Are perceived bad working conditions and perceived workplace bullying associated with doctor visits? Results of the nationally representative German General Social Survey

Background: The reason for doctor visits associated with bad working conditions (and workplace bullying) remains unknown. Therefore, the aim of this study was to examine the association between perceived working conditions as well as workplace bullying and the number of doctor visits as well as the reason for seeing a doctor. Methods: Data were derived from the German General Social Survey, a representative cross-section of the population in the year 2014. Self-reported doctor visits in the last 3 months were used as outcome measure. Self-rated working conditions (noise, bad air; time/performance pressure; bad working atmosphere; overtime; hifts/night work; hard physical labour) and workplace bullying were assessed. The reason for seeing a doctor was also recorded (acute illness; chronic illness; feeling unwell; requesting advice; visit to the doctor’s office without consulting the doctor (e.g., need to get a prescription); preventive medical check-up/vaccination). Regression analysis stratified by sex was conducted. Results: Adjusting for various potential confounders, Poisson regressions showed that workplace bullying was associated with increased doctor visits in men, but not in women. Contrarily, time/performance pressure at work was only associated with increased doctor visits in women, but not in men. Furthermore, the probability of visiting the doctor for reasons of acute illness or feeling unwell increased with workplace bullying in men. The probability of visiting the doctor because of feeling unwell increased with time/performance pressure in women. Conclusions: Our findings stress the association between adverse working conditions (workplace bullying as well as time/performance pressure at work) and doctor visits, with remarkable gender differences. Longitudinal studies are required to confirm the present findings and to obtain further insights into this relationship

The Association of Post-Materialism with Health Care Use: Findings of a General Population Survey in Germany

(1) The aim of this study was to identify the association between post-materialism and health care use (in terms of the frequency of doctor visits and the reason for doctor visits). (2) Data were taken from the German General Social Survey (a representative sample of individuals aged 18 years and over, n = 3338). The Inglehart’s post-materialist index was used to quantify post-materialism. The doctor visits (self-reported) in the past three months served as an outcome measure. The reasons for seeing a doctor served as an additional outcome measure (acute illness; chronic illness; feeling unwell; requesting advice; visit to the doctor’s office without consulting the doctor (e.g., need to get a prescription); preventive medical check-up/vaccination). (3) After adjusting for several covariates, negative binomial regressions revealed that compared with materialism, post-materialism was associated with decreased doctor visits (total sample; women). Moreover, the likelihood of visiting the doctor for reasons of chronic illnesses was lower in post-materialistic women, whereas the likelihood of visiting the doctor for reasons of preventive medical check-up/vaccination was higher in post-materialistic women. (4) Study findings identify an unexplored link between post-materialism and doctor visits in women. One may conclude that in the long-term, the increased likelihood of preventive medical check-ups in post-materialistic women will be beneficial in decreasing the need for doctor visits for reasons of chronic illnesses. However, future research is required to elucidate the underlying mechanisms

Associations between changes in physical activity and perceived social exclusion and loneliness within middle-aged adults: longitudinal evidence from the German Ageing Survey

Previous research showed negative associations between physical activity and loneliness in older adults. However, information on associations among middle-aged adults is scarce. In this prognostic factor study, we investigated if starting or stopping to follow the WHO physical activity recommendations was associated with changes in perceived social exclusion and loneliness in this age bracket

Auswirkungen der demographischen Entwicklung auf die Zahl der Pflegefälle: Vorausschätzungen bis 2020 mit Ausblick auf 2050

In general, demographic development is expected to increase the number of cases needing nursing care. In order to explore the possible dynamics in this area, this papers employs a demographic model of the DIW which integrates among others a steadily increasing life expectancy. Grouping by sex, age and intensity of nursing care, the model calculates in advance the number of nursing cases. Calculations include patients both from the statutory and from the private nursing care insurance. According to the calculations presented, the number of patients needing nursing care is expected to increase by 52 % or by one million cases by 2020. By the year 2050, the number of patients needing nursing care will reach 4.7 million cases which increases the current level by a factor of 2.5. As the number of cases needing intensive or most intensive nursing care will increase more than the number of cases just needing significant nursing care, the average intensity in care needed will grow. Need for care and assistance will thus grow more dynamically than the number of cases. Demographic factors alone make the need for inpatient nursing care increase more strongly than that for outpatient assistance. This trend is further pushed forward by the changing structure of families and households, by the increasing participation of women in the labour market and by increasing age of those family members who render nursing care. The increase in the number of cases needing nursing care does not only challenge social security. More than that, the increase in demand for outpatient care as well as for partly or full inpatient nursing care makes up a significant potential for new employment. This potential can be realised by setting the respective framework conditions. Even if there is political consensus for an increase in private insurance of the risk of nursing care, the contribution rate to the Von der demographischen Entwicklung wird allgemein eine Zunahme der Zahl Pflegebedürftiger erwartet. Um die mögliche Dynamik in diesem Bereich aufzuzeigen, wird mit Hilfe des DIW-Bevölkerungsmodells, das u.a. die weiterhin steigende Lebenserwartung modelliert, die Zahl der Pflegefälle differenziert nach Geschlecht, Altersgruppen und Schweregrad der Pflegebedürftigkeit vorausberechnet. Die Zahl der Pflegefälle umfasst hier sowohl die Leistungsempfänger aus der sozialen als auch aus der privaten Pflegeversicherung. Nach den hier vorgelegten Berechnungen dürfte die Zahl Pflegebedürftiger bis 2020 um 52 % oder rund 1 Million steigen. Im Jahre 2050 wird die Zahl der Pflegebedürftigen mit 4,7 Millionen das 2,5fache des heutigen Niveaus erreichen. Da die Zahl der Schwer- und Schwerstpflegebedürftigen stärker steigt als die der "Erheblich Pflegebedürftigen", wird sich der Grad der durchschnittlichen Pflegebedürftigkeit erhöhen. Der Versorgungs- und Betreuungsbedarf weist damit ein dynamischeres Wachstum auf als die Zahl der Pflegefälle. Bereits rein demographisch bedingt wird die Nachfrage nach stationären Pflegediensten stärker steigen als nach ambulanter Betreuung. Diese Tendenz wird durch die veränderten Familien- und Haushaltsstrukturen, die weiterhin steigende Erwerbsbeteiligung der Frauen sowie die Alterung der familiären Pflegekräfte verstärkt. Die Zunahme der Zahl Pflegebedürftiger stellt nicht nur für die soziale Sicherung eine Herausforderung dar, die Nachfragesteigerung nach ambulanten, teilstationären und vollstationären Pflegediensten eröffnet auch merkliche Beschäftigungspotentiale. Diese gilt es durch entsprechende Rahmenbedingungen zu erschließen. Auch wenn es einen politischen Konsens für eine stärkere private Absicherung des Pflegerisikos geben sollte, wird der heute auf 1,7 % festgeschriebene Beitragssatz keinesfalls ausreichen. Erforderlich ist zudem eine Aufwertung der Pflegediensttätigkeiten, um qualifiziertes Personal für die entsprechenden Berufsfelder gewinnen zu können.Ageing population, Long-term care, potential of new employment, estimations for 2020

Sexual satisfaction among sexual minority and heterosexual middle-aged and older adults

Sexual satisfaction is an important part of sexual health and overall well-being. A large number of older people continue to be sexually active, and many are satisfied with their sex life. However, little is known about whether sexual satisfaction differs according to sexual orientation. Therefore, the aim of the study was to investigate whether sexual satisfaction differs according to sexual orientation in later life. The German Ageing Survey (DEAS) is a nationally representative study of the German population aged 40+. In the third wave (2008), data on both sexual orientation (heterosexual; homosexual, bisexual, other) and sexual satisfaction (1-very dissatisfied to 5-very satisfied) were collected. Multiple regression analyses with sampling weights were performed (stratified by age: 40-64; 65+).We included 4,856 individuals in our analysis (mean age 57.6±11.6; 40-85 years, 50.4% were women, 92.3% (n=4,483) were heterosexual and 7.7% (n=373) were sexual minority adults). In sum, 55.9% of heterosexual individuals and 52.3% of sexual minority adults were satisfied or very satisfied with their sex life. Multiple regression analysis showed that sexual orientation was not significantly associated with sexual satisfaction among both middle-aged (β=0.07; p=0.45) and older adults (β=0.01; p=0.87). Higher sexual satisfaction was associated with lower loneliness scores, partnership satisfaction, importance of sexuality and intimacy and better health status.Our analysis showed that sexual orientation was not significantly associated with sexual satisfaction among both middle-aged and older adults. Lower loneliness, better health status, and partnerships satisfaction significantly contributed to higher sexual satisfaction. Approximately 45% of older individuals (aged 65 years and older), regardless of their sexual orientation, were still satisfied with their sex life

Do sexual minorities believe that they die earlier? Results from a large, representative survey

While various consequences of belonging to sexual minorities have been examined - it remains completely unclear whether sexual minorities believe that they die earlier. Thus, our aim was to investigate the association between sexual orientation and expected longevity

Determinants of Patient Use and Satisfaction With Synchronous Telemental Health Services During the COVID-19 Pandemic:Systematic Review

Background: Several recent studies examined patient use and satisfaction with synchronous telemental health services in response to the widespread implementation during the COVID-19 pandemic. However, a systematic review of recent literature on the determinants of these outcomes is missing. Objective: The aim of this systematic review was to give an extensive overview of the literature on and highlight the influential determinants of patient use and satisfaction with synchronous telemental health services during the COVID-19 pandemic.Methods: This review satisfied the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was registered in PROSPERO. Peer-reviewed, quantitative studies that observed the determinants of patient use or satisfaction with synchronous telemental health services during the COVID-19 pandemic were included. PubMed, PsycInfo, and Web of Science database searches were conducted in August 2022 for English and German language studies published from 2020 onward. Key steps were performed by 2 reviewers. Determinants were synthesized into major categories informed by the dimensions of the widely used and established Unified Theory of Acceptance and Use of Technology. Result: Of the 20 included studies, 10 studies examined determinants of patient use, 7 examined determinants of patient satisfaction, and 3 observed both outcomes. The quality of the studies was mainly good or fair. There was substantial heterogeneity in the study designs, methods, and findings. Sociodemographic characteristics and health-related determinants were mostly considered. Some of the major dimensions of the Unified Theory of Acceptance and Use of Technology were neglected in recent studies. Although most findings were mixed or nonsignificant, some indications for potential relationships were found (eg, for sex, age, and symptom severity). Conclusion: The findings revealed potential target groups (eg, female and young patients with mild symptoms) for future postpandemic telemental health interventions. However, they also identified patient groups that were harder to reach (eg, older patients with severe symptoms); efforts may be beneficial to address such groups. Future quantitative and qualitative research is needed to secure and expand on recent findings, which could help improve services. PROSPERO CRD42022351576; https://tinyurl.com/yr6zrva5</p

The Association Between Self-Regulation and Daily Sports Activities in a Nationally Representative Sample of Older Adults. Findings From the German Ageing Survey

There is a large body of literature about the determinants of exercising regularly in older adults. However, to date, there is limited evidence showing that self-regulation is associated with exercising regularly. Existing studies are mostly restricted to rather specific or small samples. Thus, the purpose of this study was to examine whether self-regulation is associated with daily sports activities among older adults. For the current study, cross-sectional data were used from the German Ageing Survey (n = 7,757), a nationally representative sample of community-dwelling individuals aged 40 and over in Germany. Logistic regression analysis showed that daily sports activities is positively associated with self-regulation [OR: 1.32 (95%-CI: 1.11–1.58)]. The present study highlights the importance of an association between daily sports activities and self-regulation. Knowledge about this association is useful in addressing cases where older adults exercise less than daily

The Excess Costs of Depression and the Influence of Sociodemographic and Socioeconomic Factors: Results from the German Health Interview and Examination Survey for Adults (DEGS)

Introduction The aim of this study was to estimate excess costs of depression in Germany and to examine the influence of sociodemographic and socioeconomic determinants. Methods Annual excess costs of depression per patient were estimated for the year 2019 by comparing survey data of individuals with and without self-reported medically diagnosed depression, representative for the German population aged 18–79 years. Differences between individuals with depression (n = 223) and without depression (n = 4540) were adjusted using entropy balancing. Excess costs were estimated using generalized linear model regression with a gamma distribution and log-link function. We estimated direct (inpatient, outpatient, medication) and indirect (sick leave, early retirement) excess costs. Subgroup analyses by social determinants were conducted for sex, age, socioeconomic status, first-generation or second-generation migrants, partnership, and social support. Results Total annual excess costs of depression amounted to €5047 (95% confidence interval [CI] 3214–6880) per patient. Indirect excess costs amounted to €2835 (1566–4103) and were higher than direct excess costs (€2212 [1083–3341]). Outpatient (€498), inpatient (€1345), early retirement (€1686), and sick leave (€1149) excess costs were statistically significant, while medication (€370) excess costs were not. Regarding social determinants, total excess costs were highest in the younger age groups (€7955 for 18–29-year-olds, €9560 for 30–44-year-olds), whereas total excess costs were lowest for the oldest age group (€2168 for 65+) and first-generation or second-generation migrants (€1820). Conclusions Depression was associated with high excess costs that varied by social determinants. Considerable differences between the socioeconomic and sociodemographic subgroups need further clarification as they point to specific treatment barriers as well as varying treatment needs.Peer Reviewe

Validity and responsiveness of the EQ-5D in assessing and valuing health status in patients with somatoform disorders

Background: The EQ-5D is a generic questionnaire providing a preference-based index score applicable to cost-utility analysis. This is the first study to validate the EQ-5D in patients with somatoform disorders. Methods: Data of the EQ-5D descriptive system, the British and the German EQ-5D index and the EQ Visual Analogue Scale, the Patient Health Questionnaire 15, the Patient Health Questionnaire 9, the Whiteley Index 7 and the Short Form 36 were collected from 294 patients at baseline, 244 at 6 months and 256 at 12 months after baseline. The discriminative ability of the EQ-5D was evaluated by comparison with a general population sample and by the ability to distinguish between different symptom severities. Convergent validity was analysed by assessing associations between the EQ-5D and the other instruments. Responsiveness was evaluated by analysing the effects on scores between two measurements in groups of patients reporting worse, same or better health. The Bonferroni correction was employed. Results: For all items of the EQ-5D except ‘self-care’, patients with somatoform disorders reported more problems than the general population. The EQ-5D showed discriminative ability in patients with different symptom severities. For nearly all reference instruments there were significant differences in mean scores between respondents with and without problems in the various EQ-5D items and strong correlations with the EQ Visual Analogue Scale and the EQ-5D index scores. Evidence for the responsiveness of the EQ-5D could only be found for patients with better health; effects were medium at the utmost. Conclusions: The EQ-5D showed a considerable validity and a limited responsiveness in patients with somatoform disorders. Trial registration: Current Controlled Trials ISRCTN5528079