Parental Influence on Their Adult Children's Sexual Values: A Multi-National Comparison Between the United States, Spain, Costa Rica, and Peru.

We examined the influence of perceived parental sexual values, religiosity, and family environment on young adults' sexual values from the United States (n = 218), Spain (n = 240), Costa Rica (n = 172), and Peru (n = 105). On average, and across the four national groups, the messages young adults received from their parents about broad domains of sexual behaviors (masturbation, non-intercourse types of heterosexual sexual activity, premarital sex, same-sex activity, and cohabiting) were unequivocally restrictive. By contrast, across the four groups, young adults on average held rather permissive sexual values and their values differed significantly from those of their parents. Moreover, the nature of perceived parental sexual values (restrictive vs. permissive) was not associated significantly with young adults' sexual values, age of sexual debut, or number of sexual partners. Comparatively, Spanish young adults held the most permissive sexual values, whereas US young adults held the most restrictive sexual values. Religiosity was the strongest predictor of young adults' sexual values, followed by perceived parental sexual values and influence. In conclusion, it appears that despite having perceived restrictive parental messages about sex, these young adults currently hold permissive sexual attitudes, thus calling into question the influence parents actually have on their adult children's sexual values.

Emotional distress and health-related quality of life in patients on hemodialysis: the clinical value of COOP-WONCA charts.

BACKGROUND: A significant percentage of patients on hemodialysis (HD) present with affective disorders such as anxiety and/or depression. The purpose of this study was to explore adaptive mixed affective disorders of patients on HD and to analyze the clinical value of a brief health-related quality-of-life (HRQoL) instrument, the COOP-WONCA charts, in our population of HD patient. METHODS: Seventy-five patients (mean age 49.2 years; range 20.1-64.9), who had been on HD for a mean 110 months (range 6.1-364.5 months) were studied. The Beck Depression Inventory (BDI), Hamilton Scale of Depression (HDRS) and Hamilton Scale of Anxiety (HARS) were used. To evaluate patient HRQoL, we used the validated Spanish version of the COOP-WONCA charts. RESULTS: Of the 75 patients studied, 44.0% (BDI) and 53.4% (HDRS) had some depressive symptoms which were moderate-severe in 14.7% (BDI) and in 22.7% (HDRS). Anxiety symptoms were observed in 46.6% of the patients (13.3% were of moderate-severe degree). There was a high level of association between both depression scales (BDI and HDRS) (r=0.70; p<0.001), as well as between both scales and the HARS (HDRS, r=0.82; p<0.001; BDI, r=0.53; p<0.001). The most affected dimensions of the COOP-WONCA charts were "Physical fitness" and "Overall health," whereas the least affected were "Social activities" and "Daily activities." The global score of the COOP-WONCA charts was associated with the presence of depressive (BDI, r=0.64, and HDRS, r=0.75; p<0.001) and anxiety symptoms (HARS, r=0.52; p<0.001). A score of >or= 3 corresponding to the dimension "Feelings" on the COOP-WONCA charts allowed the detection of 81.8% of the patients with clinically significant depressive symptoms (BDI >18), with a sensitivity of 96.8% and a specificity of 75% for this cutoff point. CONCLUSIONS: A high percentage of patients on HD present with mixed emotional disorders (anxiety and/or depression); a good correlation is observed between HRQoL and the levels of anxiety and depression in these patients; and measuring HRQoL with the COOP-WONCA charts may help diagnose such problems.

Assessment of health-related quality of life in chronic dialysis patients with the COOP/WONCA charts.

BACKGROUND: The aim of the present work was to determine the health-related quality of life (HRQOL) of our patients on hemodialysis using the COOP/WONCA charts. A further aim was to explore its psychometric characteristics. METHODS: The present study included all patients attending the hemodialysis unit of our hospital. The comparative study of the results was conducted with other population groups in which this questionnaire has been applied previously (primary-care patients, their accompanying persons, pregnant women, Alzheimer patient carers and drug addicts). The dimensional structure of the questionnaire was explored by factorial analysis of principal components, and internal consistency was evaluated with the Cronbach alpha factor. Concurrent validity was determined by comparative analysis of the results of the COOP/WONCA charts with those of another questionnaire, the 36-item short form of the Quality of Life Score (SF-36). To do so, 60 randomly chosen patients completed both questionnaires. RESULTS: 98.9% of patients completed the COOP/WONCA charts in their entirety. The mean scores of all the charts, with the exception of overall health, are in the range of what could be called 'favorable area of quality of life' (below 3). With respect to the rest of the groups, the dialysis patients had the best scores on the 'feelings' and 'social activities' charts and none of the worst ones. The joint factorial analysis revealed that the questionnaire has a 3-factor structure: factor 1 or daily functioning, factor 2 or quality of life and health, factor 3 or the psychosocial factor. The Cronbach alpha value for the 9 charts was 0.766. All the correlations between equivalent dimensions of questionnaires COOP/WONCA and SF-36 were statistically significant (p < 0.01). The convergent validity mean was 0.57 and the discriminant validity mean was 0.22, appreciably lower than convergent validity. CONCLUSIONS: This study shows that the process of psychological adaptation to problems deriving from dialysis is satisfactory. Moreover, the COOP/WONCA charts are a useful instrument for the determination of the HRQOL in hemodialysis patients without losing psychometric quality.