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Thema M, Beretzky Z, Brodszky V. Monetary valuation of one year in full capability and health based on demographics, health status, income and well-being. Expert Rev Pharmacoecon Outcomes Res 2024; 24:679-686. [PMID: 38656228 DOI: 10.1080/14737167.2024.2347647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/17/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Budget constraints in health-care systems have led to the popularity of Cost Effectiveness Thresholds (CET) to achieve efficient allocation of resources. The capability approach has been hailed for its potentially richer evaluative capabilities compared to the QALY in terms of thresholds. Extensive research, however, is still limited. RESEARCH DESIGN AND METHODS This study estimated the monetary value of a year in full capability (YFC) and compared it to monetary value of a QALY for the Hungarian population. Data was collected from a large, cross sectional, representative online survey on the adult Hungarian population. Applying the wellbeing valuation method, health, capability, and income were then regressed against wellbeing to estimate 'shadow prices' for one QALY and YFC controlling for gender, age, employment, education, marital and social support. To examine 'core' regression coefficients, a robustness check was conducted. RESULTS Health (VAS) and capability (ICECAP-A) had a positive and significant effect on Subjective Well-Being. The monetary values of one QALY and one YFC were 39 459 EUR and 58 148 EUR respectively. CONCLUSIONS These tools provide a systematic approach to determining 'compensating income' for certain illnesses, disabilities and levels of pain. The capability approach shown to be broader than the QALY.
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Affiliation(s)
- Mabore Thema
- Doctoral School of Business and Management, Corvinus University of Budapest, Budapest, Hungary
| | - Zsuzsanna Beretzky
- Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary
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Vogel JS, Bruins J, Swart M, Liemburg E, van der Gaag M, Castelein S. Effects of an eating club for people with a psychotic disorder on personal recovery: Results of a randomized controlled trial. J Behav Ther Exp Psychiatry 2023; 81:101871. [PMID: 37315478 DOI: 10.1016/j.jbtep.2023.101871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/24/2023] [Accepted: 05/06/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVES Many people with a psychotic disorder are coping with severe psychosocial limitations related to their illness. The current randomized controlled trial (RCT) investigates the effects of an eating club intervention (HospitalitY (HY)) aimed to improve personal and societal recovery. METHODS In 15 biweekly sessions participants received individual home-based skill training and guided peer support sessions in groups of three participants from a trained nurse. A multi-center RCT was conducted (intended sample size: n = 84; n = 7 per block) in patients with a diagnosis of schizophrenia spectrum receiving community treatment. HospitalitY was compared to a Waiting List Control (WLC) condition at three time points (baseline, end-of-treatment (8 months) and follow-up (12 months)) using personal recovery as primary outcome and loneliness, social support, self-stigma, self-esteem, social skills, (social) functioning, independency competence, and psychopathology as secondary outcomes. Outcomes were evaluated with a mixed modeling statistical procedure. RESULTS The HY-intervention had no significant effects on personal recovery or secondary outcomes. More attendance was associated with higher scores on social functioning. LIMITATIONS With N = 43 participants included, power was insufficient. Seven HY-groups were started, from which three discontinued before the sixth meeting, one HY group stopped due the start of the COVID-19 pandemic. CONCLUSIONS Despite a promising pilot study on feasibility, the current RCT did not show any effects of the HY intervention. A mixed qualitative-quantitative research methods might be more appropriate for researching the HospitalitY-intervention to investigate what social and cognitive processes are at play in this peer guided social intervention.
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Affiliation(s)
- Jelle Sjoerd Vogel
- Lentis Psychiatric Institute, Lentis Research, Hereweg 80, 9725 AG, Groningen, the Netherlands; University of Groningen, Faculty of Behavioural and Social Sciences, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30001, 9700 RB, Groningen, the Netherlands.
| | - Jojanneke Bruins
- Lentis Psychiatric Institute, Lentis Research, Hereweg 80, 9725 AG, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30001, 9700 RB, Groningen, the Netherlands
| | - Marte Swart
- Lentis Psychiatric Institute, Flexible Assertive Community Treatment Groningen, Hereweg 80, 9725 AG, Groningen, the Netherlands
| | - Edith Liemburg
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30001, 9700 RB, Groningen, the Netherlands
| | - Mark van der Gaag
- VU University Amsterdam, Department of Clinical Psychology, Van der Boechorststraat 1, 1081 BR, Amsterdam, the Netherlands; Amsterdam Public Mental Health Research Institute, Van der Boechorststraat 1, 1081 BR, Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Department of Psychosis Research, Zoutkeetsingel 40, 2512 HN, The Hague, the Netherlands
| | - Stynke Castelein
- Lentis Psychiatric Institute, Lentis Research, Hereweg 80, 9725 AG, Groningen, the Netherlands; University of Groningen, Faculty of Behavioural and Social Sciences, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30001, 9700 RB, Groningen, the Netherlands
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Lozano-Hernández CM, Cladellas YP, Gil Conesa M, Garin O, Forés MF, del Cura-González I. Functional social support: A systematic review and standardized comparison of different versions of the DUFSS questionnaire using the EMPRO tool. PLoS One 2023; 18:e0291635. [PMID: 37713437 PMCID: PMC10503721 DOI: 10.1371/journal.pone.0291635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 09/03/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Functional social support is one of the most established predictors of health, and the Duke-UNC Functional Social Support Questionnaire (DUFSS) is one of the most commonly used instruments to measure this parameter. The objective of this study is to systematically review the available evidence on the psychometric and administration characteristics of the different versions of the DUFSS and perform a standardized assessment though to a specifically designed tool. METHODS A systematic review was performed in the PubMed/MEDLINE, SCOPUS, WOS and SCIELO databases. All articles that contained information on the development process of the instrument, the psychometric properties and aspects related to its administration were included, without restrictions based on publication date, language, or the version of the questionnaire that was studied. The selection and extraction procedure were carried out by two researchers. The articles finally included were peer-reviewed through a standardised assessment using the Evaluating the Measurement of Patient-Reported Outcomes (EMPRO) tool. PROSPERO registration number: CRD42022342977. RESULTS A total of 54 articles were identified. After eliminating duplicates and screening articles based on the selection criteria, 15 studies that examined the DUFSS questionnaire resulting in 4 different versions: 3 articles obtained the 8-item version; 11 the 11-item version; and a single article obtained two versions, the 14-item version and the 5-item version. At least 60% of them did so in a young adult population, predominantly female and with a medium-low socio-economic level or with characteristics of social vulnerability. The EMPRO evaluation showed that the 11-item version (54.01 total score) was the only one that had been studied on all recommended attributes and had higher total scores than the other versions: 8 items (36.31 total score), 14 items (27.48 total score) and 5 items (23.81 total score). This difference appears in all attributes studied, with the highest scores in "reliability (internal consistency)" and "validity". CONCLUSIONS Of the 4 versions identified in the DUFSS questionnaire, the 11-item version was found to be optimal based on the EMPRO standardized tool. Although, a priori, we could prioritise its use in epidemiological studies over the other versions, it should be noted that this version should also be used with caution because there are attributes that have not been studied.
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Affiliation(s)
- Cristina M. Lozano-Hernández
- Interuniversity Doctoral Program in Epidemiology and Public Health, Rey Juan Carlos University, Alcorcon (Madrid), Spain
- Research Unit, Primary Health Care Management Madrid, Madrid, Spain
- Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS- (RICORS), Spain
- Biosanitary Research and Innovation Foundation of Primary Care (FIIBAP), Spain
| | - Yolanda Pardo Cladellas
- Networking Group of the Centre for Biomedical Research, Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Unit, Institut Mar d’Investigacion Mèdiques (IMIM-Hospital del Mar), Barcelona, Spain
- Autonomous University of Barcelona, Spain
| | - Mario Gil Conesa
- Preventive Medicine and Public Health Physician, Castellón General Hospital, Castellón, Valencian Community, Castellón, Spain
| | - Olatz Garin
- Networking Group of the Centre for Biomedical Research, Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Pompeu Fabra University, Barcelona, Spain
| | - Montserrat Ferrer Forés
- Networking Group of the Centre for Biomedical Research, Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Unit, Institut Mar d’Investigacion Mèdiques (IMIM-Hospital del Mar), Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
| | - Isabel del Cura-González
- Research Unit, Primary Health Care Management Madrid, Madrid, Spain
- Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS- (RICORS), Spain
- Department of Medical Specialties and Public Health. Faculty of Health Sciences Rey Juan Carlos University, Madrid, Spain
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Madundo K, Knettel BA, Knippler E, Mbwambo J. Prevalence, severity, and associated factors of depression in newly diagnosed people living with HIV in Kilimanjaro, Tanzania: a cross-sectional study. BMC Psychiatry 2023; 23:83. [PMID: 36726113 PMCID: PMC9890688 DOI: 10.1186/s12888-022-04496-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/23/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Depression is particularly common among people living with Human Immunodeficiency Virus (HIV), with some studies showing a prevalence of depression three times higher among people living with HIV as compared to the general public. The stress associated with being diagnosed with HIV can be quite impactful, including concerns about one's long-term health, stigma, and the burden of long-term treatment. Therefore, it is common for a new HIV diagnosis to contribute to the onset of depressive symptoms. The objective of this study was to determine the prevalence and severity of depression, and its associated factors in people diagnosed with HIV within the past 12 months. METHODS We conducted a cross-sectional survey with patients newly diagnosed with HIV at three hospitals in the Kilimanjaro region of Tanzania utilizing a locally validated version of the Patient Health Questionnaire-9 (PHQ-9) as a screener for depression, the Demographic Health Survey (SES-DHS8) for socio-demographic characteristics, and the Duke-UNC Functional Social Support Questionnaire (FSSQ) to assess perceived social support. We enrolled 272 participants between September and December 2020, diagnosed with HIV within the past 12 months. Analysis of Co-variance (ANCOVA) and Bonferroni post-hoc analysis were used to determine associations of sociodemographic variables with the dependent variable of depression. RESULTS Overall prevalence of depression in our sample was 41%, including 54 participants (20%) with moderate symptoms, 42 (15%) with moderately severe symptoms, and 16 (6%) with severe symptoms. Severity was highest in participants diagnosed with HIV less than 1 month ago. An ANCOVA model (overall F = 4.72, p < 0.001) assessing factors associated with greater depression severity revealed significant effects of study site (F = 7.6, p < 0.001), female gender (F = 5.11, p = 0.02), and less time since HIV diagnosis (F = 12.3, p < 0.001). CONCLUSION The study demonstrates very high prevalence of depression among people living with HIV in this setting, particularly among those newly diagnosed, female participants, and those seen at the larger regional referral hospital. Integration of mental health screening and interventions into CTC care is vital in the first visits following a positive test result and may be tailored to meet the needs of patients at highest risk for developing symptoms of depression.
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Affiliation(s)
- Kim Madundo
- Department of Mental Health and Psychiatry, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
| | - Brandon A Knettel
- Duke University School of Nursing and Duke Global Health Institute, Durham, NC, USA
| | - Elizabeth Knippler
- Duke Centre for AIDS Research, Duke University School of Nursing, Durham, NC, USA
| | - Jessie Mbwambo
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Lozano-Hernández CM, López-Rodríguez JA, Rico-Blázquez M, Calderón-Larrañaga A, Leiva-Fernández F, Prados-Torres A, del Cura-González I. Sex differences in social support perceived by polymedicated older adults with multimorbidity. MULTIPAP study. PLoS One 2022; 17:e0268218. [PMID: 35895702 PMCID: PMC9328549 DOI: 10.1371/journal.pone.0268218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 04/25/2022] [Indexed: 11/18/2022] Open
Abstract
The beneficial effects of social support on morbidity, mortality, and quality of life are well known. Using the baseline data of the MULTIPAP study (n = 593), an observational, descriptive, cross-sectional study was carried out that analyzed the sex differences in the social support perceived by polymedicated adults aged 65 to 74 years with multimorbidity. The main outcome variable was social support measured through the Duke-UNC-11 Functional Social Support (DUFSS) questionnaire in its two dimensions (confident support and affective support). For both sexes, the perception of functional social support was correlated with being married or partnered and having a higher health-related quality of life utility index. In women, it was correlated with a higher level of education, living alone, and treatment adherence, and in men with higher monthly income, prescribed drugs and fewer diagnosed diseases.
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Affiliation(s)
- Cristina M. Lozano-Hernández
- Research Unit, Primary Health Care Management, Madrid, Spain
- Interuniversity Doctoral Program in Epidemiology and Public Health, Rey Juan Carlos University, Alcorcon (Madrid), Spain
- Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS-(RICORS), Madrid, Spain
- Biosanitary Research and Innovation Foundation of Primary Care (FIIBAP), Madrid, Spain
| | - Juan Antonio López-Rodríguez
- Research Unit, Primary Health Care Management, Madrid, Spain
- Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS-(RICORS), Madrid, Spain
- Biosanitary Research and Innovation Foundation of Primary Care (FIIBAP), Madrid, Spain
- Department of Medical Specialties and Public Health, Faculty of Health Sciences Rey Juan Carlos University, Madrid, Spain
- General Ricardos Primary Health Care Centre, Madrid, Spain
| | - Milagros Rico-Blázquez
- Research Unit, Primary Health Care Management, Madrid, Spain
- Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS-(RICORS), Madrid, Spain
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry of the Complutense University of Madrid, Madrid, Spain
| | - Amaia Calderón-Larrañaga
- Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS-(RICORS), Madrid, Spain
- Joint Action on Chronic Diseases (JA-CHRODIS) European Commission, Brussels, Belgium
- Department of Neurobiology, Aging Research Centre, Care Sciences and Society, Karolinska Institute & Stockholm University, Stockholm, Sweden
- EpiChron Research Group on Chronic Diseases, Aragon Health Sciences Institute, Miguel Servet University Hospital, Zaragoza, Spain
| | - Francisca Leiva-Fernández
- Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS-(RICORS), Madrid, Spain
- Multiprofessional Teaching Unit for Family and Community Care Primary Care District Málaga-Guadarhorce, Málaga, Spain
- Biomedical Research Institute of Malaga-IBIMA, Andalusian Health Service, Málaga, Spain
| | - Alexandra Prados-Torres
- Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS-(RICORS), Madrid, Spain
- EpiChron Research Group on Chronic Diseases, Aragon Health Sciences Institute, Miguel Servet University Hospital, Zaragoza, Spain
| | - Isabel del Cura-González
- Research Unit, Primary Health Care Management, Madrid, Spain
- Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS-(RICORS), Madrid, Spain
- Department of Medical Specialties and Public Health, Faculty of Health Sciences Rey Juan Carlos University, Madrid, Spain
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Psaros C, Smit JA, Mosery N, Bennett K, Coleman JN, Bangsberg DR, Safren SA. PMTCT Adherence in Pregnant South African Women: The Role of Depression, Social Support, Stigma, and Structural Barriers to Care. Ann Behav Med 2020; 54:626-636. [PMID: 32128556 PMCID: PMC7459185 DOI: 10.1093/abm/kaaa005] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Depression is a robust predictor of nonadherence to antiretroviral (ARV) therapy, which is essential to prevention of mother-to-child transmission (PMTCT). Women in resource-limited settings face additional barriers to PMTCT adherence. Although structural barriers may be minimized by social support, depression and stigma may impede access to this support. PURPOSE To better understand modifiable factors that contribute to PMTCT adherence and inform intervention development. METHODS We tested an ARV adherence model using data from 200 pregnant women enrolled in PMTCT (median age 28), who completed a third-trimester interview. Adherence scores were created using principal components analysis based on four questions assessing 30-day adherence. We used path analysis to assess (i) depression and stigma as predictors of social support and then (ii) the combined associations of depression, stigma, social support, and structural barriers with adherence. RESULTS Elevated depressive symptoms were directly associated with significantly lower adherence (est = -8.60, 95% confidence interval [-15.02, -2.18], p < .01). Individuals with increased stigma and depression were significantly less likely to utilize social support (p < .01, for both), and higher social support was associated with increased adherence (est = 7.42, 95% confidence interval [2.29, 12.58], p < .01). Structural barriers, defined by income (p = .55) and time spent traveling to clinic (p = .31), did not predict adherence. CONCLUSIONS Depression and social support may play an important role in adherence to PMTCT care. Pregnant women living with HIV with elevated depressive symptoms and high levels of stigma may suffer from low social support. In PMTCT programs, maximizing adherence may require effective identification and treatment of depression and stigma, as well as enhancing social support.
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Affiliation(s)
- Christina Psaros
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Jennifer A Smit
- MatCH Research Unit, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
- School of Pharmacy and Pharmacology, Faculty of Health Sciences, University of Kwazulu-Natal, Durban, South Africa
| | - Nzwakie Mosery
- MatCH Research Unit, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Kara Bennett
- Bennett Statistical Consulting, Inc., Ballston Lake, NY
| | - Jessica N Coleman
- Department of Psychology and Neuroscience, Duke University, Durham, NC
- Duke Global Health Institute, Duke University, Durham, NC
| | - David R Bangsberg
- School of Public Health, Oregon Health Sciences University–Portland State University, Portland, OR
| | - Steven A Safren
- Department of Psychology, University of Miami, Coral Gables, FL
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Lozano-Hernández CM, López-Rodríguez JA, Leiva-Fernández F, Calderón-Larrañaga A, Barrio-Cortes J, Gimeno-Feliu LA, Poblador-Plou B, del Cura-González I. Social support, social context and nonadherence to treatment in young senior patients with multimorbidity and polypharmacy followed-up in primary care. MULTIPAP Study. PLoS One 2020; 15:e0235148. [PMID: 32579616 PMCID: PMC7314051 DOI: 10.1371/journal.pone.0235148] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/09/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of nonadherence to treatment and its relationship with social support and social context in patients with multimorbidity and polypharmacy followed-up in primary care. METHODS This was an observational, descriptive, cross-sectional, multicenter study with an analytical approach. A total of 593 patients between 65-74 years of age with multimorbidity (≥3 diseases) and polypharmacy (≥5 drugs) during the last three months and agreed to participate in the MULTIPAP Study. The main variable was adherence (Morisky-Green). The predictors were social support (structural support and functional support (DUFSS)); sociodemographic variables; indicators of urban objective vulnerability; health-related quality of life (EQ-5D-5L-VAS & QALY); and clinical variables. Descriptive, bivariate and multivariate analyses with logistic regression models and robust estimators were performed. RESULTS Four out of ten patients were nonadherent, 47% had not completed primary education, 28.7% had an income ≤1050 €/month, 35% reported four or more IUVs, and the average perceived health-related quality of life (HRQOL) EQ-5D-5L-VAS was 65.5. The items that measure functional support, with significantly different means between nonadherent and adherent patients were receiving love and affection (-0.23; 95%CI: -0.40;-0.06), help when ill (-0.25; 95%CI: -0.42;-0.08), useful advice (-0.20; 95%CI: -0.37;-0.02), social invitations (-0.22; 95%CI:-0.44;-0.01), and recognition (-0.29; 95%CI:-0.50;-0.08). Factors associated with nonadherence were belonging to the medium vs. low tertile of functional support (0.62; 95%CI: 0.42;0.94), reporting less than four IUVs (0.69; 95%CI: 0.46;1.02) and higher HRQOL perception (0.98; 95%CI: 0.98;0.99). CONCLUSIONS Among patients 65-74 years of age with multimorbidity and polypharmacy, lower functional support was related to nonadherence to treatment. The nonadherence decreased in those patients with higher functional support, lower urban vulnerability and higher perceived health status according to the visual analog scale of health-related quality of life.
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Affiliation(s)
- Cristina M. Lozano-Hernández
- Research Unit, Primary Health Care Management, Madrid, Spain
- Interuniversity Doctoral Program in Epidemiology and Public Health, Rey Juan Carlos University, Alcorcon, Madrid, Spain
- Research Network in Health Services in Chronic Diseases (REDISSEC) ISCIII, Madrid, Spain
- Biosanitary Research and Innovation Foundation of Primary Care (FIIBAP), Madrid, Spain
| | - Juan A. López-Rodríguez
- Research Unit, Primary Health Care Management, Madrid, Spain
- Research Network in Health Services in Chronic Diseases (REDISSEC) ISCIII, Madrid, Spain
- Biosanitary Research and Innovation Foundation of Primary Care (FIIBAP), Madrid, Spain
- Department of Medical Specialties and Public Health, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
- General Ricardos Primary Health Care Centre, Madrid, Spain
| | - Francisca Leiva-Fernández
- Research Network in Health Services in Chronic Diseases (REDISSEC) ISCIII, Madrid, Spain
- Multiprofessional Teaching Unit for Family and Community Care Primary Care District Málaga-Guadarhorce, Málaga, Spain
- Biomedical Research Institute of Malaga-IBIMA, Andalusian Health Service, Málaga, Spain
| | - Amaia Calderón-Larrañaga
- Research Network in Health Services in Chronic Diseases (REDISSEC) ISCIII, Madrid, Spain
- Joint Action on Chronic Diseases (JA-CHRODIS) European Commission, Brussels, Belgium
- Aging Research Centre, Department of Neurobiology, Care Sciences and Society, Karolinska Institute & Stockholm University, Stockholm, Sweden
- EpiChron Research Group on Chronic Diseases, Aragonese Institute of Health Sciences (IACS), IIS Aragón, Zaragoza, Spain
| | - Jaime Barrio-Cortes
- Research Unit, Primary Health Care Management, Madrid, Spain
- Biosanitary Research and Innovation Foundation of Primary Care (FIIBAP), Madrid, Spain
| | - Luis A. Gimeno-Feliu
- Research Network in Health Services in Chronic Diseases (REDISSEC) ISCIII, Madrid, Spain
- EpiChron Research Group on Chronic Diseases, Aragonese Institute of Health Sciences (IACS), IIS Aragón, Zaragoza, Spain
- San Pablo Primary Health Care Centre, Aragon Health Service, Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - Beatriz Poblador-Plou
- Research Network in Health Services in Chronic Diseases (REDISSEC) ISCIII, Madrid, Spain
- EpiChron Research Group on Chronic Diseases, Aragonese Institute of Health Sciences (IACS), IIS Aragón, Zaragoza, Spain
- Miguel Servet University Hospital, Zaragoza, Spain
| | - Isabel del Cura-González
- Research Unit, Primary Health Care Management, Madrid, Spain
- Research Network in Health Services in Chronic Diseases (REDISSEC) ISCIII, Madrid, Spain
- Department of Medical Specialties and Public Health, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
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Understanding the Meaning of Conformity to Feminine Norms in Lifestyle Habits and Health: A Cluster Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041370. [PMID: 32093306 PMCID: PMC7068260 DOI: 10.3390/ijerph17041370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 02/17/2020] [Indexed: 11/16/2022]
Abstract
Background: Gender roles impact different spheres of life and lead women to behavioral patterns and lifestyle habits associated with femininity, generating important differences between men and women in health. The present study analyzed relationships between conformity to the feminine norms and different lifestyle indicators: Educational level, marital status, alcohol consumption, tobacco consumption, sleeping hours, social support, and physical activity. Additionally, cluster analysis was developed in order to identify different patterns of gender role conformity. Methods: The sample was made up of 347 women age 18-70 from Spain. Data collection was conducted during 2014. Results: Multiple logistic regression analyses produced odds ratios showing that women with lower feminine role conformity were more likely to use tobacco and alcohol, but less likely to share their lives with someone. Cluster analysis found four different profiles of gender role conformity related to different patterns of alcohol consumption and marital status. Conclusions: Conformity to feminine norms was associated with basic affective conditions such as sharing life with others and with alcohol and tobacco consumption, but not with physical activity, social support, and sleep duration. Whereas tobacco and alcohol use have important health implications, public health systems should pay attention to gender-related variables in order to design and implement specific prevention programs.
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Rotberg B, Junqueira Y, Gosdin L, Mejia R, Umpierrez GE. The Importance of Social Support on Glycemic Control in Low-income Latinos With Type 2 Diabetes. AMERICAN JOURNAL OF HEALTH EDUCATION 2016. [DOI: 10.1080/19325037.2016.1203838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | - Lucas Gosdin
- Emory University School of Medicine
- Emory University, Rollins School of Public Health
| | - Roberto Mejia
- Emory University School of Medicine
- Emory University, Rollins School of Public Health
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Mas-Expósito L, Amador-Campos JA, Gómez-Benito J, Mauri-Mas L, Lalucat-Jo L. Clinical case management for patients with schizophrenia with high care needs. Community Ment Health J 2015; 51:165-70. [PMID: 24972907 DOI: 10.1007/s10597-014-9741-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 06/16/2014] [Indexed: 11/25/2022]
Abstract
The aim of this study is to establish the effectiveness of a clinical case management (CM) programme compared to a standard treatment programme (STP) in patients with schizophrenia. Patients for the CM programme were consecutively selected among patients in the STP with schizophrenia who had poor functioning. Seventy-five patients were admitted to the CM programme and were matched to 75 patients in the STP. Patients were evaluated at baseline and at 1 year follow-up. At baseline, patients in the CM programme showed lower levels of clinical and psychosocial functioning and more care needs than patients in the STP. Both treatment programmes were effective in maintaining contact with services but the CM programme did not show advantages over the STP on outcomes. Differences between groups at baseline may be masking the effects of CM at one year follow-up. A longer follow-up may be required to evaluate the real CM practices effects.
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Affiliation(s)
- Laia Mas-Expósito
- Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain
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Tempier R, Balbuena L, Lepnurm M, Craig TKJ. Perceived emotional support in remission: results from an 18-month follow-up of patients with early episode psychosis. Soc Psychiatry Psychiatr Epidemiol 2013; 48:1897-904. [PMID: 23661149 DOI: 10.1007/s00127-013-0701-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 04/26/2013] [Indexed: 01/22/2023]
Abstract
PURPOSE Serious mental illness is known for the damage that it inflicts on the social network and social support of patients. Although many studies have used relapse and rehospitalisation as outcomes, recent research has emphasized the importance of a fuller definition of recovery that includes social function. In this study, our goal is to investigate the association of social support with sustained remission in patients with early episode psychosis. METHODS A secondary analysis of remission and social support was performed with 123 of 144 patients enrolled in the Lambeth Early Onset randomized clinical trial who ever achieved symptom-free status in 18 months of follow-up. Social support was measured by hours of family contact, perceived support, and network size at 6 months into an early intervention treatment program. Consensus judgments made by clinicians on symptom status at each of 18 months of follow-up were analyzed for consecutive months spent in remission. Direct and mediated effects of social support on remission were calculated using Poisson regression and path analysis, respectively. RESULTS 114 of 123 patients achieved remission after about 7 months on average [mean 6.81 (SD 4.17)]. In univariate models, perceived emotional support predicted longer time spent in remission, while moderate family contact predicted shorter remission duration. Perceived practical support was not associated with remission. Perceived emotional support mediated the association between family contact and remission and between network size and remission. These results are not totally attributable to a specialized early intervention treatment. CONCLUSION Structural measures of support probably contribute to the maintenance of remission through the patient's perception of emotional support.
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Affiliation(s)
- Raymond Tempier
- Department of Psychiatry, Montfort Hospital, 713 Montreal Road, Ottawa, ON, K1K 0T2, Canada,
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Mas-Expósito L, Amador-Campos JA, Gómez-Benito J, Lalucat-Jo L. Considering variables for the assignment of patients with schizophrenia to a case management programme. Community Ment Health J 2013; 49:831-40. [PMID: 23775241 DOI: 10.1007/s10597-013-9621-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 06/03/2013] [Indexed: 12/16/2022]
Abstract
The elements and intensity of case management (CM) practices should be established according to patients' needs. Therefore, greater understanding of patients' needs in such community-based programmes is essential. This paper addresses this issue by characterizing two groups of patients receiving CM or a standard treatment programme (STP) and identifying the characteristics of patients receiving CM services. We recruited 241 patients with schizophrenia from 10 Adult Mental Health Centres in Barcelona (Catalonia, Spain). We analyzed the profile of new patients included in a clinical, non-intensive CM program against that of patients in a STP. CM patients, compared with STP patients, have a lower educational level and quality of life; greater use of health care services, and higher levels of psychiatric symptoms, disability and unmet needs. Community psychiatric visits, social services, education, physical health and needs were significantly associated with CM services. This study may help in identifying patients' needs and strengthening the CM programme.
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Affiliation(s)
- Laia Mas-Expósito
- Department of Research, Centre d'Higiene Mental Les Corts, c/Numància 103-105 baixos, 08029, Barcelona, Spain
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