Social networks and health

Dit onderzoek betreft de relaties tussen kenmerken van sociale netwerk en de gezondheid. Na een beschrijving van de sociale netwerken van de Nederlanders, en een overzicht van relaties met indicatoren van gezondheid, volgt een theoretische uitwerking van mogelijke relaties met behulp van de theorie van het sociale kapitaal. Deze theoretische uitwerking wordt geïllustreerd met voorbeelden uit de onderzoeksliteratuur. Vervolgens wordt deze uitwerking getoetst in 3 opeenvolgende hoofdstukken: 1) effecten van sociale netwerken op de gezondheid via sociale regulatie van gezondheidsgedrag; 2) effecten van sociale steun bij bepaalde gebeurtenissen op de gevolgen van die gebeurtenissen; 3) effecten van gezondheidsstatus op de samenstelling van het sociale netwerk. Het boek wordt afgesloten met een samenvatting en discussie van de gebruikte theorie en methoden

Social networks and health

Dit onderzoek betreft de relaties tussen kenmerken van sociale netwerk en de gezondheid. Na een beschrijving van de sociale netwerken van de Nederlanders, en een overzicht van relaties met indicatoren van gezondheid, volgt een theoretische uitwerking van mogelijke relaties met behulp van de theorie van het sociale kapitaal. Deze theoretische uitwerking wordt geïllustreerd met voorbeelden uit de onderzoeksliteratuur. Vervolgens wordt deze uitwerking getoetst in 3 opeenvolgende hoofdstukken: 1) effecten van sociale netwerken op de gezondheid via sociale regulatie van gezondheidsgedrag; 2) effecten van sociale steun bij bepaalde gebeurtenissen op de gevolgen van die gebeurtenissen; 3) effecten van gezondheidsstatus op de samenstelling van het sociale netwerk. Het boek wordt afgesloten met een samenvatting en discussie van de gebruikte theorie en methoden

Psychosocial problems in primary care: some results from the Dutch National Study of Morbidity and Interventions in General Practice.

According to standardized screening instruments, mental distress is a common phenomenon among many patients who visit their general practitioner. However, a number of patients who seem to be in need of mental help do not put forward such a demand for help, whereas other patients who express psychosocial problems to their GP are not considered to be in need, according to a standardized measure. In this paper, a distinction has been made between the objectified needs of the patient as expressed by a standardized assessment, and the demands of the patient, expressed by the Reason for Encounter, stated during their visit at the GP. Results of a follow-up study of two cohorts of patients have been presented: one cohort presented during a 3 month period at least one articulated demand for psychosocial help, a second cohort presented at least one somatic complaint, considered by the GP as being psychological by character, without presenting any psychosocial complaint in that period. Objective needs for mental help of patients in both cohorts were assessed by means of the General Health Questionnaire. During one year all consultations of these two cohorts were registered. The following questions have been put forward: what demands for help have been put forward by the patients, what treatment have these patients got, and what has been the course of the problems during one year of patients with different needs and demands. From the results the following conclusions may be drawn: many patients with a probable mental illness (according to their objective need) present only physical symptoms.(ABSTRACT TRUNCATED AT 250 WORDS) (aut. ref.

The somatizing patient in general practice.

Objective: The exploratory study described in this article followed two groups of patients over a twelve-month period. Subjects were drawn from a pool of patients who had consulted their general practitioner during the three-month selection period. One group consisted of patients who had consulted their general practitioner at least once about a physical complaint that the GP regarded as predominantly psychosocial: these patients did not articulate complaints of an explicitly mental or social nature. The second group was characterized by the fact that its members voiced precisely such mental or social complaints. Method: The study investigated the extent to which the two groups (which were comparable in the severity of their complaints)differ with respect to patient characteristics such as the severity of their possible psychological problems, the frequency with which they visited their GPs, and the types of complaints - e.g. mental, psychosomatic and purely physical - they presented. Results: It was found that patients in the first group, whose somatic complaints were seen to have a psychosocial basis, are not the dependent types generally mentioned in theories about somatization. In fact, they adopt a more independent attitude to the GP than do patients voicing mental complaints. There are indications that for 'somatizing' patients, underlying mental problems are less important than for 'psychologizing' patients. Conclusion: Both the somatizing patients and the psychologizing patients continued very frequent visits to their GP during the 12-month research period, although chiefly to address physicial complaints that the GP also assessed as such. (aut.ref.

The importance of the GHQ in general practice.

The relationship between General Health Questionnaire (GHQ) score and complaints presented at the general practitioners office was examined, and showed that the correlation between them is not as high as might be expected. Many patients who present psychosocial problems to their GP appear to have a low GHQ score; many patients with a high GHQ score exclusively present somatic complaints, which are also assessed by the GP as being purely somatic. Implications of the results are discussed. (aut. ref.

An orientation toward help-seeking for emotional problems.

In recent years, many researchers tried to explain the social selection in use of mental health care services. A modest role is attributed to the orientation toward help-seeking. This article studies this orientation. Our research-population consisted of 10,171 Dutch persons, aged 18 and older. Analysis showed that most people are prone to seek help for one or more emotional problems. People who are more prone to seek help are younger, have had more education and have a higher family income. They have more often acquaintances working in mental health care. People who are more prone to seek help do not see chance as the locus of control of health. These people are less dependent on their GP for common disorders and are more open about mental health matters. The results of discriminant analysis are not satisfactory, but when we try to distinguish the groups of people who are and who are not willing to seek help, we see that the best discriminating factor is their help-seeking attitude for common disorders. People who have high expectations from the GP for common disorders, clearly do have a preference to seek help for the emotional problems. The groups of people who are more willing to seek help from the GP compared to mental health professionals cannot be distinguished by these expectations. Here the level of education discriminates fairly well: people who are more prone to seek help from a GP have a lower educational level. Future research should be focussed on the testing of a theoretical model that explains the orientation toward help-seeking for emotional problems and selection in help-seeking with longitudinal data. (ref. aut.

Physical activity in relation to cognitive decline in elderly men: the FINE study

BACKGROUND: Physical activity may be associated with better cognition. OBJECTIVE: To investigate whether change in duration and intensity of physical activity is associated with 10-year cognitive decline in elderly men. METHODS: Data of 295 healthy survivors, born between 1900 and 1920, from the Finland, Italy, and the Netherlands Elderly (FINE) Study were used. From 1990 onward, physical activity was measured with a validated questionnaire for retired men and cognitive functioning with the Mini-Mental State Examination (maximum score 30 points). RESULTS: The rates of cognitive decline did not differ among men with a high or low duration of activity at baseline. However, a decrease in activity duration of >60 min/day over 10 years resulted in a decline of 1.7 points (p <0.0001). This decline was 2.6 times stronger than the decline of men who maintained their activity duration (p = 0.06). Men in the lowest intensity quartile at baseline had a 1.8 (p = 0.07) to 3.5 (p = 0.004) times stronger 10-year cognitive decline than those in the other quartiles. A decrease in intensity of physical activity of at least half a standard deviation was associated with a 3.6 times stronger decline than maintaining the level of intensity (p = 0.003). CONCLUSIONS: Even in old age, participation in activities with at least a medium-low intensity may postpone cognitive decline. Moreover, a decrease in duration or intensity of physical activity results in a stronger cognitive decline than maintaining duration or intensit

Selection in the social network: effects of chronic diseases.

Background: this article deals with the consequences of disease for someone's personal social network. It is hypothesized that the duration of a socially severe disease will affect the social network in such a way that the proportions of women, kin, long-standing relationships and people living nearby are higher for people suffering from a disease longer. Contacts with colleagues will decline. Methods: these hypotheses were tested on the data of a representative sample of the Dutch, gathered by means of a health interview (N=10, 110). The presence and duration of diseases were measured by a checklist of 23 chronic diseases. The social severity of a disease was determined by its visibility, threat to others and functional disablement. The network characteristics in this study were church membership, membership of voluntary organizations, number of close friends, number of supportgivers, proportions of kin, women, colleagues, long-standing relationships and people living nearby. Gender, education, life-cycle stage and work status were taken into account in all analyses. Results: logistic and linear regression analyses showed that the duration of a disease, whatever the degree of social severity, does not affect the network strongly. People suffering longer from socially severe chronic diseases reported fewer friends and supportgivers. People suffering longer from moderately severe chronic diseases reported fewer supportgivers for health-related support. The results on socially mild chronic diseases were not in line with the expectations: people who are ill longer reported more friends and fewer women in their network. Conclusion: we conclude that in a general population the duration of diseases hardly has any effort on social network characteristics. (aut.ref.