higher prevalence in university students compared to adolescents and adults. Its reciprocity with mental being indicators, such as psychological flourishing, would be expected, but prior to this study had not yet been empirically examined. In addition, the predictive value of purpose in life (PIL) on university students' GD and psychological flourishing also remained unknown. This 1-year longitudinal study was the first to test the potential bidirectional relationships among PIL, self-reported GD symptoms, and psychological flourishing. METHODS In this study, a total of 283 university students (39.6% females; age = 18-27 years, M = 20.47, SD = 1.15) completed an anonymous questionnaire at both baseline and a year later in a follow-up study. RESULTS The results of our cross-lagged analysis did not show the hypothesized reciprocity between GD symptoms and psychological flourishing (P > 0.05). However, PIL significantly predicted fewer GD symptoms (β = -0.23, P < 0.001) and higher levels of psychological flourishing (β = 0.30, P < 0.001) in the follow-up study. Moreover, psychological flourishing predicted PIL a year later. CONCLUSION The findings demonstrate the potential efficacy of purpose/meaning oriented interventions in gambling prevention and in well-being promotion programs.
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Affiliation(s)
- Meng Xuan Zhang
- Department of Psychology, Faculty of Social Sciences, University of Macau, Taipa, Macao, China
- Center for Cognitive and Brain Sciences, University of Macau, Taipa, Macao, China
| | - Hong Mian Yang
- Center for Cognitive and Brain Sciences, University of Macau, Taipa, Macao, China
| | - Kwok-Kit Tong
- Department of Psychology, Faculty of Social Sciences, University of Macau, Taipa, Macao, China
| | - Anise M. S. Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Taipa, Macao, China
- Center for Cognitive and Brain Sciences, University of Macau, Taipa, Macao, China
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71
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Chen Y, Kim ES, Shields AE, VanderWeele TJ. Antecedents of Purpose in Life: Evidence from A Lagged Exposure-Wide Analysis. COGENT PSYCHOLOGY 2020; 7. [PMID: 33072817 DOI: 10.1080/23311908.2020.1825043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Potential antecedents to having a sense of purpose in life remain understudied. As researchers begin contemplating purpose as a promising target of public health intervention, it is critical to identify its antecedents. Using prospective data from the Nurses' Health Study II (2009-2016; N ranged from 3,905 to 4,189), this study evaluated a wide range of potential antecedents of purpose, including: psychosocial well-being, psychological distress, employment characteristics, lifestyle, and physical health factors. In separate regression models we regressed purpose in life on each candidate antecedent. In each model, we adjusted for the prior value of purpose, prior values of all exposure variables, and various other covariates simultaneously. Bonferroni correction was used to correct for multiple testing. The results suggested that positive affect and the number of close relatives were each associated with higher purpose (e.g., β=0.14, 95% CI: 0.11, 0.17 for positive affect). Several psychological distress indicators were inversely associated with purpose, including depressive symptoms, anxiety symptoms, loneliness, and hopelessness (e.g., β=-0.16, 95% CI: -0.19, -0.13 for depressive symptoms). There was also some evidence suggesting that fewer close friends, living alone, and unemployment/retirement were associated with lower purpose. There was, however, little evidence that health behaviors or physical health were associated with subsequent purpose. This study extends the literature by providing longitudinal evidence with rigorous analytic methodologies, and by considering a wide range of potential antecedents of purpose including some that have seldom been examined previously.
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Affiliation(s)
- Ying Chen
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eric S Kim
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alexandra E Shields
- Department of Medicine, Harvard Medical School, Boston, MA; Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Tyler J VanderWeele
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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72
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Kim ES, Shiba K, Boehm JK, Kubzansky LD. Sense of purpose in life and five health behaviors in older adults. Prev Med 2020; 139:106172. [PMID: 32593729 PMCID: PMC7494628 DOI: 10.1016/j.ypmed.2020.106172] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 05/10/2020] [Accepted: 06/14/2020] [Indexed: 11/19/2022]
Abstract
Accumulating evidence shows that a higher sense of purpose in life is associated with lower risk of chronic conditions and premature mortality. Health behaviors might partially explain these findings, however, the prospective association between sense of purpose and health behaviors is understudied. We tested whether a higher sense of purpose at baseline was associated with lower likelihood of developing unhealthy behaviors over time. Prospective data were from the Health and Retirement Study, a national sample of U.S. older adults. Our sample included 13,770 adults assessed up to five times across eight years. Among people who met recommended guidelines for a given health behavior outcome at baseline, those in the top versus lowest quartile of purpose in life had 24% lower likelihood of becoming physically inactive (95% CI: 0.68-0.85), 33% lower likelihood of developing sleep problems (95% CI: 0.58-0.79), and 22% lower likelihood of developing unhealthy body mass index (BMI) (95% CI: 0.69-0.87) in sociodemographic-adjusted models. Further there was a marginal reduction in smoking relapse (HR = 0.65, 95% CI: 0.41-1.03) and no association with heavy alcohol use (HR = 1.02, 95% CI: 0.81-1.29). Findings for physical inactivity, sleep problems, and unhealthy BMI remained evident after further adjusting for baseline health status and depression. Our results, suggest that a sense of purpose in life might emerge (with further research) as a valuable target to consider for interventions aimed at helping older adults maintain some health behaviors.
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Affiliation(s)
- Eric S Kim
- Department of Psychology, University of British Columbia, Vancouver, Canada; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America; Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States of America.
| | - Koichiro Shiba
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, CA, United States of America
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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Schnell T, Krampe H. Meaning in Life and Self-Control Buffer Stress in Times of COVID-19: Moderating and Mediating Effects With Regard to Mental Distress. Front Psychiatry 2020; 11:582352. [PMID: 33173525 PMCID: PMC7538834 DOI: 10.3389/fpsyt.2020.582352] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 08/28/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND As evidenced by several studies, mental distress increased substantially during the COVID-19 pandemic. In this period, citizens were asked to exercise a high degree of self-control with regard to personal and social health behavior. At the same time, we witnessed an increase of prosocial acts and shared creative expressions, which are known to serve as sources of meaning. Meaning in life and self-control are acknowledged psychological resources. Especially in times of crisis, meaning in life has been shown to be a crucial factor for resilience and coping. However, threatening and stressful situations can also jeopardize existential security and trigger crises of meaning. The present study aimed to document levels of acute COVID-19 stress and general mental distress in Germany and Austria during the lockdown and in the weeks thereafter. In order to identify potential risk factors related to demographics and living conditions, their associations with COVID-19 stress were analyzed exploratively. The primary objective of the study, however, was to investigate the buffering effect of two psychological resources-meaningfulness and self-control-with regard to the relation between acute COVID-19 stress and general mental distress. Finally, a potential aggravation of mental distress due to the occurrence of crises of meaning was examined. METHOD A cross-sectional survey was conducted online during lockdown (survey group 1) and the subsequent weeks characterized by eased restrictions (survey group 2). A total of N = 1,538 German-speaking participants completed a questionnaire battery including a novel measure of acute COVID-19 stress, meaningfulness and crisis of meaning (SoMe), self-control (SCS-KD), and a screening of general mental distress, measured by core symptoms of depression and anxiety (PHQ-4). In a first step, associations between living conditions, demographics, and COVID-19 stress were explored. Second, a moderation and a mediation model were tested. Meaningfulness, a measure of presence of meaning in life, as well as self-control were proposed to serve as buffers in a time of crisis, thus moderating the relation between acute COVID-19 stress and general mental distress (double moderation). Crisis of meaning, operationalizing an experienced lack of meaning in life, was proposed to mediate the relationship between acute COVID-19 stress and general mental distress, with an assumed moderation of the association between COVID-19 stress and crisis of meaning by survey group (lockdown versus eased restrictions after lockdown), and a hypothesized moderation of the link between crisis of meaning and general mental distress by self-control (dual moderated mediation). RESULTS COVID-19 stress was slightly right-skewed. Scores were higher during lockdown than in the weeks thereafter. The rate of clinically significant general mental distress was high, exceeding prevalence rates from both the general population and clinical samples of the time before the pandemic. In the weeks following the lockdown (group 2), general mental distress and crisis of meaning were significantly higher than during lockdown (group 1), whereas meaningfulness and self-control were significantly lower. Demographically, age had the strongest association with COVID-19 stress, with older participants perceiving less acute stress (r = -.21). People who were partnered or married suffered less from COVID-19 stress (η2 = .01). Living alone (η2 = .006), living in a room versus a flat or house (η2 = .008), and being unemployed due to the pandemic (η2 = .008) were related to higher experience of COVID-19 stress. COVID-19 stress and general mental distress were strongly related (r = .53). Both meaningfulness and self-control were negatively associated with general mental distress (r = -.40 and -.36, respectively). They also moderated the relationship between COVID-19 stress and general mental distress: When meaningfulness was high, high COVID-19 stress was related to substantially lower PHQ-4 scores than when meaningfulness was low. The same held for self-control: High scores of self-control were associated with lower PHQ-4 scores especially when COVID-19 stress was high. Crisis of meaning mediated the relationship between COVID-19 stress and PHQ-4. There was a higher likelihood of crises of meaning occurring when COVID-19 stress was high; crisis of meaning, in turn, was associated with general mental distress. Survey group moderated the first path of this mediation, i.e., the relationship between COVID-19 stress and crisis of meaning: High scores of COVID-19 stress were associated more strongly with crisis of meaning in the second survey group (after the lockdown). Self-control moderated the second path, i.e., the relationship between crisis of meaning and PHQ-4: When a crisis of meaning was present, self-control could buffer its effect on general mental distress. CONCLUSIONS Also in the present study among German-speaking participants, general mental distress was high. Scores were higher after than during the lockdown, indicating an ongoing destabilization for a significant part of the population. People who saw a meaning in their lives and who were capable of self-control reported substantially less mental distress. Meaningfulness and self-control also served as buffers between COVID-19 stress and general mental distress: When COVID-19 stress was high, the presence of meaningfulness and self-control accounted for lower general mental distress. Moreover, people who suffered strongly from COVID-19 stress were more likely to develop a crisis of meaning which, in turn, was associated with higher general mental distress. This suggests that ongoing anxiety and depression might (also) be based on existential struggles. Again here, self-control buffered the impact of crisis of meaning on general mental health. We conclude from these findings that public health policies can support citizens in coping with large-scale crises by enabling experiences of meaningfulness, e.g., through transparent and reliable modes of communicating goals and necessary intermediate steps. Moreover, health professionals are well advised to invite individuals to confront existential questions and struggles, and to encourage them to exercise self-control. The latter can be boosted by keeping higher-order goals salient-which again is inherently linked to an understanding of their meaning.
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Affiliation(s)
- Tatjana Schnell
- Existential Psychology Lab, Institute of Psychology, University of Innsbruck, Innsbruck, Austria
- Psychology of Religion, MF Norwegian School of Theology, Religion and Society, Oslo, Norway
| | - Henning Krampe
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Zhang MX, Yang HM, Tong KK, Wu AMS. The prospective effect of purpose in life on gambling disorder and psychological flourishing among university students. J Behav Addict 2020; 9:756-765. [PMID: 32817587 PMCID: PMC8943680 DOI: 10.1556/2006.2020.00046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/22/2020] [Accepted: 06/30/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND AND AIMS Gambling disorder (GD) is a mental disorder with a relatively higher prevalence in university students compared to adolescents and adults. Its reciprocity with mental being indicators, such as psychological flourishing, would be expected, but prior to this study had not yet been empirically examined. In addition, the predictive value of purpose in life (PIL) on university students' GD and psychological flourishing also remained unknown. This 1-year longitudinal study was the first to test the potential bidirectional relationships among PIL, self-reported GD symptoms, and psychological flourishing. METHODS In this study, a total of 283 university students (39.6% females; age = 18-27 years, M = 20.47, SD = 1.15) completed an anonymous questionnaire at both baseline and a year later in a follow-up study. RESULTS The results of our cross-lagged analysis did not show the hypothesized reciprocity between GD symptoms and psychological flourishing (P > 0.05). However, PIL significantly predicted fewer GD symptoms (β = -0.23, P < 0.001) and higher levels of psychological flourishing (β = 0.30, P < 0.001) in the follow-up study. Moreover, psychological flourishing predicted PIL a year later. CONCLUSION The findings demonstrate the potential efficacy of purpose/meaning oriented interventions in gambling prevention and in well-being promotion programs.
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Affiliation(s)
- Meng Xuan Zhang
- Department of Psychology, Faculty of Social Sciences, University of Macau, Taipa, Macao, China,Center for Cognitive and Brain Sciences, University of Macau, Taipa, Macao, China
| | - Hong Mian Yang
- Center for Cognitive and Brain Sciences, University of Macau, Taipa, Macao, China
| | - Kwok-Kit Tong
- Department of Psychology, Faculty of Social Sciences, University of Macau, Taipa, Macao, China
| | - Anise M. S. Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Taipa, Macao, China,Center for Cognitive and Brain Sciences, University of Macau, Taipa, Macao, China,Corresponding author. E-mail:
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Masters KS, Shaffer JA, Vagnini KM. The Impact of Psychological Functioning on Cardiovascular Disease. Curr Atheroscler Rep 2020; 22:51. [PMID: 32772177 DOI: 10.1007/s11883-020-00877-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW We report on recent findings pertaining to the relationship of both negative and positive indicators of psychological functioning with cardiovascular disease (CVD) and briefly describe possible mechanistic pathways to account for these relationships. RECENT FINDINGS A body of observational literature suggests that (1) depression is predictive of CVD and is a consequence of CVD; (2) anxiety is related to CVD but the precise nature of this relationship remains unclear; and (3) negative affectivity and Type D personality are constructs that combine aspects of negative psychological functioning that have shown relationships with CVD and are worthy of future investigation. Positive psychological constructs of meaning/purpose and optimism predict better cardiovascular outcomes and other positive psychological constructs have received promising, but limited, attention in the literature. Key remaining questions concern the magnitude and directionality of possible causal relationships as well as the mechanisms accounting for them.
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Affiliation(s)
- Kevin S Masters
- Department of Psychology, University of Colorado Denver, Denver, CO, 80217-3364, USA.
| | - Jonathan A Shaffer
- Department of Psychology, University of Colorado Denver, Denver, CO, 80217-3364, USA
| | - Kaitlyn M Vagnini
- Department of Psychology, University of Colorado Denver, Denver, CO, 80217-3364, USA
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Sacha M, Sacha J, Wieczorowska-Tobis K. Multidimensional and Physical Frailty in Elderly People: Participation in Senior Organizations Does Not Prevent Social Frailty and Most Prevalent Psychological Deficits. Front Public Health 2020; 8:276. [PMID: 32793534 PMCID: PMC7385307 DOI: 10.3389/fpubh.2020.00276] [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: 10/16/2019] [Accepted: 05/27/2020] [Indexed: 11/26/2022] Open
Abstract
Purpose: The study explores how the involvement in community-based senior organizations affects the prevalence of multidimensional and physical frailty among community dwelling elderly people. Materials and Methods: The group of 1,024 elderly people (270 males) over the age of 65 years (mean age 72.6 ± 6.3 years; range 65–93 years) took part in this study. The subjects completed a questionnaire regarding multidimensional (i.e., the Tilburg Frailty Indicator, TFI) and physical frailty (i.e., the FRAIL scale), as well as factors associated with frailty and participation in senior organizations. Results: The prevalence of multidimensional frailty (if at least 5 points in the TFI) was 54.6%, and the prevalence of physical frailty (if at least 3 points in the FRAIL scale) and a non-robust status (if any point in the FRAIL scale was positive) was 6.3 and 52.9%, respectively. The most prevalent frailty deficits were missing other people (66.6%), feeling nervous or anxious (65.9%), and feeling down (65.5%). Members of senior organizations presented a lower prevalence of multidimensional and physical frailty comparing with non-members. This was mainly caused by a lower prevalence of physical deficits and problems with memory; however, the prevalence of social deficits was similar in both groups. Senior organizations had no influence on the most widespread frailty deficits, i.e., missing other people, feeling nervous or anxious, and feeling down. Conclusions: Multidimensional frailty and physical non-robust status are common among people over the age of 65 years. Participation in senior organizations is associated with lower risk of physical frailty; however, it has no effect on social frailty and the most prevalent psychological deficits. This information has important implications for practical management with senior problems and may influence community strategies concerning elderly people.
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Affiliation(s)
- Magdalena Sacha
- Department of Palliative Medicine, Poznan University of Medical Sciences, Poznaǹ, Poland
| | - Jerzy Sacha
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland.,Department of Cardiology, University Hospital, University of Opole, Opole, Poland
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An outcome-wide analysis of bidirectional associations between changes in meaningfulness of life and health, emotional, behavioural, and social factors. Sci Rep 2020; 10:6463. [PMID: 32296106 PMCID: PMC7160137 DOI: 10.1038/s41598-020-63600-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 03/30/2020] [Indexed: 01/16/2023] Open
Abstract
The sense that one is living a meaningful life is associated with positive health outcomes, but less is known about the role of changes in sense of meaning. This outcome-wide analysis investigated bidirectional associations between changes in ratings of doing worthwhile things in life and 32 factors in 6 domains of human function in 5,694 men and women (M = 66.65 years) from the English Longitudinal Study of Ageing. Participants rated the extent they felt that the things they did in life were worthwhile in 2012 and 2014. Analyses were adjusted for age, gender, education and social class, and were weighted for non-response. We found that health (e.g. few chronic diseases, no chronic pain), emotional wellbeing (e.g. few depressive symptoms, good sleep), greater physical activity, social factors (e.g. close relationships, friends, organizational membership, volunteering, cultural engagement), and economic factors (wealth, income), at baseline were associated with 2 year increases in worthwhile ratings. Conversely, increases in worthwhile ratings over 2 years were related to more favourable health, emotional, behavioural, and social changes between 2012 and 2016 independently of baseline levels. These bidirectional relationships highlight the importance of maintaining worthwhile activities at older ages.
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Cattaneo G, Bartrés-Faz D, Morris TP, Solana Sánchez J, Macià D, Tormos JM, Pascual-Leone A. The Barcelona Brain Health Initiative: Cohort description and first follow-up. PLoS One 2020; 15:e0228754. [PMID: 32045448 PMCID: PMC7012435 DOI: 10.1371/journal.pone.0228754] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 01/22/2020] [Indexed: 11/19/2022] Open
Abstract
The Barcelona Brain Health Initiative is a longitudinal cohort study that began in 2017 and aims to understand and characterize the determinants of brain health maintenance in middle aged adults. A cohort of 4686 individuals between the ages of 40 and 65 years free from any neurological or psychiatric diseases was established, and we collected extensive demographic, socio-economic information along with measures of self-perceived health and lifestyles (general health, physical activity, cognitive activity, socialization, sleep, nutrition and vital plan). Here we report on the baseline characteristics of the participants, and the results of the one-year follow-up evaluation. Participants were mainly women, highly educated, and with better lifestyles compared with the general population. After one year 60% of participants completed the one-year follow-up, and these were older, with higher educational level and with better lifestyles in some domains. In the absence of any specific interventions to-date, these participants showed small improvements in physical activity and sleep, but decreased adherence to a Mediterranean diet. These changes were negatively associated with baseline scores, and poorer habits at baseline were predictive of an improvement in lifestyle domains. Of the 2353 participants who completed the one-year follow-up, 73 had been diagnosed with new neurological and neuropsychiatric diseases. Changes in vital plan at follow-up, as well as gender, sleep quality and sense of coherence at baseline were shown to be significant risk factors for the onset of these diagnoses. Notably, gender risk factor decreased in importance as we adjusted by sleep habits, suggesting its potential mediator effects. These findings stress the importance of healthy lifestyles in sustaining brain health, and illustrate the individual benefit that can be derived from participation in longitudinal observational studies. Modifiable lifestyles, specifically quality of sleep, may partially mediate the effect of other risk factors in the development of some neuropsychiatric conditions.
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Affiliation(s)
- Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - David Bartrés-Faz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Timothy P. Morris
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Javier Solana Sánchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Dídac Macià
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Josep M. Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States of America
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Pizzo PA. A Prescription for Longevity in the 21st Century: Renewing Purpose, Building and Sustaining Social Engagement, and Embracing a Positive Lifestyle. JAMA 2020; 323:415-416. [PMID: 31917444 DOI: 10.1001/jama.2019.21087] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Philip A Pizzo
- Departments of Pediatrics and Microbiology and Immunology, Stanford University, Stanford, California
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Tulip C, Fisher Z, Bankhead H, Wilkie L, Pridmore J, Gracey F, Tree J, Kemp AH. Building Wellbeing in People With Chronic Conditions: A Qualitative Evaluation of an 8-Week Positive Psychotherapy Intervention for People Living With an Acquired Brain Injury. Front Psychol 2020; 11:66. [PMID: 32082221 PMCID: PMC7006056 DOI: 10.3389/fpsyg.2020.00066] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 01/10/2020] [Indexed: 12/17/2022] Open
Abstract
Research indicates that Acquired Brain Injury (ABI) is associated with significant and chronic impairment across multiple areas of functioning including physical, cognitive, emotional and behavioral domains. Whilst impairments associated with ABI can be ameliorated, cure is seldom possible. The emergence of positive psychology reflects a paradigm shift in health and wellbeing research, highlighting the role of character strengths, positive emotions, meaning, and resilience. Positive psychology interventions have been demonstrated to improve wellbeing in a variety of populations, although research investigating the impact of positive psychotherapy for people living with ABI are sparse. Here we characterize the experience of an 8-week positive psychotherapy intervention for 13 people living with ABI including four mentors and nine participants using thematic analysis of transcripts collected during mini-groups and one-to-one interviews. Six main themes were identified including empowerment, social opportunity, coping, cultivation of positive emotion, consolidation of skills and barriers. Results indicated that wellbeing can be promoted and improved in individuals with ABI. Recent theoretical developments in wellbeing science highlight scope to improve the intervention by connecting individuals to their communities and spending time in nature.
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Affiliation(s)
- Chloe Tulip
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, United Kingdom
| | - Zoe Fisher
- Health and Wellbeing Academy, College of Human and Health Sciences, Swansea University, Swansea, United Kingdom
- Community Brain Injury Service, Swansea Bay University Health Board, Morriston Hospital, Swansea, United Kingdom
| | - Helen Bankhead
- Community Brain Injury Service, Swansea Bay University Health Board, Morriston Hospital, Swansea, United Kingdom
| | - Lowri Wilkie
- Community Brain Injury Service, Swansea Bay University Health Board, Morriston Hospital, Swansea, United Kingdom
- School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Julia Pridmore
- Health and Wellbeing Academy, College of Human and Health Sciences, Swansea University, Swansea, United Kingdom
| | - Fergus Gracey
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Jeremy Tree
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, United Kingdom
| | - Andrew H. Kemp
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, United Kingdom
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81
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Aftab A, Lee EE, Klaus F, Daly R, Wu TC, Tu X, Huege S, Jeste DV. Meaning in Life and Its Relationship With Physical, Mental, and Cognitive Functioning: A Study of 1,042 Community-Dwelling Adults Across the Lifespan. J Clin Psychiatry 2019; 81:19m13064. [PMID: 31846240 PMCID: PMC7138140 DOI: 10.4088/jcp.19m13064] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 11/15/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To examine the relationship of presence and search for meaning in life with age, physical and mental well-being, and cognitive functioning across the adult lifespan. METHODS Cross-sectional data from 1,042 adults in the Successful AGing Evaluation (SAGE)-a multicohort study of adult community-dwelling residents of San Diego County, California-were analyzed. Presence of meaning ("Presence") and search for meaning in life ("Search") were assessed with the Meaning in Life Questionnaire. Physical and mental well-being were measured using the Short Form 36 Health Survey (SF-36). Telephone Interview for Cognitive Status-modified was employed to screen for overall cognitive function. Study data were collected from January 2013 to June 2014. RESULTS Presence of meaning exhibited an inverted U-shaped relationship whereas Search showed a U-shaped relationship with age (with Presence peaking and Search reaching the lowest point around age 60). Statistical modeling using generalized estimating equations revealed that physical well-being (SF-36 physical composite score) correlated negatively with age (P < .001) and positively with Presence (P < .001), and there was an age group x Presence interaction (P = .018), such that the relationship was stronger in subjects over age 60. Mental well-being correlated positively with age (P < .001) and Presence (P < .001) and negatively with Search (P = .002). Cognitive function correlated inversely with age (P < .001) and with Search (P < .001). Significant covariates of Presence and Search had small effect sizes, except for a medium effect size for satisfaction with life and Presence in adults over age 60 (P < .001). CONCLUSIONS Presence and search for meaning in life are important for health and well-being, though the relationships differ in adults younger and older than 60 years. Better understanding of the longitudinal relationships of meaning of life with well-being is warranted to design interventions to increase meaning of life and improve health and functioning.
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Affiliation(s)
- Awais Aftab
- Department of Psychiatry, University of California San Diego, La Jolla, CA,VA San Diego Healthcare System, La Jolla, CA
| | - Ellen E. Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA,VA San Diego Healthcare System, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Federica Klaus
- Department of Psychiatry, University of California San Diego, La Jolla, CA,VA San Diego Healthcare System, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Rebecca Daly
- Department of Psychiatry, University of California San Diego, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Tsung-Chin Wu
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA,Department of Mathematics, University of California San Diego, La Jolla, CA
| | - Xin Tu
- Department of Psychiatry, University of California San Diego, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA,Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA
| | - Steven Huege
- Department of Psychiatry, University of California San Diego, La Jolla, CA,VA San Diego Healthcare System, La Jolla, CA
| | - Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA,Department of Neurosciences, University of California San Diego, La Jolla, CA
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82
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Alimujiang A, Khoja L, Wiensch A, Pike MC, Webb PM, Chenevix-Trench G, Chase A, Richardson J, Pearce CL. "I am not a statistic" ovarian cancer survivors' views of factors that influenced their long-term survival. Gynecol Oncol 2019; 155:461-467. [PMID: 31706666 DOI: 10.1016/j.ygyno.2019.10.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/03/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Although a high proportion of women with advanced stage ovarian cancer die within five years, approximately 30% will survive longer than this. The factors contributing to exceptional survival are currently poorly understood. The viewpoints of ovarian cancer survivors were qualitatively explored to determine the factors they felt have influenced their exceptional ovarian cancer survival. METHODS Four focus groups, one each in Los Angeles (California), Ann Arbor (Michigan), New York (New York) and Edmonton (Alberta, Canada), were conducted with women who had survived at least five years. Physical activity, diet, meditation, prayer, treatment, complementary medicine, and side effects were explored in semi-structured discussions. The audiotaped sessions were transcribed and coded and then analyzed using Dedoose Version 8.0.35, a qualitative analysis software. RESULTS Of the 26 women who participated, 23 had advanced stage disease. Three overarching themes emerged: (a) survivors had improved their 'lifestyles', including but not limited to fitness and diet; (b) survivors were able to draw on strong support systems, which included family, friends, support groups, faith communities, and healthcare workers; and (c) survivors had a strong life purpose, which manifested as positivity, taking charge of their lives, and advocating for themselves. CONCLUSIONS Long-term survivors have varying experiences with their cancer, but identified lifestyle modification, motivation and persistence, strong life purpose, and strong support systems as key elements in their better survival. These preliminary findings indicate the need for further prospective studies to determine whether meaningful differences exist between short term and long term survivors on these characteristics.
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Affiliation(s)
- Aliya Alimujiang
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Lilah Khoja
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Ashley Wiensch
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Malcolm C Pike
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Penelope M Webb
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, 4006, QLD, Australia
| | | | - Anne Chase
- Multidisciplinary Ovarian Cancer Outcomes Group, Regina, Sk. S4T 7X8, Canada
| | - Jean Richardson
- Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles, CA, USA
| | - Celeste Leigh Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
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83
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Radomski MV, Swenson KK, Anheluk M, Zola J, Kreiger R, Rabusch S, Halsten J, Kath K, Carroll G, Zust BL. The feasibility of a purpose-renewal intervention after treatment for early stage breast cancer: A brief report. J Psychosoc Oncol 2019; 38:501-509. [DOI: 10.1080/07347332.2019.1692990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | | | - Mattie Anheluk
- Courage Kenny Rehabilitation Institute, Minneapolis, Minnesota, USA
| | - Joette Zola
- Courage Kenny Rehabilitation Institute, Minneapolis, Minnesota, USA
| | - Rob Kreiger
- Courage Kenny Research Center, Minneapolis, Minnesota, USA
| | - Stacey Rabusch
- Courage Kenny Research Center, Minneapolis, Minnesota, USA
| | - Jerry Halsten
- Courage Kenny Rehabilitation Institute, Minneapolis, Minnesota, USA
| | - Kristina Kath
- Courage Kenny Research Center, Minneapolis, Minnesota, USA
| | - Ginger Carroll
- Courage Kenny Research Center, Minneapolis, Minnesota, USA
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84
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Buckley R, Brough P, Hague L, Chauvenet A, Fleming C, Roche E, Sofija E, Harris N. Economic value of protected areas via visitor mental health. Nat Commun 2019; 10:5005. [PMID: 31719526 PMCID: PMC6851373 DOI: 10.1038/s41467-019-12631-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/24/2019] [Indexed: 11/08/2022] Open
Abstract
We evaluate methods to calculate the economic value of protected areas derived from the improved mental health of visitors. A conservative global estimate using quality-adjusted life years, a standard measure in health economics, is US$6 trillion p.a. This is an order of magnitude greater than the global value of protected area tourism, and two to three orders greater than global aggregate protected area management agency budgets. Future research should: refine this estimate using more precise methods; consider interactions between health and conservation policies and budgets at national scales; and examine links between personalities and protected area experiences at individual scale.
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Affiliation(s)
- Ralf Buckley
- Griffith University, Gold Coast, QLD, Australia, 4222.
| | - Paula Brough
- Griffith University, Gold Coast, QLD, Australia, 4222
| | - Leah Hague
- Griffith University, Gold Coast, QLD, Australia, 4222
| | | | - Chris Fleming
- Griffith University, Gold Coast, QLD, Australia, 4222
| | - Elisha Roche
- Griffith University, Gold Coast, QLD, Australia, 4222
| | | | - Neil Harris
- Griffith University, Gold Coast, QLD, Australia, 4222
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85
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Das SK, Mason ST, Vail TA, Blanchard CM, Chin MK, Rogers GT, Livingston KA, Turgiss JL. Sustained Long-Term Effectiveness of an Energy Management Training Course on Employee Vitality and Purpose in Life. Am J Health Promot 2019; 34:177-188. [PMID: 31698916 PMCID: PMC7323763 DOI: 10.1177/0890117119883585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose: Programs designed to sustainably improve employee well-being are urgently needed but
insufficiently researched. This study evaluates the long-term effectiveness of a
commercial well-being intervention in a worksite setting. Design: A pre/postintervention repeated analysis with follow-up at 6, 12, and 18 months. Setting: Office-based worksites (for-profit, nonprofit, and mixed work-type; n = 8). Participants: One hundred sixty-three employees with a mean age of 47 (11) years (57% female). Intervention: A 2.5-day group-based behavioral program emphasizing vitality and purpose in life
(PiL). Measures: Rand Medical Outcomes Survey (MOS) 36-Item Short Form (SF-36) with a focus on vitality
(primary outcome), Ryff PiL Scale, Center for Epidemiologic Studies Depression Scale,
Profile of Mood States, Rand MOS Sleep Scale, physical activity, body weight, blood
pressure, and blood measures for glucose and lipids at baseline, 6, 12, and 18
months. Analysis: General linear models with repeated measures for mean values at baseline and
follow-up. Results: At 18-month follow-up, sustained improvements were observed for vitality, general
health, and mental health domains of SF-36 and PiL (P < .001 for all
measures). Sleep, mood, vigor, physical activity, and blood pressure were also improved
at 18 months (P < .05 for all measures). Conclusions: An intensive 2.5-day intervention showed sustained improvement in employee quality of
life, PiL, and other measures of well-being over 18 months.
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Affiliation(s)
- Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Shawn T Mason
- Johnson & Johnson, Health and Wellness Solutions Inc, New Brunswick, NJ, USA
| | - Taylor A Vail
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Caroline M Blanchard
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Meghan K Chin
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Gail T Rogers
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Kara A Livingston
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Jennifer L Turgiss
- Johnson & Johnson, Health and Wellness Solutions Inc, New Brunswick, NJ, USA
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86
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Kim ES, Delaney SW, Kubzansky LD. Sense of Purpose in Life and Cardiovascular Disease: Underlying Mechanisms and Future Directions. Curr Cardiol Rep 2019; 21:135. [PMID: 31673815 PMCID: PMC10683927 DOI: 10.1007/s11886-019-1222-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE OF REVIEW In this review, we synthesize recent research that has reported associations of a higher sense of purpose in life with reduced risk of developing cardiovascular disease (CVD), and then explore mechanisms that might underlie these associations. RECENT FINDINGS Accumulating observational and experimental evidence suggests that having a higher sense of purpose might influence CVD risk through three pathways: (1) enhancement of other psychological and social resources that buffer against the cardiotoxic effects of overwhelming stress; (2) indirect effects through health behaviors; and (3) direct effects on biological pathways. A sense of purpose in life is emerging as an independent risk factor for incident CVD. A key remaining question is whether purpose causally effects CVD risk; in the "Future Research Directions" section, we focus on work needed to establish causality and provide suggestions for next steps.
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Affiliation(s)
- Eric S Kim
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02215, USA.
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA.
| | - Scott W Delaney
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02215, USA
| | - Laura D Kubzansky
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02215, USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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87
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Stapleton FB. The 2019 Joseph W. St. Geme, Jr Leadership Award Address: Ubuntu: The Power of Social Connections. Pediatrics 2019; 144:peds.2019-1887. [PMID: 31570654 DOI: 10.1542/peds.2019-1887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2019] [Indexed: 11/24/2022] Open
Abstract
The following is an address given by the author in receipt of the Joseph W. St. Geme, Jr Leadership Award, presented by the Federation of Pediatric Organizations at the Pediatric Academic Societies Meeting in Baltimore, Maryland, on April 27, 2019.
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Affiliation(s)
- F Bruder Stapleton
- Department of Pediatrics, School of Medicine, University of Washington and Seattle Children's Research Institute, Seattle, Washington
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