Health Behaviors and Health-Related Quality of Life Among U.S. Adults Aged 18-64 Years

Cross-sectional study to identify health literacy, health behavior, and quality of life in Chofu and Komae cities in Japan: Formative research in community-based nursing practice

The Jikei Academic Nursing Practice Center for the Community developed a community nursing practice that matched community health problems and concerns in Chofu and Komae cities, suburban areas of the Tokyo Metropolis. This study aimed to identify health problems and high-risk populations via an understanding of the practice of health behaviors, health literacy, and quality of life. This was an online, cross-sectional study conducted in September 2023. In total, 1520 (Chofu: n = 1170; Komae: n = 350) participants were enrolled. Participants' demographic characteristics, health literacy, health behaviors, and quality of life scores were obtained. Sleep quality was poor compared with national data. Younger participants had higher poor health literacy, did not practice health behaviors, and had a lower quality of life. In addition, parenting and informal nursing care for family members were associated with unhealthy eating, smoking, drinking, and poor quality of life. This study found that health problems and concerns before planning were significant in increasing the salience of interventions for community residents. Based on the findings of this study, an action plan for community-wide nursing practice was created.

Habitual Sleep Duration and Health-Related Quality of Life in Family Caregivers: Findings from the Behavioral Risk Factor Surveillance System

BACKGROUND

Insufficient sleep duration is associated with poor health-related quality of life (HRQoL). However, this relationship has not been studied in family caregivers, a group at high risk of insufficient sleep duration and poor HRQoL.

OBJECTIVE

To examine the associations between habitual sleep duration and HRQoL measures in family caregivers.

METHODS

This cross-sectional study used data from 23,321 caregivers in the 2016 Behavioral Risk Factor Surveillance System. The HRQoL measures were health status and poor mental and physical health days. A multivariable logistic regression model was used to assess the association between sleep duration (<7, 7-9, >9 hours) and health status (fair or poor versus good to excellent). Zero-inflated negative binomial models were used to analyze the association of sleep duration with poor mental and physical health days.

RESULTS

Fair or poor health status was significantly higher in caregivers with short (odds ratio [OR], 1.40; 95% CI: 1.12, 1.74) and long (OR, 2.07; 95% CI: 1.34, 3.21) sleep duration. Short sleep duration was associated with a higher number of poor mental health days (IRR [incident rate ratio], 1.17; 95% CI: 1.04, 1.31) and poor physical health days (IRR, 1.26; 95% CI: 1.10, 1.45). Long sleep duration was associated with more poor mental health days (IRR, 1.31; 95% CI: 1.08, 1.60).

CONCLUSION

Extremes in sleep duration were associated with lower HRQoL. These findings point to the need for interventions that promote adequate sleep and address factors underlying extremes in sleep duration in the context of family caregiving.

Health Behaviours and the Quality of Life of Students of Medical Fields during the COVID-19 Pandemic

(1) Background: Social distancing and closing down public spaces associated with learning, leisure and physical activity limited the spread of COVID-19. These measures had an impact not only on the economy and education but also on health behaviours and the quality of life of individuals affected by the restrictions. The aim of this study was to identify the role of health behaviours in the perception of the quality of life of students during the COVID-19 pandemic. (2) Methods: This study was conducted among 796 students of the University of Warmia and Mazury in Olsztyn in the first quarter of 2022. Subgroup 1 consisted of students at the Public Health School (n = 428; 53.8%) and subgroup 2 consisted of students belonging to the Faculty of Veterinary Medicine (n = 368; 46.2%). The diagnostic survey method was applied, and an original survey questionnaire, the Health Behaviour Inventory and the Quality of Life Questionnaire (WHOQoL-Bref version) were used. (3) Results: The largest contribution to the prediction of quality of life of students in subgroup 1 was made by a positive mental attitude related to avoiding too strong emotions, which explained 19% of the result variability in the somatic domain (ßeta = 0.24; R2 = 0.21), 20% of the result variability in the psychological domain (ßeta = 0.36; R2 = 0.20), 16% of the result variability in the social domain (ßeta = 0.52; R2 = 0.17) and 17% of the result variability in the environmental domain (ßeta = 0.19; R2 = 0.19). Moreover, in subgroup 2, a predominantly positive mental attitude significantly predicted quality of life in the somatic domain, explaining 23% of the result variability (ßeta = 0.24; R2 = 0.26), while it explained 25% of the result variability in the psychological domain (ßeta = 0.47; R2 = 0.25), 16% of the result variability in the social domain (ßeta = 0.46; R2 = 0.17) and 21% of the result variability in the environmental domain (ßeta = 0.38; R2 = 0.23). (4) Conclusions: Positive correlations between health behaviours and the quality of life among the study participants were determined. Health-promoting behaviours had a beneficial impact on the respondents' quality of life during the COVID-19 pandemic. The category of health behaviours described as a positive mental attitude was an important predictor for the participants' quality of life.

Effect of self-regulating fatigue on health-related quality of life of middle-aged and elderly patients with recurrent stroke: a moderated sequential mediation model

Although the association between self-regulation of fatigue and health-related quality of life (HRQoL) has been confirmed, the potential mechanism remains unclear. This study aimed to explore the role of health literacy, health behavior, and exercise frequency in the relationship among middle-aged and elderly patients with recurrent stroke. A cross-sectional survey was conducted. A total of 176 patients completed the survey, in which self-regulation of fatigue, HRQoL, health literacy and health behavior were measured by questionnaires. Based on Bootstrap analyses, a moderating sequential mediation model using PROCESS software was constructed with health literacy and health behavior as mediators and exercise frequency as the moderator. Of the participants, the mean age was 65.44 ± 12.43 years. Self-regulation of fatigue was found to affect HRQoL indirectly through two significant mediation pathways: (1) health literacy (β=-0.11, 95%CI = -0.20, -0.03), which accounted for 28.79% of the total effect, and (2) health literacy and health behavior (β=-0.02, 95%CI = -0.05, -0.00), which accounted for 4.80% of the total effect. Exercise frequency moderated the relationship between self-regulating fatigue and HRQoL. Specifically, the interaction term between self-regulating fatigue and exercise frequency significantly predicted HRQoL (β = 0. 25, t = 2.55, p < 0.05). These findings highlight the role of health literacy and health behavior as sequential mediators of the relationship between self-regulating fatigue and HRQoL. Moreover, exercise frequency moderated the relationship between self-regulating fatigue and HRQoL. Encouraging patients with recurrent stroke to increase exercise frequency appropriately might improve HRQoL for patients with poor health literacy and health behavior.

Clustered health risk behaviors with comorbid symptoms of anxiety and depression in young adults: Moderating role of inflammatory cytokines

BACKGROUND

People with multiple health risk behaviors (HRBs) are at higher risk for psychological problems, and vice versa. However, the mechanisms underlying this association remain unknown.

METHOD

We collected questionnaire and blood sample data from 2 universities in Anhui and Jiangxi Provinces. Demographic information, HRBs and blood samples were collected at baseline. Depression/anxiety symptoms were collected using questionnaires at follow-up. Latent class analysis was used to explore clustered HRBs pattern, and logistic regression analysis was used to examine the association between clustered HRBs quantity, pattern and anxiety-depression symptoms comorbidity. The Mplus software was used to analyze the moderating effects of inflammatory cytokines.

RESULTS

Compared to the HRB low-risk group, the substance dependence group (OR: 1.89, 95%CI: 1.11-3.21) and sedentary group (OR: 2.98, 95%CI: 1.48-6.02) had a higher risk of anxiety-depression comorbid symptoms. Compared to participants with no clustered HRBs, participants with 2 HRBs (OR: 2.16 95%CI: 1.17-4.00) and >3 HRBs (OR: 3.55, 95%CI: 1.68-7.48) were more likely to suffer from comorbid symptoms of anxiety and depression. Moreover, IL-6, IL-1β, IL-10 had negative moderating effects between clustered HRBs pattern and comorbid symptoms of anxiety and depression.

LIMITATIONS

Recall bias may exist for anxiety / depression symptoms, and cannot exclude unmeasured confounders or the effect of residual confounding.

CONCLUSIONS

This study finds clustered HRBs have a significant impact on mental health among young adults, and inflammatory cytokine evidence supports a negative moderating effect on the relationship. Interventions that decrease clustered HRBs may support mental health development in adolescence.

Avoiding threats, but not acquiring benefits, explains the effect of future time perspective on promoting health behavior

Promoting health behavior among the public is always a pressing issue. The present research systematically investigated the association between future time perspective and adherence to health behavior including dietary habits, physical activities, and substance use in a Chinese college student sample (N = 519). Results showed that individuals with stronger future time perspective were more likely to adhere to health behavior. Moreover, building upon the health belief model and the protection motivation theory, the present research further explored the underlying mechanisms. Results revealed that it is perceived threats of not carrying out health behavior, but not perceived benefits of carrying out health behavior, that asymmetrically explained the association between stronger future time perspective and greater adherence to health behavior. These findings contribute to both the future time perspective literature and the health behavior literature.

Health-Promoting Factors and Their Relationships with the Severity of Symptoms in Patients with Anxiety Disorders during the COVID-19 Pandemic

BACKGROUND

Anxiety disorders are one of the most common mental disorders in the modern world. The COVID-19 pandemic has led to the onset of many mental disorders in people who did not have them before. It can be suspected that in people who already had anxiety disorders before the pandemic, their quality of life has significantly deteriorated.

AIM

The aim of the study was to assess the relationships between life satisfaction, acceptance of illness, the severity of anxiety and depression symptoms and health behaviors in a group of patients diagnosed with anxiety disorders during the COVID-19 pandemic.

MATERIAL AND METHODS

The study was conducted in the period from March 2020 to March 2022. There were 70 people among the respondents, including 44 women aged 44.06 ± 14.89 years and 26 men aged 40.84 ± 16.72 years. All persons were diagnosed with generalized anxiety disorder. Patients with other co-occurring disorders were excluded, i.e., depression and signs of organic damage to the central nervous system, as were those with cognitive disorders that prevented the completion of the questionnaires. The following scales were used in the study: the Satisfaction with Life Scale (SWLS), Acceptance of Illness Scale (AIS), Health Behavior Inventory (HBI) and Hospital Anxiety and Depression Scale (HADS). Spearman's rank correlation coefficient and the Mann-Whitney U test were used for statistical analyses.

RESULTS

In the Satisfaction in Life questionnaire, the respondents obtained an average score of 17.59 ± 5.74 points. In the AIS scale, the mean score obtained by the patients was 27.10 ± 9.65 points. In the overall Health Behavior Inventory (HBI), the average score was 79.52 ± 15.24 points. In the HADS questionnaire, probants obtained an average of 8.17 ± 4.37 points in the depression subscale and 11.55 ± 4.46 points in the anxiety subscale. In addition, there were significant negative correlations between life satisfaction (SWLS) and the severity of anxiety and depression (HADS). The lower the perceived quality of life, the significantly higher the anxiety and depressive disorders. The result obtained in the Health Behavior Inventory (HBI) as well as in the subscale of Prohealth Activities (PHA) was negatively associated with the severity of anxiety symptoms. Prohealth activities should therefore be developed to prevent anxiety disorders, as well as to promote positive mental attitudes. In the study, the average result obtained in the subscale of positive mental attitudes correlated negatively with both anxiety and depressive symptoms.

CONCLUSIONS

Life during the pandemic was assessed by patients as unsatisfactory. Health-promoting behaviors, and especially positive mental attitudes, may play a protective role in relation to anxiety and depressive symptoms in a situation of increased stress related to the COVID-19 pandemic in a group of patients with anxiety disorders.

Association between lifestyle behaviors and health-related quality of life among primary health care physicians in China: A cross-sectional study

Background

Primary health care (PHC) serves as the gatekeeper of health system and PHC physicians take on significant obligations to provide health care services in the pursuit of Universal Health Coverage (UHC). PHC physicians' health-related quality of life (HRQoL) can have a strong impact on patients, physicians and the health care system. Lifestyle interventions are found to be effective to improve HRQoL. The purpose of this study was to evaluate the association between lifestyle behaviors and HRQoL among PHC physicians, so that lifestyle intervention can be tailored by policy makers for health promotion.

Methods

A survey covering 31 provinces and administrative regions in China was conducted in 2020 using a stratified sampling strategy. Data on sociodemographic characteristics lifestyle behaviors and HRQoL were collected by a self-administered questionnaire. HRQoL was measured through EuroQol-five dimension-five level (EQ-5D-5L) instrument. A Tobit regression model was performed to evaluate the association between sociodemographic characteristics, lifestyle behaviors and HRQoL.

Results

Among 894 PHC physicians who completed the survey, Anxiety/Depression (AD) was the dimension with the most problems reported (18.1%). Regular daily routine (β = 0.025, 95%CI 0.004 to 0.045) and good sleep quality (β = 0.049, 95% CI = 0.029 to 0.069) were protective factors for HRQoL, while smoking (β = −0.027, 95% CI = −0.079 to −0.003) and frequency of eating breakfast (β = −0.041, 95%CI = −0.079 to −0.003) were negatively associated with HRQoL. Physical activity and alcohol drinking were not significantly associated with HRQoL.

Conclusion

These findings suggest that tailored interventions on daily routine, improving sleep quality, and tobacco control among PHC physicians may be effective strategies to improve their HRQoL.

Association of lifestyle behaviors with health-related quality of life among patients with hematologic diseases

PURPOSE

Health-related quality of life (HRQoL) is a multi-dimensional construct used to assess the impact of health status on quality of life, and it is known to be affected by lifestyle behaviors. This study focused on multiple lifestyle behaviors among patients with hematologic diseases, including physical activity, dietary intake, sleep quality, occupational exposure, alcohol consumption and smoking. The main objective was to investigate the association of both individual and clustering of health behaviors with HRQoL among the population with hematologic diseases based on a comprehensive lifestyle survey.

METHODS

A total of 539 patients with hematologic diseases aged over 18 years were enrolled in this cross-sectional study. Latent class analysis was used to identify homogeneous, mutually exclusive lifestyle classes, and multinomial logistic regression was then performed to explore the association of lifestyle classes membership with HRQoL. Meanwhile, multiple linear regression and quantile regression were used to identify the relationship between individual lifestyle behaviors and HRQoL.

RESULTS

A three-class model was selected based on conceptual interpretation and model fit. We found no association between multiple lifestyle behaviors and HRQoL in the 3-class model, either in the whole patients or in subgroups stratified by hematological malignancies. Further research on each lifestyle found that physical activity, dietary intake, occupational exposure, alcohol consumption or smoking were independent of HRQoL. Sleep quality was positively associated with HRQoL.

CONCLUSION

Our findings suggested that clustering of lifestyle behaviors may not be an indicator to reflect the health quality of patients with hematologic diseases. Sleep represents a viable intervention target that can confer health benefits on the hematologic patients.

Applying the PDSA cycle to a group activity promoting lifestyle change for the active ageing of older Thai adults - a focused ethnography

Background

The proportion of the older Thai population is increasing rapidly. Lifestyle may impact active ageing in later life. Interventions that empower older Thai adults to initiate and carry out lifestyle changes are needed. This study applied the Plan-Do-Study-Act (PDSA) cycle, a tool for improving lifestyle changes, with the aim of exploring interactions among older Thai adults when participating in group activities.

Method

Focused ethnography was used based on participant observations, field notes and video recordings of 15 older Thai adults aged 62–78 years.

Results

Older Thai adults faced difficulties at the beginning since they were unfamiliar with initiating and carrying out lifestyle changes according to the PDSA concept. This provided a learning opportunity enabling older Thai adults to reach their individual goals of lifestyle change.

Conclusions

The PDSA cycle has the potential to empower older adults in group contexts to promote lifestyle changes related to active ageing.

Model Construction of Using Physiological Signals to Detect Mental Health Status

BACKGROUND

Mental health is a direct indicator of human mental activity, and it also affects all aspects of the human body. It plays a very important role in monitoring human mental health.

OBJECTIVES

To design a mental health state detection model based on physiological signals to detect human mental health.

METHODS

For the detection of mental health, the sliding window method is used to divide the physiological signal dataset and the corresponding time into several segments and then calculate the physiological signal data in the sliding window for each physiological signal to form a sequence of characteristic values; according to the heart rate variability of the physiological signal, the heart rate variability (HRV) is extracted from the interval spectrum waveform: through the discrete trend analysis in statistics, the change characteristics of the ECG signal are analyzed, and the sequence statistical indicators of the physiological signal are calculated. With the help of a support vector machine used for the significant accuracy with less computation power, the physiological signals of the mental state are classified, and the discriminant function of the mental health state signals is normalized. A mental health state detection model is constructed according to the index system, the optimal solution of the model is obtained through the optimization function, and the mental health state detection is completed.

RESULT

The detection error of the proposed model is less which improves the detection accuracy and is less time consuming.

CONCLUSION

The detection model using physiological signals is proposed to evaluate the mental health status. As compared to the other detection models, its detection time is short and method error is always less than 2% which shows its accuracy and effectiveness.

Health-related quality of life in women after colposcopy: results from a longitudinal patient survey

BACKGROUND

Information concerning the health-related quality-of-life (HRQoL) consequences of colposcopy is limited, particularly over time. In a longitudinal study, we investigated women's HRQoL at 4, 8 and 12 months post colposcopy and the factors associated with this.

METHODS

Women attending colposcopy at two large hospitals affiliated with the national screening programme in Ireland were invited to complete questionnaires at 4, 8 and 12 months post colposcopy. HRQoL was measured using the EQ-5D-3L and compared across a range of socio-demographic, clinical and attitudinal variables. A mixed-effects logistic multivariable model was employed to investigate associations between these variables and low HRQoL.

RESULTS

Of 584 women initially recruited, 429, 343 and 303 completed questionnaires at 4, 8 and 12 months, respectively. The mean overall HRQoL score for the sample across all time points was 0.90 (SD 0.16). Approximately 18% of women experienced low HRQoL at each of the three time points. In multivariable testing, over the entire 12-month follow-up period, non-Irish nationals (OR 8.99, 95% CI 2.35-34.43) and women with high-grade referral cytology (OR 2.78, 95% CI 1.08-7.13) were at higher odds of low HRQoL. Women who were past (OR 0.20, 95% CI 0.07-0.58) or never (OR 0.42, 95% CI 0.16-1.12) smokers were at lower odds of low HRQoL than current smokers. As women's satisfaction with their healthcare increased their odds of experiencing low HRQoL fell (OR per unit increase 0.51, 95% CI 0.34-0.75).

CONCLUSIONS

Women's HRQoL did not change over the 12 months post colposcopy, but some subgroups of women were at higher risk of experiencing low HRQoL. These subgroups may benefit from additional support.