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Ikar N, Sommer S, Schmidt M, Löwe C, Kasten S, Gavrilov B, Hunzelar C, Bockheim F, Paños-Willuhn J, Offenberg L, Oberholz M, Weltermann B. Unemployed individuals contact GPs more frequently but report lower satisfaction: results of the population-based DEGS1 and the GPCare-1 patient survey. Sci Rep 2022; 12:6670. [PMID: 35461341 PMCID: PMC9035161 DOI: 10.1038/s41598-022-10621-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 04/08/2022] [Indexed: 11/09/2022] Open
Abstract
Unemployment is associated with a variety of adverse health-related outcomes, yet little data on primary care services for this risk group exist. Using data from two surveys, we analyzed the frequency of GP contacts and patients' experiences with GPs comparing unemployed with employed individuals. Data of the German Health Interview and Examination Survey for Adults (DEGS1), a nationwide cross-sectional study (n = 8151), were analyzed regarding associations between employment status and the number of GP visits. The General Practice Care-1 study (GPCare-1), a cross-sectional questionnaire survey (n = 813), evaluated patients' communication with their GP. Data were collected from June to August 2020 in 12 teaching practices affiliated with our university. The statistical analysis included individuals of working age (18-64 years old) (DEGS1 n = 5659, GPCare-1 n = 587). In both studies, working age subpopulations were analyzed (DEGS1: n = 5659 of 8151, GPCare-1: n = 587 of 813). In DEGS1, the prevalence of unemployment was 6.5% (n = 372). Unemployed individuals had more GP contacts in the last 12 months (4.50 vs. 2.86, p < 0.001). In the GPCare-1 study, unemployed individuals (6.6%, n = 39) were significantly less satisfied with GP communication: enough space in consultations (42.9% vs. 60.3%, p = 0.043), feeling comfortable to address sensitive topics (44.1% vs. 65.9%, p = 0.010), problems taken very seriously by GP (48.6% vs. 70.6%, p = 0.007). Yet, they were more willing to accept GPs' help for psychosocial burdens (67.6% vs. 47.6%, p = 0.024). GPs should be aware that patients with unemployment wish more support to cope with their burdening situation.
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Affiliation(s)
- N Ikar
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
| | - S Sommer
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - M Schmidt
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - C Löwe
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - S Kasten
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - B Gavrilov
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - C Hunzelar
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - F Bockheim
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - J Paños-Willuhn
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - L Offenberg
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - M Oberholz
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - B Weltermann
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
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Motolese F, Rossi M, Albergo G, Stelitano D, Villanova M, Di Lazzaro V, Capone F. The Psychological Impact of COVID-19 Pandemic on People With Multiple Sclerosis. Front Neurol 2020; 11:580507. [PMID: 33193033 PMCID: PMC7662111 DOI: 10.3389/fneur.2020.580507] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/14/2020] [Indexed: 12/22/2022] Open
Abstract
Objective: The coronavirus disease 2019 (COVID-19) has radically changed the world in a few weeks. Italy has been one of the first and most affected countries with more than 30,000 deaths up to now. Public health measures as quarantine or national lockdown are necessary to limit the spread of infectious diseases, but it is unsurprising that depriving people of their liberty has negative psychological effects. This is especially the case for people with chronic diseases, including neurological conditions like multiple sclerosis (MS). People with MS (PwMS) have a higher burden of neuropsychiatric comorbidities and are known to undertake maladaptive coping strategies in stress conditions. The aim of the present study is to investigate the impact of COVID-19 pandemic lockdown on mental health of an Italian cohort of PwMS in comparison with healthy controls (HCs). Methods: A total of 60 PwMS and 50 HCs (chosen among patients' cohabitants) were asked to answer a Web-based survey. This survey inquired about the impact of COVID-19 on patient's quality of life, job, and daily routine. Mood, fatigue, and sleep quality were evaluated using the Beck Depression Inventory II (BDI-II), the Generalized Anxiety Disease 7 (GAD-7), the Fatigue Severity Scale (FSS), and the Pittsburgh Sleep Quality Index (PSQI). Results: Overall, patients had higher scores of BDI, FSS, and PSQI, and these differences were statistically significant (p < 0.05). When we looked at the subscores of the BDI, we detected a statistically significant difference for the neurovegetative part—that concerns with sleep, appetite, sex, and quality of sleep (p < 0.05). One out of five patients reported new symptoms or worsening of known symptom, in particular, sensory disturbances, and fatigue. However, no symptoms were severe enough to require hospitalization. When we looked for correlations among variables, we found that there was a significant relationship between unemployment and BDI total score, GAD-7, and PSQI in MS group. The presence of new symptoms or the worsening of symptoms positively related to FSS and to PSQI. Discussion: We identified that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic had a significant impact on the psychological status of patients with MS. Compared with the general population, PwMS presented a higher burden of depressive symptoms, a worse sleep quality and perceived an increase in fatigue level, one of the most disabling symptoms of MS. The COVID-19 epidemic poses a challenge to psychological resilience. More studies are warranted to better understand the long-term consequences of the pandemic on mental health of vulnerable people during the disease outbreaks.
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Affiliation(s)
- Francesco Motolese
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Mariagrazia Rossi
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Giuliano Albergo
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Domenica Stelitano
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Marialucia Villanova
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Fioravante Capone
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.,NeXT: Neurophysiology and Neuroengineering of Human-Technology Interaction Research Unit, Campus Bio-Medico University, Rome, Italy
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Strober LB, Chiaravalloti N, DeLuca J. Should I stay or should I go? A prospective investigation examining individual factors impacting employment status among individuals with multiple sclerosis (MS). Work 2018; 59:39-47. [DOI: 10.3233/wor-172667] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Lauren B. Strober
- Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers, State University of New Jersey – New Jersey Medical School, Newark, NJ, USA
| | - Nancy Chiaravalloti
- Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers, State University of New Jersey – New Jersey Medical School, Newark, NJ, USA
| | - John DeLuca
- Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers, State University of New Jersey – New Jersey Medical School, Newark, NJ, USA
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