Impact of the timing, type and severity of disability on the subjective well-being of individuals with disabilities

Subjective Well-Being Population Norms and Inequalities in Hungary: A Large Cross-Sectional, Internet-Based Survey

OBJECTIVES

This study aimed to provide subjective well-being (SWB) population norms in Hungary and explore the contribution of explanatory factors of SWB inequality among the Hungarian adult general population.

METHODS

The data originated from a large representative internet-based cross-sectional survey in Hungary, which was conducted in 2020. We applied validated multi-item instruments for measuring SWB, namely Satisfaction With Life Scale (SWLS) and World Health Organization-Five Well-Being Index (WHO-5). Multiple linear regressions were used to examine the relationship between demographic-socioeconomic-health status and both well-being instruments. The concentration index (CI) was used to measure the degree of income-related inequality in well-being.

RESULTS

A total of 2001 respondents were enrolled with the means ± SD WHO-5 scores and SWLS scores of 0.51 ± 0.21 and 0.51 ± 0.23, respectively. Higher household income, higher educational level, better general health status, and absence of chronic morbidity were significant positive predictors for both WHO-5 and SWLS scores. The CI of WHO-5 scores was lower than that of SWLS scores in the total sample (0.0480 vs 0.0861) and in subgroups by gender (male, 0.0584 vs 0.1035; female, 0.0302 vs 0.0726). The positive CI values implied a slight pro-rich SWB inequality in this population. The regression analyses showed a positive association of SWB with having a higher household income and a better general health status.

CONCLUSIONS

This is the first representative study in Hungary to compare population norm of 2 well-being instruments and analyze well-being inequality. Slight pro-rich inequality was found consistently with both SWB measures. Our findings support the need for health and social policies that effectively tackle inequalities in Hungary.

Predictive nomogram for soft robotic hand rehabilitation of patients with intracerebral hemorrhage

Background

Few studies focused on the risk factors for hand rehabilitation of intracerebral hemorrhage (ICH) using of soft robotic hand therapy (SRHT). The aim of this study was to establish a predictive nomogram for soft robotic hand rehabilitation in patients with ICH.

Methods

According to the Brunnstrom motor recovery (BMR) stage, the patients were grouped into poor and good motor function groups. The data of patient demographic information and serum level of C-terminal Agrin Fragment (CAF), S100B and neurofilament light (NfL) were collected. The logistic regression was used to analyze the risk factors for poor hand function.

Results

Finally, we enrolled 102 and 103 patients in the control and SRHT groups. For the SRHT group, there were 17 and 86 cases with poor and good motor function at 6-months follow-up respectively. In the good motor function group, the Fugl-Meyer Assessment-Wrist and Hand (FMA-WH score) and BMR score at admission were all better than that in the poor motor function group respectively (p < 0.001). The mean serum level of CAF, S100B and NfL in the good motor function group were 2.5 ± 0.82 ng/mL, 286.6 ± 236.4 ng/L and 12.1 ± 10.4 pg/mL respectively, which were lower than that in the poor motor function group (p < 0.001, Table 3). The multivariate logistic regression showed that hematoma volume (OR = 1.47, p = 0.007), FMA-WH score admission (OR = 0.78, p = 0.02), S100B (OR = 1.32, p = 0.04), and NfL (OR = 1.24, p = 0.003) were all significant predictors of poor motor function.

Conclusions

We found that Soft robotic hands therapy benefited in hand function in patients with ICH and hematoma volume, FMA-WH score admission, S100B, and NfL were all significant predictors for poor motor function of patients with ICH.

The effects of the COVID-19 pandemic on the psychosocial well-being of people with disabilities

Background

Before the COVID-19 pandemic, people with mobility, vision, hearing, and cognitive disabilities were at a higher risk of lower psychosocial well-being than people without disabilities. It is, therefore, of great importance to investigate whether the pandemic has exacerbated this difference.

Objective

This study examines whether people with disabilities (categorized as mobility, vision, hearing, cognitive, and any disabilities) report more COVID-19-related negative effects on psychosocial well-being (loneliness, decreased social contact, decreased hope for the future, concerns about being infected) than people without disabilities.

Methods

We analyzed population-based data from the Finnish Health, Welfare, and Services (FinSote) survey carried out in 2020–2021 (N = 22 165, age 20+). Logistic regression models were applied, controlling for the effects of age, sex, partnership, living alone, and education.

Results

All disability groups, except those with vision disabilities, reported significantly more often that the pandemic increased loneliness than people without disabilities. There were no significant differences between the disability groups and people without disabilities in decreased social contacts. People with only mobility and cognitive disabilities reported significantly more often that the pandemic decreased their hope for the future than those without disabilities. All disability groups were more often concerned about being infected than people without disabilities, but this effect was not significant among people 75 or older.

Conclusion

The psychosocial well-being of people with specific types of disabilities should receive special attention during crises like the COVID-19 pandemic.

Intelligent environments for all: a path towards technology-enhanced human well-being

Emerging intelligent environments are considered to offer significant opportunities to positively impact human life, both at an individual and at a societal level, and in particular to provide useful means to support people in their daily life activities and thus improve well-being for everybody, especially for older people and for people with limitations of activities. In this context, accessibility and usability, although necessary, are not sufficient to ensure that applications and services are appropriately designed to satisfy human needs and overcome potential functional limitations in the execution of everyday activities fundamental for well-being. This position paper puts forward the claim that, in order to achieve the above objective, it is necessary that: (i) the design of Assistive Intelligent Environments is centered around the well-being of people, roughly intended as the possibility of executing the (everyday) human activities necessary for living (independently), thus emphasizing usefulness in addition to usability; (ii) the technological environment is orchestrated around such activities and contains knowledge about how they are performed and how people need to be supported to perform them; (iii) the environment makes use of monitoring and reasoning capabilities in order to adapt, fine-tune and evolve over time the type and level of support provided, and this process takes place considering ethical values; (iv) the applications must also support the possibility of contact with other people, who in many cases may be the only effective help. Moving forward from the Design for All paradigm, this paper discusses how the latter can be revisited under the perspective of technology's usefulness and contribution to human well-being. Subsequently, it introduces a practical notion of well-being based on the ICF classification of human functions and activities and discusses how such notion can constitute the starting point and the focus of design approaches targeted to assist people in their everyday life mainly (but not exclusively) in the home environment. As a subsequent step, the need for integrating Artificial Intelligence capabilities in assistive intelligent environments is discussed, based on the complexity of the human problems to be addressed and the diversity of the types of support needed. The proposed approach is exemplified and illustrated through the experience acquired in the development of four applications, addressing vital aspects of human life, namely nutrition, stress management, sleep management and counteracting loneliness. Finally, based on the acquired experience, the need to take into account ethical values in the development of assistive intelligent environments is discussed.

Social Deprivation and Congenital Upper Extremity Differences-An Assessment Using PROMIS

PURPOSE

Social deprivation, a measure of socioeconomic status, has been shown to negatively affect perceptions of orthopedic conditions and outcomes of treatment. The objective of this study was to assess whether social deprivation correlates with subjective assessment of function in pediatric patients with congenital hand differences.

METHODS

Patients enrolled in the Congenital Upper Limb Differences (CoULD) registry were assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS). The PROMIS scores for Pain Interference, Peer Relations, Anxiety, Depression, and Upper Extremity (UE) function were obtained for all patients 5 years and older at initial presentation. Social deprivation was determined by the Area Deprivation Index (ADI); the index ranges from 0 to 100 with higher scores being the most deprived. The PROMIS scores were correlated with the ADI for all patients.

RESULTS

Three hundred seventy-five pediatric patients with congenital UE differences were evaluated. Average age was 11 years, 56% were female, and 55% had bilateral involvement. Overall, PROMIS scores were within 1 SD of normal for Peer Relations, Pain, Depression, and Anxiety. However, child-reported scores for UE function (39) were more than 1 SD below the national average (50). The mean ADI for the cohort was lower than the national average, indicative of less deprivation, with 14% of patients in the most deprived national quartile. Children in the highest ADI quartile reported PROMIS scores that reflected higher Pain Interference (41 vs 45), lower Peer Relations (55 vs 50), higher Anxiety (44 vs 49), and higher Depression (43 vs 47) than children in the lowest ADI quartile.

CONCLUSIONS

The PROMIS scores were normal for psychosocial measures in children with congenital hand differences when evaluated as an entire cohort. However, child self-reported PROMIS scores for Pain Interference, Peer Relations, Anxiety, and Depression were worse in more socially deprived areas, suggesting more psychosocial challenges in these children.

CLINICAL RELEVANCE

Pediatric patients with congenital upper extremity differences in areas of higher social deprivation report lower psychosocial well-being. The care of these individuals must be considered within the context of their environment because they may be more at risk for negative outcomes secondary to environmental and societal stressors.

Associations Between Religious/Spiritual Practices and Well-Being in Indian Elderly Rural Women

Religion and spirituality (R/S) are embedded in all aspects of life in India, a predominantly rural economy. The aim of this mixed methods study was to assess the associations between a culturally tailored intervention and preexisting religious/spiritual (R/S) practices with indicators of well-being and factors which contribute to happiness among elderly rural women from Haryana state, India. The study consisted of three groups: field experimental group (FEG; n = 24); practitioners of preexisting R/S practices for at least 6 weeks Satsang (SG, n = 54), Brahma Kumaris (BKG, n = 54), and Radha Soami (RSG, n = 30), and non-practitioners of R/S practices (n = 64). All groups completed self-report measures of overall happiness and life satisfaction, global health, quality of life, and health status and physical health. Results revealed that FEG participants improved significantly on physical health, body balancing, and self-care; no changes were observed on the other well-being measures following the intervention. Practitioners of preexisting R/S practices were found significantly different from the non-practitioners on some indicators of health, quality of life, and well-being. Qualitative measures pointed to the importance of R/S and family and interpersonal relationships among elderly rural women.

Understanding subjective well-being: perspectives from psychology and public health

Background

Individual subjective well-being (SWB) is essential for creating and maintaining healthy, productive societies. The literature on SWB is vast and dispersed across multiple disciplines. However, few reviews have summarized the theoretical and empirical tenets of SWB literature across disciplinary boundaries.

Methods

We cataloged and consolidated SWB-related theories and empirical evidence from the fields of psychology and public health using a combination of online catalogs of scholarly articles and online search engines to retrieve relevant articles. For both theories and determinants/correlates of SWB, PubMed, PsychINFO, and Google Scholar were used to obtain relevant articles. Articles for the review were screened for relevance, varied perspectives, journal impact, geographic location of study, and topicality. A core theme of SWB empirical literature was the identification of SWB determinants/correlates, and over 100 research articles were reviewed and summarized for this review.

Results

We found that SWB theories can be classified into four groups: fulfillment and engagement theories, personal orientation theories, evaluative theories, and emotional theories. A critical analysis of the conflicts and overlaps between these theories reveals the lack of a coherent theoretical and methodological framework that would make empirical research systematically comparable. We found that determinants/correlates of SWB can be grouped into seven broad categories: basic demographics, socioeconomic status, health and functioning, personality, social support, religion and culture, and geography and infrastructure. However, these are rarely studied consistently or used to test theories.

Conclusions

The lack of a clear, unifying theoretical basis for categorizing and comparing empirical studies can potentially be overcome using an operationalizable criterion that focuses on the dimension of SWB studied, measure of SWB used, design of the study, study population, and types of determinants and correlates. From our review of the empirical literature on SWB, we found that the seven categories of determinants/correlates identified may potentially be used to improve the link between theory and empirical research, and that the overlap in the determinant/correlates as they relate to multiple theory categories may enable us to test theories in unison. However, doing so in the future would require a conscious effort by researchers in several areas, which are discussed.

Stigma of persons with disabilities in South Africa: Uncovering pathways from discrimination to depression and low self-esteem

Despite the fact that universal inclusion is a basic principle of the Sustainable Development Goals, the inclusion of persons with disabilities in humanitarian interventions and development policies remains elusive. Persons with disabilities face high risks of poverty, poor nutrition, limited inclusion in labor markets and poor mental health as a result. Stigma is likely to play a negative role in this regard and yet, no study has investigated the impact of stigma on depression and self-esteem of persons with disabilities. To address this gap in the literature, we conducted in June 2017 a random sample disability case control household study in Soweto, a township in Johannesburg, South Africa. Using propensity score analysis and structural equation modeling, we investigated the relationship between disability, stigma, depression and self-esteem controlling for socioeconomic covariates. Our main empirical results showed that stigma significantly mediates the association between disability and higher depression on the one hand and between disability and lower self-esteem on the other. This mediating effect exists even after controlling for age, gender, marital status, education, employment and wealth. We also found strong direct associations between disability and depressive mood, somatic indicators and negative feelings such as unhappiness and low self-esteem. Unemployment aggravates depression and low self-esteem while low education worsens self-esteem only. In addition, depression exacerbates low self-esteem. Both unemployment and low education are more common among persons with disabilities aggravating the disability, depression, poor self-esteem nexus. Similarly, persons with disabilities who are more likely to be depressed are also at higher risk of low self-esteem. These results point to a vicious reinforcing circle of exclusion from society, despair and self-deprecation, which could prove difficult to break. Substantial psycho-social support and anti-stigma policies anchored in local cultural values, engaging persons with disabilities and their communities, are required to break this vicious circle.

•

Disability is associated with high depression and low self-esteem in South Africa.

•

Stigma partially mediates links between disability, depression and self-esteem.

•

Unemployment exacerbates depression and low self-esteem.

•

Education increases self-esteem.

•

Anti-stigma policies are needed to achieve Sustainable Development Goals for all.

The Effect of Becoming Disabled on the Subjective Well-Being of Religious and Nonreligious People

Positive associations between religiosity and subjective well-being (SWB) have been found in a multitude of studies. However, there has been little effort in documenting the role that religion plays in helping people during the onset of adverse circumstances in their lives. This study investigates the effect of religion on the SWB of the disabled. We utilized secondary data from the Korean Longitudinal Study of Aging from 2006 to 2016 with a sample size of 36,484. Starting with nondisabled participants, we applied a difference-in-differences approach to a fixed-effects model and compared the magnitude of the decrease in SWB resulting from disability between religious individuals and their nonreligious counterparts. The empirical results show that following a religion increased SWB by 0.94 (p < 0.01) and the onset of a disability reduced SWB by 3.57 (p < 0.01) out of 100. Furthermore, there is a significant gap in happiness levels between religious and nonreligious individuals when they are diagnosed with a disability. Becoming disabled reduces SWB for nonreligious people more than that for religious people by 2.62 (p < 0.01). This study confirms that following a religion helps people cope with adverse circumstances such as the onset of a disability.

Is it ever morally permissible to select for deafness in one's child?

As reproductive genetic technologies advance, families have more options to choose what sort of child they want to have. Using preimplantation genetic diagnosis (PGD), for example, allows parents to evaluate several existing embryos before selecting which to implant via in vitro fertilization (IVF). One of the traits PGD can identify is genetic deafness, and hearing embryos are now preferentially selected around the globe using this method. Importantly, some Deaf families desire a deaf child, and PGD-IVF is also an option for them. Selection for genetic deafness, however, encounters widespread disapproval in the hearing community, including mainstream philosophy and bioethics. In this paper I apply Elizabeth Barnes' value-neutral model of disability as mere-difference to the case of selecting for deafness. I draw on evidence from Deaf Studies and Disability Studies to build an understanding of deafness, the Deaf community, and the circumstances relevant to reproductive choices that may obtain for some Deaf families. Selection for deafness, with deafness understood as mere-difference and valued for its cultural identity, need not necessitate impermissible moral harms. I thus advocate that it is sometimes morally permissible to select for deafness in one's child.

The Association of Internet Use with Wellbeing, Mental Health and Health Behaviours of Persons with Disabilities

Introduction: There is strong evidence that people with disabilities suffer from a significant digital divide. However, there are reports indicating that Internet use may result in many benefits for those with disabilities. The aim of the study was to assess the impact that the use of the Internet has on the wellbeing and health behaviours of persons with disabilities. Methods: An analysis was carried out using the dataset obtained from Social Diagnosis, a panel study undertaken on a nationally representative sample. The records of persons with disabilities were retrieved from the dataset which was established in 2015. An analysis of the association between Internet use and the wellbeing, mental health and health behaviours of the respondents was undertaken. The variables reflecting the self-assessment of their own life and experience of loneliness were treated as being indicators of their wellbeing and the prevalence of suicidal thoughts or making use of psychological help as indicators of mental health. The health behaviours analysed in the study included smoking, excessive consumption of alcohol and undertaking physical activity. For all these variables, multivariate logistic regression models were developed. The effect of Internet use was adjusted for sociodemographic variables and the degree of disability. An analysis was performed after applying post-stratification weights available from the Social Diagnosis study. Results: The weighted study group consisted of 2529 people having a mean age of 59.33 ± 16.89 years. The group included 20.71% (N = 524) respondents with a mild, 41.58% (N = 1052) with a moderate, and 26.54% (N = 671) with a severe disability. The proportion of Internet users was 37.07% (N = 937). In all the regression models, Internet use had a significant impact on the dependent variables. After adjustment for sociodemographic variables and the degree of disability, the Internet users more frequently assessed their lives as happy (odds ratio, 95% confidence interval: 1.86, 1.47–2.37) and less frequently experienced loneliness (0.63, 0.49–0.81) or suicidal thoughts (0.47, 0.35–0.65). In addition, they needed psychological help less frequently (0.50, 0.35–0.72). Interestingly, Internet users undertook some form of physical activity or sport more often (2.41, 1.87–3.13) and fewer smoked cigarettes (0.70, 0.54–0.91) or consumed alcohol excessively (0.32, 0.19–0.56). Conclusions: The use of the Internet by people with disabilities was associated with improved wellbeing, better mental health and more beneficial health behaviours. These findings support the development of intensive actions to reduce the digital divide for the population of people with disabilities.

The impact of disability type and visibility on self-concept and body image: Implications for mental health nursing

WHAT IS KNOWN ON THE SUBJECT?: Physical appearance, as in the case of individuals with physical disabilities who use a cane, walker or wheelchair, also influence others' reactions and as a result, may lead to one's negative or positive feelings and thoughts. A disability that is not observable by others, as in the case of individuals with psychiatric disabilities (mental illnesses), may also have a negative impact on one's feelings and thoughts, due to stigma associated with psychiatric disabilities. To date, research has mainly focused on the way persons with a noticeable type of disability think about themselves. It is also important to evaluate the impact of disability type on ones' feelings and thoughts, and compare persons with visible and invisible disabilities. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We asked 119 adults (over the age of 18 years) with different types of disabilities to complete a set of questionnaires and found that those who had a disability that was not observable by others (a psychiatric disability) felt more negative about themselves and their body than those who had a disability that was observable by others (a physical disability). The study extends the current knowledge on the impact of disability type and its visibility on the way persons with disabilities think about themselves. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings suggest that healthcare services should be modified to address the psychological needs of people with different types of disability. Mental health nurses should identify practices in the community that will improve the feelings and thoughts of consumers with disabilities, and especially those who cope with a psychiatric disability. Abstract Introduction Individuals with disabilities often face stigma and discrimination, which may negatively affect their self-concept. To date, research has mainly focused on the psychological implications of living with a noticeable physical disability. Less attention has been given to individuals with invisible psychiatric disabilities as a stigmatized subgroup in the disability community. Aim To evaluate the impact of disability type and its visibility on the self-concept and body image. Method A cross-sectional quantitative study design was implemented to compare the self-concept and body image of individuals with visible physical disabilities and individuals with invisible psychiatric disabilities (n = 119). Pearson correlations, ANOVA and multiple linear regression models were performed. Results Individuals with invisible psychiatric disabilities reported lower levels of self-concept and body image compared to individuals with visible physical disabilities. Gender, family status and the severity level of the disability were found to be associated with self-concept and body image. Discussion The study extends the current knowledge by showing that disability visibility might play a protective role for persons with physical disabilities compared to persons with psychiatric disabilities. Implications for Practice Mental health nurses should apply practices to enhance the self-concept and body image of consumers with invisible psychiatric disabilities.

The health and quality of life of Thalidomide survivors as they age - Evidence from a UK survey

Background

In the late 1950s and early 1960s the drug Thalidomide was marketed across the world as a non-addictive tranquilizer. Despite being given to pregnant women as a safe treatment for morning sickness, Thalidomide caused serious damage to the unborn child. Much has been written about the drug and the birth defects it caused but evidence about the health of Thalidomide survivors as they age is limited.

Aim

The aim of this study was to: explore the health and wellbeing UK Thalidomide survivors; document the health problems experienced by them as they reach their mid-50s; and examine the impacts on their health-related quality of life and employment.

Methods

A health and wellbeing survey of 351 UK Thalidomide survivors, which gathered information about home and employment circumstances, recent health problems, and health related quality of life (using SF12 Health Survey). Overall analysis focused on descriptive statistics; the association between respondents’ health related quality of life and original impairment was examined using Pearson Correlation; and a three step Hierarchical Regression was used to explore the influence of five factors which narrative responses suggested might be important.

Results

As Thalidomide survivors reach their mid-50’s they are experiencing a wide range of secondary health problems, in particular musculoskeletal problems, and depression and anxiety, with multimorbidity a growing issue. These health problems are having a negative impact on their employment (two fifths are unable to work) and their physical health related quality of life, which is significantly poorer than the general population.

Discussion

Having lived relatively independent lives, many Thalidomide survivors are now having to adjust to growing disability. The study provides further evidence of the accumulative impact of disability over peoples’ lifetimes and highlights the value of a life course perspective in understanding the complex experience of growing older with a disability.

Psychosocial Well-Being Associated With Activity of Daily Living Stages Among Community-Dwelling Older Adults

Objectives: Activity of daily living (ADL) stages demonstrated ordered associations with risk of chronic conditions, hospitalization, nursing home use, and mortality among community-living elderly. This article explores the association of stages with psychosocial well-being. We hypothesized that higher ADL stages (greater ADL limitation) are associated with more restricted social networks, less perceived social support, greater social isolation, and poorer mental health. Methods: Cross-sectional data from the National Social Life, Health, and Aging Project (N = 3,002) were analyzed in regression models and latent factor models. Results: Although ADL stages had a nearly monotonic relationship with most mental health measures (e.g., Center for Epidemiologic Studies Depression Scale [CES-D]), only the complete limitation stage (Stage IV) showed significant disadvantage in the majority of social network measures. Discussion: The study may aid clinicians and policy makers to better understand the social and mental health needs of older adults at different ADL stages and provide well-planned social and mental health care.

Self-esteem as mediator and moderator of the relationship between stigma perception and social alienation of Chinese adults with disability

BACKGROUND

Several studies show the relationship between self-esteem and stigma perception and also between self-esteem and social alienation, but none sufficiently analyze the relationship between stigma perception and social alienation of people with disability.

OBJECTIVE/HYPOTHESIS

The primary aim of this paper is to investigate the mediator and moderator effects of self-esteem on the relationship between stigma perception and social alienation of people with disability.

METHODS

The participants were 129 adults with disability (80 males and 49 females) from eight communities in China. Data was collected by using the stigma perception scale, self-esteem scale, social avoidance scale, social anxiety subscale of the self-consciousness scale, and loneliness scale. Each item is rated on a 5-point scale (1 = "strongly disagree" to 5 = "strongly agree").

RESULTS

Stigma perception was positively correlated with social avoidance (p < 0.001), social anxiety (p < 0.001), and loneliness (p < 0.001). Self-esteem was inversely correlated with social avoidance (p < 0.001), social anxiety (p < 0.001), loneliness (p < 0.001), and stigma perception (p < 0.001).

CONCLUSIONS

Self-esteem partially mediated the relationship between stigma perception and social avoidance, social anxiety and loneliness. Moreover, self-esteem moderated the relationship between stigma perception and social avoidance, but not on social anxiety and loneliness.

Factores psicosociales predictores de la calidad de vida en personas en situación de discapacidad física

El presente estudio correlacional descriptivo se propuso evaluar los factores que determinan la calidad de vida (CV) relacionada con la salud en 78 personas con discapacidad física que vivían en Bogotá, y hacían parte de un proyecto de inclusión laboral dirigido por una ONG. Se evaluó la calidad de vida relacionada con la salud (Cuestionario de Salud SF36 y visita domiciliaria), al igual que las condiciones asociadas a la discapacidad y algunos factores psicológicos (Escala de Autoeficacia Generalizada, Prueba de Imagen Corporal, Inventario de Estilos de Afrontamiento, Prueba de optimismo disposicional, Inventario de Depresión de Beck y Escala de Ansiedad de Zung). Se utilizó un modelo de ecuaciones estructurales para encontrar el poder predictivo de las variables en la calidad de vida. El modelo obtenido predecía un 39% de la varianza, incluyendo en orden de peso relativo aportando variables como condiciones de enfermedad, depresión, afrontamiento centrado en la fantasía, trascendencia, pesimismo, ansiedad y autoeficacia. Se discuten los hallazgos y las limitaciones del estudio.

"I'm afraid I have bad news for you…" Estimating the impact of different health impairments on subjective well-being

Bad health decreases individuals' happiness, but few studies measure the impact of specific illnesses. We apply matching estimators to examine how changes in different (objective) conditions of bad health affect subjective well-being for a sample of 100,265 observations from the British Household Panel Survey (BHPS) database (1996-2006). The strongest effect is for alcohol and drug abuse, followed by anxiety, depression and other mental illnesses, stroke and cancer. Adaptation to health impairments varies across health impairments. There is also a puzzling asymmetry: strong adverse reactions to deteriorations in health appear alongside weak increases in well-being after health improvements. In conclusion, our analysis offers a more detailed account of how bad health influences happiness than accounts focusing on how bad self-assessed health affects individual well-being.

Religion, spirituality, and health: the research and clinical implications

This paper provides a concise but comprehensive review of research on religion/spirituality (R/S) and both mental health and physical health. It is based on a systematic review of original data-based quantitative research published in peer-reviewed journals between 1872 and 2010, including a few seminal articles published since 2010. First, I provide a brief historical background to set the stage. Then I review research on R/S and mental health, examining relationships with both positive and negative mental health outcomes, where positive outcomes include well-being, happiness, hope, optimism, and gratefulness, and negative outcomes involve depression, suicide, anxiety, psychosis, substance abuse, delinquency/crime, marital instability, and personality traits (positive and negative). I then explain how and why R/S might influence mental health. Next, I review research on R/S and health behaviors such as physical activity, cigarette smoking, diet, and sexual practices, followed by a review of relationships between R/S and heart disease, hypertension, cerebrovascular disease, Alzheimer's disease and dementia, immune functions, endocrine functions, cancer, overall mortality, physical disability, pain, and somatic symptoms. I then present a theoretical model explaining how R/S might influence physical health. Finally, I discuss what health professionals should do in light of these research findings and make recommendations in this regard.

Lower well-being of young Australian adults with self-reported disability reflects their poorer living conditions rather than health issues

OBJECTIVE

To determine the extent to which the lower well-being of young Australians with disabilities could be accounted for by increased rates of exposure to adversity and reduced access to personal, economic, social and community resources.

METHODS

Secondary analysis of data extracted from Waves 1 (2001) to 8 (2008) of the annual longitudinal survey of Household Income and Labour Dynamics in Australia.

RESULTS

Self-reported disability was associated with significantly lower scores on all indicators of psychological well-being. However, people self-reporting disability were more likely to be exposed to adversity and less likely to have access to a range of personal, economic, material, social and community resources. When these between-group differences in social context were controlled for, the between-group differences in psychological well-being were largely eliminated.

CONCLUSION

Our results suggest that, among younger adults in Australia, the association between disability and lower psychological well-being largely reflects their increased risk of exposure to adversity and reduced access to resources, rather than the presence of health conditions or impairments per se.

IMPLICATIONS

Public health interventions aimed at improving the well-being of young adults with a disability need to address the predominantly social determinants of well-being in this group.

The prevalence of hopelessness among adults: disability and other related factors

BACKGROUND

Hopelessness has become an important issue in the fields of health and social care.

OBJECTIVE

This study aims to determine the prevalence of hopelessness and its association with the current health condition, disability, and other socio-demographic characteristics.

METHOD

The cross-sectional study sampled a population of 501 adults in Bolu, Turkey. Questionnaires included the Household Questionnaire, the Health Condition Questionnaire, Beck Hopelessness Scale, and Brief Disability Questionnaire. Data were collected through face-to-face home interviews between September 29 and October 11, 2003.

RESULTS

The prevalence of hopelessness was 30.9%. It was higher among the literate (60.0%) (p < 0.05), males (35.0%) (p > 0.05), and agricultural workers and peasants (50.0%, 41.9%) (p < 0.05). Almost half of the participants were disabled, and 44.6% of the subjects with disabilities were hopeless (p < 0.05). Being without hope was statistically significant with gender, social class, perceived health, and disability (p < 0.05). The risk of hopelessness increased in subjects with perceived bad health, lowered social class, and disability, compared with the reference groups.

CONCLUSIONS

In this study, hopelessness prevalence was high and it was also associated with the current state of health, perceived health, disability, and some socio-demographic variables. It will be important to increase the number of studies related to hopelessness and associated factors for improved mental health services planning at population level.

Health and Happiness among Older Adults

The relationship between health and happiness was explored using a cross-sectional survey of 383 community-dwelling older adults. As a function of self-reported health, median happiness was increasing at a decreasing rate; happiness variability was decreasing at a decreasing rate. In multivariable logistic regression, lowest-quartile happiness was associated with poverty, unfavorable subjective health, debilitating pain and urinary incontinence, but not with the comorbidity count or other comorbidities. The results, robust to common method bias, suggest that subjective health measures are better predictors of happiness than objective measures are, except for conditions that disrupt daily functioning or are associated with social stigma.

Is well-being U-shaped over the life cycle?

We present evidence that psychological well-being is U-shaped through life. A difficulty with research on this issue is that there are likely to be omitted cohort effects (earlier generations may have been born in, say, particularly good or bad times). First, using data on 500,000 randomly sampled Americans and West Europeans, the paper designs a test that can control for cohort effects. Holding other factors constant, we show that a typical individual's happiness reaches its minimum - on both sides of the Atlantic and for both males and females - in middle age. Second, evidence is provided for the existence of a similar U-shape through the life-course in East European, Latin American and Asian nations. Third, a U-shape in age is found in separate well-being regression equations in 72 developed and developing nations. Fourth, using measures that are closer to psychiatric scores, we document a comparable well-being curve across the life cycle in 2 other data sets (1) in GHQ-N6 mental health levels among a sample of 16,000 Europeans, and (2) in reported depression-and-anxiety levels among 1 million UK citizens. Fifth, we discuss some apparent exceptions, particularly in developing nations, to the U-shape. Sixth, we note that American male birth-cohorts seem to have become progressively less content with their lives. Our results are based on regression equations in which other influences, such as demographic variables and income, are held constant.