scholarly journals Stress and perceived health among primary care visitors in two corners of Europe: Scandinavia and Greece

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Jenny Koppner ◽  
Marios Chatziarzenis ◽  
Tomas Faresjö ◽  
Elvar Theodorsson ◽  
Annika Thorsell ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Perceived Stress ◽  
Perceived Health ◽  
Long Term Effects ◽  
Primary Health ◽  
The Future ◽  
Logistic Regressions

Abstract Background The global financial crisis emerging in 2008 struck Greece especially hard, whereas Scandinavian countries were less affected. This has created a unique opportunity to study the long-term effect of community stress on populations. Increasing frequencies of mental health issues and poorer perceived health among the Greek population have been reported. The physiological marker of long-term stress, cortisol in hair, is applied in this study together with measures of perceived health and stress, depression and anxiety. Our aim was to study self-reported and physiological stress, perceived health, including mental health, in the general population of Greece compared to Scandinavia, in order to assess long-term effects of the economic crisis on these parameters. Methods A cross-sectional comparative study of adult (18–65 years) Primary Health Care visitors from semi-rural areas in Greece (n = 84) and Scandinavia (n = 140). Data collection was performed in 2012, and encompassed a questionnaire with a variety of health and stress indicators as well as hair samples for analyzes of cortisol levels. Results The Greek sample reported significantly poorer overall health (p < 0.0001) than the Scandinavians and a significantly higher perceived stress (p < 0.0001). The Greeks were also less hopeful of the future (p < 0.0001), and to a larger extent fulfilled the HAD criteria for depression (p < 0.0001) and anxiety (p = 0.002). The strongest predictors explaining ill health in logistic regressions were being Greek (p = 0.001) and feeling hopeless about the future p = 0.001, OR = 6.00 (CI 2.10–14.88). Strong predictors in logistic regressions for high perceived stress were anxiety: high (p < 0.0001) and medium (p = 0.0001), as well as medium depression (p = 0.02). Conclusions Greek adult Primary Health Care visitors perceived their health more negatively than the Scandinavians, including a higher presence of depression, anxiety, and a lower hope for the future. The Greeks also reported higher perceived stress, but this was not reflected in higher cortisol levels. The findings presented here, identify possible adverse long-term effects of the economic crisis in the examined Greek population that are not seen in the Scandinavian cohort. These differences may also be interpreted against the background of socio-cultural differences in the northern and south-eastern corners of Europe.

scholarly journals Perceived Health and Stress among Primary Care visitors - a comparative cross-sectional study between Greece and Scandinavia

2020 ◽  
Author(s):  
Jenny Koppner ◽  
Marios Chatziarzenis ◽  
Tomas Faresjö ◽  
Elvar Theodorsson ◽  
Annika Thorsell ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Perceived Stress ◽  
Perceived Health ◽  
Cross Sectional ◽  
Primary Health ◽  
The Future ◽  
Logistic Regressions ◽  
Cortisol Levels

Abstract Background: Health behavior varies highly across European countries, and stress and stress-related disorders are commonly seen in European Primary Health Care. Greece has suffered deeply from the 2008 international financial crisis, whereas Scandinavian countries were less affected. Several reports of increasing mental health issues and poorer perceived health among the Greek population have been published. Self-reported health and stress are established public health indicators. A novel physiological marker of long-term stress, cortisol in hair, is at hand and applied in this study. Here, our aim was to study perceived health, including mental health, and self-reported and biological stress in Greece compared to Scandinavia. Methods: A cross-sectional comparative study of adult (18-65) Primary Health Care visitors from semi-rural areas in Greece (n=84) and Scandinavia (n=140). Data collection encompassed a questionnaire with a variety of health and stress indicators and hair samples for analyzes of cortisol levels. Results: The Greek sample reported significantly poorer overall health (p<0.0001) than the Scandinavians and significantly higher perceived stress (p<0.0001). The Greeks were also less hopeful of the future (p<0.0001), and to a larger extent fulfilled the HAD criteria for depression (p<0.0001) and anxiety (p=0.002). There were no significant differences in cortisol levels between the study-groups. The strongest predictors explaining ill health in logistic regressions were being Greek (p=0.001) and feeling hopeless about the future p=0.001, OR= 6.00 (CI; 2.10-14.88). Strong predictors in logistic regressions for high perceived stress were anxiety: high (p=<0.0001) and medium, (p=0.0001), as well as medium depression (p=0.02). Participants with either low or high cortisol levels, and those that reported ill health, had elevated self-reports of high stress, but these did not reach statistical significance.Conclusions: The results suggest that Greek adult Primary Health Care visitors perceived their health more negatively than the Scandinavians, including a higher presence of depression, anxiety, and a lower hope for the future. The Greeks also reported higher perceived stress, not reflected in higher cortisol levels. These findings could be interpreted against the background of socio-cultural differences in northern and southern Europe, and might also reflect the economic crisis that the Greek population experienced at that time.

Perceived health and high consumers of care: a study of mental health problems in a Swedish primary health care district

1993 ◽  
Vol 23 (3) ◽  
pp. 763-770 ◽  
Author(s):  
L. Borgquist ◽  
L. Hansson ◽  
P. Nettelbladt ◽  
G. Nordström ◽  
G. Lindelöw
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Problems ◽  
Perceived Health ◽  
Health Problems ◽  
Check List ◽  
Sickness Absenteeism ◽  
Care Clinic ◽  
Primary Health

SynopsisMany patients with mental health problems are treated in primary health care services. They are often multi-users of care. In the present investigation we have studied patients visiting primary health care clinics who have been assessed for mental health problems according to the Hopkins Symptom Check List (HSCL-25). Two quality-of-life instruments (the Nottingham Health Profile and the Mood Adjective Check List) were applied to describe further the perceived health of the sample.A random sample of 93 patients was chosen out of 388 patients visiting a primary health care clinic in a Swedish health care district during four weeks in January and February 1990, and these patients were followed prospectively during one year. High consumers of health care during the follow-up period scored a poor perceived health. ‘Feeling worthless’, predicted a high number of days of sickness absenteeism. Hidden cases, not detected by the GPs, consumed more resources than those identified by the GPs. The importance of training and educating general practitioners in the early detection of patients with mental health problems is discussed.

Earthquakes, Fuel Crisis, Power Outages, and Health Care in Nepal: Implications for the Future

2017 ◽  
Vol 11 (5) ◽  
pp. 625-632 ◽  
Author(s):  
Bipin Adhikari ◽  
Shiva Raj Mishra ◽  
Sujan Babu Marahatta ◽  
Nils Kaehler ◽  
Kumar Paudel ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Emergency Care ◽  
Health Care Services ◽  
Health Hazards ◽  
Long Term Effects ◽  
Power Outages ◽  
Care Services ◽  
The Future

AbstractEarthquakes are a major natural calamity with pervasive effects on human life and nature. Similar effects are mimicked by man-made disasters such as fuel crises and power outages in developing countries. Natural and man-made disasters can cause intangible human suffering and often leave scars of lifelong psychosocial damage. Lessons from these disasters are frequently not implemented. The main objective of this study was to review the effects of the 2015 earthquakes, fuel crisis, and power outages on the health services of Nepal and formulate recommendations for the future. The impacts of earthquakes on health can be divided into immediate, intermediate, and long-term effects. Power outages and fuel crises have health hazards at all stages. It is imperative to understand the temporal effects of earthquakes, because the major needs soon after the earthquake (emergency care) are vastly different from long-term needs such as rehabilitation and psychosocial support. In Nepal, the inadequate and nearly nonexistent specialized health care at the peripheral level claimed many lives during the earthquakes and left many people disproportionately injured. Preemptive strategies such as mobile critical care units at primary health centers, intensive care training for health workers, and alternative plans for emergency care must be prioritized. Similarly, infrastructural damage led to poor sanitation, and alternative plans for temporary settlements (water supply, food, settlements logistics, space for temporary settlements) must be in place where the danger of disease outbreak is imminent. While much of these strategies are implementable and are often set as priorities, long-term effects of earthquakes such as physical and psychosocial supports are often overlooked. The burden of psychosocial stresses, including depression and physical disabilities, needs to be prioritized by facilitating human resources for mental health care and rehabilitation. In addition, inclusion of mental health and rehabilitation facilities in government health care services of Nepal needs to be prioritized. Similarly, power outages and fuel crises affect health care disproportionately. In the current context where permanent solutions may not be possible, mitigating health hazards, especially cold chain maintenance for essential medicines and continuation of life-saving procedures, are mandatory and policies to regulate all health care services must be undertaken. (Disaster Med Public Health Preparedness. 2017;11:625–632)

Disaster Management in Rural and Remote Primary Health Care: A Scoping Review

2021 ◽  
Vol 36 (3) ◽  
pp. 362-369
Author(s):  
Katie A. Willson ◽  
Gerard J. FitzGerald ◽  
David Lim
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Care ◽  
Disaster Management ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Disaster Preparedness ◽  
Rural And Remote ◽  
Primary Health

AbstractObjective:This scoping review aims to map the roles of rural and remote primary health care professionals (PHCPs) during disasters.Introduction:Disasters can have catastrophic impacts on society and are broadly classified into natural events, man-made incidents, or a mixture of both. The PHCPs working in rural and remote communities face additional challenges when dealing with disasters and have significant roles during the Prevention, Preparedness, Response, and Recovery (PPRR) stages of disaster management.Methods:A Johanna Briggs Institute (JBI) scoping review methodology was utilized, and the search was conducted over seven electronic databases according to a priori protocol.Results:Forty-one papers were included and sixty-one roles were identified across the four stages of disaster management. The majority of disasters described within the literature were natural events and pandemics. Before a disaster occurs, PHCPs can build individual resilience through education. As recognized and respected leaders within their community, PHCPs are invaluable in assisting with disaster preparedness through being involved in organizations’ planning policies and contributing to natural disaster and pandemic surveillance. Key roles during the response stage include accommodating patient surge, triage, maintaining the health of the remaining population, instituting infection control, and ensuring a team-based approach to mental health care during the disaster. In the aftermath and recovery stage, rural and remote PHCPs provide long-term follow up, assisting patients in accessing post-disaster support including delivery of mental health care.Conclusion:Rural and remote PHCPs play significant roles within their community throughout the continuum of disaster management. As a consequence of their flexible scope of practice, PHCPs are well-placed to be involved during all stages of disaster, from building of community resilience and contributing to early alert of pandemics, to participating in the direct response when a disaster occurs and leading the way to recovery.

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