This study assessed whether adolescents' socioeconomic background, health and health behaviours are associated with later risk of poisoning hospitalization.
A prospective cohort of 54,169 Finns aged 14-18 years was followed for an average of 10.6 years. The end-point of the study was poisoning hospitalization, death or termination of follow-up in 2001. The relationships of socioeconomic background, health and health behaviour characteristics with poisoning hospitalization were studied with adjusted Cox's proportional hazard model.
We identified 443 persons (0.8%) with a diagnosed poisoning leading to hospital admission. The mean age at the time of the poisoning hospitalization was 22.7 years. The strongest risk factors for poisoning hospitalization in males were more than three stress symptoms weekly (HR 1.9), poor school success (HR 1.9) and not living with both of the parents in adolescence (HR 1.8). In females, the strongest risk factors were more than three stress symptoms weekly (HR 2.1), poor school success (HR 2.2) and recurring drunkenness as drinking style (HR 1.7).
Poor school performance, health and health-compromising behaviour adopted in adolescence are associated with a poisoning hospitalization risk in adulthood. Daily smoking and recurring drunkenness were strongly associated with a later poisoning hospitalization.
The aim was to study the association between stress level and chronic facial pain, while controlling for the effect of depression on this association, during a three-year follow-up in a general population-based birth cohort.
In the general population-based Northern Finland 1966 Birth Cohort, information about stress level, depression and facial pain were collected using questionnaires at the age of 31 years. Stress level was measured using the Work Ability Index. Depression was assessed using the 13-item depression subscale in the Hopkins Symptom Checklist-25. Three years later, a subsample of 52 subjects (42 women) with chronic facial pain and 52 pain-free controls (42 women) was formed.
Of the subjects having high stress level at baseline, 73.3% had chronic facial pain, and 26.7% were pain-free three years later. The univariate logistic regression analysis showed that high stress level at 31 years increased the risk for chronic facial pain (crude OR 6.1, 95%, CI 1.3-28.7) three years later. When including depression in a multivariate model, depression associated statistically significantly with chronic facial pain (adjusted OR 2.5, 95%, CI 1.0-5.8), whereas stress level did not (adjusted OR 2.3, 95%, CI 0.6-8.4).
High stress level is connected with increased risk for chronic facial pain. This association seems to mediate through depression.
The aim of this study was to analyze whether exposure to workplace bullying among 5701 female employees in the Danish eldercare sector increases the risk of onset of a major depressive episode (MDE).
Participants received questionnaires in 2004-2005 and again in 2006-2007. MDE was assessed with the Major Depression Inventory. We examined baseline bullying as a predictor of onset of MDE at follow-up using multiple logistic regression. We further conducted a cross-sectional analysis at the time of follow-up among participants who at baseline were free of bullying, MDE, and signs of reduced psychological health. Finally, we analyzed reciprocal effects, by using baseline bullying and baseline MDE as predictors for bullying and MDE at follow-up.
Onset rates of MDE in the groups of no, occasional, and frequent bullying were 1.5%, 3.4%, and 11.3%, respectively. Odds ratios (OR) for onset of MDE were 2.22 [95% confidence interval (95% CI) 1.31-3.76] for occasional bullying and OR 8.45 (95% CI 4.04-17.70) for frequent bullying, after adjustment for covariates. In the cross-sectional analysis, OR were 6.29 (95% CI 2.52-15.68) for occasional bullying and 20.96 (95% CI 5.80-75.80) for frequent bullying. In the analyses on reciprocal effects, both baseline bullying [occasional: OR 2.12 (95% CI 1.29-3.48) and frequent: OR 6.39 (95% CI 3.10-13.17)] and baseline MDE [OR 7.18 (95% CI 3.60-14.30] predicted MDE at follow-up. However, only baseline bullying [occasional: OR 7.44 (95% CI 5.94-9.31) and frequent: OR 11.91 (95% CI 7.56-18.77)] but not baseline MDE [OR 0.93 (95% CI 0.47-1.84)] predicted bullying at follow-up.
Workplace bullying increased the risk of MDE among female eldercare workers. MDE did not predict risk of bullying. Eliminating bullying at work may be an important contribution to the prevention of MDE.
The purpose of this work was to develop an understanding of the meaning of disability for individuals living with chronic obstructive pulmonary disease (COPD) in a Canadian midwestern community from an emic perspective. A focused ethnographic design was used. Fifteen individuals participated in interviews. Narrative analysis was used to examine the interview data. Data analysis revealed 65 dilemma stories consisting of two structural components: the impairment, and the justification/explanation of the impairment. Participants' impairment might or might not have been known to others. In both situations, individuals were faced with choices of whether to explain/justify or attempt to conceal the impairment. Participants told these dilemma stories to convey the meaning of COPD as a disability invisible to others, and at times, to themselves. The information gained from this research will serve as an essential complement to the existing knowledge about this important yet often invisible chronic illness.
In a prospective population-based study, mothers and fathers of 1,247 children reported their physical and mental health during pregnancy, after delivery, within the child's first 18 months of life, and at 12 years. Additionally, maternal health clinic nurses rated parents' well-being and perceived need for support. At age 12, child outcomes were also measured using CBCL and YSR externalizing and internalizing scales. Results indicate that both ante- and postnatal maternal distress predicted future externalizing problems in offspring. Conversely, fathers' postnatal distress predicted subsequent internalizing problems. Furthermore, mother's depressed mood in the first trimester best predicted the child's externalizing problems at age 12. Nurses's ratings of mother's antenatal and perinatal need for support, perinatal distress, and family's need for support were associated with both internalizing and externalizing problems at age 12. Maternal antenatal distress increases the risk of offspring's externalizing problems in preadolescense, and postnatal distress in either parent increases the risk of internalizing problems. Parental self-reports and indirect ratings from health care providers during pregnancy and infancy may therefore reliably recognize offspring at risk for subsequent psychiatric symptomatology.
The Copenhagen Psychosocial Questionnaire (COPSOQ) comprises dimensions (emotional demands, demands of hiding emotions, meaning of work, quality of leadership, and predictability) that are not in the job strain or the effort-reward imbalance (ERI) models. The study aim was to investigate whether these dimensions explain changes in vitality and mental health over and above the job strain and ERI models.
A cohort of 3552 employees in 2000 were followed up in 2005 (cohort participation of 51%). Regression analyses were carried out with mental health and vitality as dependent variables. A significance level of 0.01 was applied when comparing regression models.
Regarding mental health, both the full COPSOQ-ERI model (p = 0.005) and the full job strain-COPSOQ model (p = 0.01) were significantly better than the ERI and the job strain models. Regarding vitality, none of the full COPSOQ models (i.e. with new COPSOQ dimensions together with job strain or ERI respectively) was significantly better than the ERI (p = 0.03) or the job strain (p = 0.04) models. Emotional demands and low meaning of work predicted poor mental health and low vitality.
In relation to mental health, new psychosocial risk factors have the potential to add to the predictive power of the job strain and ERI models. The current practice of including only items from the ERI and job strain models in public health studies should be reconsidered. Theories regarding the status of, for example, emotional demands and meaning of work should be developed and tested.
We examined whether organizational justice is associated with sleep quality and performance in a population-based sample of 1,729 Finnish registered nurses working full time. In addition, we tested psychological mechanisms mediating the potential association. The results of multivariate linear regression analyses showed higher organizational justice to be associated with fewer sleeping problems (ß values range from -.20 to -.11) and higher self-reported performance (ß values range from .05 to .35). Furthermore, psychological distress (related to the psychological stress model) and job involvement (related to the psychosocial resource model) mediated the association between organizational justice and sleep. Sleeping problems partly mediated the association between organizational justice and performance. Psychological distress explained 51% to 83% and job involvement explained 10% to 15% of the total effects of justice variables on sleeping problems. The findings provide support for the psychological stress model and offer practical implications for reducing nurses' sleeping problems.
This study examined whether active on-call hours and the co-occurrence of lifestyle risk factors are associated with physicians' turnover intentions and distress.
Cross-sectional survey data on randomly selected female (N=1571) and male (N=1081) physicians, aged 25 to 65 years, from The Finnish Health Care Professionals Study were used. The outcome measures were turnover intentions and distress (general health questionnaire). Smoking, heavy drinking, overweight, and low physical activity were assessed as lifestyle risk factors. Analyses of covariance were used to analyze the data.
After adjustment for gender, age, employment sector, and job satisfaction, the analyses showed that the physicians who had been on active call more than 40 hours per month reported more distress than the group not on call (P=0.046). The physicians with two or more risk factors also had more distress (P
Sources of perceived stress, coping style and coping efficacy were investigated among psychiatric patients being discharged to the community. The study's purpose was to (i) qualitatively characterize sources of perceived stress; (ii) identify preferred coping styles, and (iii) test the effectiveness of coping styles. Thematic coding of participants' narratives revealed that dominant stressors were family relationships, mental health symptoms, and employment issues. Consistent with previous findings among non-clinical samples, problem-focused coping styles were predictive of decreased perceived stress and increased perceived efficacy, whereas emotion-oriented coping styles were negatively associated with these outcomes. Contrary to hypotheses, avoidance coping styles was unrelated to outcomes.
This study examined the relationship between hearing impairment and mental distress. We hypothesized that fear of negative evaluation by others and avoidant communication strategies are associated with increased symptoms of depression.
Hearing-impaired adults (N = 105) who signed up for a stress management course completed the Hospital Anxiety and Depression Scale (HAD; Zigmond & Snaith, 1983), the Fear of Negative Evaluation Scale (FNE; Watson & Friend, 1969), and the Conversation Tactics Checklist (CONV; Hallam et al., 2007). The participants' ratings of subjective hearing disability were assessed on a 5-point Likert scale and pure-tone audiometry obtained. Hierarchical multiple regression analysis was used to assess associations between fear of negative evaluation, avoidance, and symptoms of depression.
OBJECTIVE hearing impairment was moderate or less for 81% (n = 87) of participants, and the correlation between subjective hearing disability and objective hearing impairment was not significant. Multiple regression analysis showed that fear of negative evaluation and avoidant communication strategies contributed significantly to the variance in depression symptoms, and the total explained variance was 41.7%, F(5, 93) = 13.32, p = .000. Subjective and objective hearing disability did not make significant contributions.
Symptoms of depression appear to be closely related to fear of negative evaluation by others and use of avoidant communication strategies. Future clinical studies should address whether targeting these problems in rehabilitation interventions decreases depressive symptoms among hearing-impaired individuals.