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Brückner RM, Schönenberg A, Wientzek R, Schreiber M, Prell T. Exploring factors associated with self-rated health in individuals with diabetes and its impact on quality of life: Evidence from the Survey of Health, Ageing, and Retirement in Europe. J Diabetes 2024. [PMID: 38168898 DOI: 10.1111/1753-0407.13522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/13/2023] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Self-rated health (SRH), a measure of self-reported general health, is a robust predictor of morbidity and mortality in various populations, including people with diabetes. Diabetes is negatively associated with SRH and quality of life (QoL). Little is known about how people with diabetes rate their health and which aspects influence the rating. Also, the predictive value of SRH on future QoL has not yet been evaluated. METHODS We analyzed data from 46 592 participants of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using linear regression, we aimed to determine which sociodemographic, socioeconomic, medical, social, mental, and health behavior factors determine SRH in people with diabetes. In addition, we analyzed the predictive value of SRH on future QoL using the generalized estimating equations procedure. RESULTS We determined that country, current job situation, hospitalization, pain, polypharmacy, memory, eyesight, activities of daily living, number of chronic diseases, and depression are all linked to SRH. Together these variables explained 38% of the SRH's variance, whereas depression, pain, and memory had the greatest influence on SRH of people with diabetes. We also found that SRH independently predicted future QoL, supported by a regression coefficient of β = -1.261 (Wald chi-square test, χ2 = 22.097, df = 1, p < .05). CONCLUSIONS As SRH is linked to future QoL, we conclude that incorporating SRH assessment into medical evaluations can help health care professionals gaining a more comprehensive understanding of an individual's health trajectory and supporting patients to enhance their QoL.
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Affiliation(s)
| | | | - Rebecca Wientzek
- Department of Geriatrics, Halle University Hospital, Halle, Germany
| | - Mandy Schreiber
- Department of Internal Medicine II, Halle University Hospital, Halle, Germany
| | - Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle, Germany
- Department of Neurology, Jena University Hospital, Jena, Germany
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Kjeldsberg M, Tschudi-Madsen H, Bruusgaard D, Natvig B. Factors related to self-rated health: a survey among patients and their general practitioners. Scand J Prim Health Care 2022; 40:320-328. [PMID: 35587746 PMCID: PMC9397452 DOI: 10.1080/02813432.2021.2022341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To explore associations between general practice patients' SRH and symptoms, diagnoses, chronic conditions, unexplained conditions, and life stressors. DESIGN A cross-sectional study. Data were collected from GP and patient questionnaires. SETTING General practices in Southeast Norway. SUBJECTS 47 general practitioners (GPs) who included 866 consecutive patients. MAIN OUTCOME MEASURES SRH was measured with a single question from the COOP-WONCA overall health chart and dichotomized into good/poor SRH. Binary logistic regression models were used in the analyses. RESULTS Poor SRH was reported by 48% of the patients in the past week. A higher prevalence of poor SRH was found for women, middle-aged, recipients of social security grants, patients diagnosed with asthenia, lower back pain, and depression/anxiety, and for patients with reported life stressors and unexplained conditions. We found an almost linear association between the number of symptoms and the likelihood of reporting poor SRH. The probability of reporting poor SRH increased along with an increasing number of symptoms for common diagnoses. In a multivariate analysis, the only number of symptoms, being in receipt of social security grants and being retired was associated with poor SRH. CONCLUSION The likelihood of reporting poor SRH increased with an increasing number of symptoms, partly independent of the diagnosis given by GPs. This result coincides with our previous findings of a strong association between the number of symptoms, function, and health. The symptom burden thus appears to be an important factor for SRH among patients in general practice.KEY POINTSThere is a high prevalence of poor SRH in general practice patients.The likelihood of reporting poor SRH is partly independent of the diagnosis given.The number of symptoms was the factor strongest associated with poor SRH.
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Affiliation(s)
- Mona Kjeldsberg
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- CONTACT Mona Kjeldsberg General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, P.O. Box 1130Blindern, N-0318, Oslo, Norway
| | - H. Tschudi-Madsen
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - D. Bruusgaard
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - B. Natvig
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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Fylkesnes K, Jakobsen MD, Henriksen NO. The value of general health perception in health equity research: A community-based cohort study of long-term mortality risk (Finnmark cohort study 1987-2017). SSM Popul Health 2021; 15:100848. [PMID: 34195347 PMCID: PMC8237603 DOI: 10.1016/j.ssmph.2021.100848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 11/08/2022] Open
Abstract
Background General health perception as measured by self-rated health (SRH) is an individual's synthesis of personal overall health and has value in its own right. In addition, this subjective perspective has a unique predictive power of subsequent mortality and adds valuable information not captured by objective measures. We studied the relationship between SRH and subsequent mortality to demonstrate how simple self-ratings can enhance our understanding of health inequities. Methods Data from a population-based survey conducted in Finnmark 1987/1988 were linked to the Norwegian Cause of Death Registry for information on all deaths by the end of 2017. We used Cox proportional hazard regression modelling to estimate the relative effects of all-cause mortality separately for sex and age (30–49 and 50–62 years) with stepwise adjustment for socio-demographics and various other health status and behavioural measures. Results The age-adjusted power of mortality prediction of SRH was strong (most pronounced in the youngest age-group) but markedly attenuated by other factors. Education inequality in mortality was most substantial in the youngest age-group, which might partly be due to a combination of selective mortality and historical changes in health inequality. In comparison, educational inequality in SRH was clearly pronounced regardless of age. Work disability pension appeared as the common key factor affecting the mortality prediction of SRH and educational inequity for both subsequent mortality and SRH. Conclusion SRH adds unique information to our understanding of health inequities. The consistency in shared predictors of educational inequity concerning both mortality and SRH underscores the correspondence of these measures. In addition to predicting the fatal effects of social selection mechanisms, SRH adds non-fatal effects and seems less prone to selective mortality. The results are relevant to approaches in health equity research and have important policy implications. Self-rated health yielded robust age adjusted mortality predictions. Self-rated health adds unique information to our understanding of health inequities. Educational inequity in mortality is extensive, but it narrows with age, which can be explained by selective mortality and historical changes. Measures to reduce preventable workforce exclusions can be effective for achieving or maintaining health equity.
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Affiliation(s)
- Knut Fylkesnes
- Centre for International Health University of Bergen, Norway
| | - Monika Dybdahl Jakobsen
- Centre for Care Research North, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Self-rated health and the risk of incident type 2 diabetes mellitus: A cohort study. Sci Rep 2019; 9:3697. [PMID: 30842537 PMCID: PMC6403398 DOI: 10.1038/s41598-019-40090-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 02/08/2019] [Indexed: 12/15/2022] Open
Abstract
We aimed to evaluate the association between self-rated health (SRH) and the risk of incident type 2 diabetes mellitus (T2D). This cohort study consisted of 250,805 Korean men and women without T2D at baseline. SRH was assessed at baseline with a self-administered structured questionnaire. Incident T2D was defined as fasting serum glucose ≥126 mg/dL, HbA1C ≥6.5%, or use of medication for T2D during follow-up. After adjustment for possible confounders including age, center, year of screening exam, smoking status, alcohol intake, physical activity, education level, total calorie intake, body mass index, sleep duration, depressive symptoms, family history of diabetes, history of hypertension, and history of cardiovascular disease, the multivariable-adjusted hazard ratios (95% confidence intervals) for incident T2D comparing good, fair, and poor or very poor SRH to very good SRH were 1.20 (0.98-1.48), 1.63 (1.33-1.98), and 1.83 (1.47-2.27), respectively. These associations were consistently observed in clinically relevant subgroups. Fair or poorer SRH was independently and positively associated with the development of T2D in a large-scale cohort study of apparently healthy Korean adults, indicating that SRH is a predictor of metabolic health. Physicians involved in diabetes screening and management should routinely consider SRH when evaluating T2D risk as well as overall health.
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Hetlevik Ø, Vie TL, Meland E, Breidablik HJ, Jahanlu D. Adolescent self-rated health predicts general practice attendance in adulthood: Results from the Young-HUNT1 survey. Scand J Public Health 2018; 47:37-44. [PMID: 29708028 DOI: 10.1177/1403494818772212] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
AIMS Self-rated health (SRH) is a predictor of future health. However, the association between SRH in adolescence and health problems and health care utilization in adulthood has rarely been investigated. The aim of this study was to examine adolescent SRH as a predictor of general practitioner consultations in adulthood. METHODS SRH was registered in the Young-HUNT1 survey in 1995-1997 ( N=8828, mean age 16 years, 88% participation rate). General practitioner consultations during 2006-2014 were obtained from a national claims database. The predictive value of adolescent SRH on general practitioner consultations in adulthood was analysed by regression models estimating the relative risks (RR) for the total number of consultations and consultations for psychological, gastrointestinal, musculoskeletal or respiratory problems. Age, sex and baseline measures of chronic disease and health care attendance were used as the adjusting variables. RESULTS SRH was reported as 'very good' by 28.4%, 'good' by 60.6% and 'not good' by 11.0% of the respondents. The increases in consultation rates were 21% (RR 1.21, 95% CI 1.15-1.27) and 52% (RR 1.52, 95% CI 1.40-1.64) when comparing respondents with 'very good' SRH to those with 'good' and 'not good' SRH, respectively. We also demonstrated a dose-response association between adolescent SRH and general practitioner consultations for psychological, gastrointestinal, musculoskeletal or respiratory problems. CONCLUSIONS SRH in adolescence is a predictor for general practitioner consultations in adult life. Previous research shows that SRH is influenced by factors such as well-being, health behaviour, functional status and body satisfaction. Intervention studies are needed to evaluate whether population-based and clinical interventions can improve SRH by improving these factors among adolescents.
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Affiliation(s)
- Øystein Hetlevik
- 1 Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Tina L Vie
- 2 Centre of Health Research, Førde Hospital Trust, Norway
| | - Eivind Meland
- 1 Department of Global Public Health and Primary Care, University of Bergen, Norway
| | | | - David Jahanlu
- 3 Department of Life Sciences and Health, Norway.,4 Akershus University College of Applied Sciences, Norway
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Raymakers AJN, Gillespie P, Murphy E, Cupples ME, Smith SM, Murphy AW, Griffin MD, Benyamini Y, Byrne M. Patient reported health status and all-cause mortality in patients with coronary heart disease. Fam Pract 2018; 35:172-178. [PMID: 29092028 DOI: 10.1093/fampra/cmx094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE Patients with coronary heart disease (CHD) experience reduced quality of life which may be associated with mortality in the longer term. This study explores whether patient-rated physical and mental health status was associated with mortality at 6-year follow-up among patients with CHD attending primary care in Ireland and Northern Ireland. METHODS This study is a secondary data analysis of patients with CHD recruited to a cluster randomized controlled trial from 2004 to 2010. Data collected included patient-rated physical component summary (PCS) and mental component summary (MCS) scores of health status (from the 12-Item Short-Form Health Survey (SF-12)), demographics and clinical parameters at baseline, and all-cause mortality at 6-year follow-up. Multivariate regression was conducted using generalized estimating equations (GEE) with a log-link function. Results are presented as odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS The study consisted of 762 individuals with mean age 67.6 years [standard deviation (SD): 9.8], and was 29% female. Mean baseline SF-12 mental (MCS) and physical (PCS) component scores were 50.0 (SD: 10.8) and 39.6 (SD: 11.2), respectively. At 6-year follow-up, the adjusted OR for the baseline MCS for mortality was 0.97 (95% CI: 0.95-0.99) and for the PCS 0.97 (95% CI: 0.95-0.99). For every five-point increase in MCS and PCS scores, there was a 14% reduction in the likelihood of all-cause mortality. CONCLUSIONS Overall, the magnitude of effect for both mental health status and physical health status was similar; higher scores were significantly associated with a lower risk of mortality at 6-year follow-up.
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Affiliation(s)
- Adam J N Raymakers
- CÚRAM SFI Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland.,Health Economics and Policy Analysis Centre, Department of Economics, National University of Ireland Galway, Galway, Ireland
| | - Paddy Gillespie
- CÚRAM SFI Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland.,Health Economics and Policy Analysis Centre, Department of Economics, National University of Ireland Galway, Galway, Ireland
| | - Edel Murphy
- HRB Primary Care Clinical Trials Network Ireland, Galway, Ireland
| | - Margaret E Cupples
- UKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University Belfast, Belfast, Northern Ireland
| | - Susan M Smith
- Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Andrew W Murphy
- HRB Primary Care Clinical Trials Network Ireland, Galway, Ireland.,Discipline of General Practice, National University of Ireland Galway, Galway, Ireland
| | - Matthew D Griffin
- CÚRAM SFI Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland.,Regenerative Medicine Institute (REMEDI), School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
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Affiliation(s)
- Sara Wallström
- Institute of Health and Care Sciences, University of Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, University of Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden
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Olsson K, Nilsson J, Hörnsten Å, Näslund U. Patients' self-reported function, symptoms and health-related quality of life before and 6 months after transcatheter aortic valve implantation and surgical aortic valve replacement. Eur J Cardiovasc Nurs 2016; 16:213-221. [PMID: 27169460 DOI: 10.1177/1474515116650342] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Aortic stenosis is the most common valve disease in western countries and has poor prognosis without treatment. Surgical aortic valve replacement (SAVR) is the gold standard, and transcatheter aortic valve implantation (TAVI) is a new method that is used in high-risk patients who are denied surgery. The purpose of treatment is not only to save life, but also to reduce symptoms and increase health-related quality of life (HRQoL). OBJECTIVE The aim of this study was to describe patients' self-reported outcomes in terms of physical function, symptoms, dependence, HRQoL, and cognitive function after TAVI and SAVR. METHODS All patients treated with TAVI during 1 year ( n = 24) and age-matched patients treated with SAVR ( n = 24) were included. Data were collected on the day before and at 6 months after treatment using structural questionnaires. RESULTS Self-rated function was low before treatment and increased at follow-up. A quarter of all patients reported syncope at baseline, and none reported this at follow-up. Breathlessness was reported by all patients to be the most limiting cardiac symptom, but the TAVI patients reported more severe symptoms. At 6 months' follow-up, symptoms were reduced, but breathlessness and fatigue were still common, especially in the TAVI group. HRQoL, which was very low in the TAVI group at baseline, increased in all dimensions except social function. CONCLUSION We found no change in cognitive function or dependence at follow-up. There was no difference in the size of improvement between groups. The results could be helpful when informing future patients in order to give them realistic expectations.
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Affiliation(s)
- Karin Olsson
- 1 Cardiology, Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,2 Department of Nursing, Umeå University, Umeå, Sweden
| | - Johan Nilsson
- 1 Cardiology, Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Åsa Hörnsten
- 2 Department of Nursing, Umeå University, Umeå, Sweden
| | - Ulf Näslund
- 1 Cardiology, Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Waller G, Janlert U, Hamberg K, Forssén A. What does age-comparative self-rated health measure? A cross-sectional study from the Northern Sweden MONICA Project. Scand J Public Health 2015; 44:233-9. [PMID: 26644159 DOI: 10.1177/1403494815618554] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 11/15/2022]
Abstract
AIMS Self-rated health comprehensively accounts for many health domains. Using self-ratings and a knowledge of associations with health domains might help personnel in the health care sector to understand reports of ill health. The aim of this paper was to investigate associations between age-comparative self-rated health and disease, risk factors, emotions and psychosocial factors in a general population. METHODS We based our study on population-based cross-sectional surveys performed in 1999, 2004 and 2009 in northern Sweden. Participants were 25-74 years of age and 5314 of the 7500 people invited completed the survey. Comparative self-rated health was measured on a three-grade ordinal scale by the question 'How would you assess your general health condition compared to persons of your own age?' with the alternatives 'better', 'worse' or 'similar'. The independent variables were sex, age, blood pressure, cholesterol, body mass index, self-reported myocardial infarction, stroke, diabetes, physical activity, smoking, risk of unemployment, satisfaction with economic situation, anxiety and depressive emotions, education and Karasek scale of working conditions. Odds ratios using ordinal regression were calculated. RESULTS Age, sex, stroke, myocardial infarction, diabetes, body mass index, physical activity, economic satisfaction, anxiety and depressive emotions were associated with comparative self-rated health. The risk of unemployment, a tense work situation and educational level were also associated with comparative self-rated health, although they were considerably weaker when adjusted for the the other variables. Anxiety, depressive emotions, low economic satisfaction and a tense work situation were common in the population. CONCLUSIONS Emotions and economic satisfaction were associated with comparative self-rated health as well as some medical variables. Utilization of the knowledge of these associations in health care should be further investigated.
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Affiliation(s)
- Göran Waller
- Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, Umeå, Sweden
| | - Urban Janlert
- Department of Public Health and Clinical Medicine, Division of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Katarina Hamberg
- Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, Umeå, Sweden
| | - Annika Forssén
- Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, Umeå, Sweden
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