Improving quality of life in patients with chronic kidney disease: influence of acceptance and personality

Background. A low health-related quality of life (HQL) is associated with the evolution of chronic kidney disease (CKD) and mortality in patients in end-stage of the disease. Therefore research on psychological determinants of HQL is emerging. We investigate whether acceptance of the disease contributes to a better physical and mental health-related quality of life (PHQL and MHQL). We also examine the impact of personality characteristics on acceptance, PHQL and MHQL. Methods. In this cross-sectional study, patients from an outpatient clinic of nephrology completed self-report questionnaires on quality of life, acceptance and personality characteristics. We performed correlations, regression analyses and a path analysis. Results. Our sample of 99 patients had a mean duration of CKD of 10.81 years and a mean estimated Glomerular Filtration Rate (eGFR) by Modification of Diet in Renal Disease (MDRD)-formula of 34.49 ml/min (SD 21.66). Regression analyses revealed that acceptance had a significant positive contribution to the prediction of PHQL and MHQL. Neuroticism was negatively associated with acceptance and MHQL. Path analysis showed that 37% of the total effect of neuroticism on MHQL was mediated by acceptance. Conclusions. Acceptance is an important positive variable in accounting for HQL, however, clinicians must be aware that if patients have a high level of neuroticism they are likely to have more difficulties with this coping strategy. These results provide a better understanding of psychological determinants of HQL in CKD, which can initiate another approach of these patients by nephrologists, specific psychological interventions, or other supporting public health services

Maternal Life Satisfaction and Child Outcomes: Are They Related?

This paper investigates the association between maternal life satisfaction and the developmental functioning of two- to three-year-old children as well as the socio-emotional behaviorof five- to six-year-old children. We use data from the German Socio-Economic Panel Study (SOEP), which allows us to control for a rich set of child and parental characteristics and to use the mother's life satisfaction before the birth of her child as an instrument to eliminate potential reverse causality. The results indicate that the more satisfied the mother, the better her child's verbal skills and the lower his or her socio-emotional problems. The relation is more pronounced for boys than for girls. The results are robust even when mothers' personality or mothers' cognitive skills are controlled for.Life satisfaction, subjective well-being, mothers, children, child development, skill formation, instrumental variable

Comorbidities of psychiatric and headache disorders in Nepal: implications from a nationwide population-based study

Background Headache disorders, anxiety and depression – the major disorders of the brain – are highly comorbid in the western world. Whether this is so in South Asia has not been investigated, but the question is of public-health importance to countries in the region. We aimed to investigate associations, and their direction(s), between headache disorders (migraine, tension-type headache [TTH] and headache on ≥15 days/month) and psychiatric manifestations (anxiety, depression and neuroticism), and how these might affect quality of life (QoL). Methods In a nationwide, cross-sectional survey of the adult Nepalese population (N = 2100), trained interviewers applied: 1) a culturally-adapted version of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire to diagnose headache disorders; 2) a validated Nepali version of the Hospital Anxiety and Depression Scale (HADS) to detect anxiety (HADS-A), depression (HADS-D) and comorbid anxiety and depression (HADS-cAD); 3) a validated Nepali version of the Eysenck Personality Questionnaire Revised Short Form-Neuroticism (EPQRS-N); and 4) the World Health Organization Quality of Life 8-question scale (WHOQOL-8). Associations with headache types were analysed using logistic regression for psychiatric caseness and linear regression for neuroticism. Adjustments were made for age, gender, household consumption, habitat, altitude and use of alcohol and marijuana. Results HADS-A was associated with any headache (p = 0.024), most strongly headache on ≥15 days/month (AOR = 3.2) followed by migraine (AOR = 1.7). HADS-cAD was also associated with any headache (p = 0.050, more strongly among females than males [p = 0.047]) and again most strongly with headache on ≥15 days/month (AOR = 2.7), then migraine (AOR = 2.3). Likewise, neuroticism was associated with any headache (p < 0.001), most strongly with headache on ≥15 days/month (B = 1.6), followed by migraine (B = 1.3). No associations were found between HADS-D and any headache type, or between TTH and any psychiatric manifestation. Psychiatric caseness of any sort, when comorbid with migraine or TTH, aggravated the negative impact on QoL (p < 0.001). Conclusion Headache disorders are highly comorbid with anxiety and show associations with neuroticism in Nepal, with negative consequences for QoL. These findings call for reciprocal awareness, and a holistic coordinated approach to management and in the health service. Care for common headache and common psychiatric disorders should be integrated in primary care.publishedVersion© 2016 Risal et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/

Anxiety and depression in Nepal: prevalence, comorbidity and associations

BACKGROUND: Anxiety and depression are two important contributors to the global burden of disease. In many developing countries, including Nepal, their prevalences are yet to be assessed. METHODS: A nationwide cross-sectional study was conducted among a representative sample of Nepalese adults aged 18–65 years (N = 2100), selected by multistage random cluster sampling and interviewed at home during unannounced visits. The validated questionnaires included the Hospital Anxiety and Depression Scale (HADS), to detect cases of anxiety (HADS-A), depression (HADS-D) and comorbid anxiety and depression (HADS-cAD), the Eysenck Personality Questionnaire Revised Short Form-Neuroticism (EPQRS-N), and the World Health Organization Quality of Life 8-question scale (WHOQOL-8). Logistic regression analyses were used to explore associations of caseness with four groups of variables: demographic, domicile, substance use, and behavioural and health. RESULTS: Age- and gender-adjusted point prevalences of HADS-A, HADS-D and HADS-cAD were 16.1, 4.2 and 5.9 % respectively. In a multivariate model, HADS-A was positively associated with urban residence (AOR = 1.82; p < 0.001) and neuroticism (AOR = 1.32; p < 0.001), and negatively with alcohol consumption (AOR = 0.71; p = 0.041). HADS-D was positively associated with marijuana use (AOR = 3.61; p = 0.017) and negatively with quality of life (QoL) (AOR = 0.86; p < 0.001). HADS-cAD was positively associated with widowhood (AOR = 2.71; p = 0.002), urban residence (AOR = 2.37; p = 0.001), living at altitude ≥2000 m (AOR = 2.32; p = 0.002) and neuroticism (AOR = 1.26; p < 0.001), and negatively with alcohol use (AOR = 0.56; p = 0.026) and QoL (AOR = 0.79; p < 0.001). CONCLUSION: Depression and anxiety are important mental health conditions in Nepal, and major contributors to public ill health, being very highly prevalent, comorbid and associated with psychosocial burden. They are also linked to the unique topography, habitation and social structure of the country. High prevalence coupled with the disabling nature of these disorders establishes their health-care priority and their importance in national health policy

Profiles of physical, emotional and psychosocial wellbeing in the Lothian birth cohort 1936

<p>Abstract</p> <p>Background</p> <p>Physical, emotional, and psychosocial wellbeing are important domains of function. The aims of this study were to explore the existence of separable groups among 70-year olds with scores representing physical function, perceived quality of life, and emotional wellbeing, and to characterise any resulting groups using demographic, personality, cognition, health and lifestyle variables.</p> <p>Methods</p> <p>We used latent class analysis (LCA) to identify possible groups.</p> <p>Results</p> <p>Results suggested there were 5 groups. These included High (n = 515, 47.2% of the sample), Average (n = 417, 38.3%), and Poor Wellbeing (n = 37, 3.4%) groups. The two other groups had contrasting patterns of wellbeing: one group scored relatively well on physical function, but low on emotional wellbeing (Good Fitness/ Low Spirits,n = 60, 5.5%), whereas the other group showed low physical function but relatively well emotional wellbeing (Low Fitness/Good Spirits, n = 62, 5.7%). Salient characteristics that distinguished all the groups included smoking and drinking behaviours, personality, and illness.</p> <p>Conclusions</p> <p>Despite there being some evidence of these groups, the results also support a largely one-dimensional construct of wellbeing in old age—for the domains assessed here—though with some evidence that some individuals have uneven profiles.</p

The effect of reciprocal motives, personality traits and wage differnences on public employee's job satisfaction

This study explores the determinants of public employees' job satisfaction. We are focusing on three concepts - reciprocal motives, personality traits and wage differences - to explain job satisfaction and production sector affiliation. Estimation results obtained from multivariate analyses on individual level data from the German Socio-economic Panel Study (GSOEP) can be summarized in three points: First, in contrast to reciprocal motives, personality traits have a unique and direct effect on public and private sector employees' job satisfaction. Second, even though we cannot proof that public employees at the high-end of the earnings distribution trade a loss in pecuniary benefits against an increase in non-pecuniary benefits, the empirical analysis strongly supports the notion that public employees' job satisfaction function varies across the earnings distribution. Finally, public employees' personal characteristics can be associated with lower levels of negative reciprocity, conscientiousness and neuroticism, pointing out to a potential self-selection and recruitment bias in the public sector. -- Diese Studie untersucht die Determinanten der Arbeitszufriedenheit von Beschäftigten im öffentlichen Dienst. Wir konzentrieren uns auf drei Konzepte - reziprokes Verhalten, Persönlichkeitsmerkmale und Lohndifferenzen - um Arbeitszufriedenheit und Produktionssektorzugehörigkeit zu erklären. Die vorläufigen Ergebnisse der multivariaten Analyse auf Basis der Daten des Sozio-oekonomischen Panels (SOEP) 2005 können in drei Punkten zusammengefasst werden: Erstens, im Gegensatz zur Reziprozität, haben die Persönlichkeitsmerkmale einen distinkten und direkten Einfluss auf die Arbeitszufriedenheit im öffentlichen und privaten Sektor. Zweitens, wir finden systematische Variation in den Determinanten der Arbeitszufriedenheit öffentlich und privat Beschäftigter in Abhängigkeit von deren Position in der Lohneinkommensverteilung. Drittens, die empirische Analyse liefert Anhaltspunkte, dass Personen mit geringerer negativer Reziprozität, Gewissenhaftigkeit, Neurotizismus tendenziell eher im öffentlichen Sektor beschäftigt sind.

Quality of Life and Affect across the Adult Lifespan

The premise of this dissertation is based on the work of M. Powell Lawton, in particular his theories of Environmental Press: Lawton and Nahemow, 1973) and the Dual-Channel Hypothesis: Lawton, 1996; Lawton, Winter, Kleban, & Ruckdeschel, 1999). Study 1 used a correlational approach to test Lawton and colleagues: 1999) model in a community sample of people across the adult lifespan, thereby expanding previous findings to individuals under age 60. Study 2 used an experimental approach to determine if individuals are affectively susceptible to differing environmental conditions based on their performance on a cognitive task. Whereas Study 1 provided a naturalistic picture of the interrelationships between affect and how individuals perceive the various facets of their lives, Study 2 allowed for a controlled look at the singular effect of objective environment on affective experience. In the correlational study I found that Lawton\u27s dual channel hypothesis: 1996) was an insufficient model for explaining the relationships between quality of life and affect. The quality of an older adult\u27s physical health directly influenced negative affect and indirectly influenced positive affect by influencing the quality of externally engaging phenomena such as environmental satisfaction and time quality, which in turn directly influenced positive affect. These relationships were replicated in a younger sample, providing further evidence that the dual channel hypothesis is insufficient as a model of quality of life and affect and that these relationships are as complex in younger adults as they are in older adults. The findings from Study 2 contributed to this notion. With age, the more it appears we actively select environmental conditions that allow us to maximize our positive affect and minimize our negative affect. Perhaps most notably is the role personality played in how individuals perceived and managed their environment and how individuals experienced affect. Neurotic individuals were not only more prone to perceive their lives as lower in quality, but they were also more sensitive to poor environmental conditions. These studies reveal the complexity of the relationships between how we perceive our lives, how we experience our environments, and how these perceptions and experiences influence our subjective well-being

Sense of coherence as a mediator between perceived neighborhood characteristics and health

We examine how sense of coherence (SOC) mediates the association between perceived neighborhood characteristics and health, using micro data collected from a nationwide Internet survey in Japan conducted in 2011 (N = 9,940). We focus on the impact of neighborhood dissatisfaction, various aspects of perceived neighborhood characteristics, and trust in neighbors on self-rated health and four types of unhealthy behaviors: performing no exercise, sleeping for short periods, smoking, and eating no breakfast. After controlling for SOC, the direct relationship between subjective neighborhood assessment and health was less pronounced. At the same time, a mediation analysis reveals that the impact of neighborhood characteristics on health is highly mediated by SOC. Moreover, the extent of SOC mediation differs substantially across combinations of specific neighborhood characteristics and health variables. Among neighborhood characteristics, perceived safety tends to directly affect health with limited mediation. Among the unhealthy behaviors, performing no exercise is associated with a wide variety of neighborhood characteristics, the impacts of which are substantially mediated by SOC. We believe that this study presents a new aspect to the analysis of the association between one’s perception of his/her neighborhood and health.Sense of coherence, self-rated health, perceived neighborhood characteristics, mediation analysis, Japan

Building Winners? An Empirical Evaluation of Public Business Assistance in the Founding Process

This paper investigates economic and subjective effects of public business assistance delivered to nascent entrepreneurs in Germany. Employing cluster analysis, we explore the actual scope and intensity of business assistance used. Then we analyze predictors of take-up and perceived usefulness taking into account the different patterns of utilized assistance. Finally, we assess economic effects by studying subsequent business performance employing propensity score matching. We cannot reveal that business assistance translates into better start-up performance. However, we find that a lack of personal entrepreneurial resources predicts take-up of business assistance in general as well as perceived usefulness of comprehensive business assistance.entrepreneurship, business assistance, policy evaluation, entrepreneurial resources, big five

Setting the Set Point: Initial Predictors of Life Satisfaction in Early Adulthood

In this article, we examine the patterns of association among a number of different factors that may contribute to differences in the initial baseline level of subjective well-being among young people in transition to adulthood. By examining the nature and patterns of these associations, we intend to identify potential areas where strategies may be developed-at the individual, micro, or macro level of policy-to influence the determinants of the baseline level of subjective well-being that are not attributable to genetic or inherited traits.