Quelle: Journal of Public Health, 18 (2010) 4, S 403-411
Inhalt: Aim: The first goal of this study was to assess the prevalence of different health risk behaviours among Romanian young people. Next, the interrelationship between different health risk behaviours as well as age and gender differences with respect to health risk behaviours were examined. Subjects and methods: Self-administered questionnaires were completed by a sample of 1,598 junior high school students, senior high school students and university students from urban and rural areas of two counties of Romania. Results: The results showed that 31% of junior high school students, 59.7% of senior high school students and 64.8% of university students reported more than one risk behaviour. Many of the risk behaviours were likely to correlate with each other and the strongest correlation was found between smoking, alcohol-related behaviour and precocious sexual intercourse. Factor analysis revealed that among junior high school students all health risk behaviours loaded on one factor. In senior high school students and university students the risk behaviours split into two factors, based probably on their frequency and severity. Factor 1 comprised smoking, alcohol-related behaviours as well as precocious sexual intercourse, while factor 2 included less common behaviours: violence, delinquency and illicit drug use. No gender differences were observed regarding the relationship between health risk behaviours. Conclusion: The results stress the importance of developing prevention programmes among Romanian youth for the behaviours discussed. Further research is needed to identify how to best offer these programmes: as stand-alone programmes or as an integrated set of programmes and whether the same approach has to be taken for younger and older adolescents.
Schlagwörter:Drogenkonsum; drug use; Gesundheit; female pupil; Student; student; Prävention; tobacco consumption; Sexualverhalten; Tabakkonsum; pupil; prevention; Gesundheitspolitik; Romania; Jugendlicher; sex behavior; alcohol consumption; Schülerin; Rumänien; Risikoverhalten; Schüler; health policy; Gesundheitsverhalten; gender; adolescent; health education; Alkoholkonsum; Gesundheitserziehung; risk behavior; health behavior; health; Health risk behaviours; Romanian adolescents; Health education
SSOAR Kategorie:Bildungswesen Sekundarstufe I, Medizinsoziologie, Gesundheitspolitik, Bildungswesen Sekundarstufe II
Attitudinal and socio-structural determinants of cervical cancer screening and HPV vaccination uptake: a quantitative multivariate analysis
Titelübersetzung:Einstellung und soziostrukturelle Determinanten zu Gebärmutterkrebs-Screening und HP-Virus-Schutzimpfung: eine quantitativ-multivariate Analyse
Quelle: Journal of Public Health, 18 (2010) 2, S 179-188
Inhalt: Aim: The introduction of the human papillomavirus (HPV) vaccine enables for the first time in the history of cancer prevention the possibility of combating the major cause of a cancer even before its onset. The secondary prevention measure of cervical cancer screening has thus been complemented by a primary prevention measure. The aim of this study is to analyse the determinants of uptake of preventive measures against cervical cancer as a basis for comparing the determinants of screening attendance with those of HPV vaccination attendance. Subject and methods: A population-based representative survey comprising 760 randomly selected women aged 14 to 65 was performed in the German federal state of Mecklenburg-Western Pomerania. Prevention behaviour, attitudes towards cervical cancer screening and HPV vaccination, and knowledge about cervical cancer and HPV were investigated by means of a structured questionnaire. Descriptive analyses and multivariate logistic regression analyses were conducted to identify the determinants of screening and HPV vaccine uptake. Results: Attendance both at screening and at HPV vaccination was best predicted by attitudinal factors. Positive connotations of cancer prevention measures and utility expectations, fear of cancer and high subjective risk perception were conducive to attendance at screening and HPV vaccination. Screening attendance was less regular among women of lower socioeconomic status. In contrast, HPV vaccination uptake was higher for young women with lower educational attainment and lower social class. Knowledge did not impact prevention behaviour significantly. There is no trade-off between screening and vaccination attendance; the vast majority of respondents was aware of the necessity of regular screening attendance even when vaccinated against HPV. Conclusions: Uptake rates for existing primary and secondary prevention measures against cervical cancer can be enhanced by fostering perceptions of utility and positive connotations of regular screening and becoming vaccinated against HPV. Elderly women in particular should be encouraged to attend screening by means of a recall system. Given the low overall level of knowledge about cervical cancer and its risk factors, there is a need for education about the necessity and utility of prevention to reach women of all social classes.
Schlagwörter:Gesundheit; vaccination; Prävention; risk; cancer; determinants; preventive medical examination; prevention; sozioökonomische Faktoren; Federal Republic of Germany; Vorsorgeuntersuchung; Mecklenburg-Western Pomerania; Gesundheitsvorsorge; Gesundheitsverhalten; knowledge; attitude; Risiko; health care; Krankheit; socioeconomic factors; woman; Mecklenburg-Vorpommern; Krebs; Impfung; Determinanten; health behavior; Risikoabschätzung; health; illness; Wissen; risk assessment; Einstellung; Cervical cancer prevention; Cervical screening; HPV vaccination; Attitudes; Socio-structural determinants; soziostrukturelle Faktoren
Quelle: Journal of Public Health, 18 (2010) 5, S 489-496
Inhalt: Aim: This study aimed to describe perceptions and experiences related to access and utilization of health care services of African and Brazilian immigrant women in Portugal. Subjects and methods: Six focus groups were conducted with 35 African and Brazilian women with low income and living in Lisbon, chosen through purposive sampling. Content analysis was undertaken through identification of themes and categories. Results: African and Brazilian women expressed different perceptions and patterns of use of health care services. Most participants pointed out several barriers to access and utilization of services related to legal issues, economic constraints or health professionals' attitudes. Conclusion: These results highlight the challenges to providing health care within a multicultural setting and the need to assure the provision of integrated and comprehensive health care services. Improving access to general health care is essential in order to minimize disadvantages from vulnerable subgroups, like immigrant women. Supporting better integration into the health system may lead to improved health outcomes.
Schlagwörter:perception; Afrikaner; Gesundheit; discrimination; health care delivery system; Wahrnehmung; Gesundheitswesen; African; Erfahrung; Diskriminierung; Migrant; Benchmarking; sozioökonomische Faktoren; Einwanderung; attitude; benchmarking; migrant; Krankheit; socioeconomic factors; comparison; woman; Portugal; Portugal; sociocultural factors; soziokulturelle Faktoren; immigration; health; Vergleich; illness; Einstellung; experience; Immigrant women; Perceptions; Experiences; Access and utilization of health care services
Quelle: Journal of Public Health, 19 (2010) 3, S 269-280
Inhalt: Aim: The aim of this study was to analyse the health-related quality of life (HRQOL) of primary family caregivers in comparison to the reference values of the average population. Subjects and methods: Data collection took place in the Werra-Meißner district in 2009 with a response rate of 102 primary family caregivers of frail elderly people. The health-related quality of life was measured with the Short Form 36 health survey (SF 36) and compared with the German reference values. Results: Compared to the health values of the normative sample, primary caregivers show significantly lower rates in all dimensions of health-related quality of life. In particular, caregivers between the ages of 53 to 61 report extremely low health values. Caregiving women compared to non-caregiving women have highly significant differences in all subscales of the SF 36. Caregiving men also report highly significant differences to non-caregiving men in all dimensions of the SF 36 except for Physical Functioning and General Health (p < 0.01). Caregivers in general and especially caregiving women aged 53 to 61 (midlife) were identified as at-risk groups for poor health. The latter report lower vitality and well-being, which may be a consequence of both social isolation and social impacts from multiple role demands. Conclusion: The identified high-risk groups of family caregivers, caregivers in midlife and especially caregiving women in midlife, should be supported by social measures, e.g., training courses for family caregivers, particularly in their home setting, and various types of respite care in order to sustain their health.
Schlagwörter:psychische Belastung; Gesundheit; alter Mensch; family member; Lebensqualität; Hessen; risk; health consequences; Federal Republic of Germany; häusliche Pflege; nursing care for the elderly; psychological stress; quality of life; Auswirkung; Risiko; home care; Krankheit; Altenpflege; Hesse; impact; elderly; gesundheitliche Folgen; gender-specific factors; health; Familienangehöriger; illness; family caregiver; health-related quality of life; SF 36; gender differences
Predictors of work ability in occupations with psychological stress
Titelübersetzung:Vorhersage der Arbeitsfähigkeit in Berufen mit psychologischem Stress
Autor/in:
Seibt, Reingard; Spitzer, Silvia; Blank, Matthes; Scheuch, Klaus
Quelle: Journal of Public Health, 17 (2008) 1, S 9-18
Inhalt: Aim: This study aimed to detect health- and work-related predictors of poor and good work ability in teachers (TE) and office workers (OW). Method: Work ability and its influence factors were analyzed in 100 female TE and 60 female OW aged between 25 and 60 years. The work ability was evaluated with the work ability index questionnaire and the health status with the vitality measurement system®. In addition, cardiac risk factors, burnout risk, as well as the working demands and effort-reward ratio were taken into account. Predictors of work ability were analyzed by using a CHAID analysis. The number of complaints represents the best predictor to divide both occupational groups into subgroups with different work abilities (criterion variable). Results: Poor work ability is caused by many complaints and cardiovascular risk factors. By contrast, excellent work ability is associated with few complaints, the occupation “office workers,” a younger vital functional age, and the absence of burnout symptoms, which means in comparison with OW, TE have a 1.6 times higher risk for impaired work ability. Furthermore, the absence of burnout symptoms is a resource of TE, whereas OWs tend to have a younger vital functional age compared to their calendrical age. Although this analysis is able to explain 61.2% of the influence on impaired work ability, research for further causes must be undertaken. Conclusion: The results reflect the positive effect of a high educational level and a challenging job on the preservation of good work ability. Moreover, they draw the attention to the psychological and psychosocial strains of TE. TEs are exposed more frequently to feeling overstrained; this probably effects a higher retirement rate due to illness.
Changes in secondary pharmacological prevention of acute coronary syndromes and stroke after hospital discharge: a 6-month follow-up study of German primary care patients
Quelle: Journal of Public Health, 17 (2008) 1, S 3-7
Inhalt: Aim: This study examined modifications in secondary preventive medication between the time of hospital discharge (HD) and during a 6-month follow-up treatment of outpatients with acute coronary syndromes (ACS) and stroke. Subjects and methods: During a 6-month period, a health diary was completed on a weekly basis by 98 patients who were initially hospitalised with ACS and 29 patients with strokes in the Cologne area (Germany). Changes in medication between the time of HD and follow-up treatment (weeks 2, 12, and 24) were recorded. Results: On average, patients with ACS took six medications, whereas patients with stroke took five medications per day. ACS patients received beta-blockers (96%), lipid-lowering agents (80%), and angiotensin-converting enzyme (ACE) inhibitors (64%) at HD, and no changes in medication were made during follow-up treatment. However, there was a significant decrease in prescriptions of clopidogrel among ACS patients within 6 months, and about 13% of ACS patients did not receive an antiplatelet agent at any time. Stroke patients received beta-blockers (50%), lipid-lowering agents (67%), and antiplatelet agents, such as acetylsalicylic acid (57%) or clopidogrel (27%), at the time of HD, and no significant changes in medication were instituted during follow-up treatment. Conclusion: Treatment of ACS patients with the combination of acetylsalicylic acid and clopidogrel was insufficient, although it has been shown that this combination is highly effective in secondary prevention of ACS. Besides medical reasons, the cost-containment restrictions (“medication budget”) for German physicians might explain the observed failure of guideline-oriented medication. Furthermore, no changes in medications occurred regarding blood-pressure- and lipid-lowering agents.