The generalizability of empirically derived syndromes of collateral-reported elder psychopathology across 11 societies

The purpose of this study was to test whether a syndrome model of elder psychopathology derived from collateral ratings, such as from spouses and adult children, in the United States would be generalizable in 11 other societies. Societies represented South America, Asia, and Europe. The Older Adult Behavior Checklist (OABCL) was completed by collateral informants for 6141 60- to 102-year-olds. The tested model comprised syndromes designated as Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited. The model was tested using confirmatory factor analyses in each society separately. The primary model fit index showed a good fit for all societies, while the secondary model fit indices showed acceptable to a good fit for all societies. The items loaded strongly on their respective factors, with a median item loading of 0.69 across the 11 societies. By syndrome, the overall median item loadings ranged from 0.47 for Worries to 0.77 for Functional Impairment. The OABCL syndrome structure was thus generalizable across the tested societies. The OABCL can be used for broad assessment of psychopathology for elders of diverse backgrounds in nursing services and research.

The Association of Socio-demographic Determinants and Mammography Screening in women in Serbia

Introduction

Serbian screening mammography programs target women 50-69 years with biennial screening.

Methods

Research was conducted as a cross-sectional study on a sample of 2784 women aged 50-69 years in Serbia, as a part of the Health Survey in Serbia, 2013. The association between the socio-demographic determinants as independent variables, and mammography screening (within the past 2 years) as dependent variable were examined using univariate and binary logistic regression. Multivariate model were adjusted for marital status, education, employment status, DHS Wealth Index, type of settlement and self-perceived health. The minimum level of significance was p < 0.05.

Results

Only 22.2% of women aged 50-69 have done mammograms within the past 2 years in Serbia. In binary logistic regression model as predictors for a mammogram were singled out level of education, wealth index and self-perceived health. Women with medium level of education have 1.4 times higher chance to perform a mammogram in relation to those with low education (OR = 1.4; 95%CI 1.12-1-80), while women with high level of education have 1.8 times higher chance to do a mammogram in relation to those with low education (OR = 1.8; 95%CI 1.33-2.58). Women with good financial situation were 1.4 times more likely to perform a mammogram in relation to those with poor financial situation (OR = 1.4; 95%CI 1.05-1.80). Women who perceived their health as well have 26% less chance to do a mammogram compared to those who perceived their health as a poor (OR = 0.74; 95%CI 0.56-0.97).

Conclusions

This study showed the disparity in the prevalence of mammography utilization. The predictors for mammogram performance among women were: high level of education, high wealth index and self-perceived health as poor.

Key messages

The only breast cancer screening test that has been proven effective in organized, population-based programs is mammography screening. Screening mammography reduces the risk of death due to breast cancer. It is useful for detecting all types of breast cancer, including invasive ductal and invasive lobular cancer.

Social determinants of self-rated health in women

Background

Social determinants of health determine the extent to which a person possesses the physical, social and personal resources to stay healthy and achieve personal aspirations, satisfy needs, and cope with the environment.

Methods

Data from a cross-sectional study - The 2013 National Health Survey in Serbia was used. The study involved 1840 women aged 20 years and over in the Province of Vojvodina. The research instrument was a specially designed questionnaire. Multivariate logistic regression was implemented to assess the association between self-rated health as a dependent variable and social-demographic characteristics of women as independent variables (age, type of settlement, marital status, material status - DHS Wealth Index (WI), level of education, employment status, social support (Oslo-3 Social Support Scale), smoking and alcohol consumption.

Results

Out of a total 38.8% of women had a low level of education, according to WI 49.3% were poor, 21.9% were unemployed and 11.5% had poor social support. Every third woman was a smoker (31.9%) and 21.3% self-rated their health as poor. The number of women with poor health increased significantly with the decrease in social support, level of education and WI (from 14.3% among women with strong social support to 36.0% with poor social support, from 8.5% among highly educated to 31,4% among the low educated, from 11.1% among the rich to 24.4% among the poor). Multivariate logistic regression indicated that poor social support (OR = 3.96; 95%CI=2.34-6.70), low level of education (OR = 2.87; 95%CI=1.47-5.58), WI category of poor (OR = 1.77; 95%CI=1.10-2.84), ex smoking (OR = 2.49; 95%CI=1.51-4.08) and smoking (OR = 2.16; 95%CI=1.42-3.29) were significantly associated with poor self-rated health.

Conclusions

The research shows that there is a strong association between social determinants and self-rated health, which demands multi-disciplinary strategies to improve health and reduce health inequalities.

Key messages

Protecting the health of women is not only a basic human right, it is also crucial for health and economic development. Social determinants of health are leading causes of the health inequalities and demand an adequate health policy development at local, as well as at the national level.

The generalizability of Older Adult Self-Report (OASR) syndromes of psychopathology across 20 societies

OBJECTIVES

As the world population ages, psychiatrists will increasingly need instruments for measuring constructs of psychopathology that are generalizable to diverse elders. The study tested whether syndromes of co-occurring problems derived from self-ratings of psychopathology by US elders would fit self-ratings by elders in 19 other societies.

METHODS/DESIGN

The Older Adult Self-Report (OASR) was completed by 12 826 adults who were 60 to 102 years old in 19 societies from North and South America, Asia, and Eastern, Northern, Southern, and Western Europe, plus the United States. Individual and multigroup confirmatory factor analyses (CFAs) tested the fit of the seven-syndrome OASR model, consisting of the Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited syndromes.

RESULTS

In individual CFAs, the primary model fit index showed good fit for all societies, while the secondary model fit indices showed acceptable to good fit. The items loaded strongly on their respective factors, with a median item loading of .63 across 20 societies, and 98.7% of the loadings were statistically significant. In multigroup CFAs, 98% of items demonstrated approximate or full metric invariance. Fifteen percent of items demonstrated approximate or full scalar invariance, and another 59% demonstrated scalar invariance across more than half of societies.

CONCLUSIONS

The findings supported the generalizability of OASR syndromes across societies. The seven syndromes offer empirically based clinical constructs that are relevant for elders of different backgrounds. They can be used to assess diverse elders and as a taxonomic framework to facilitate communication, services, research, and training in geriatric psychiatry.

Physical activity and self-perceived health of women in the Province of Vojvodina

Introduction

Women suffer from many diseases that are associated with low level of physical activity. The aim of this paper was to estimate the association between physical activity and self- perceived health of women in the Province of Vojvodina.

Methods

Research was conducted as a cross-sectional study on a sample of 1356 women aged 20-65 years in Vojvodina, as a part of the National Health Survey in Serbia, 2013. Physical activity was analysed through 3 domains of physical activity - as leisure time physical activity, walking and cycling for transportation and physical activity at work. Univariate and binary logistic regression was used to estimate the association of poor self-perceived health as dependent variable with 3 domains of physical activity. Multivariate model were adjusted for age, type of settlement, DHS Wealth Index, education and employment status.

Results

One of twelve women was physically active in leisure time 150 minutes and more (8.1%), 50.0% of women walked for transportation 150 minutes and more weekly, while 16.5% cycled 150 minutes and more weekly. Women who never walked for transportation had 9.17 time higher chance to self-perceived their health as poor compared to those who are active 150 minutes and more weekly (OR = 9.17; 95%CI 4.16-20.18), while women who are inactive at work had 1.74 higher chance to self-perceived their health as poor compared to working active women (OR = 1.74; 95%CI 1.14-2.66).

Conclusions

Physical activity at work and in the form of walking for transportation showed as predictors of poor self-perceived health.

Key messages

Regular physical activity can improve womens’ health and help prevent many of the diseases and conditions that are major causes of death and disability for women around the world. Physical activity can contribute to building self-esteem and confidence and can provide a vehicle for social integration and equality for women in society.