scholarly journals Αξιολόγηση της λήψης απόφασης και της ποιότητας ζωής του ασθενή στην επιλογή χειρουργικής θεραπείας καρκίνου ορθού με διορθική ενδοσκοπική μικροχειρουργική TEMS

2021 ◽  
Author(s):  
Αλεξάνδρα Κορέλη
Keyword(s):  
Gold Standard ◽  
Transanal Endoscopic Microsurgery ◽  
Short Form ◽  
Cross Sectional Survey ◽  
College Hospital ◽  
Cross Sectional ◽  
Wexner Score ◽  
King's College ◽  
Endoscopic Microsurgery ◽  
Sexual Function Questionnaire

H διορθική ενδοσκοπική μικροχειρουργική (TEMS) είναι μια ελάχιστα επεμβατική διαδικασία, η οποία αφαιρεί με τοπική εκτομή τον όγκο του ορθού διατηρώντας τους σφιγκτήρες και τη λειτουργία του ορθού και εφαρμόζεται σε καρκίνο ορθού πρώιμου σταδίου. H επέμβαση επιτρέπει γρήγορη ανάρρωση και βραχεία νοσηλεία με πολύ χαμηλότερα ποσοστά νοσηρότητας και θνητότητας από τη ριζική χειρουργική επέμβαση (χαμηλή εκτομή ορθού ή κοιλιοπερινεική εκτομή) που είναι η κύρια θεραπεία (Gold standard). Αρκετές μελέτες δείχνουν ότι η θεραπεία των όγκων ορθού πρώιμου σταδίου με TEMS είναι ασφαλής, με χαμηλά ποσοστά στην τοπική υποτροπή και υψηλά ποσοστά επιβίωσης. Επιπλέον, έχουν δείξει ότι η TEMS έχει ανάλογα ογκολογικά αποτελέσματα με τη ριζική χειρουργική εκτομή ταυτόχρονα με πολύ χαμηλότερη νοσηρότητα και θνητότητα. Συνεπώς, η απόφαση ως προς την επιλογή ανάμεσα σε θεραπείες με παρόμοια κλινικά και παθολογοανατομικά αποτελέσματα βασίζεται στην εμπειρία του ασθενή και την ποιότητα ζωής (ΠΖ) που ακολουθεί τη θεραπεία. Η ποιότητα ζωής στους ασθενείς αυτούς δεν έχει διερευνηθεί επαρκώς και δεν είναι γνωστό κατά πόσο δικαιώνει την απόφασή τους υπέρ της TEMS. Η συμμετοχή του ασθενή στην απόφαση για την θεραπεία του αναγνωρίζεται ως θεμελιώδης παράμετρος στην σύγχρονη περίθαλψη και είναι γνωστό ότι έχει ευνοϊκή συνέπεια στην εμπειρία του ασθενή. Έως σήμερα δεν είναι γνωστό ποιοι είναι οι παράγοντες που επηρεάζουν την απόφαση του ασθενή στην επιλογή της θεραπείας TEMS έναντι της ριζικής χειρουργικής θεραπείας. Σκοπός: Σκοπός της παρούσας έρευνας είναι να διερευνηθούν οι παράμετροι που επηρεάζουν τη λήψη απόφασης του ασθενή στην επιλογή της χειρουργικής θεραπείας καρκίνου του ορθού και να αξιολογηθεί η ποιότητα ζωής μετά από διορθική ενδοσκοπική μικροεπέμβαση (Transanal endoscopic microsurgery, TEMS). Σχεδιασμός: Η μελέτη διαθέτει διασταυρούμενο συγχρονικό σχεδιασμό (cross sectional survey).Πλαίσιο: Χειρουργική μονάδα εντέρου-ορθού, King’s College Hospital, κέντρο περιφερειακής αναφοράς θεραπείας TEMS.Πληθυσμός και μέθοδοι: Στη μελέτη συμπεριελήφθησαν ασθενείς διαγνωσμένοι με καρκίνο ορθού: Τ1-Τ2 – N0-M0 σταδίου, οι οποίοι είχαν υποβληθεί σε θεραπεία ΤΕΜS. Στο ερευνητικό ερωτηματολόγιο συμπεριλήφθηκαν τρία έγκυρα ερωτηματολόγια: για τη μέτρηση της γενικής ποιότητας ζωής χρησιμοποιήθηκε το Short Form SF12v2, η εντερική εγκράτεια αξιολογήθηκε με την κλίμακα Wexner Score (CCF-FIS), η σεξουαλική λειτουργικότητα μετρήθηκε με το Sexual Function Questionnaire (SFQ) ερωτηματολόγιο. Οι απόψεις των ασθενών για τη λήψη απόφασης και την εμπειρία τους στη θεραπεία συλλέχθηκαν με ειδικά σχεδιασμένο ερωτηματολόγιο των ερευνητών. Το ελάχιστο διάστημα διερεύνησης ορίστηκε στα τρία χρόνια μετά-TEMS. Έκβαση: Ποιότητα ζωής, εμπειρία ασθενών στην TEMS θεραπεία και οι απόψεις των ασθενών για τη λήψη απόφασης στην επιλογή της θεραπείας TEMS. Αποτελέσματα: Το 86,2% των ασθενών θα έμμενε στην αρχική τους απόφαση και θα επέλεγε πάλι την TEMS θεραπεία με μέση τιμή τα 6,9 (SD=2.0) έτη μετά-TEMS. Τη δήλωση αυτή επηρέασαν η ικανοποίηση από την εμπειρία (p=0,003), η ικανοποιητική μετεγχειρητική λειτουργία του εντέρου (p<0,001), η καλύτερη εγκράτεια Wexner Score (p=0,020) και η υψηλή συνέπεια μεταξύ εμπειρίας και προεγχειρητικής πληροφόρησης (p=0.049). Ο βαθμός ικανοποίησης της εμπειρίας TEMS συσχετίστηκε με την υποστήριξη από την οικογένεια (p=0,034) και τον βαθμό συμφωνίας μεταξύ εμπειρίας και προεγχειρητικής πληροφόρησης (p=0,047), όπως επίσης, έδειξε συσχέτιση με την λειτουργικότητα του εντέρου (p=0,026) και την ψυχική ποιότητα ζωής (p=0,003). Οι δύο διαστάσεις της γενικής ποιότητας ζωής, φυσική και ψυχική, ήταν συγκρίσιμες ως προς τον γενικό πληθυσμό κυμαινόμενες σε παρόμοια επίπεδα και είχαν αρνητική συσχέτιση με το βαθμό εντερικής εγκράτειας (Wexner Score) (r=-0,40 p=0,019) και (r=-0,-38 p=0,025), αντίστοιχα. Το μέσο σκορ στην κλίμακα Wexner ήταν 3,97 (SD=3,86). Η συνολική σεξουαλική λειτουργικότητα είχε σημαντική θετική συσχέτιση με τη φυσική ποιότητα ζωής (p=0,014) και αρνητική με την ηλικία (p=0,006), ενώ λιγότερα προβλήματα έδειξαν όσοι είχαν βελτιωμένη ψυχική ποιότητα ζωής (p=0,030). Οι ασθενείς δήλωσαν χαμηλό μετεγχειρητικό πόνο με μέσο όρο 3,1 (3,3) στη κλίμακα 0-10 που σχετίστηκε θετικά με την στήριξη της οικογένειας (p=0,009). Συμπεράσματα: Οι σημαντικοί παράγοντες για τους ασθενείς στην εμπειρία της TEMS θεραπείας είναι η επαρκής και αξιόπιστη προεγχειρητική πληροφόρηση, η καλή ποιότητα ζωής και η στήριξη της οικογένειας. Οι επαγγελματίες υγείας θα πρέπει να γνωρίζουν αυτές τις παραμέτρους και να τις συμπεριλαμβάνουν στην πρακτική τους όταν παραστέκονται στους ασθενείς τους στη λήψη απόφασης για τη χειρουργική θεραπεία στον καρκίνο του ορθού και παρέχουν πληροφορίες για συναίνεση στην επέμβαση TEMS. Τα αποτελέσματα της έρευνας δείχνουν πως η TEMS συσχετίζεται με καλή μακροπρόθεσμη μετεγχειρητική ΠΖ ενώ είναι η πρώτη μελέτη που αναδεικνύει τη μετά-TEMS ΠΖ ως τον κύριο παράγοντα που δικαιώνει τους ασθενείς για την απόφαση της θεραπευτικής τους επιλογής.

scholarly journals Adherence to the Mediterranean Diet and Its Association with the Level of Physical Activity in Fitness Center Users: Croatian-Based Study

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4038
Author(s):  
Dinko Martinovic ◽  
Daria Tokic ◽  
Lovre Martinovic ◽  
Marko Kumric ◽  
Marino Vilovic ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mediterranean Diet ◽  
Short Form ◽  
Well Being ◽  
General Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Fitness Center ◽  
Balanced Diet ◽  
The Mediterranean

The Mediterranean diet (MD) is based on the traditional cuisine of south European countries, and it is considered one of the healthiest dietary patterns worldwide. The promotion of combined MD and physical activity has shown major benefits. However, the association between physical activity and the MD in regular fitness center users is still insufficiently investigated. This cross-sectional survey-based study was conducted on 1220 fitness center users in Croatia. The survey consisted of three parts: general information, the Mediterranean Diet Serving Score (MDSS) and the International Physical Activity Questionnaire Short Form (IPAQ-SF). The results showed that 18.6% of fitness center users were adherent to the MD, and there was a significant positive correlation between the level of physical activity and the MDSS score (r = 0.302, p < 0.001). Moreover, after dividing the sample into tertiles based on the IPAQ-SF score, the third tertile (MET > 3150 min/wk) had the most fitness center users (34.4%) adherent to the MD, while the first tertile (MET < 1750 min/wk) had the least (6.1%). These outcomes emphasize the importance of physical activity as they imply that, with higher levels of physical activity, people are also possibly more aware of the importance that a healthy and balanced diet has on their well-being.

scholarly journals THE IMPACT OF INTERNET-ENABLED PHONES ON PHYSICAL ACTIVITY AMONG STUDENTS OF TERTIARY INSTITUTIONS

2021 ◽  
Vol 10 (2) ◽  
pp. 37-42
Author(s):  
Asma Khalid
Keyword(s):  
Physical Activity ◽  
Young Adults ◽  
Short Form ◽  
Smart Phones ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Tertiary Institutions ◽  
Prolonged Time ◽  
Media Applications ◽  
The Impact

BACKGROUND AND AIMS Smart phones usage is rapidly progressing day by day in young adults’ lives who have become habituated and less indulged in physical activities. Thus, this study is aimed to measure the impact of internet-enabled smart phones on physical activity of students. METHODOLOGY An online cross-sectional survey was conducted among students aged 18-30 years studying in tertiary institutions. Internet-Connectedness Index and International Physical Activity Questionnaire-Short Form were formulated in the Google Docs and distributed to participants via email or social media applications. RESULTS A total number of 252 students participated in study revealed that majority of users have own computer for prolonged time with broadband and 3G internet. Only (4.4%) participants have performed vigorous and (5.6%) moderate activities 7 days a week. Whereas (27.8%) participants spent their time sitting at desk, visiting friends, reading, sitting or lying down to watch TV for <2 hours (27.8%), <4 hours (21.8%) while >8 hours (23%) respectively. This showed that with the increased use of internet, young adults performed low physical activity. CONCLUSION It was concluded that majority of young adults have used internet for prolonged time on computer/laptop/cell phones whereas limited participants reported to have regular physical activity however, no significant association was found between the impacts of internet-connectedness with physical activity.

Abstract 204: Cross-sectional Survey of Quality of Life and Workload Among Japanese Physicians Working in Stroke Care: The Nationwide Survey of Acute Stroke Care Capacity for Proper Designation of Comprehensive Stroke Center in Japan (J-ASPECT) Study

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Fumiaki Nakamura ◽  
Kunihiro Nishimura ◽  
Misa Takegami ◽  
Yoshihiro Miyamoto ◽  
Koji Iihara
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Short Form ◽  
Stroke Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Neurosurgical Society ◽  
The Mean ◽  
Population Norm

Objective: Approximately 40% of stroke physicians in Japan are in a state of burnout. The quality of life (QOL) of physicians working in stroke care is unclear. We aimed to compare health-related QOL (HRQOL) between physicians working in stroke care and the general population, and to evaluate personal and professional characteristics associated with HRQOL of physicians working in stroke care. Design: Cross-sectional survey. Setting and Participants: All board-certified members of the Japanese Neurosurgical Society and the Societas Neurologica Japonica working in Japan. Main outcome measure: Scores of HRQOL (physical and mental) as assessed by the Short-Form 8 (SF-8). Statistical analysis: We compared scores of physician’s HRQOL with standard values of the general population. Factors associated with HRQOL were identified by multivariable regression analysis with stepwise variable selection. Results: Of 11,211 stroke physicians who received the survey, 2279 (20.3%) completed the surveys. The mean physical QOL score was 49.4 points (95% CI: 49.1 to 49.7), which was similar to the population norm. However, the mean mental QOL score was below the population norm (46.1 points [95% CI: 45.7 to 46.4]), and 20.8% (475/2279) of stroke physicians had a score lower than one standard deviation below the population norm. The physical QOL score was lower in women than in men (coefficient = –1.66 [95% CI: –2.82 to –0.50]). An increase in nights on call per week was associated with a lower physical QOL (each additional 1 time per week = –0.39 [–0.53 to –0.25]), and an increase in mean sleep time was associated with a higher physical QOL score (each additional 1 hour = 0.87 [0.55 to 1.20]). Physicians who worked more than 40 hours per week had a lower mean mental QOL score than those who worked less than 40 hours per week (each additional 10 hour = –0.40 [–0.57 to –0.24]). A higher salary was associated with a higher mental QOL score (lower than $100 000 = reference; $100 000-149 000 = 0.08 [–1.10 to 1.27]; $150 000-199 000 = 0.68 [–0.61 to 1.97]; $200 000 or more = 1.90 [0.46 to 3.34]), and an increase of 1 day off per week was associated with an increase in mental QOL score (each additional 1 day = 0.88 [0.24 to 1.52]). Limitation: This study was based on a cross-sectional design and was thus unable to determine the causal effects of factors. Conclusion: Mental QOL scores of stroke physicians are significantly lower than those of the population norm. Work hours, salary, and numbers of days off are associated with the mental QOL score.

scholarly journals Prevalence and Socio-Demographic Predictors of Food Insecurity in Australia during the COVID-19 Pandemic

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2682 ◽  
Author(s):  
Katherine Kent ◽  
Sandra Murray ◽  
Beth Penrose ◽  
Stuart Auckland ◽  
Denis Visentin ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Household Income ◽  
Short Form ◽  
Binary Logistic Regression ◽  
University Education ◽  
Household Food Security ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Household Food ◽  
Vulnerable Households

The COVID-19 pandemic has exacerbated economic vulnerabilities and disrupted the Australian food supply, with potential implications for food insecurity. This study aims to describe the prevalence and socio-demographic associations of food insecurity in Tasmania, Australia, during the COVID-19 pandemic. A cross-sectional survey (deployed late May to early June 2020) incorporated the U.S. Household Food Security Survey Module: Six-Item Short Form, and fifteen demographic and COVID-related income questions. Survey data (n = 1170) were analyzed using univariate and multivariate binary logistic regression. The prevalence of food insecurity was 26%. The adjusted odds of food insecurity were higher among respondents with a disability, from a rural area, and living with dependents. Increasing age, a university education, and income above $80,000/year were protective against food insecurity. Food insecurity more than doubled with a loss of household income above 25% (Adjusted Odds Ratio (AOR): 2.02; 95% CI: 1.11, 3.71; p = 0.022), and the odds further increased with loss of income above 75% (AOR: 7.14; 95% CI: 2.01, 24.83; p = 0.002). Our results suggest that the prevalence of food insecurity may have increased during the COVID-19 pandemic, particularly among economically vulnerable households and people who lost income. Policies that support disadvantaged households and ensure adequate employment opportunities are important to support Australians throughout and post the COVID-19 pandemic.

Principals’ Instructional Leadership towards Teachers' Self-Efficacy

2018 ◽  
Vol 7 (3.30) ◽  
pp. 449
Author(s):  
Nitce Isa Medina Machmudi Isa ◽  
Azlin Norhaini Mansor ◽  
Jamalul Lail Abdul Wahab ◽  
Bity Salwana Alias
Keyword(s):  
Instructional Leadership ◽  
Self Efficacy ◽  
Leadership Practices ◽  
Rating Scale ◽  
Short Form ◽  
School Level ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Right ◽  
High Level

Principals’ instructional leadership practices have proved to be an imperative predictor to teachers’ self-efficacy. Yet, educators are concerned about the ability to adapt to new instructional leaderships due to unspoken principal-teacher expectations. This paper discusses the extent of instructional leadership practices by two newly transferred principals at two different schools. The purpose of this quantitative study was to examine how their instructional leadership practices affected the self-efficacy of the teachers. Through the use of a cross-sectional survey, responses made by 64 teachers employed in one public school and one privately-run school, were compared. The Principal Instructional Management Rating Scale (PIMRS) Teacher Short Form and the Teachers’ Sense of Efficacy Scale (TSES) were used for data collection. The findings showed a high level of instructional leadership practices and self-efficacy in both schools. The test results indicated a strong and positive relationship between the principals’ perceived instructional leadership practices and the teachers’ self-efficacy. Some of the details even suggested that newly transferred principals enforce specific school goals as their main agenda. Nevertheless, the areas of significance identified by this study may help district school superintendents develop the right knowledge to support newly transferred principals in their instructional leadership, thus enhancing teachers’ self-efficacy at the school level.  

scholarly journals Prevalence of food insecurity among military households with children 5 years of age and younger

2016 ◽  
Vol 19 (13) ◽  
pp. 2458-2466 ◽  
Author(s):  
Sarah Grenier Wax ◽  
Susan M Stankorb
Keyword(s):  
Food Insecurity ◽  
Family Member ◽  
Military Service ◽  
San Antonio ◽  
Short Form ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Supplemental Food ◽  
Targeted Interventions ◽  
Food Insecure Households

AbstractObjectiveFood insecurity increases risk of health conditions that may decrease military readiness. The aim of the present study was to define the prevalence of food insecurity among households with young children utilizing military installation childcare facilities and to describe household characteristics associated with food insecurity among this population.DesignCross-sectional survey including demographic questions and the US Department of Agriculture Food Security Survey Module six-item short form given to households (n 248) enrolled in Joint Base San Antonio Child Development Centers (JBSA-CDC) during the spring of 2015.SubjectsDepartment of Defense families with at least one child less than 6 years old enrolled in a JBSA-CDC.SettingsJoint Base San Antonio, TX, USA.ResultsNearly one in seven families reported food insecurity. Households were more likely to be food-insecure if the head of household’s highest level of education was high school or equivalent (P=0·003) and if the head of household was unmarried/unpartnered (P=0·001). Among food-insecure households headed by military service members, all were junior enlisted or non-commissioned officers (E1–E9). Food-insecure households were less likely to live off-post in owned or rented homes compared with those who were food-secure (P=0·016). Other characteristics associated with food insecurity included at least one family member enrolled in the Exceptional Family Member Program (P=0·020) and more children in the household (P=0·029). Few families reported enrolment in government supplemental food programmes.ConclusionsFood insecurity is prevalent in military families. Targeted interventions and policies can be developed using the demographic risk factors identified in the present study.

The Association between Subjective and Clinical Indicators of Health in Prospective Vietnamese Migrants

2005 ◽  
Vol 17 (1) ◽  
pp. 46-50 ◽  
Author(s):  
RE Watkins ◽  
AJ Plant ◽  
D. Sang ◽  
TF O'Rourke ◽  
AA Eltom ◽  
...  
Keyword(s):  
Health Status ◽  
Screening Program ◽  
Short Form ◽  
Medical Screening ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Clinical Indicators ◽  
Status Assessment ◽  
Reported Health ◽  
Self Reported Health Status

We conducted a cross-sectional survey of 1669 prospective Vietnamese migrants who had applied to migrate to Australia to describe the association between self-reported health status and several commonly used clinical indicators of health among prospective Vietnamese migrants. Participants were recruited from the International Organization for Migration's standardised medical screening program.' We found that clinical indicators of health are related to self-reported health status among prospective Vietnamese migrants. Self-reported health status, which was assessed using a modified version of the Short Form-36 health survey, was significantly associated with clinical indicators of health, including the number of body system abnormalities identified during medical screening, evidence of tuberculosis on chest radiograph, and self-reported weight loss over the previous six months. These findings support the validity of self-reported health status assessment among prospective migrants, although the assessment of subjective indicators of health during compulsory medical screening may be limited by reporting bias. Asia Pac J Public Health 2005: 17(1): 46-50.

Co-infection with gonorrhoea and chlamydia: how much is there and what does it mean?

2003 ◽  
Vol 14 (2) ◽  
pp. 109-113 ◽  
Author(s):  
Sarah Creighton ◽  
Melinda Tenant-Flowers ◽  
Christopher B Taylor ◽  
Rob Miller ◽  
Nicola Low
Keyword(s):  
Dual Infection ◽  
Cross Sectional Study ◽  
Heterosexual Men ◽  
Age Group ◽  
Sectional Study ◽  
College Hospital ◽  
Cross Sectional ◽  
Age And Gender ◽  
King's College ◽  
And Gender

A cross-sectional study of new clients with either gonorrhoea or chlamydia attending King's College Hospital in 1998. One thousand two hundred and thirty-nine women and 1141 men had gonorrhoea, chlamydia or both. Overall, 24.2% (124/512) of heterosexual men and 38.5% (136/353) of women with gonorrhoea also had chlamydia ( P<0.001). Of heterosexual males 18.8% (124/660) and 13% (136/1022) of females with chlamydia also had gonorrhoea ( P=0.002). Ethnicity had no effect on the proportion of co-infection after controlling for age and gender. Clients with dual infection were younger than those with either infection alone ( P=0.0001). Over half of women and a quarter of men aged 15 to 19 years were dually infected so testing for both gonorrhoea and chlamydia may be appropriate in this age group in settings outside genitourinary clinics. The high proportion of cases of gonorrhoea that also have chlamydia justifies the policy of epidemiological treatment for chlamydia.

scholarly journals Variation in Functional Independence among Stroke Survivors Having Fatigue and Depression

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Umaru Muhammad Badaru ◽  
Omoyemi Olubunmi Ogwumike ◽  
Ade Fatai Adeniyi ◽  
Olajide Olubanji Olowe
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Medical Center ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Functional Independence ◽  
Cross Sectional Survey ◽  
College Hospital ◽  
Cross Sectional ◽  
Significance Level

Objective. This study evaluated variation in functional independence in activities of daily living (ADL) and instrumental activities of daily living (IADL) among individuals with poststroke fatigue (PSF) and poststroke depression (PSD).Methods. A cross-sectional survey involved 65 consenting poststroke survivors who were purposively recruited from physiotherapy clinics of the University College Hospital, Ibadan, Adeoyo Maternity Teaching Hospital, Ibadan, and Federal Medical Center, Gusau. Participants were assessed for symptoms of PSD with short geriatric depression scale-15, PSF with fatigue severity scale, ADL with Barthel Index and IADL with Nottingham extended ADL scale. Data analysis was done using Chi-square and unpairedt-test with significance level being 0.05.Results. Participants’ age ranged from 58 to 80 years. PSD alone (P=0.002) and both PSF and PSD (P=0.02) were significantly associated with ADL, while PSF alone was not (P=0.233). PSD alone (P=0.001) and both PSF and PSD (P=0.001) significantly negatively affected IADL, while PSF alone had no significant effect (P=0.2).Conclusions. Participants with PSD alone and those with both PSF and PSD had lower functional independence in ADL and IADL.

scholarly journals The interaction of adverse childhood experiences and gender as risk factors for depression and anxiety disorders in US adults: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Robert C. Whitaker ◽  
Tracy Dearth-Wesley ◽  
Allison N. Herman ◽  
Amy E. Block ◽  
Mary Howard Holderness ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anxiety Disorder ◽  
Adverse Childhood Experiences ◽  
Emotional Abuse ◽  
Short Form ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Childhood Experiences ◽  
Adverse Childhood

Abstract Background Exposure to adverse childhood experiences (ACEs) and being female are distinct risk factors for having a major depressive episode (MDE) or an anxiety disorder (AD) in adulthood, but it is unclear whether these two risk factors are synergistic. The purpose of this study was to determine whether exposure to ACEs and being female are more than additive (synergistic) in their association with MDE and AD in US adults. Methods We pooled cross-sectional survey data in the Midlife in the United States study from two nationally-representative cohorts of English-speaking US adults. Data from the first cohort were collected in 2004–2006 and from the second in 2011–2014. Data from both cohorts included the 12-month prevalence of MDE and AD (generalized anxiety disorder or panic disorder) assessed with the Composite International Diagnostic Interview Short Form, gender (here termed female and male), and the count of five categories of exposure to ACEs: physical, sexual, or emotional abuse; household alcohol or substance abuse; and parental separation or divorce. Results Of the 5834 survey respondents, 4344 (74.5%) with complete data on ACEs were included in the analysis. Mean (SD) age was 54.1 (13.8) years and 53.9% were female. The prevalences of MDE, AD, and exposure to 3–5 categories of ACEs were 13.7, 10.0, and 12.5%, respectively. After adjusting for covariates (age, race, and current and childhood socioeconomic disadvantage), for those with both risk factors (female and 3–5 ACEs) the prevalence of MDE was 26.9%. This was 10.2% (95% CI: 1.8, 18.5%) higher than the expected prevalence based on the additive associations of the two risk factors. The adjusted prevalence of AD among females with 3–5 ACEs was 21.9%, which was 11.4% (95% CI: 4.0, 18.9%) higher than the expected prevalence. Conclusions For both MDE and AD, there was synergy between the two risk factors of exposure to ACEs and being female. Identification and treatment of MDE and AD may benefit from understanding the mechanisms involved in the synergistic interaction of gender with ACEs.

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