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Abstract
Musculoskeletal and mental health complaints are common in the general population and frequent reasons for healthcare utilization and work absence. Illness perceptions, coping expectancies, rumination and self-stigma are important factors in the management of these health complaints and factors closely linked to health literacy (HL). The aims of the study were to identify helpful elements in a brief intervention (BI) targeting HL regarding common musculoskeletal and mental health complaints and to identify patient perceptions of how the intervention was helpful and whether it affected their subsequent coping. Three focus group interviews with 14 patients were conducted. Systematic text condensation was used for the analysis, supported by the health literacy skill (HLS) framework to sharpen the focus on intervention elements related to the acquisition and utilization of HLSs. Results revealed the importance of receiving comprehensible health information and guidance, the use of metaphors to create recognizable narratives and the use of practical examples and exercises. Normalizing the experienced health complaints, together with a safe and accommodating clinical environment, facilitated the change process. The BI initiated processes that contributed to acceptance, resilience and empowerment, aiding work-life balance and return to work. The study presents authentic narratives of value for future focus in BI.
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Affiliation(s)
- Tone Langjordet Johnsen
- Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, POB 2168, 3103 Tønsberg, Norway
- Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Raveien 215, 3184 Horten, Norway
| | - Torill Helene Tveito
- Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Raveien 215, 3184 Horten, Norway
| | - Irene Øyeflaten
- NORCE Norwegian Research Centre, Nygårdsgaten 112, 5008 Bergen, Norway
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Bouldin ED, Taylor CA, Knapp KA, Miyawaki CE, Mercado NR, Wooten KG, McGuire LC. Unmet needs for assistance related to subjective cognitive decline among community-dwelling middle-aged and older adults in the US: prevalence and impact on health-related quality of life. Int Psychogeriatr 2021; 33:689-702. [PMID: 32883384 PMCID: PMC8630807 DOI: 10.1017/s1041610220001635] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To estimate the prevalence of unmet needs for assistance among middle-aged and older adults with subjective cognitive decline (SCD) in the US and to evaluate whether unmet needs were associated with health-related quality of life (HRQOL). DESIGN Cross-sectional. SETTING US - 50 states, District of Columbia, and Puerto Rico. PARTICIPANTS Community-dwelling adults aged 45 years and older who completed the Cognitive Decline module on the 2015--2018 Behavioral Risk Factor Surveillance System reported experiencing SCD and always, usually, or sometimes needed assistance with day-to-day activities because of SCD (n = 6,568). MEASUREMENTS We defined SCD as confusion or memory loss that was happening more often or getting worse over the past 12 months. Respondents with SCD were considered to have an unmet need for assistance if they sometimes, rarely, or never got the help they needed with day-to-day activities. We measured three domains of HRQOL: (1) mental (frequent mental distress, ≥14 days of poor mental health in the past 30 days), (2) physical (frequent physical distress, ≥14 days of poor physical health in the past 30 days), and (3) social (SCD always, usually, or sometimes interfered with the ability to work, volunteer, or engage in social activities outside the home). We used log-binomial regression models to estimate prevalence ratios (PRs). All estimates were weighted. RESULTS In total, 40.2% of people who needed SCD-related assistance reported an unmet need. Among respondents without depression, an unmet need was associated with a higher prevalence of frequent mental distress (PR = 1.55, 95% CI: 1.12-2.13, p = 0.007). Frequent physical distress and social limitations did not differ between people with met and unmet needs. CONCLUSIONS Middle-aged and older adults with SCD-related needs for assistance frequently did not have those needs met, which could negatively impact their mental health. Interventions to identify and meet the unmet needs among people with SCD may improve HRQOL.
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Affiliation(s)
- Erin D Bouldin
- Alzheimer's Disease and Healthy Aging Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA
| | - Christopher A Taylor
- Alzheimer's Disease and Healthy Aging Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kenneth A Knapp
- Department of Public Health, New York Medical College, Valhalla, NY, USA
| | | | - Nicholas R Mercado
- Department of Medicine, Donald and Barbara Zucker School of Medicine, Hofstra University/Northwell, Hempstead, NY, USA
- School of Health Professions and Human Services, Hofstra University, Hempstead, NY, USA
- Division of Medical Ethics, Northwell Health, New York, NY, USA
| | - Karen G Wooten
- Alzheimer's Disease and Healthy Aging Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lisa C McGuire
- Alzheimer's Disease and Healthy Aging Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Ekerholt K, Bergland A. Embodied Knowledge - the Phenomenon of Subjective Health Complaints reflected upon by Norwegian Psychomotor Physiotherapy specialists. Physiother Theory Pract 2021; 38:2122-2133. [PMID: 33957856 DOI: 10.1080/09593985.2021.1920073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Many patients report subjective health complaints (SHCs) during primary health care consultations. Objective: To elucidate Norwegian Psychomotor Physiotherapy (NPMP) specialists' clinical experiences in treatment of patients suffering from SHCs. Methods: Twelve NPMP specialists were interviewed. The transcripts were qualitatively analyzed using systematic text condensation. Results: "Embodied knowledge" seemed to be an unfamiliar concept to those suffering from SHCs. The NPMP specialists regarded increased body awareness to be a vital element in the process of recovery from SHCs. Differences between NPMP specialists' professional view and that of some medical doctors were reported. Three categories emerged from the material: 1) "The process of establishing a joint understanding of subjective health complaints"; 2) "The process of increasing the patients' embodied awareness"; and 3) "The challenge of sharing embodied knowledge in inter-professional communication." Conclusion: The NPMP specialists emphasized the importance of increasing patients' consciousness of their embodied knowledge. They searched to adjust their therapeutic approaches, depending on the individual patient's specific problems and degree of emotional and/or bodily strain. The NPMP specialists experienced the importance of creating a shared understanding of the meaning embedded in SHCs between patients, NPMP specialists, and medical doctors.
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Affiliation(s)
- Kirsten Ekerholt
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Astrid Bergland
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
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Moksnes UK, Bjørnsen HN, B Eilertsen ME, Espnes GA. The role of perceived loneliness and sociodemographic factors in association with subjective mental and physical health and well-being in Norwegian adolescents. Scand J Public Health 2021; 50:432-439. [PMID: 33709812 DOI: 10.1177/1403494821997219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AIMS Adolescence is a particularly salient period for understanding the role of perceived loneliness for subjective health and well-being. This study investigated sociodemographic differences (sex, age, self-reported socio-economic status (SES)) in loneliness and associations between sociodemographic factors, loneliness and self-rated health (SRH), subjective health symptoms, symptoms of depression/anxiety and mental well-being (MWB) in a sample of Norwegian adolescents. METHODS The study was based on a cross-sectional sample of 1816 adolescents aged 15-21 years. The participants reported scores on an 11-item scale assessing subjective health complaints (SHC), one item each assessing SRH and loneliness, the 10-item version of the Hopkins Symptom Checklist and the seven-item version of the Warwick-Edinburgh Mental Well-Being Scale. SES was assessed using perceived family economy and parents' education. Data were analysed with descriptive, comparative and multiple linear regression analyses. RESULTS The multivariate results showed that boys scored significantly higher on MWB than girls did, whereas girls scored significantly higher on loneliness, depression/anxiety and SHC. Perceptions of poorer family finances were significantly associated with higher levels of SHC and depression/anxiety, lower levels of MWB and more negative SRH. Loneliness showed significant positive associations with depression/anxiety and SHC, and significant negative associations with MWB and SRH. A significant moderation effect of sex by loneliness was found in association with depression/anxiety, with stronger associations for girls. CONCLUSIONS The findings in this study support the significant roles of sex, perceptions of family finances and loneliness in association with adolescent's subjective mental and physical health and well-being, especially mental health.
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Affiliation(s)
- Unni K Moksnes
- Norwegian University of Science and Technology, Trondheim, Norway Department of Public Health and Nursing/NTNU Centre for Health Promotion Research, Norway
| | - Hanne N Bjørnsen
- Norwegian University of Science and Technology, Trondheim, Norway Department of Public Health and Nursing/NTNU Centre for Health Promotion Research, Norway
| | - Mary-Elizabeth B Eilertsen
- Norwegian University of Science and Technology, Trondheim, Norway Department of Public Health and Nursing/NTNU Centre for Health Promotion Research, Norway
| | - Geir Arild Espnes
- Norwegian University of Science and Technology, Trondheim, Norway Department of Public Health and Nursing/NTNU Centre for Health Promotion Research, Norway
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Dauphinot V, Bouteloup V, Mangin J, Vellas B, Pasquier F, Blanc F, Hanon O, Gabelle A, Annweiler C, David R, Planche V, Godefroy O, Rivasseau‐Jonveaux T, Chupin M, Fischer C, Chêne G, Dufouil C, Krolak‐Salmon P. Subjective cognitive and non-cognitive complaints and brain MRI biomarkers in the MEMENTO cohort. Alzheimers Dement (Amst) 2020; 12:e12051. [PMID: 32647745 PMCID: PMC7335902 DOI: 10.1002/dad2.12051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/23/2020] [Accepted: 05/26/2020] [Indexed: 12/05/2022]
Abstract
INTRODUCTION Subjective cognitive complaints may be a signature of preclinical stage Alzheimer's disease. However, the link between subjective cognitive and non-cognitive complaints and brain alterations remains unclear. METHODS The relationship between cognitive and non-cognitive complaints and brain biomarkers, measured by structural magnetic resonance imaging, was investigated in 2056 participants of the MEMENTO cohort of outpatients, who were dementia-free at baseline. We assessed whether the cognitive status at inclusion or the presence of the apolipoprotein E gene variant (APOE) ε4 could modulate the association between the intensity of complaints and brain lesions. RESULTS Smaller hippocampal volume was associated with higher memory complaints and discomfort in daily life. In APOE ε4 carriers, smaller whole-brain white matter and gray matter volumes and gyrification indices in several regions of interest of the parietal and temporal lobes, in the entorhinal and the para-hippocampal gyrus, were associated with higher memory complaint score. CONCLUSIONS The intensity of subjective complaints in not only memory but discomfort in daily life was associated with brain degeneration markers. The presence of APOE ε4 modulated the relationships between subjective memory complaints and brain alterations.
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Affiliation(s)
- Virginie Dauphinot
- Clinical and Research Memory Centre of LyonLyon Institute for ElderlyCharpennes HospitalUniversity Hospital of LyonLyonFrance
| | - Vincent Bouteloup
- InsermBordeaux Population Health Research CenterUMR 1219Bordeaux UniversityISPEDBordeaux UniversityBordeauxFrance
- University hospital of BordeauxPublic Health CenterBordeauxFrance
| | - Jean‐François Mangin
- CATI Multicenter Neuroimaging Platform (http://cati‐neuroimaging.com)Gif‐sur‐YvetteParisFrance
- NeurospinCEAParis‐Saclay UniversityGif‐sur‐YvetteFrance
| | - Bruno Vellas
- GérontopôleUniversity hospital of Toulouse (CHU Toulouse)ToulouseFrance
- Inserm UMR1027University of Toulouse III Paul SabatierToulouseFrance
| | - Florence Pasquier
- Univ LilleInserm 1171, CHUClinical and Research Memory Research Centre (CMRR) of DistalzLilleFrance
| | - Frédéric Blanc
- Clinical and Memory Research Centre of Strasbourg (CMRR)University hostpital of StrasbourgGeriatrics unitGeriatric Day HospitalStrasbourgFrance
| | - Olivier Hanon
- Geriatry unitParis Descartes UniversityBroca hospitalParisFrance
| | - Audrey Gabelle
- Clinical and Research Memory center of MontpellierDepartment of NeurologyGui de Chauliac HospitalUniversity of MontpellierMontpellierFrance
| | - Cédric Annweiler
- Department of Geriatric MedicineAngers University HospitalAngers University Memory Clinic; Research Center on Autonomy and Longevity; UPRES EA 4638University of AngersAngersFrance
- Robarts Research InstituteDepartment of Medical BiophysicsSchulich School of Medicine and Dentistrythe University of Western OntarioLondonOntarioCanada
| | - Renaud David
- Clinical and Research Memory Centre of Nice University hospital of NiceEA COBTeKCôte d'Azur UniversityNiceFrance
| | - Vincent Planche
- Clinical and Research Memory Centre of BordeauxClinical neurosciences centreUniversity hospital of BordeauxF‐33000 BordeauxFrance et 2. Univ. BordeauxCNRSgérontopole Institute of Neurodegenerative DiseasesBordeauxFrance
| | - Olivier Godefroy
- Departments of NeurologyAmiens University Hospital (CHU Amiens)and Laboratory of Functional Neurosciences (EA 4559)Jules Verne University of PicardieAmiensFrance
- Institute of the Brain and Spinal CordInsermU1127,3 CNRS, UMR 7225Sorbonne UniversityParisFrance
| | - Thérèse Rivasseau‐Jonveaux
- Clinical and Research Memory Centre of LorraineHospital of BraboisCognitive‐behavioral unitPaul Spillmann CentreCHRU de NancyFrance
- Communications Research GroupInterpsy EA4432 PsychologyUniversity of LorraineNancyFrance
| | - Marie Chupin
- CATI Multicenter Neuroimaging Platform (http://cati‐neuroimaging.com)Gif‐sur‐YvetteParisFrance
- NeurospinCEAParis‐Saclay UniversityGif‐sur‐YvetteFrance
| | - Clara Fischer
- CATI Multicenter Neuroimaging Platform (http://cati‐neuroimaging.com)Gif‐sur‐YvetteParisFrance
- NeurospinCEAParis‐Saclay UniversityGif‐sur‐YvetteFrance
| | - Geneviève Chêne
- InsermBordeaux Population Health Research CenterUMR 1219Bordeaux UniversityISPEDBordeaux UniversityBordeauxFrance
- University hospital of BordeauxPublic Health CenterBordeauxFrance
| | - Carole Dufouil
- InsermBordeaux Population Health Research CenterUMR 1219Bordeaux UniversityISPEDBordeaux UniversityBordeauxFrance
- University hospital of BordeauxPublic Health CenterBordeauxFrance
| | - Pierre Krolak‐Salmon
- Clinical and Research Memory Centre of LyonLyon Institute for ElderlyCharpennes HospitalUniversity Hospital of LyonLyonFrance
- Clinical and Research Memory Centre of LorraineHospital of BraboisCognitive‐behavioral unitPaul Spillmann CentreCHRU de NancyFrance
- Communications Research GroupInterpsy EA4432 PsychologyUniversity of LorraineNancyFrance
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Moksnes UK, Espnes GA. Sense of Coherence in Association with Stress Experience and Health in Adolescents. Int J Environ Res Public Health 2020; 17:E3003. [PMID: 32357461 DOI: 10.3390/ijerph17093003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 01/23/2023]
Abstract
This study investigated the associations between sex, age, socio-economic status, stress, sense of coherence (SOC), and health (mental wellbeing, depressive symptoms, self-rated health, and subjective health complaints) in Norwegian adolescents aged 13–19 years. Furthermore, the study investigated the potential protective or compensatory role from SOC on the association between stress and health. Methods: The study was based on a cross-sectional sample of 1233 adolescents. Data were analyzed with descriptive, comparative, and multiple linear regression analyses. Results: Girls reported significantly higher scores on depressive symptoms and subjective health complaints than boys. Stress was significantly and positively associated with depressive symptoms. SOC associated significantly with all outcome variables; and especially with mental wellbeing and depressive symptoms. Significant interaction effects of sex in combination with stress and SOC were found in association with depression and mental wellbeing. Associations were strongest for girls. Conclusion: The findings provided support for the significant role of SOC as a coping resource, especially in relation to adolescents’ mental health; weaker associations were found with subjective health complains and self-rated health. The findings also mainly supported a compensatory role of SOC on the association between stress and health during adolescence.
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Abstract
Background: Divorce experience (DE) may cause health and self-conceptual problems, but these consequences might also be caused by conflicts and lack of conversational confidence (CC) with one or both parents. We investigated how DE impacted CC and how DE and CC impacted health complaints and self-esteem in a two-year longitudinal cohort study. Methods: The study was performed between 2011 and 2013 among 1225 students in junior high school (aged 11 and 13 years in 2011). We used binary logistic analyses to account for how DE impacted CC, and linear regression analyses to examine how DE and CC impacted on subjective health and self-esteem in 2013. Results: The study revealed that former and recent DEs impacted CC with fathers only. The impact was most evident for the more severe forms of conversational difficulties. DE in itself predicted only self-esteem, and CC with parents mediated this association. CC with both mothers and fathers had strong temporal causal associations with the outcomes two years later. Only CC with fathers impacted changes of the health complaints and self-esteem in full-model residual change analyses. Conclusions: The study proves a sex-specific effect on loss of CC between fathers and children after divorce. The impairment of CC has predictive repercussions on the health and self-conception of adolescents in their middle teenage years. From a public-health perspective, preserving the relation and the confidence between children and their fathers after divorce seems an important task.
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Affiliation(s)
- Eivind Meland
- Department of Global Public Health and Primary Care, Research Group for General Practice, Universitetet i Bergen Det medisinsk-odontologiske fakultet, Norway
| | | | - Frode Thuen
- Center for Evidence-Based Practice, Western Norway University of Science, Norway
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Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is a rare genetic disorder with usually benign nerve tumours, skin problems, pain and cardiovascular problems among common complications. AIMS To examine work participation and experiences in relation to health complaints among adults with NF1. METHODS We conducted a cross-sectional self-reported survey among 142 persons with NF1 (mean age = 50.3 years, SD = 12.0; 62% females). We measured physical and social dimensions of work experiences with eight items from the third wave of the epidemiological survey 'Nord-Trøndelag Health Study' (HUNT3). We compared NF1 data to 27 036 HUNT3 controls. We measured health complaints with the 29-item Subjective Health Complaints Inventory (SHC; subscales musculoskeletal pain, pseudoneurology and gastrointestinal problems) and compared NF1 data to norms. RESULTS Compared to controls, significantly more persons with NF1 reported workplace bullying (13% versus 5%) and work as physically exhausting (74% versus 44%), whereas fewer reported work autonomy (64% versus 80%). Women with NF1 reported significantly more SHC than female norms (99% versus 86%). Men with NF1 reported significantly more pseudoneurology and gastrointestinal problems compared to male norms (76% versus 58%). SHC explained 9% of the variance in physical work experiences (β = -0.47; 95% CI -0.76 to -0.19) and 8% of the variance in social work experiences (β = 0.48; 95% CI 0.18-0.78). CONCLUSION Persons with NF1 experience more physical and social work problems, and both work domains were related to health complaints. Individualized assessment and information to co-workers and managers may represent ways to increase work participation among persons with NF1.
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Affiliation(s)
- Krister W Fjermestad
- Department of Psychology, University of Oslo, Oslo, Norway.,Frambu Resource Centre for Rare Disorders, Siggerud, Norway
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Studer RK, Nielsen C, Klumb PL, Hildebrandt H, Nater UM, Wild P, Heinzer R, Haba-Rubio J, Danuser B, Gomez P. The mediating role of mood in the relationship between perseverative cognition, sleep and subjective health complaints in music students. Psychol Health 2019; 34:754-770. [PMID: 30755031 DOI: 10.1080/08870446.2019.1574014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Subjective health complaints (SHC) are frequent in musicians. These complaints may be particularly distressing in this population because they are performance relevant. This paper aims at testing a model positing that (a) perseverative cognition (PC) predicts sleep duration/quality, (b) sleep duration/quality predicts SHC and (c) mood is a mediator of these associations. DESIGN Participants were 72 music students (mean age (SD): 22.7 (3.0) years), and the assessment period consisted of seven consecutive days, with a solo performance on the fifth day. MAIN OUTCOME MEASURES Self-reported total sleep time (TST) and sleep quality were assessed 30 min after wake-up, and objective TST/sleep quality were assessed with an actigraphy watch. PC and mood were measured five times a day. Daily SHC were assessed at 9 p.m. RESULTS PC did not significantly predict sleep duration/quality. Self-reported and objective TST and sleep quality were all significantly associated with SHC. Mood played a mediating role in each of these relationships with the exception of objective sleep quality. CONCLUSION The tested model on the association among PC, sleep and SHC and the mediating role of mood received partial support, highlighting the importance of sleep and mood in the emergence of SHC among university music students.
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Affiliation(s)
- Regina K Studer
- a Institut universitaire romand de Santé au Travail (Institute for Work and Health) , University of Lausanne and University of Geneva , Epalinges - Lausanne , Switzerland
| | - Carole Nielsen
- a Institut universitaire romand de Santé au Travail (Institute for Work and Health) , University of Lausanne and University of Geneva , Epalinges - Lausanne , Switzerland
| | - Petra L Klumb
- b Department of Psychology , University of Fribourg , Switzerland
| | - Horst Hildebrandt
- c Swiss University Centre for Music Physiology, Zurich University of the Arts , Zurich , Switzerland
| | - Urs M Nater
- d Clinical Psychology, Department of Psychology , University of Vienna , Austria
| | - Pascal Wild
- a Institut universitaire romand de Santé au Travail (Institute for Work and Health) , University of Lausanne and University of Geneva , Epalinges - Lausanne , Switzerland.,e Scientific Management, Institut national de recherche et de sécurité (INRS) , Nancy , France
| | - Raphaël Heinzer
- f Centre d'Investigation et de Recherche sur le Sommeil (CIRS) , Centre hospitalier universitaire vaudois (CHUV) , Lausanne , Switzerland
| | - José Haba-Rubio
- f Centre d'Investigation et de Recherche sur le Sommeil (CIRS) , Centre hospitalier universitaire vaudois (CHUV) , Lausanne , Switzerland
| | - Brigitta Danuser
- a Institut universitaire romand de Santé au Travail (Institute for Work and Health) , University of Lausanne and University of Geneva , Epalinges - Lausanne , Switzerland
| | - Patrick Gomez
- a Institut universitaire romand de Santé au Travail (Institute for Work and Health) , University of Lausanne and University of Geneva , Epalinges - Lausanne , Switzerland
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Abstract
OBJECTIVE Worry is an important perpetuating factor of Medically Unexplained Symptoms (MUS). Former research has shown that a worry postponement instruction is effective in reducing Subjective Health Complaints (SHC) in non-clinical samples. This study aimed to (1) replicate these findings in a MUS-analogue student-sample and (2) assess alexithymia as a moderator. DESIGN The current study had an experimental design with two waves of data collection: pre- and post-intervention. MAIN OUTCOME MEASURES A MUS-analogue student-sample consisting of 114 undergraduate students with high self-reported health worry and a minimum of two doctor visits in the previous year with no current diagnosis for a (chronic or acute) disease were instructed to register their worry frequency and duration eight times per day via an experience sampling-application on their smartphones. The intervention group additionally postponed their worries to a 30-minute period in the evening. SHC were assessed pre- and post-intervention. RESULTS The intervention did not have an effect on worry or SHC. Alexithymia did not moderate this effect (p's > .05). CONCLUSION Our study did not find evidence for the effectiveness of the worry reduction intervention on SHC in a MUS-analogue student-sample. This finding contributes to several previous studies that have found mixed evidence for the effectiveness of the worry reduction intervention on SHC and suggests that the worry intervention may not be effective in all cases.
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Affiliation(s)
- Lynn Mobach
- a Behavioural Science Institute, Radboud University , Nijmegen , The Netherlands
| | - Hein T van Schie
- a Behavioural Science Institute, Radboud University , Nijmegen , The Netherlands
| | - Gérard W B Näring
- a Behavioural Science Institute, Radboud University , Nijmegen , The Netherlands
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Selinheimo S, Vasankari T, Jokela M, Kanervisto M, Pirkola S, Suvisaari J, Paunio T. The association of psychological factors and healthcare use with the discrepancy between subjective and objective respiratory-health complaints in the general population. Psychol Med 2019; 49:121-131. [PMID: 29554990 DOI: 10.1017/s0033291718000582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND We examined the prevalence of self-perceived respiratory symptoms (SRS) in the absence of any objective findings of respiratory pathology, and the association of such prevalence with psychological factors and healthcare use in the general population. METHODS The study was conducted among a nationally representative sample of Finnish adults (BRIF8901). Respiratory functioning was measured by a spirometry test. Structured questionnaires were used to measure SRS, physician visits and psychological factors of alexithymia, sense of coherence, illness worry and common mental disorders. Individuals with a diagnosed respiratory disease or a severe psychiatric disorder, determined in a diagnostic interview, were excluded, giving a sample comprising 4544 participants. RESULTS Twenty-six per cent of the general population and 36% of those with no diagnosed severe psychiatric disorder or respiratory disease experienced SRS despite a normal spirometry result. Psychological factors were associated with SRS (0.0001 < p < 0.032), and on the number of physician visit explaining 42.7% of the difference in visits between individuals with and without SRS, respectively. Illness worry was associated most strongly with SRS [odds ratio (OR) 1.29, 95% confidence interval (CI) 1.19-1.41, p < 0.0001] and higher numbers of physician visits (OR 1.35, CI 1.32-1.38, p < 0.00001), even after several adjustments. CONCLUSIONS Respiratory symptoms without objective findings are common in the general population. The study results underline the role of psychological factors in the reporting of respiratory symptoms and the associated medical burden, thereby indicating the functional nature of the symptomatology.
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Affiliation(s)
| | | | - Markus Jokela
- Department of Psychology and Logopedics,Faculty of Medicine,University of Helsinki,Helsinki,Finland
| | | | - Sami Pirkola
- Health Sciences, andUniversity Hospital Psychiatric Department,University of Tampere,Tampere,Finland
| | - Jaana Suvisaari
- Department of Health,National Institute for Health and Welfare,Helsinki,Finland
| | - Tiina Paunio
- Finnish Institute of Occupational Health,Helsinki,Finland
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Abstract
AIM The first aim of this study was to explore the prevalence of loneliness and subjective health complaints (SHCs) among school-aged children in Finland. The second aim was to analyse to what extent perceived loneliness explains any variance in SHCs among school-aged children. METHOD A representative sample of 5925 Finnish children and adolescents from grades 5 ( Mage=11.8 years), 7 ( Mage=13.8) and 9 ( Mage=15.8) completed the Health Behaviour in School-aged Children (HBSC) survey. Descriptive statistics were used to examine the prevalence of health complaints and loneliness. Structural equation modelling was used to test how strongly loneliness was associated with SHCs. RESULTS The prevalence of loneliness and SHCs was higher among girls and increased with age. Loneliness was a significant predictor of health complaints, especially of psychological symptoms among girls and among ninth grade students. CONCLUSIONS The findings indicate that loneliness is a major risk to the health and well-being of school-aged children. The strong association between loneliness and SHCs highlights the importance of active preventive actions to reduce loneliness.
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Affiliation(s)
- Nelli Lyyra
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Raili Välimaa
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Jorma Tynjälä
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
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Eliasen M, Jørgensen T, Schröder A, Dantoft TM, Fink P, Poulsen CH, Johansen NB, Eplov LF, Skovbjerg S, Kreiner S. Somatic symptom profiles in the general population: a latent class analysis in a Danish population-based health survey. Clin Epidemiol 2017; 9:421-433. [PMID: 28883742 PMCID: PMC5574686 DOI: 10.2147/clep.s137167] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Purpose The aim of this study was to identify and describe somatic symptom profiles in the general adult population in order to enable further epidemiological research within multiple somatic symptoms. Methods Information on 19 self-reported common somatic symptoms was achieved from a population-based questionnaire survey of 36,163 randomly selected adults in the Capital Region of Denmark (55.4% women). The participants stated whether they had been considerably bothered by each symptom within 14 days prior to answering the questionnaire. We used latent class analysis to identify the somatic symptom profiles. The profiles were further described by their association with age, sex, chronic disease, and self-perceived health. Results We identified 10 different somatic symptom profiles defined by number, type, and site of the symptoms. The majority of the population (74.0%) had a profile characterized by no considerable bothering symptoms, while a minor group of 3.9% had profiles defined by a high risk of multiple somatic symptoms. The remaining profiles were more likely to be characterized by a few specific symptoms. The profiles could further be described by their associations with age, sex, chronic disease, and self-perceived health. Conclusion The identified somatic symptom profiles could be distinguished by number, type, and site of the symptoms. The profiles have the potential to be used in further epidemiological studies on risk factors and prognosis of somatic symptoms but should be confirmed in other population-based studies with specific focus on symptom burden.
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Affiliation(s)
- Marie Eliasen
- Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup
| | - Torben Jørgensen
- Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup.,Department of Public Health, University of Copenhagen, Copenhagen.,Department of Clinical Medicine, Aalborg University, Aalborg
| | - Andreas Schröder
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus C
| | - Thomas Meinertz Dantoft
- Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup
| | - Per Fink
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus C
| | - Chalotte Heinsvig Poulsen
- Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup.,Mental Health Centre Copenhagen, The Capital Region of Denmark, Hellerup, Denmark
| | - Nanna Borup Johansen
- Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup
| | - Lene Falgaard Eplov
- Mental Health Centre Copenhagen, The Capital Region of Denmark, Hellerup, Denmark
| | - Sine Skovbjerg
- Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup
| | - Svend Kreiner
- Department of Public Health, University of Copenhagen, Copenhagen
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Johnsen TL, Eriksen HR, Indahl A, Tveito TH. Directive and nondirective social support in the workplace - is this social support distinction important for subjective health complaints, job satisfaction, and perception of job demands and job control? Scand J Public Health 2017; 46:358-367. [PMID: 28820017 PMCID: PMC5946658 DOI: 10.1177/1403494817726617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS Social support is associated with well-being and positive health outcomes. However, positive outcomes of social support might be more dependent on the way support is provided than the amount of support received. A distinction can be made between directive social support, where the provider resumes responsibility, and nondirective social support, where the receiver has the control. This study examined the relationship between directive and nondirective social support, and subjective health complaints, job satisfaction and perception of job demands and job control. METHODS A survey was conducted among 957 Norwegian employees, working in 114 private kindergartens (mean age 40.7 years, SD = 10.5, 92.8% female), as part of a randomized controlled trial. This study used only baseline data. A factor analysis of the Norwegian version of the Social Support Inventory was conducted, identifying two factors: nondirective and directive social support. Hierarchical regression analyses were then performed. RESULTS Nondirective social support was related to fewer musculoskeletal and pseudoneurological complaints, higher job satisfaction, and the perception of lower job demands and higher job control. Directive social support had the opposite relationship, but was not statistically significant for pseudoneurological complaints. CONCLUSIONS It appears that for social support to be positively related with job characteristics and subjective health complaints, it has to be nondirective. Directive social support was not only without any association, but had a significant negative relationship with several of the variables. Nondirective social support may be an important factor to consider when aiming to improve the psychosocial work environment. TRIAL REGISTRATION Clinicaltrials.gov: NCT02396797. Registered 23 March 2015.
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Affiliation(s)
- Tone Langjordet Johnsen
- 1 Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Norway.,2 Department of Health, Social and Welfare Studies, University College of Southeast Norway, Norway
| | - Hege Randi Eriksen
- 3 Uni Research Health, Bergen, Norway.,4 Department of Sport and Physical Activity, Western Norway University of Applied Sciences, Norway
| | - Aage Indahl
- 1 Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Norway
| | - Torill Helene Tveito
- 2 Department of Health, Social and Welfare Studies, University College of Southeast Norway, Norway.,3 Uni Research Health, Bergen, Norway
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Merkus SL, Hoedeman R, Mæland S, Weerdesteijn KHN, Schaafsma FG, Jourdain M, Canevet JP, Rat C, Anema JR, Werner EL. Are there patient-related factors that influence sickness certification in patients with severe subjective health complaints? A cross-sectional exploratory study from different European countries. BMJ Open 2017; 7:e015025. [PMID: 28733298 PMCID: PMC5642667 DOI: 10.1136/bmjopen-2016-015025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To develop hypotheses about whether there are patient-related factors that influence physicians' decision-making that can explain why some patients with severe subjective health complaints (SHCs) are more likely to be granted sick leave than others. DESIGN Exploratory cross-sectional. SETTING Assessments of patient-related factors after watching nine authentic video recordings of patients with severe SHC from a Norwegian general practice. Our previous study showed that three of these nine patients were less likely than the remaining six patients to be granted sick leave by physicians from five European countries. PARTICIPANTS In total, 10 assessors from Norway, the Netherlands and France. OUTCOMES The direction in which the assessments may contribute towards the decision to grant a sickness certificate (increasing or decreasing the likelihood of granting sick leave). RESULTS Physicians consider a wide variety of patient-related factors when assessing sickness certification. The overall assessment of these factors may provide an indication of whether a patient is more likely or less likely to be granted sick leave. Additionally, some single questions (notable functional limitations in the consultation, visible suffering, a clear purpose for sick leave and psychiatric comorbidity) may indicate differences between the two patient groups. CONCLUSIONS Next to the overall assessment, no notable effect of the complaints on functioning and suffering, a lack of a clear purpose for sick leave and the absence of psychiatric comorbidity may be factors that could help guide the decision to grant sick leave. These hypotheses should be tested and validated in representative samples of professionals involved in sickness certification. This may help to understand the tacit knowledge we believe physicians have when assessing work capacity of patients with severe SHC.
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Affiliation(s)
- Suzanne L Merkus
- Research Unit for General Practice, Uni Research Health, Bergen, Norway
- Department of Public and Occupational Health, VU University Medical Centre, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
| | - Rob Hoedeman
- Department of Science, ArboNed Occupational Health Services, Utrecht, The Netherlands
| | - Silje Mæland
- Research Unit for General Practice, Uni Research Health, Bergen, Norway
- Department of Occupational Therapy, Physiotherapy and Radiography, Bergen University College, Bergen, Norway
| | - Kristel H N Weerdesteijn
- Department of Public and Occupational Health, VU University Medical Centre, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Frederieke G Schaafsma
- Department of Public and Occupational Health, VU University Medical Centre, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Maud Jourdain
- Department of General Practice, Faculty of Medicine, University of Nantes, Nantes, France
| | - Jean-Paul Canevet
- Department of General Practice, Faculty of Medicine, University of Nantes, Nantes, France
| | - Cédric Rat
- Department of General Practice, Faculty of Medicine, University of Nantes, Nantes, France
| | - Johannes R Anema
- Department of Public and Occupational Health, VU University Medical Centre, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Erik L Werner
- Research Unit for General Practice, Uni Research Health, Bergen, Norway
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
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Låftman SB, Magnusson C. Do health complaints in adolescence negatively predict the chance of entering tertiary education in young adulthood? Scand J Public Health 2017; 45:878-885. [PMID: 28699425 DOI: 10.1177/1403494817713649] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Self-reported psychological and psychosomatic health complaints, such as nervousness, sadness, headache and stomach-ache, are common among adolescents, particularly among girls, and studies suggest that the prevalence has risen among adolescent girls during the last few decades. However, only a limited number of studies have investigated the potential long-term consequences of such health complaints. The aim of the current study was to assess whether psychological and psychosomatic health complaints in adolescence predict the chance of entering tertiary education in young adulthood among women and men. METHODS The data used are from the Swedish Young-LNU, which is based on a nationally representative sample with self-reported survey information from adolescents aged 10-18 years in 2000 and from the same individuals at ages 20-28 in 2010 ( n=783). Information was also collected from parents and from official registers. RESULTS Linear probability models showed that self-reported psychological complaints in adolescence were associated with a lower chance of having entered tertiary education 10 years later. This association was accounted for by differences in grade point average (GPA), suggesting that GPA may mediate the association between psychological complaints and later education. The pattern was similar for both genders. Furthermore, among men, psychosomatic complaints in adolescence were significantly associated with a lower likelihood of having entered tertiary education 10 years later when adjusting for GPA and social class in adolescence. A similar but non-significant tendency was found among women. CONCLUSIONS The findings suggest that health complaints in adolescence may have long-term consequences in terms of lower educational attainment.
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Affiliation(s)
- Sara B Låftman
- 1 Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Charlotta Magnusson
- 2 Swedish Institute for Social Research (SOFI), Stockholm University, Stockholm, Sweden
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TJALVIN G, MAGERØY N, BRÅTVEIT M, LYGRE SHL, HOLLUND BE, MOEN BE. Odour as a determinant of persistent symptoms after a chemical explosion, a longitudinal study. Ind Health 2017; 55:127-137. [PMID: 27916759 PMCID: PMC5383410 DOI: 10.2486/indhealth.2016-0155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/28/2016] [Indexed: 06/06/2023]
Abstract
Foul-smelling environmental pollution was a major concern following a chemical workplace explosion. Malodorous pollution has previously been associated with aggravated physical and psychological health, and in persons affected by a trauma, an incidence-related odour can act as a traumatic reminder. Olfaction may even be of significance in the development and persistence of post-traumatic stress symptoms (PTSS). The present longitudinal study assessed whether perceived smell related to malodorous environmental pollution in the aftermath of the explosion was a determinant of subjective health complaints (SHC) and PTSS among gainfully employed adults, when the malodorous pollution was present, and after pollution clean-up. Questionnaire data from validated instruments were analysed using mixed effects models. Individual odour scores were computed, and the participants (n=486) were divided into high and low odour score groups, respectively. Participants in the high odour score group (n=233) reported more SHC and PTSS than those in the low odour score group (n=253), before and even after the pollution was eliminated. These associations lasted for at least three years after the pollution was removed, and might indicate that prompt clean-up is important to avoid persistent health effects after malodorous chemical spills.
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Affiliation(s)
- Gro TJALVIN
- Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Norway
| | - Nils MAGERØY
- Department of Occupational Medicine, Haukeland University Hospital, Norway
| | - Magne BRÅTVEIT
- Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Norway
| | | | - Bjørg Eli HOLLUND
- Department of Occupational Medicine, Haukeland University Hospital, Norway
| | - Bente Elisabeth MOEN
- Centre for International Health, Faculty of Medicine and Dentistry, University of Bergen, Norway
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Aanesen F, Meland E, Torp S. Gender differences in subjective health complaints in adolescence: The roles of self-esteem, stress from schoolwork and body dissatisfaction. Scand J Public Health 2017; 45:389-396. [PMID: 28385116 DOI: 10.1177/1403494817690940] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS The aims of this study were to examine subjective health complaints among Norwegian adolescents and assess the development of gender differences in subjective health complaints between age 14 and 16; to investigate whether self-esteem, stress from schoolwork or body dissatisfaction affected adolescents' subjective health complaints; and determine whether these factors could explain the excess of subjective health complaints among girls. METHODS We used multiple linear regression analyses to analyse longitudinal survey data from 751 Norwegian adolescents at the ages of 14 and 16. The results from various cross-sectional and prospective analyses were compared. RESULTS Girls reported more subjective health complaints than boys, and gender differences increased from age 14 to 16. Self-esteem and stress from schoolwork had cross-sectional and prospective associations with subjective health complaints. Stress from schoolwork at age 14 was also associated with changes in subjective health complaints from age 14 to 16. The cross-sectional mediation analyses indicated that self-esteem and stress from schoolwork accounted for 61% of the excess of subjective health complaints among girls at age 16. The same variables measured at age 14 accounted for 24% of the gender differences in subjective health complaints two years later. The investigated factors could not account for the increase in gender differences in subjective health complaints between ages 14 and 16. CONCLUSIONS The findings showed that self-esteem and stress from schoolwork were associated with subjective health complaints during adolescence. These factors could partially explain the excess of subjective health complaints among girls.
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Affiliation(s)
- Fiona Aanesen
- 1 Department of Health, Social and Welfare Studies, University College of Southeast Norway, Tønsberg, Norway
| | - Eivind Meland
- 2 Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Steffen Torp
- 1 Department of Health, Social and Welfare Studies, University College of Southeast Norway, Tønsberg, Norway
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Eliassen KE, Hjetland R, Reiso H, Lindbæk M, Tschudi-Madsen H. Symptom load and general function among patients with erythema migrans: a prospective study with a 1-year follow-up after antibiotic treatment in Norwegian general practice. Scand J Prim Health Care 2017; 35:75-83. [PMID: 28277054 PMCID: PMC5361422 DOI: 10.1080/02813432.2017.1288812] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Promptly treated erythema migrans (EM) has good prognosis. However, some patients report persistent symptoms. Do patients with EM have more symptoms than the general population? We describe individual symptoms and general function in EM-patients at time of diagnosis and one year after treatment. DESIGN Prospective study with 1-year follow up after treatment. Questionnaires included a modified version of the Subjective Health Complaints Inventory, comprising three additional Lyme borreliosis (LB) related symptoms. General function was assessed using a five-point scale modified from the COOP/WONCA charts. SETTING Norwegian general practice. SUBJECTS A total of 188 patients were included in a randomized controlled trial comparing three antibiotic regimens for EM, of whom 139 had complete data for this study. MAIN OUTCOME MEASURES Individual symptoms, symptom load and general function. RESULTS Mild symptoms were common, reported by 84.9% at baseline and by 85.6% at follow-up. At baseline, patients reported a mean of 5.4 symptoms, compared with 6.2 after one year. Severely bothersome symptoms and severely impaired general function were rare. Tiredness was the most reported symptom both at baseline and at follow-up. Palsy (other than facial) was the least reported symptom, but the only one with a significant increase. However, this was not associated to the EM. CONCLUSION The symptom load was comparable to that reported in the general population. We found an increase in symptom load at follow-up that did not significantly affect general function. IMPLICATION Monitoring patients' symptom loads prior to treatment reduce the probability of attributing follow-up symptoms to LB. Key points Erythema migrans has a good prognosis.Patients treated for erythema migrans have a slight increase in symptom load one year after treatment. This increase does not affect general function. The levels of subjective health complaints in patients treated for erythema migrans are comparable to the background population.
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Affiliation(s)
- Knut Eirik Eliassen
- Department of General Practice, Norwegian Antibiotic Centre for Primary Care, University of Oslo, Oslo, Norway
- CONTACT Knut Eirik Eliassen Department of General Practice, Norwegian Antibiotic Centre for Primary Care, University of Oslo, PO Box 1130 Blindern, N-0318 Oslo, Norway
| | - Reidar Hjetland
- Department of Microbiology, Førde General Hospital, Førde Health Trust, Førde, Norway
| | - Harald Reiso
- Norwegian National Advisory Unit on Tick-borne Diseases, Sørlandet Hospital, Arendal, Norway
| | - Morten Lindbæk
- Department of General Practice, Norwegian Antibiotic Centre for Primary Care, University of Oslo, Oslo, Norway
| | - Hedda Tschudi-Madsen
- Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
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Tabak I, Mazur J. Social support and family communication as factors protecting adolescents against multiple recurrent health complaints related to school stress. Dev Period Med 2016; 20:27-39. [PMID: 27416623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION One reason of increased psychological and somatic health problems in adolescence is intensification of stress in school and everyday life. There is little evidence to what extent the level of school achievements shapes this relationship. AIM The aim of the study was to investigate determinants of subjective health complaints in schoolaged children, taking into account the interaction effects. METHODS Anonymous survey was conducted in Poland in 2013/2014 on the sample of 4,545 students, as a part of the HBSC (Health Behaviour in School-aged Children) study. On the basis of prevalence of eight symptoms in the past 6 months, a standardized index of health complaints (SCL - Subjective Complaints Checklist) was calculated (0-100). To predict its variability three hierarchical linear models (five blocks) were estimated, separately for three levels of school achievements. Support from family, classmates and teachers as well as family communication were considered as protective factors, which can reduce the negative impact of stress. All analyses were adjusted for age, gender and family affluence. RESULTS The standardized SCL index was equal to 23.2 in boys and 32.5 in girls. The high level of school stress was reported by 28.5% boys and 35.6% girls, respectively. Regarding these two measures, similar patterns of change were observed, increase with age and with deterioration of academic achievement. Final multivariate models explained 22-25% variability of SCL, slightly more among worst students. Accumulation of low family support and high level of school stress caused the highest increase in the SCL index in very good students. CONCLUSIONS School performance is an important determinant of subjective health complaints in adolescence, also modifying the impact of other risk and protective factors.
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Affiliation(s)
- Izabela Tabak
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland, e-mail:
| | - Joanna Mazur
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
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Versluis A, Verkuil B, Brosschot JF. Reducing worry and subjective health complaints: A randomized trial of an internet-delivered worry postponement intervention. Br J Health Psychol 2015; 21:318-35. [PMID: 26511764 DOI: 10.1111/bjhp.12170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 10/01/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Several studies have shown that perseverative, worrisome thoughts are prospectively related to subjective health complaints (SHC) and that a short worry postponement intervention can decrease these complaints. As SHC and worry are prevalent and costly, we tested whether the intervention can be offered online to reduce these complaints in the general population. DESIGN A randomized parallel-group trial was conducted with self-selected participants from the general population. METHODS Via the research website, 996 participants were instructed to register their worrying for 6 consecutive days. The intervention group was instructed to postpone worry to a special 30-min period in the early evening. The Subjective Health Complaints inventory, as administered before and after the intervention, and daily worry frequency and duration were considered the primary outcomes. RESULTS Three hundred and sixty-one participants completed the study. Contrary to our expectation, the registration group (n = 188) did not differ from the intervention group (n = 163) in SHC (ηp² = .000, CI [0.000-0.003]), or in worry frequency or duration. Nevertheless, the different worry parameters were moderately related to SHC (r between .238 and .340, p ≤ .001). CONCLUSIONS In contrast to previous studies using pen-and-pencil versions of the worry postponement intervention, this study suggests that a direct online implementation was not effective in reducing SHC and worry. Overall, participants had high trait worry levels and reported difficulty with postponing worrying. Reducing SHC and worries via the Internet might require more elaborate interventions that better incorporate the advantages of delivering interventions online. STATEMENT OF CONTRIBUTION What is already known on this subject? The perseverative cognition hypothesis argues that perseverative cognition, such as worry and rumination, acts as a mediator by which psychosocial stress may produce negative health effects. Prior research has indeed shown that worry and subjective health complaints (SHC) are prospectively related, but causality studies - that is, showing that changes in worry induce changes in health outcomes - are scarce and have mainly been conducted in young samples. These studies showed that reducing worry, using a worry postponement intervention, can reduce daily worrying and SHC. What does this study add? Trait and daily worrying are associated with SHC. An online worry postponement intervention is ineffective in reducing worry and SHC. Paper-and-pencil interventions cannot directly be used as online interventions.
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Affiliation(s)
- Anke Versluis
- Health, Medical and Neuropsychology Unit, Leiden University, The Netherlands
| | - Bart Verkuil
- Clinical Psychology Unit, Leiden University, The Netherlands
| | - Jos F Brosschot
- Health, Medical and Neuropsychology Unit, Leiden University, The Netherlands
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Kökönyei G, Józan A, Morgan A, Szemenyei E, Urbán R, Reinhardt M, Demetrovics Z. Perseverative thoughts and subjective health complaints in adolescence: Mediating effects of perceived stress and negative affects. Psychol Health 2015; 30:969-86. [PMID: 25599581 DOI: 10.1080/08870446.2015.1007982] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Stable tendency to perseverative thoughts such as trait rumination and worry can influence somatic health. The purpose of the study was to investigate the relationship between perseverative thoughts and somatic complaints, and the possible mediating effects of perceived stress, negative and positive affectivity in adolescence. Having an acute or a chronic condition was also assessed to be controlled for and to reveal their effects on symptom reporting. Three hundred and six adolescents from 7th to 12th grade with mean age of 16.33 (SD = 1.29) participated in the study. Mediation analysis suggested that impact of trait-like perseverative thoughts on complaints were mediated by perceived stress and negative affectivity. Having an acute condition had also an effect on symptom reporting through increased negative affectivity. Our results highlight that ruminations or worry as stable intrapersonal characteristics are relevant processes in health and can be potential targets in prevention programmes in adolescence.
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Affiliation(s)
- Gyöngyi Kökönyei
- a Institute of Psychology , Eötvös Loránd University , Budapest , Hungary
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Abstract
The valuation of health-related states, including pain, is a critical issue in clinical practice, health economics, and pain neuroscience. Surprisingly the monetary value people associate with pain is highly context-dependent, with participants willing to pay more to avoid medium-level pain when presented in a context of low-intensity, rather than high-intensity, pain. Here, we ask whether context impacts upon the neural representation of pain itself, or alternatively the transformation of pain into valuation-driven behavior. While undergoing fMRI, human participants declared how much money they would be willing to pay to avoid repeated instances of painful cutaneous electrical stimuli delivered to the foot. We also implemented a contextual manipulation that involved presenting medium-level painful stimuli in blocks with either low- or high-level stimuli. We found no evidence of context-dependent activity within a conventional "pain matrix," where pain-evoked activity reflected absolute stimulus intensity. By contrast, in right lateral orbitofrontal cortex, a strong contextual dependency was evident, and here activity tracked the contextual rank of the pain. The findings are in keeping with an architecture where an absolute pain valuation system and a rank-dependent system interact to influence willing to pay to avoid pain, with context impacting value-based behavior high in a processing hierarchy. This segregated processing hints that distinct neural representations reflect sensory aspects of pain and components that are less directly nociceptive whose integration also guides pain-related actions. A dominance of the latter might account for puzzling phenomena seen in somatization disorders where perceived pain is a dominant driver of behavior.
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Petanidou D, Giannakopoulos G, Tzavara C, Dimitrakaki C, Ravens-Sieberer U, Kolaitis G, Tountas Y. Identifying the sociodemographic determinants of subjective health complaints in a cross-sectional study of Greek adolescents. Ann Gen Psychiatry 2012; 11:17. [PMID: 22748205 DOI: 10.1186/1744-859X-11-17] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 05/10/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Experience of common health symptoms without a clear physical or psychological cause, such as headache or dizziness, is often reported in adolescence. The present study attempted to investigate associations of self-reported subjective health complaints (SHC) with a number of sociodemographic factors of Greek adolescents. METHODS Questionnaires were administered to a Greek nationwide random school-based sample of adolescents aged 12 to 18 years and their parents in 2003. Data from 922 adolescent-parent pairs were analyzed (response rate = 63%). Adolescents' reported subjective health complaints were assessed for their association with a number of sociodemographic factors: age, sex, type of area of residence according to level of urbanization, immigration background, parental education and employment status, family socioeconomic status and perceived quality of financial resources (PQFR). Multiple linear regression analysis was used to assess the association of the aforementioned factors with subjective health complaints as the dependent variable. RESULTS Most sociodemographic variables, apart from area of residence and immigration background, were independently associated with subjective health complaints in the univariate analyses. The multiple linear regression analysis, however, limited the factors that could predict adolescents' subjective health complaints to four (age, sex, Family Affluence Scale score and perceived quality of financial resources). Some considerations regarding parental employment status and immigration background are highlighted. CONCLUSIONS Our study highlights the sociodemographic components of subjective health complaints in the Greek adolescent population. The need to include adolescent-specific measures when collecting information on adolescents' social background is underlined. Identifying vulnerable adolescent populations could lead to effective health promoting and preventive interventions.
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Nilsen S, Werner EL, Maeland S, Eriksen HR, Magnussen LH. Considerations made by the general practitioner when dealing with sick-listing of patients suffering from subjective and composite health complaints. Scand J Prim Health Care 2011; 29:7-12. [PMID: 20822375 PMCID: PMC3347936 DOI: 10.3109/02813432.2010.514191] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To explore GPs' considerations in decision-making regarding sick-listing of patients suffering from SHC. DESIGN Qualitative analysis of data from nine focus-group interviews. SETTING Three cities in different regions of Norway. Participants. A total of 48 GPs (31 men, 17 women; aged 32-65) participated. The GPs were recruited when invited to a course dealing with diagnostic practice and assessment of sickness certificates related to patients with composite SHCs. RESULTS Decisions on sick-listing patients with SHCs were regarded as a very challenging task. Trust in the patient's own story and self-judgement was deemed crucial, but many GPs missed hard evidence of illness and loss of function. Several factors that might influence decision-making were identified: the patients' ability to present their story to evoke sympathy, the GP's prior knowledge of the patient, and the GPs' own experience as a patient and their tendency to avoid conflicts. The approach to the task of sick-listing differed from patient-led cooperation to resistant confrontation. CONCLUSION AND IMPLICATIONS Issuing sickness certification in patients with composite health complaints is considered challenging and burdensome. It is seen as mainly patient-driven, and the decisions vary according to GPs' attitudes, beliefs, and personalities. Guiding the GPs to a more focused awareness of the decision process should be considered.
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Affiliation(s)
| | - Erik Lønnmark Werner
- Uni Health, Bergen, Norway
- Research Unit for General Practice, Uni Research, Bergen, Norway
| | | | - Hege Randi Eriksen
- Uni Health, Bergen, Norway
- Hemil, Research Centre for Health Promotion, University of Bergen, Bergen, Norway
| | - Liv Heide Magnussen
- Uni Health, Bergen, Norway
- Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
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Gregersen K, Lind RA, Valeur J, Bjørkkjær T, Berstad A, Lied GA. Duodenal administered seal oil for patients with subjective food hypersensitivity: an explorative open pilot study. Int J Gen Med 2010; 3:383-92. [PMID: 21189836 PMCID: PMC3008292 DOI: 10.2147/ijgm.s13013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Indexed: 11/23/2022] Open
Abstract
Short-term duodenal administration of n-3 polyunsaturated fatty acid (PUFA)-rich seal oil may improve gastrointestinal complaints in patients with subjective food hypersensitivity, as well as joint pain in patients with inflammatory bowel disease (IBD). The aim of the present explorative pilot study was to investigate whether 10-day open treatment with seal oil, 10 mL self-administrated via a nasoduodenal tube 3 times daily, could also benefit nongastrointestinal complaints and quality of life (QoL) in patients with subjective food hypersensitivity. Twenty-six patients with subjective food hypersensitivity, of whom 25 had irritable bowel syndrome (IBS), were included in the present study. Before and after treatment and 1 month posttreatment, patients filled in the Ulcer Esophagitis Subjective Symptoms Scale (UESS) and the Gastrointestinal Symptom Rating Scale (GSRS) for gastrointestinal symptoms and subjective health complaints (SHC) inventory for nongastrointestinal symptoms in addition to short form of the Nepean dyspepsia index (SF-NDI) for evaluation of QoL. Compared with baseline, gastrointestinal, as well as nongastrointestinal, complaints and QoL improved significantly, both at end of treatment and 1 month posttreatment. The consistent improvements following seal oil administration warrant further placebo-controlled trials for confirmation of effect.
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Affiliation(s)
- Kine Gregersen
- Institute of Medicine, University of Bergen, Bergen, Norway
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