RESUMO
OBJECTIVE: To assess differences in the relationship between violence factor exposure and tobacco product pattern use (exclusive and poly), we hypothesized that compared with heterosexuals, sexual minority youth would be more likely to report exclusive-tobacco and poly-tobacco use patterns, and controlling for violence factors would attenuate these associations. STUDY DESIGN: Data from 27â513 US high-school youth were analyzed from the Centers for Disease Control and Prevention's Youth Risk Factor Surveillance System from 2015 and 2017. We fit sex-stratified, weighted, adjusted log-Poisson models to compare past 30-day exclusive combustible, exclusive e-cigarette, and poly-tobacco use in across sexual orientation. Then, models were adjusted for past-year experiences of physical fighting, bullying, attempting suicide, and physical and sexual dating violence. RESULTS: Compared with heterosexual girls with other-sex partners, sexual minority girls were more likely to use exclusive combustible, exclusive e-cigarette, or poly-tobacco products. When adjusting for violence factors, most tobacco use associations were partially attenuated for all sexual minority girls, and completely attenuated for exclusive e-cigarette use among all sexual minority girls. CONCLUSIONS: Sexual minority girls have greater exclusive- and poly-tobacco use compared with heterosexual girls. Tobacco interventions for sexual minority youth should address the risks of poly-tobacco use as well as violence-based risk factors.
Assuntos
Comportamento Sexual/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Estudantes , Produtos do Tabaco/efeitos adversos , Uso de Tabaco/epidemiologia , Violência/estatística & dados numéricos , Adolescente , Feminino , Seguimentos , Humanos , Incidência , Masculino , Estudos Retrospectivos , Parceiros Sexuais , Estados Unidos/epidemiologiaAssuntos
Aconselhamento , Fertilidade/fisiologia , Pessoas Transgênero/psicologia , Adolescente , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Stroke is a primary cause of death and disability in upper-middle-income countries such as Colombia. Given the lack of comprehensive rehabilitation for stroke patients in Colombia, there is a need to assess longitudinal mental health problems poststroke in this region. OBJECTIVE: To compare the course of mental health in stroke patients to healthy controls over the first year poststroke in Ibague, Colombia. DESIGN: Cross-sectional study. SETTING: The Psychological Attention Center of Antonio Nariño University in Ibague, Colombia. PARTICIPANTS: Stroke patients (n = 50) and age- and gender-matched healthy controls (n = 50). METHODS: Patients and controls completed self-report Spanish versions of demographic information, injury-related characteristics, and mental health questionnaires MAIN OUTCOME MEASUREMENTS: Outcomes assessed included mental health (depression, anxiety, and stress) at 3, 6, and 12 months poststroke. RESULTS: Hierarchical linear models suggested that stroke patients had worse depression and anxiety over time than controls (P < .001). Among patients, depression and anxiety decreased over time (P < .001), whereas stress increased over time (P < .01). The findings suggest that although anxiety and depression improved over time in stroke patients, their mental health remained significantly lower than that of controls. CONCLUSIONS: This is the first study to examine the course of mental health over the first year poststroke in Latin America, specifically in Ibague, Colombia. Despite the improvements in anxiety and depression over the first year poststroke, patient anxiety and depression were still worse in comparison to those in healthy controls. The current findings indicate a need for rehabilitation services in Colombia, especially targeting mental health issues. LEVEL OF EVIDENCE: I.
Assuntos
Saúde Mental , Acidente Vascular Cerebral/psicologia , Estudos de Casos e Controles , Colômbia , Estudos Transversais , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Life expectancy is increasing in Latin America resulting in the need for more family caregivers for older adults with dementia. The purpose of the current study was to examine the relationships between personal strengths (optimism, sense of coherence [SOC], and resilience) and the mental health of dementia caregivers from Latin America. METHOD: Primary family dementia caregivers (n = 127) were identified via convenience sampling at the Instituto de Neurociencias de San Lucas, Argentina, and CETYS University, in Baja California, Mexico and completed measures of these constructs. FINDINGS: Personal strengths explained between 32% and 50% of the variance in caregiver mental health. In a series of hierarchical multiple regressions, more manageability (ß = -.38, p = .001), general resilience (ß = -.24, p = .012), and social competence (ß = -.21, p = .034) were uniquely associated with lower depression. Greater comprehensibility (ß = -.28, p = .008) was uniquely associated with decreased burden, and manageability was marginally related (ß = -.21, p< .10). Greater optimism (ß = .37, p< .001) and manageability (ß = .27, p = .004) were uniquely associated with increased life satisfaction. DISCUSSION: The personal strengths of caregivers in Latin America may be particularly important for their mental health because of the culturally imbedded sense of duty toward older family members. IMPLICATIONS: Incorporating strengths-based approaches into research on caregiver interventions in regions where caregiving is a highly culturally valued role such as Latin America may have the potential to improve the mental health of dementia caregivers.
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Adaptação Psicológica , Cuidadores/psicologia , Demência/psicologia , Demência/terapia , Transtornos Mentais/psicologia , Adulto , Idoso , Ansiedade/etnologia , Ansiedade/etiologia , Ansiedade/psicologia , Argentina/etnologia , Cuidadores/estatística & dados numéricos , Estudos Transversais , Depressão/etnologia , Depressão/etiologia , Depressão/psicologia , Família/etnologia , Família/psicologia , Feminino , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Transtornos Mentais/etnologia , Transtornos Mentais/etiologia , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , México/etnologia , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Qualidade de Vida/psicologia , Autorrelato , Estresse Psicológico/complicações , Estresse Psicológico/etnologia , Inquéritos e QuestionáriosRESUMO
This cross-sectional, quantitative, self-report study examined the relationship between family dynamics (cohesion, flexibility, pathology/ functioning, communication, family satisfaction, and empathy) and mental health (depression, burden, stress, and satisfaction with life [SWL]) in 90 dementia caregivers from Colombia. Hierarchical multiple regressions controlling for caregiver demographics found that family dynamics were significantly associated with caregiver depression, stress, and SWL and marginally associated with burden. Within these regressions, empathy was uniquely associated with stress; flexibility with depression and marginally with SWL; and family communication marginally with burden and stress. Nearly all family dynamic variables were bivariately associated with caregiver mental health variables, such that caregivers had stronger mental health when their family dynamics were healthy. Family-systems interventions in global regions with high levels of familism like that in the current study may improve family empathy, flexibility, and communication, thereby producing better caregiver mental health and better informal care for people with dementia.
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Cuidadores/psicologia , Demência/enfermagem , Depressão/psicologia , Relações Familiares , Estresse Psicológico/psicologia , Adulto , Idoso , Colômbia , Comunicação , Estudos Transversais , Empatia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Satisfação Pessoal , Análise de Regressão , Fatores de RiscoRESUMO
Research in Caucasian populations has begun to examine the broad associations between physical and mental health in dementia caregivers. However, the examination of this relationship in Latin America is largely absent from the literature despite the fact that the region will see a major increase in dementia cases over the next 20 years. The current study examined the associations between health-related quality of life (HRQOL) and mental health in 90 dementia caregivers from Colombia, South America. A canonical correlation found that higher caregiver HRQOL was related to better mental health, as expected. Caregivers with high vitality and low role limitations due to physical problems tended to have low depression and high satisfaction with life. Follow-up multiple regressions found that caregiver role limitations due to physical problems was uniquely associated with satisfaction with life, whereas vitality, role limitations due to physical problems, and pain were uniquely associated with burden (although the pain effect was likely error due to a suppressor effect). Additionally, vitality and social functioning were uniquely negatively related to depression. Because of the extremely high overlap between these two sets of variables, dementia interventions are needed in Latin America that target both caregiver mental and physical health, as both likely operate in unison and influence each other.
Assuntos
Cuidadores/psicologia , Demência/enfermagem , Saúde Mental , Qualidade de Vida/psicologia , Adulto , Colômbia/epidemiologia , Demência/epidemiologia , Demência/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To examine the patterns of family dynamics that are most associated with the mental health of traumatic brain injury (TBI) caregivers from Mexico. It was hypothesized that healthier family dynamics would be associated with better caregiver mental health. DESIGN: A cross-sectional study of self-reported data collected from TBI caregivers through the Mexican National Institute of Rehabilitation in Mexico City, Mexico, the premier public medical facility in Mexico that provides rehabilitation services to patients with various disabilities. SETTING: One public outpatient medical and rehabilitation facility. PARTICIPANTS: Sixty-eight caregivers of individuals with moderate-to-severe TBI from Mexico City, Mexico, were related to an individual with TBI who was ≥3 months after injury, a primary caregiver for ≥3 months, familiar with the patient's history, and without neurologic or psychiatric conditions. The average (standard deviation) age of caregivers was 50.94 ± 12.85 years), and 82% were women. METHODS: The caregivers completed Spanish versions of instruments that assessed their own mental health and family dynamics. MAIN OUTCOME MEASUREMENTS: Outcomes assessed included family dynamics (Family Adaptability and Cohesion Evaluation Scale-Fourth Edition; Family Communication Scale; Family Satisfaction Scale; Family Assessment Device-General Functioning; and Relationship-Focused Coping Scale), and caregiver mental health (Patient Health Questionnaire-9, Zarit Burden Interview, and Satisfaction with Life Scale). RESULTS: Results of canonical correlation analyses suggested that caregiver mental health and family dynamics were positively related, with a large effect size. Caregivers with high family satisfaction and cohesion tended to have a low burden and high satisfaction with life. In addition, caregiver depression and burden were positively related to each other and were both inversely related to caregiver satisfaction with life. CONCLUSIONS: TBI caregiver interventions in Latino populations would likely benefit from including programming or techniques to improve family dynamics, especially family cohesion, given the strong potentially reciprocal influence of these dynamics on caregiver mental health.