O envelhecimento populacional e as alterações socioestruturais recentes no contexto brasileiro tem aumentado a probabilidade de que os cuidados prestados a idosos doentes ou dependentes sejam assumidos por indivíduos também idosos. As particularidades da sobrecarga experimentada por idosos são pouco descritas pela literatura de pesquisa gerontológica, carecendo, ainda, de modelos explicativos. O presente estudo buscou testar um modelo teórico-empírico de associações explicativas de sobrecarga subjetiva de idosos cuidadores considerando sexo, idade, intensidade da ajuda prestada, comprometimento cognitivo do idoso receptor do cuidado e autoavaliação de saúde. Trata-se de um estudo de corte transversal desenvolvido a partir dos dados de um estudo maior do Programa de Pós-Graduação em Gerontologia da Faculdade de Ciências Médicas da Unicamp Bem-estar psicológico de idosos que cuidam de outros idosos no contexto da família que envolveu idosos com 60 anos ou mais, que prestam cuidados a familiares também idosos dependentes no contexto domiciliar. Foram selecionadas variáveis de caracterização sociodemográficas e econômica da amostra, da intensidade da ajuda prestada em atividades básicas e instrumentais de vida diária, do comprometimento cognitivo do idoso cuidado por meio da aplicação do Clinical Dementia Rating Scale Sum of boxes, de autoavaliação geral da saúde e da Escala de Sobrecarga de Zarit. O modelo explicativo proposto foi testado por meio da análise de equações estruturais via Path analysis com auxílio do programa estatístico SAS System for Windows (Statistical Analysis System), versão 9.2. A amostra foi composta por 138 idosos, em sua maioria mulheres (76%), cônjuges (64%), prestando cuidado, em média, há 4,4 anos (±4,1) e auxiliando em sete tarefas (±3,6). Resultados da Path analysis revelaram caminhos associativos entre o sexo e a sobrecarga mediados pelo comprometimento cognitivo do idoso receptor de cuidados e autoavaliação de saúde do cuidador. Houve associações entre sexo e intensidade da ajuda prestada mediadas pelo comprometimento cognitivo do idoso receptor de cuidados. O modelo resultante sugere que a sobrecarga de idosos cuidadores não é produto direto da intensidade da ajuda e do comprometimento cognitivo e que a autopercepção de saúde pode influenciar seus efeitos. Reproduz as concepções presentes em modelos psicológicos de adaptação ao estresse ressaltando a centralidade da saúde como recurso importante para o cuidador idoso / The ageing population and recent socio-structural changes in Brazil have increased the likelihood that the care to the elderly will be provided by another elderly individual. The burden specificities experienced by older caregivers are little described in the gerontological literature, therefore lacking explanatory models. The present study aims to test a theoretical-empirical model of explanatory associations of subjective burden of older caregivers considering variables as sex, age, aid intensity provided, cognitive impairments of the recipient of care and self-rate health. This is a cross-sectional study based on data from a larger study entitled \"Psychological well-being of the elderly who care for other elderly in the family context\", consisting of individuals aged 60 and over who provide care to family members at the home. Sociodemographic and economic variables of the sample, the intensity of the assistance given in basic and instrumental activities of daily living, were selected from the cognitive impaired of the elderly care through the application of the Clinical Dementia Rating Scale - Sum of boxes, of general health self-assessment and the Zarit Burden Scale. The proposed explanatory model was tested through the analysis of structural equations via Path analysis. The sample consisted of 138 elderly people, mostly women (76%), spouses (64%), with average time of care 4.4 years (± 4.1) and seven tasks (± 3.6). Results from Path analysis shows associative paths between sex and overload mediated by cognitive impairments of elderly care recipient and self-rated health. There were associations between sex and intensity of aid provided mediated by the cognitive impairment of the elderly care recipient. Although it explains little of the variability, the model suggests that the caregiver burden is not a direct product of the cognitive impairment of the recipient of care and that self-rated health can influence its effects. It replicates conceptions presented in different psychological models of adaptation to stress emphasizing the centrality of health as an important resource for older caregivers

Scholars have long theorized that religious contexts provide health-promoting social integration and regulation. A growing body of literature has documented associations between individual religiosity and health as well as macro–micro linkages between religious contexts, religious participation, and individual health. Using unique data on individuals and county contexts in the United States, this study offers new insight by using multilevel analysis to examine meso–micro relationships between religion and health. We assess whether and how the relationship between individual religiosity and health depends on communal religious contexts. In highly religious contexts, religious individuals are less likely to have poor health, while nonreligious individuals are markedly more likely to have poor health. In less religious contexts, religious and nonreligious individuals report similar levels of health. Consequently, the health gap between religious and nonreligious individuals is largest in religiously devout contexts, primarily due to the negative effects on nonreligious individuals’ health in religious contexts.

<p>This cross-sectional study investigated the use of health benefits in relation to the self-rated health of employees at two medium-sized industrial enterprises in Hälsingland. The method used to investigate this was through a self-designed questionnaire consisting 19 questions about health, lifestyle and health benefits at the workplace. A total of 100 questionnaires were distributed in the two companies, hence 50 surveys at each workplace. The response rate was measured to 88 % and 74 %, which means a loss of 6 persons and 13 persons. The results showed that Company nr 1 offers its employees a health benefits consisting of free access to gym in the company premises after working hours and financial contributions to training-cards. These benefits are used regularly by 29% of respondents. Company nr 2 currently offered no health benefits for their employees. The results also showed that 66% of the respondents at Company nr 1 rated their physical health as <em>Excellent</em> or <em>Good</em> and 79% consider their mental health as <em>Excellent</em> or <em>Good</em>. At Company nr 2, 65 % of the participants responded that they consider their physical health as Excellent or Good and 84% consider their mental health as <em>Excellent</em> or <em>Good</em>. The study also found that more than half of the participants in the two companies had a BMI (Body Mass Index) greater than 26. The conclusion from this is that the health benefits offered at Company nr 1 is used sparingly and that more than half of the participants at both companies consider their physical and mental health as <em>Excellent</em> or <em>Good</em>.</p>

<p>The number of persons who are not employed has increased in Sweden since the early 1990s. Unemployment has been found to influence health, especially when unemployment rates are low. The extent to which unemployment affects health when unemployment is high is less clear, and this needs to be further studied. To improve health in the population, the health care system should offer equal access to health care according to need. It is important to study whether the employment status hinders the fulfilment of this goal. </p><p>This thesis is based on four papers: Paper I and II aimed at analysing self-rated health versus mortality risk in relation to employment status, during one period of low unemployment and one period of high unemployment. Paper III and IV assessed the use of medical health care services and unmet care needs among persons who were unemployed or otherwise not employed. The goal was to analyse what health problems lead people to either seek or abstain from seeking care, and what factors encumber or facilitate this process. </p><p>The overall results indicate that being unemployed or outside the labour force was associated with an excess risk of poor self-rated health, symptoms of depression, mental and physical exhaustion and mortality. The differences in self-rated health between the unemployed and employed were larger when unemployment levels were high, than when they were low. More groups of the unemployed were also afflicted with poor health when unemployment was high. Thus, poor health among the unemployed seems to be a public health problem during high levels of unemployment. Lack of employment was related to abstaining from seeking care, despite perceiving a need for care, and this was related to psychological symptoms. To deal with the needs of the unemployed and others who are outside the labour force it would be useful to develop and implement interventions within the health care system. These should focus on psychological and psychosocial problems. Future research should analyse how to facilitate health-promoting interventions among persons who are not anchored in the labour market. </p>

Psykometriska egenskaper presenteras från en nyöversatt självskattningsskala för funktionsnedsättning vid social fobi. Liebowitz Self-Rated Disability Scale (LSRDS) avser att undersöka hur ångestproblem kopplade till olika funktionsområden hindrat normal funktion dels de senaste två veckorna och dels när det varit som värst i livet. LSRDS har acceptabel test-retest reliabilitet och god intern konsistens. Den diskriminativa valideten i LSRDS är god i jämförelse mellan normalgrupp och klinisk grupp. I samband med en kognitiv beteendeterapeutisk behandling av åtta individer med social fobi har skalan provats och förefaller fånga förändringar i funktionsförmåga. Skalan föreslås preliminärt som komplement till andra skattningsformulär vid utvärdering av behandling vid social fobi.

Background: Self-rated health (SRH) is among the most frequently assessed health perceptions in epidemiological research. While the predominant focus has been the predictive relevance of SRH, there is increasing interest in understanding the nature of SRH. Recently a conceptual interpretation of SRH was proposed. Purpose: To assess the tenability of the recently proposed distinctions of self-rated health, as a spontaneous assessment of overall health, or as an enduring self-concept, or both, and to determine the significance of mental well-being, physical and social health for SRH. Methods: A cohort of individuals undergoing total joint replacement (TJR) for hip or knee osteoarthritis (OA) was followed over 6 months of recovery. Participants (n=449) completed (pre-surgery, 3 and 6 months post-surgery) measures associated with physical health: pain, physical function, sports/recreation, fatigue; mental well-being: anxiety, depression; and social health: social participation, passive/active recreation, community access. Using structural equation modeling, confirmatory factor analyses (CFA) investigated 3 latent health variables, and the responsiveness of SRH to current and changing health status, as well as its predictive significance for future health status was investigated. Results: CFA analyses confirmed relationships between observed health measures and hypothesized latent health dimensions. SRH was responsive to current and changing mental well-being. The effects of physical and social health were mediated through mental well-being. SRH was a strong predictor of future SRH and future health status. Conclusion: SRH displayed features of both an enduring self-concept and spontaneous assessment of health status; evidence is provided that both operate simultaneously. While aspects of physical health have always been perceived as the major determinants of SRH, these findings indicate that mental and social health explain much of the relationship between physical health and SRH. These results are particularly unexpected since this is a sample of individuals undergoing TJR surgery, for which pain and restricted physical function are primary indicators. Since SRH is a significant predictor of health status, TJR outcomes, health care utilization and mortality, this study suggests that health research and care, treatment and management modalities should consider a broad range of health dimensions, not only physical aspects of health, and SRH.

A single-item measure of self-rated mental health (SRMH) asks respondents to rate their mental health on a 5-point scale from ‘excellent’ to ‘poor’. SRMH is being used increasingly in research and on population health surveys. However, little is known about this item, as there are no literature reviews and few formal validation studies. The aim of this study is to understand what SRMH measures by conducting the first known systematic review of SRMH literature, followed by analysis of the Canadian Community Health Survey (CCHS 1.2). Results of the systematic review reveal SRMH has relationships with mental health scales, mental disorders, self-rated health, health problems, service utilization, and service satisfaction. Analysis of CCHS 1.2 data finds SRMH is associated with psychiatric diagnoses, distress, physical health, and sociodemographic characteristics. Both studies conclude SRMH is measuring mental health and more; however, there needs to be more research to understand the specifics of these relationships.

A single-item measure of self-rated mental health (SRMH) asks respondents to rate their mental health on a 5-point scale from ‘excellent’ to ‘poor’. SRMH is being used increasingly in research and on population health surveys. However, little is known about this item, as there are no literature reviews and few formal validation studies. The aim of this study is to understand what SRMH measures by conducting the first known systematic review of SRMH literature, followed by analysis of the Canadian Community Health Survey (CCHS 1.2). Results of the systematic review reveal SRMH has relationships with mental health scales, mental disorders, self-rated health, health problems, service utilization, and service satisfaction. Analysis of CCHS 1.2 data finds SRMH is associated with psychiatric diagnoses, distress, physical health, and sociodemographic characteristics. Both studies conclude SRMH is measuring mental health and more; however, there needs to be more research to understand the specifics of these relationships.

Background: Self-rated health (SRH) is among the most frequently assessed health perceptions in epidemiological research. While the predominant focus has been the predictive relevance of SRH, there is increasing interest in understanding the nature of SRH. Recently a conceptual interpretation of SRH was proposed. Purpose: To assess the tenability of the recently proposed distinctions of self-rated health, as a spontaneous assessment of overall health, or as an enduring self-concept, or both, and to determine the significance of mental well-being, physical and social health for SRH. Methods: A cohort of individuals undergoing total joint replacement (TJR) for hip or knee osteoarthritis (OA) was followed over 6 months of recovery. Participants (n=449) completed (pre-surgery, 3 and 6 months post-surgery) measures associated with physical health: pain, physical function, sports/recreation, fatigue; mental well-being: anxiety, depression; and social health: social participation, passive/active recreation, community access. Using structural equation modeling, confirmatory factor analyses (CFA) investigated 3 latent health variables, and the responsiveness of SRH to current and changing health status, as well as its predictive significance for future health status was investigated. Results: CFA analyses confirmed relationships between observed health measures and hypothesized latent health dimensions. SRH was responsive to current and changing mental well-being. The effects of physical and social health were mediated through mental well-being. SRH was a strong predictor of future SRH and future health status. Conclusion: SRH displayed features of both an enduring self-concept and spontaneous assessment of health status; evidence is provided that both operate simultaneously. While aspects of physical health have always been perceived as the major determinants of SRH, these findings indicate that mental and social health explain much of the relationship between physical health and SRH. These results are particularly unexpected since this is a sample of individuals undergoing TJR surgery, for which pain and restricted physical function are primary indicators. Since SRH is a significant predictor of health status, TJR outcomes, health care utilization and mortality, this study suggests that health research and care, treatment and management modalities should consider a broad range of health dimensions, not only physical aspects of health, and SRH.

I Sverige genomförs kontinuerliga befolkningsundersökningar i syfte att ge information om indikatorer på ohälsa samt risk- och skyddsfaktorer. Resultaten av dessa presenteras i olika nationella redogörelser samt landstingsrapporter. Det finns idag ingen aktuell sammanställning av ohälsans utveckling med värden för enbart Uppsala län, denna uppsats avsåg därför att bidra med detta. Resultaten visade på en minskning i den självskattade dåliga hälsan över tid, då materialet delades upp på kön och ålder. En relativ ökning av skillnaderna i ohälsa mellan förvärvsarbetande, arbetslösa och förtidspensionerade kunde också observeras. Den relativa ökningen syntes tydligast mellan förvärvsarbetande och förtidspensionerade. Riskfaktorer som visade sig särskilt effektfulla till att skatta sin hälsa som dålig eller mycket dålig var mycket dålig trivsel med sina arbetsuppgifter, svåra besvär med trötthet och svåra besvär med ängslan oro eller ångest. Vidare upplevde sig arbetslösa i högre utsträckning vara utsatta för riskfaktorn nedlåtande behandling, vilket är i linje med tidigare presenterade resultat. Resultaten i uppsatsen kan vara till hjälp vid planering för folkhälsoarbete mot skillnader i hälsa och för en god och jämlik hälsa i Uppsala län. Ifall insatserna på området behöver prioriteras kan denna uppsats vara till hjälp då den lyfter fram de förtidspensionerades utsatta situation. Eftersom den självskattade dåliga hälsan bland övriga sysselsättningsgrupper inte har förbättras under de senaste åren, kan det vara en fingervisning om att pågående insatser bör ses över. Då denna studie bekräftade tidigare resultat avseende arbetslösas upplevelse av nedlåtande behandling och dess effekt på hälsan, tyder det på att folkhälsoarbetet i länet kan lägga visst fokus på detta problem. / In Sweden continuous population surveys operates to provide information on indicators of poor health and risk and protective factors. There is currently no current compilation of ill health development of values for only Uppsala County; this paper therefore intended to contribute to this. When the material was divided by gender and age, the results showed a decrease in self-rated bad health. Also the results showed a relative increase of differences in health between occupational groups. The relative increase was shown most distinct between the employed and the early retired. Risk factors that proved particularly effective at estimating their health as poor or very poor were very poor satisfaction with your work, severe problems with fatigue, and severe problems with anxiet, worry or anxiety. Furthermore unemployed perceived themselves being exposed to the risk factor condescending treatment, which is in line with previously announced results. Therefore this paper can be helpful in planning for public health efforts to combat health disparities and for a good and equitable health in the county. If the efforts in this area need to be prioritized, then this essay can be helpful when it highlights the early-retired vulnerable situation. Since the self-rated poor healths among other employment groups haven’t improved in recent years, it may be a hint that the ongoing efforts should be reviewed. As this study confirmed previous findings regarding the unemployed experience of condescending treatment and its effect on health, it indicates that public health efforts may put some focus on this problem.