[Impact of frailty status on health and quality of life in Spanish older adults]. / Impacto del estatus de fragilidad sobre la salud y calidad de vida en personas mayores españolas.

OBJECTIVE: The aim of this study is to evaluate the predictive power of a latent measure of frailty based on the physical indicators proposed for the Survey of Health, Aging and Retirement in Europe (SHARE) on the quality of life and perceived health status in a representative sample of Spanish older adults. DESIGN: Descriptive cross-sectional study. SETTING: Spain. PARTICIPANTS: The sample was composed of 4,498 community-dwelling older Spanish adults aged 60 or over, extracted from wave six of SHARE. PRINCIPAL MEASUREMENTS: A structural equation model was used to define the frailty factor based on the five physical indicators proposed for SHARE (mobility, appetite, fatigue, activity, and strength), and test its effects on quality of life and perceived health status. RESULTS: Results showed an excellent fit of the model to the data (P<.001, CFI=.977, and SRMR=.041). Frailty factor explained 39.5% of the variance in quality of life and 61.6% of the variance in perceived health. CONCLUSIONS: The latent factor of frailty presented in this construct has an excellent fit to the data. The predictive power of frailty on the quality of life and perceived health in a sample of the Spanish population is highlighted.

[Health-care utilization in elderly (Spain 2006-2012): Influence of health status and social class]. / Utilización de servicios sanitarios en ancianos (España 2006-2012): influencia del nivel de salud y de la clase social.

OBJECTIVE: to explore health-care utilization (primary and specialized health-care, hospitalizations, day hospital and emergency services) and overuse in elderly in Spain, considering the influence of health status, sex, social class and its temporal trend. DESIGN: cross sectional study in two phases. SETTING: Spain. PARTICIPANTS: people surveyed in the National Health Surveys 2006 and 2011-12. MAIN MEASUREMENTS: Health status was measured using self-rated and diagnosed health (number and diagnoses). Social class was obtained from the last occupation of the main supporter (manual and non-manual workers). Logistic regression analyses were conducted adjusting by sex, age, health status, social class and year, obtaining its predictive capacity. RESULTS: the percentage of elderly population with health-care utilization decreased during the period analyzed. Women who belonged to the manual workers category presented the highest prevalence of low health (low self-rated health in 2006: 70.6%). Low health status was associated with a higher utilization of health-care services. Self-rated health was a better predictor of health-care utilization and overuse than diagnosed health, getting the highest predictive capacity for specialized health-care (C = 0.676). Old people from low social class used with higher frequency primary health-care and emergency services. On the other hand, specialized health-care and day hospital were more used by high social classes. CONCLUSIONS: inequalities in health and health-care utilization have been observed in elderly according social class. It is necessary to consider self-rated health as a health-care utilization predictor and to review our health-care services accessibility and equity.

[Patient evaluation and outcome measures]. / Evaluación del paciente y medida de resultados.

Both the initial evaluation and follow-up of patients with osteoarthritis require systematic evaluation of the indicators that provide information on the degree of involvement of the disease and allow its quantification. Reliable measures of disease progression help decision-making by clinicians and provide valid information on treatment response and the effectiveness of the distinct therapeutic interventions. The instruments recommended in research, as outcome measures in osteoarthritis, are pain evaluation, assessment of physical function, and self-reported global evaluation. In studies lasting more than 1 year, structural changes are evaluated through simple X-ray. Self-reported quality of life assessment and physician global assessment are also recommended as options. These indicators should be incorporated into routine clinical practice for adequate evaluation and correct follow-up of patients with osteoarthritis. The recommended pain evaluation method for use in clinical practice is the visual analog scale (VAS). The best instrument to evaluate physical function in patients with hip or knee osteoarthritis is the WOMAC scale (Western Ontario and McMaster Universities Osteoarthritis Index). For patient-reported global assessment in routine practice, the recommended scales are VAS or the SF-12 (12-item short-form health survey).

[Self-care: New evidence for its measurement in older adults]. / Autocuidado: nueva evidencia sobre su medida en adultos mayores.

INTRODUCTION: A major challenge in today's society is getting older people, not only live longer, but to have a better life, and achieve successful aging. Self-care has been identified as relevant construct in its relation to physical, psychological, and social health. Therefore, this paper aims to provide first evidence of the psychometric properties of a scale to assess self-care in older people. MATERIAL AND METHODS: The sample consisted of 443 people aged between 60 and 80years (M=66.11, SD=4.72), all of them currently participating in lifelong learning programs. There were 64.2% women, and most participants were married (73.7%). They were asked to complete the Self-Care for Older People Scale (SCOPS), the SF-8 Health Perception scale and, the Life Satisfaction scale (SWLS). Data were analysed using confirmatory factor analysis, and scale correlations between self-care and variables from its nomological network. RESULTS AND CONCLUSIONS: The tested model provided an adequate fit to the data: χ2(23)=64.257 (P<.001); comparative fit index (CFI)=.936; Tucker Lewis Index (TLI) =.899; standardized root mean square residual (SRMR) =.070; root mean square error of approximation (RMSEA) =.064 (.046-.083), supporting the original structure of three factors: physical, social, and internal self-care. These factors also showed statistically significant correlations with two important variables of their nomological network, perceived health and life satisfaction.

Factores de salud percibida y de calidad de vida al inicio de la educación universitaria en Colombia / Perceived health and quality of life factors at the beginning of university education in Colombia

Resumen El objetivo del presente estudio fue identificar factores de salud percibida y de calidad de vida en estudiantes de primer semestre de una universidad privada en Colombia. Para esto, se contó con una muestra por conveniencia de 636 estudiantes (M = 18 años, DE = 1.38) que participó en la primera medición de una investigación longitudinal denominada VIDA2020. En particular, se realizó un diseño de investigación observacional transversal, enmarcado en una investigación de cohorte. Del protocolo de evaluación del proyecto, este reporte incluye un cuestionario con datos sociodemográficos y antecedentes médicos, las subescalas de depresión y estrés del DASS-21, un ítem del SF36V-2 y el WHOQOL-BREF. En general, como resultado se encontró que el 91 % de los estudiantes valora su salud global como buena o excelente; que dicha valoración es significativamente menor en quienes reportan antecedentes de enfermedad (80.5 %) y síntomas de depresión (86.1 %) y estrés (83.1 %); que las mujeres, los migrantes y quienes reportan antecedentes de enfermedad puntúan menor calidad de vida física, psicológica y ambiental; y que el estrés y la depresión predicen menores puntajes de calidad de vida física y psicológica, con correlaciones más fuertes en comparación con las variables demográficas y médicas. Estos hallazgos permiten identificar y priorizar las necesidades especiales en salud de los nuevos estudiantes.

Abstract The aim of this study was to identify factors of perceived health and quality of life in first semester students of a private university in Colombia. For this purpose, a convenience sample of 636 students (M= 18 years, SD.=1.38) participated in this first phase of the longitudinal study called VIDA2020. An observational cross-sectional research design framed within a cohort study was used. From the assessment protocol of the project, this report includes a questionnaire with sociodemographic data and medical history, the DASS-21 depression and stress subscales, one item of the SF36V-2, and the WHOQOL-BREF. Results showed that most students (91%) rated their overall health as good or excellent, but this rating was significantly lower in those reporting a history of illness in their medical background (80.5%) and symptoms of depression (86.1%) and stress (83.1%). Women, migrants and those reporting a history of illness scored lower on physical, psychological and environmental dimensions of quality of life. Additionally, stress and depression predict lower physical and psychological quality of life scores, with stronger correlations compared to sociodemographic and medical variables. These findings allow the identification and prioritization of special health needs of new students.

[Quality of life-associated factors at one year after total hip and knee replacement: a multicentre study in Catalonia]. / Factores relacionados con la calidad de vida al año de la artroplastia total de cadera y rodilla: estudio multicéntrico en Cataluña.

AIMS: To assess the health related quality of life (HRQOL) and associated factors of patients before, and one year after, total knee (TKA) and hip (THA) arthroplasty. METHODS: A quasi-experimental prospective study conducted in hospitals with different levels of complexity and volume in Catalonia, and on patients with an indication of a TKA or THA. Demographic and psychosocial variables were recorded, and the SF-36 and WOMAC, and a question on perception of change after surgery were administered to patients by telephone interview. The standardised differences (effect size) of perceived change using the SF-36 and WOMAC scores before and after surgery were calculated. The factors associated with HRQOL one year after surgery were analysed using adjusted general linear models. RESULTS: Although there was an overall improvement in most HRQOL domains of patients (n=672), 9% saw little improvement after surgery, with their scores at baseline and follow-up being very similar (small size effect: 0.0-0.4). Women, patients with low social support, with lower scores (worse) in perceived mental health and baseline HRQOL, and who declared that their condition was more severe, perceived a poorer HRQOL one year after surgery (P<.05). CONCLUSIONS: Factors associated to a worse prognosis one year after an arthroplasty have been identified and are consistent with other published studies. The assessment of HRQOL can be a key instrument for identifying possible patients without improvement, in order to assess alternatives to an intervention, or apply other interventions in order to improve the efficiency of the healthcare process.

Happiness and health and food-related variables: Evidence for different age groups in Chile / Felicidad y variables relacionadas con la salud y los alimentos: evidencia para distintos grupos de edad en Chile

This study aimed to identify the factors determining the happiness in young and middleaged adults in Chile, including health and food-related factors, and their relationships between them. To achieve this objective, a survey was conducted on a total of 1163 people (from 20 to 65 years old), proportionally distributed in the cities over 100000 inhabitants in the central area of Chile. The main scales used were: Subjective Happiness Scale (SHS), Health Related Quality of Life Index (HRQoL), and Satisfaction with Food-related Life (SWFL). In this study, the logistic ordinal regression models were estimated. The mainfinding was that people have more unhealthy days, poorer perception of their health, and are less satisfied with their food-related life, and are less happy in both age groups. Therefore, health-related factors and SWFL are strong predictors of happiness.

En este estudio se identifican los determinantes de la felicidad en adultos jóvenes y personas de edad media en Chile, incluyendo factores relacionados con la salud y la alimentación, y las conexiones entre ellos. Un total de 1163 personas fueron entrevistadas (entre 20 y 65 años de edad), distribuidas proporcionalmente por las ciudades de más de 100000 habitantes de la zona central de Chile. Las principales escalas utilizadas fueron: Escala de Felicidad Subjetiva, Calidad de Vida Relacionada con la Salud, y Satisfacción con la Vida Relacionada con los Alimentos. En este estudio se estimaron modelos de regresión logística ordinal. El principal hallazgo es que las personas con más días no saludables, más pobre percepción de su estado de salud, y menos satisfechas con su vida relacionada con los alimentos, son menos felices en ambos grupos de edad. Esto significa que los factores relacionados con la salud y la satisfacción con la vida relacionada con los alimentos son fuertes predictores de la felicidad.

Differences in Perceived Health Status Outcomes among Heterosexual, Homosexual (Gay or Lesbian) and Bisexual Korean adolescents / Diferencias en el estatus de salud percibido entre adolescentes coreanos heterosexuales, homosexuales (gays o lesbianas) y bisexuales

The purpose of this study was to examine differences in perceived health status outcomes among heterosexual, homosexual (gay or lesbian), and bisexual Korean adolescents. Originally, in 2012, over 70,000 adolescents aged 12-18 years participated in the Eighth Korea Youth Risk Behavior Web-based Survey (KYRBWS -VIII). However, only 11,829 adolescents provided information on their sexual experiences and behaviors, such as kissing, fondling, and sexual orientations, i.e., homosexual (gay or lesbian), bisexual, or heterosexual. Therefore, data from only 11,829 adolescents surveyed were analyzed using a one -way analysis of variance, with a Scheffe post-hoc test, to determine the differences in perceived health status outcomes among Korean adolescents of the different sexual orientation groups. Boys across all 3 groups showed significant differences in general health status (p = 0.004), happiness (p = 0.045), and getting sufficient sleep (p = 0.004). Further, Scheffe post-hoc comparisons of group mean scores revealed that homosexual (gay) boys had poorer overall health (p = 0.004) and bisexual boys had less sufficient sleep (p = 0.017); however, there were no significant differences in happiness between homosexual (gay) (p = 0.651) and bisexual boys (p = 0.064) as compared to heterosexual boys. Moreover, there were no significant differences in general body shape (p = 0.320) and oral health (p = 0.549) among the 3 groups we studied. Girls differed significantly in general body shape (p = 0.026) across all 3 groups in the results of the one-way ANOVA we performed. However, according to Scheffe post-hoc analyses, no significant differences existed in general body shape among girls in both the homosexual (lesbian) and bisexual groups (p = 0.112 and 0.204, respectively). Additionally, there were no significant differences in general health status (p = 0.113), happiness (p = 0.602), oral health (p = 0.290), and getting sufficient sleep (p = 0.481) among adolescent girls in all 3 groups. From these results, we concluded that, in general, homosexual (gay or lesbian) and bisexual Korean teens do not differ significantly from heterosexual Korean teens in perceived health status outcomes.

El propósito de este estudio fue examinar las diferencias en los resultados del estado de salud percibido entre adolescentes coreanos heterosexuales, homosexuales (gays o lesbianas) y bisexuales. Originalmente, en 2012, más de 70.000 adolescentes de 12 a 18 años participaron en la Octava Encuesta Coreana para la Juventud sobre comportamientos riesgosos (KYRBWS-VIII). Sin embargo, sólo 11.829 adolescentes proporcionaron información sobre sus experiencias sexuales y comportamientos, como los besos, las caricias, y orientaciones sexuales, es decir, homosexual (gay o lesbiana), bisexual o heterosexual. Por lo tanto, los datos de sólo 11.829 adolescentes encuestados fueron analizados mediante un análisis de varianza, con una prueba post-hoc de Scheffe, para determinar las diferencias en los resultados del estado de salud percibido entre los adolescentes coreanos de los diferentes grupos de orientación sexual. Jóvenes en todos los 3 grupos mostraron diferencias significativas en el estado de salud general (p = 0,004), la felicidad (p = 0,045), y dormir lo suficiente (p = 0,004). Además, las comparaciones de grupo post-hoc de Scheffe muestran las puntuaciones significativas que revelan que los homosexuales (gay) chicos tenían peor salud general (p = 0,004) y los chicos bisexuales presentaban una deficiencia en el sueño (p = 0,017); sin embargo, no hubo diferencias significativas en la felicidad entre homosexual (Gay) (p = 0,651) y chicos bisexuales (p = 0,064) en comparación con los niños heterosexuales. Por otra parte, no hubo diferencias significativas en la forma general del cuerpo (p = 0,320) y la salud oral (p = 0,549) entre los 3 grupos estudiados. Las niñas difieren significativamente en la forma del cuerpo general (p = 0,026) en todos los 3 grupos en los resultados de la ANOVA de una vía. Sin embargo, de acuerdo con el análisis post-hoc de Scheffe, no existen diferencias significativas en forma general del cuerpo de las niñas, tanto en el homosexual (lesbiana) y bisexuales (p = 0,112 y 0,204, respectivamente). Además, no hubo diferencias significativas en el estado de salud general (p = 0,113), la felicidad (p = 0,602), la salud oral (p = 0,290), y dormir lo suficiente (p = 0,481) entre las adolescentes en los 3 grupos. A partir de estos resultados, se concluye que, en general, los adolescentes homosexuales (gays o lesbianas) y bisexuales de Corea no difieren significativamente de los adolescentes coreanos heterosexuales en los resultados del estado de salud percibido.

Salud percibida y salud real: prevalencia en las personas mayores de 60 años / Perceived health and real health: prevalence among persons aged 60 and older / Saúde percebida e saúde real: prevalência nas pessoas idosas de 60 anos

Objetivo: Analizar el estado de salud de la población mayor de 60 años y la relación que existe entre la autopercepción de la salud que tienen las personas mayores y su salud real; se valoró la mediación en esta relación de aspectos sociodemográficos como la edad y el género. Método: Diseño descriptivo, transversal, de prevalencia. Localización: 15 centros de día y 10 residencias de la provincia de Almería (España). Participantes: 1,220 personas mayores de 60 años (M = 70.9; DT = 7.9), de los cuales el 48.3% son hombres y el 51.7% mujeres. Mediciones: Se analizó el género, la edad, el estado civil, la presencia o no de diferentes enfermedades y problemas de salud, y el nivel de salud percibido. Resultados: Los problemas de salud relacionados con los huesos y articulaciones son los más frecuentes. Existen diferencias significativas (p = 0.000) en la percepción de la salud entre ambos géneros; los hombres tienen una mejor percepción de su salud. Hay una relación negativa y significativa (p < 0.001) entre la edad y la percepción de la salud. Tanto el número de enfermedades (r2 = 0.251) como la edad (r2 = 0.010) y el género (r2 = 0.002) forman parte del modelo explicativo de la percepción de salud. Conclusiones: El número de enfermedades, la edad y el género son variables que explican una cuarta parte de la variable subjetiva salud percibida, por tanto ofrecen indicios de poder ser utilizadas en la planificación de las políticas sanitarias.

Objective: To analyze the health of the population aged 60 and older, and the relationship between their perception of their health and their real condition. The relationship with social-demographic issues such as gender was also assessed. Method: Descriptive, transversal and prevalence study of 15 Day and 10 Residential Centers in the province of Almería (Spain), with 1,220 persons aged 60 and older (M = 70.9, SD = 7.9), 48.3% male and 51.7% female. Measurements Gender, age, civil status, and the presence of pathologies and health problems, as well as the perceived health level were all assessed. Results: Health problems related to bones and articulations were the most reported. There are significant differences (P=0.000) in the perception of health between both genders; males have a better perception of their health. There is a negative and significant relation (P < .001) between age and the perception of health. The number of illnesses (r2 = 0.251), age (r2 = 0.010), and gender (r2 = 0.002) are all part of the explicative model of the perception of health. Conclusions: The number of illnesses, age, and gender are variables which explain a quarter of the subjective perception of health variable, and thus, they indicate a possible use in the planning of health policies.

Objetivo: Analisar o estado de saúde da população idosa de 60 anos e, a relação que existe entre a auto percepção da saúde que realizam as pessoas idosas e a sua saúde real. Valorizou-se a intermediação de aspetos sócio demográficos como a idade e o género. Método: Desenho descritivo, transversal de prevalência. Localização: 15 centros de dia e 10 moradias da província de Almería (na Espanha). Participantes: 1220 pessoas idosas de 60 anos (M = 70.9; DT = 7.9), das quais o 48.3% são homens e o 51.7% são mulheres. Medições Analisou-se o género, a idade, o estado civil, a presença e a não presença de diferentes patologias e problemas de saúde e, o nível de saúde percebido. Resultados: Os problemas de saúde relacionados com os ossos e as articulações são os mais frequentes. Existem diferenças significativas (p = 0.000) na percepção de saúde entre ambos os géneros, os homens têm uma melhor percepção da sua saúde. Há uma relação negativa e significativa (p < 0.001) entre a idade e a percepção da saúde. Tanto o número de doenças (r2 = 0.251) como a idade (r2 = 0.010) e o género (r2 = 0.002) formam parte do modelo explicativo da percepção da saúde. Conclusõeso: O número de doenças, a idade e o género são variáveis que explicam uma quarta parte da variável subjetiva "saúde percebida", portanto, oferecem índicios de poderem ser utilizadas na planificação de políticas sanitárias.

Adaptación Universitaria y Su Relación con la Salud Percibida en Una Muestra de Jóvenes de Perú / Adaptation to College and Its Relation to Perceived Health in A Sample of Peruvian Students / Adaptação Universitária e Sua Relação com a Saúde Percebida Numa Amostra de Jovens do Peru

El propósito de este estudio fue analizar la relación entre la salud percibida y la adaptación a la vida universitaria de un grupo de jóvenes estudiantes de Lima, Perú. Para ello, se aplicó el Cuestionario de Adaptación Universitaria (QVA -R) y una medida de salud percibida, a una muestra de 281 estudiantes universitarios. Los resultados mostraron una relación positiva entre la salud percibida y las cinco áreas que miden la adaptación universitaria. El área Personal presentó la mayor relación con la salud percibida. Esto evidenció la importancia de la relación que existe entre la habilidad para adaptarse a la vida universitaria y la percepción de salud de los alumnos.

The purpose of this study was to analyze the relationship between perceived health and adaptation to college in a group of students from Lima, Peru. To that effect, the College Adaptation Questionnaire (QVA -R) and a measurement of perceived health were applied to a sample of 281 college students. Results showed a positive relation between apperceived health and the five areas used to measure college adaptation. The Personal area displayed the greatest connection to perceived health, thus highlighting the relation between the students' ability to adapt to college life and their perception of health.

O propósito deste estudo foi analisar a relação entre a saúde percebida e a adaptação à vida universitária de um grupo de jovens estudantes de Lima, Peru. Para isso, aplicou-se o Questionário de Adaptação Universitária (QVA -R) e uma medida de saúde percebida a uma amostra de 281 estudantes universitários. Os resultados mostraram uma relação positiva entre a saúde percebida e as cinco áreas que medem a adaptação universitária. A área Pessoal apresentou a maior relação com a saúde percebida. Isso evidenciou a importância da relação que existe entre a habilidade para se adaptar à vida universitária e a percepção da saúde dos alunos.

Percepción de salud en adultos mayores de la provincia Matanzas / Health perception in elderly persons from the Matanzas province

Introducción: el estudio de la calidad de vida global y de sus dimensiones es de gran utilidad en los adultos mayores, en tanto constituye un trazador cualitativo de la salud en este segmento poblacional, aquejado con frecuencia de discapacidades que limitan su desempeño social. Objetivos: identificar la percepción de la dimensión salud por parte los adultos mayores de la provincia de Matanzas, y su relación con variables seleccionadas, durante el primer semestre de 2007...

Introduction: the study of the global quality of life and of its dimensions is very useful in elderly persons since it is qualitative health marker in this population segment suffering frequently of inabilities limiting its social performance. Objectives: to identify the perception of health dimension by elderly persons from the Matanzas province and its relation to the variables selected during the first semester of 2007. Methods: a cross-sectional and descriptive study was conducted in 108 559 elderly persons selecting a sample including 714 by formula of sample size calculus for descriptive studies using multistage stratified sampling. To information collection the Minimal Examination of Mental Status and the Perceived Quality of Life Assessment were applied. Absolute and percentages frequencies were estimated applying the homogeneity test and other like Ridit Analysis and X² for regression. Processing was carried out with SPSS version 11,5 and Epidat 3,1. Results are showed in statistical charts. Results: there was predominance of high category in health dimension with values of 91,7 percent, although just as an increase in age there is a decrease of high health perception (p= 0,000). The high health perception is more marked in elderly persons with a couple, with a 95,5 percent than those without couple (88,2 percent) (p= 0,000). In spite of the fact that for all the categories of schooling variable predominated the high health perception, there is a trend to its increase according to increases the schooling level. Conclusions: the high health perception declared by study population, it is expressed in a homogenous way by sexes, but like heterogeneous by age groups, marital condition and schooling level evidencing the significant relation between these latter and the study dimension

Calidad de sueño, somnolencia diurna y salud autopercibida en estudiantes universitarios / Sleep quality, daytime sleepiness and self-perceived health university students

Se propuso establecer la relación calidad de sueño, somnolencia diurna y salud autopercibida en estudiantes universitarios, utilizando un diseño descriptivo correlacional. Los 103 estudiantes universitarios voluntarios que constituyeron la muestra contestaron el Índice de Calidad de Sueño de Pittsburgh, la escala de somnolencia de Epworth y el Cuestionario de Salud SF-12. Los datos fueron analizados mediante estadísticos descriptivos y el coeficiente de correlación de Pearson, con el programa estadístico SSPS versión 17.0. Se encontró una correlación positiva moderada entre la variable calidad de sueño y salud autopercibida (R=-0,53 >0,01), pero ninguna correlación con somnolencia diurna. No se encontró relación entre calidad de sueño, somnolencia diurna y salud autopercibida en esta investigación.

This study aimed to establish the relationship between quality of sleep, daytime sleepiness and self-perceived health in university students, using a correlational design cross-section as a research method. A sample of 103 university students volunteers answered the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and the Health Questionnaire SF-12. Data were analyzed using descriptive statistics and the Pearson correlation coefficient, using the statistical program SPSS version 17.0. There was a moderate correlation between the variable quality of sleep and perceived health (R=-0,530 >0.01). Therefore, it does not find relation between of sleep, daytime sleepiness and self-perceived health in this research.