Participation and attitudes towards gambling in Ghanaian youth: an exploratory analysis of risk and protective factors.

PURPOSE: There is little information on youth gambling in Ghana even though there is an unprecedented emergence of various types of gambling and gambling venues throughout the country. The aim of this cross-sectional exploratory study was to examine the role of perceived social difficulties and perceived protective social factors in participation and attitudes of Ghanaian youth towards gambling using data from a school-based survey (n = 770). METHODS: Participants completed measures on perceived social difficulties, perceived protective social factors, attitudes towards gambling and participation in four types of gambling. RESULTS: Sports betting was the most common form of gambling. There were significant differences in gambling participation with males gambling more than females. Youth who reported more perceived social difficulties from family and friends had a more positive attitude and a negative attitude towards gambling, respectively. Youth who reported higher protective social factors from family and teachers were less likely to have a negative attitude towards gambling. In all situations, high frequency gambling resulted in a more positive attitude towards gambling. CONCLUSION: Perceived social difficulties influences Ghanaian youths to have a positive attitude towards gambling, however, protective social factors from family and teachers may help youth to have a negative attitude towards gambling, gamble less and consequently achieve academic success.

Spiritual Well-Being, Depression, and Stress Among Hemodialysis Patients in Jordan.

PURPOSE: The spiritual dimension of a patient's life is an important factor that may mediate detrimental impacts on mental health. The lack of research investigating spiritual well-being, religiosity, and mental health among Jordanian hemodialysis patients encouraged this research. This study explored levels of spiritual well-being and its associations with depression, anxiety, and stress. DESIGN: A quantitative, cross-sectional correlational study. METHOD: A sample of 218 Jordanian Muslim hemodialysis patients completed a structured, self-administered questionnaire. The data were analyzed using descriptive statistics and linear multivariate regression models. FINDINGS: The hemodialysis patients had, on average, relatively low levels of spiritual well-being, moderate depression, severe anxiety, and mild to moderate stress. The results of the regression models indicated that aspects of spiritual well-being were negatively associated with depression, anxiety, and stress, but only existential well-being consistently retained significant associations after controlling for religious well-being, religiosity, and sociodemographic variables. CONCLUSIONS: Greater spiritual and existential well-being of Jordanian hemodialysis patients were significantly associated with less depression, anxiety, and stress. It appears that these patients use religious and spiritual beliefs and practices as coping mechanisms to overcome their depression, anxiety, and stress. The implications for holistic clinical practice are explored.

The impact of persistent poor housing conditions on mental health: A longitudinal population-based study.

Living with housing problems increases the risk of mental ill health. Housing problems tend to persist over time but little is known about the mental health consequences of living with persistent housing problems. We investigated if persistence of poor housing affects mental health over and above the effect of current housing conditions. We used data from 13 annual waves of the British Household Panel Survey (1996 to 2008) (81,745 person/year observations from 16,234 individuals) and measured the persistence of housing problems by the number of years in the previous four that a household experienced housing problems. OLS regression models and lagged-change regression models were used to estimate the effects of past and current housing conditions on mental health, as measured by the General Health Questionnaire. Interaction terms tested if tenure type modified the impact of persistent poor housing on mental health. In fully adjusted models, mental health worsened as the persistence of housing problems increased. Adjustment for current housing conditions attenuated, but did not explain, the findings. Tenure type moderated the effects of persistent poor housing on mental health, suggesting that those who own their homes outright and those who live in social housing are most negatively affected. Persistence of poor housing was predictive of worse mental health, irrespective of current housing conditions, which added to the weight of evidence that demonstrates that living in poor quality housing for extended periods of time has negative consequences for mental health.

Association between psychosomatic health symptoms and common mental illness in Ghanaian adolescents: Age and gender as potential moderators.

Little is known about the role of age and gender in the association between psychosomatic symptoms and common mental illness in Ghanaian adolescents. This cross-sectional study examined age and gender as moderators between psychosomatic symptoms and common mental illness using data from a school-based survey ( N = 770). Males reported higher psychosomatic symptoms and common mental illness, while younger adolescents reported higher common mental illness only. Psychosomatic symptoms were positively associated with common mental illness, but age and gender did not moderate this association. Interventions aimed at reducing the prevalence rate in psychosomatic symptoms are crucial in decreasing common mental illness in Ghanaian adolescents.

Development of the Arabic Spiritual Care Intervention-Provision Scale.

AIMS AND OBJECTIVES: This study develops a new instrument, the Spiritual Care Intervention-Provision Scale, and assesses its psychometric properties in an Arab Muslim nurse sample. The Spiritual Care Intervention-Provision Scale was developed to measure the frequency with which nurses provided aspects of spiritual care. BACKGROUND: Most of the available spiritual care instruments were developed in the West and reflect a predominantly Christian tradition. A review of the literature on spiritual care in nursing revealed that no instrument exists for measuring spiritual care interventions provided by nurses to Arab Muslim patients. DESIGN: A cross-sectional descriptive and correlational design. METHODS: Following an extensive literature search, review by an expert panel and a pilot study which included patients' views regarding aspects of spiritual care provided by nurses, the final version of the Spiritual Care Intervention-Provision Scale was tested in a convenience sample of 360 Jordanian Arab Muslim nurses. Correlational and factor analysis were used. RESULTS: The internal consistency of the Spiritual Care Intervention-Provision Scale was high, with α coefficient of 0·85. The exploratory factor analysis supported a two-factor structure for the Spiritual Care Intervention-Provision Scale as hypothesised. A significant positive correlation between the Spiritual Care Intervention-Provision Scale and religiosity was in the expected direction though small in magnitude. CONCLUSIONS: This study initiates the development of an instrument for the provision of spiritual care intervention by nurses that balances the religious and existential dimensions of spirituality. The Spiritual Care Intervention-Provision Scale exhibited acceptable evidence of internal consistency and validity among Jordanian Arab Muslim nurses. Further work was suggested to firmly establish all aspects of this new scale. RELEVANCE TO CLINICAL PRACTICE: This culturally specific instrument contributes to the evaluation of the provision of spiritual care by Jordanian Muslim nurses to their patients, to guide them in providing a comprehensive and appropriate spiritual care interventions and to examine the effect of spiritual care on various aspects of patient's quality of life.

Impact of Spiritual Well-Being, Spiritual Perspective, and Religiosity on the Self-Rated Health of Jordanian Arab Christians.

The purpose of this study was to explore associations of spiritual well-being, spiritual perspective, and religiosity with self-rated health in a convenience sample of 340 adult Jordanian Arab Christians. Data were collected through church and community groups. Results indicated that spiritual well-being and religiosity were positively associated with self-rated health, but in the final regression model only spiritual well-being retained a significant association after controlling for the other spiritual and religious measures. In conclusion, spirituality and religiosity are important to Jordanian Arab Christians' health and well-being, and the implications for nursing practice are explored.

Routine testing for blood-borne viruses in prisons: a systematic review.

BACKGROUND: People in prison have a higher burden of blood-borne virus (BBV) infection than the general population, and prisons present an opportunity to test for BBVs in high-risk, underserved groups. Changes to the BBV testing policies in English prisons have recently been piloted. This review will enable existing evidence to inform policy revisions. We describe components of routine HIV, hepatitis B and C virus testing policies in prisons and quantify testing acceptance, coverage, result notification and diagnosis. METHODS: We searched five databases for studies of both opt-in (testing offered to all and the individual chooses to have the test or not) and opt-out (the individual is informed the test will be performed unless they actively refuse) prison BBV testing policies. RESULTS: Forty-four studies published between 1989 and 2013 met the inclusion criteria. Of these, 82% were conducted in the USA, 91% included HIV testing and most tested at the time of incarceration. HIV testing acceptance rates ranged from 22 to 98% and testing coverage from 3 to 90%. Mixed results were found for equity in uptake. Six studies reported reasons for declining a test including recent testing and fear. CONCLUSIONS: While the quality of evidence is mixed, this review suggests that reasonable rates of uptake can be achieved with opt-in and, even better, with opt-out HIV testing policies. Little evidence was found relating to hepatitis testing. Policies need to specify exclusion criteria and consider consent processes, type of test and timing of the testing offer to balance acceptability, competence and availability of individuals.

Factor structure and psychometric properties of the General Health Questionnaire (GHQ-12) among Ghanaian adolescents.

PURPOSE: There is little information about the reliability and validity of the 12-item General Health Questionnaire (GHQ-12) in Ghana. This study sought to examine the reliability and factor structure of the GHQ-12 in Ghanaian adolescents. METHODS: High school students (N = 770) completed the GHQ-12 and the Adolescent Stress Questionnaire (ASQ). Internal consistency, convergent validity and exploratory factor analysis were used. RESULTS: A two factor structure, each with six items, was extracted. The total GHQ-12 had acceptable internal consistency and a generally high correlation with the ASQ subscales. CONCLUSION: The GHQ-12 can be used in Ghanaian samples, but more research is needed to confirm its factor structure.

Perceived social support and parental education as determinants of adolescents' physical activity and eating behaviour: a cross-sectional survey.

PURPOSE: To examine the role of perceived social support and parental education on physical activity and eating behaviour of Ghanaian adolescents. METHODS: Seven hundred and seventy Senior High School students (504 boys and 266 girls) between the ages of 14-21 years participated by completing questionnaires on perceived social support, physical activity and eating behaviour. The highest education attained by either parent or guardian was also obtained. Multivariate analysis of covariance was the main statistical test used to analyse the data. RESULTS: The results showed significant gender differences in physical activity and eating behaviour combined, with boys more likely to engage in physical activity than girls, and girls also more likely to engage in healthy eating behaviour than boys, albeit the effect was not statistically significant. While perceived social support had a significant positive effect on eating behaviour and physical activity, parental education had a significant effect only on eating behaviour but not physical activity. CONCLUSION: Perceived social support from family coupled with parental education provides more opportunities for adolescents to engage in healthy eating behaviour. Also, parents' educational attainment alone does not necessarily guarantee that adolescents will engage in physical activity; providing the needed social support and conducive home environment is more likely to induce physical activity behaviours. Finally, physical activity and eating behaviour should not be construed as alternative health behaviours as suggested by gender differentials in these health behaviours.

Social support, stress, health, and academic success in Ghanaian adolescents: a path analysis.

The aim of this study is to gain a better understanding of the role psychosocial factors play in promoting the health and academic success of adolescents. A total of 770 adolescent boys and girls in Senior High Schools were randomly selected to complete a self-report questionnaire. School reported latest terminal examination grades were used as the measure of academic success. Structural equation modelling indicated a relatively good fit to the posteriori model with four of the hypothesised paths fully supported and two partially supported. Perceived social support was negatively related to stress and predictive of health and wellbeing but not academic success. Stress was predictive of health but not academic success. Finally, health and wellbeing was able to predict academic success. These findings have policy implications regarding efforts aimed at promoting the health and wellbeing as well as the academic success of adolescents in Ghana.

The psychological costs of unsustainable housing commitments.

BACKGROUND: The extended recession and stagnant housing market in the 1990s following the boom of the late 1980s resulted in more than half a million housing repossessions. This study explores the impact of unsustainable housing commitments on psychological well-being. We test the hypotheses that housing payment problems and housing arrears have adverse impacts on heads of households' psychological well-being over and above those caused by financial hardship more generally. METHOD: Data came from the British Household Panel Survey 1991-2003 and the samples for analysis consist of: (1) 5651 male head of households producing 26618 person-year observations, and (2) 2534 female head of households producing 9091 person-year observations. Summary statistics and multivariate, fixed effects regression models are used. Mental health was measured by the 12-item General Health Questionnaire. RESULTS: For male heads of households housing payment problems and entering arrears have significant detrimental effects on mental well-being and for female heads of households longer-term housing payment problems and arrears have significant detrimental effects on mental well-being. The sizes of these effects are in addition to and larger in magnitude than those associated with financial hardship more generally. The net effects appear to be relatively stable over the time of the panel data. CONCLUSIONS: This study provides evidence that housing payment problems have independent psychological costs over and above those associated with general financial hardship. The magnitude of the effect is similar to that shown for marital breakdown and job loss.

Twelve-month psychiatric disorder among single and married mothers: the role of marital history.

OBJECTIVE: To examine differences between single and married mothers in the 12-month prevalence of psychiatric disorders. METHODS: The analysis uses data from the National Comorbidity Survey, collected in 1992-1993, and focuses on women aged 15 to 55 years with children (n=1346). Psychiatric disorders are assessed with the University of Michigan Composite International Diagnostic Interview, a survey instrument based on DSM-III-R criteria. RESULTS: Compared with married mothers, previously married mothers have elevated rates of disorders. Prevalences among single mothers who were never married are similar to those among married mothers, but they are generally lower than prevalences among mothers who experience a marital disruption. CONCLUSIONS: These results indicate that marital separation and divorce may be markers for elevated risk for psychiatric disorder among women with children. It is important to consider the impact of marital history on the relation between family structure and psychiatric outcomes.

Between family and friends: a longitudinal study of friendship choice.

The increasing role for chosen friends is a key element in current debates on individualization and the transformation of intimacy. This paper describes the changes in friendship choices over time and demonstrates how life events subsequently impact on those choices. We primarily distinguish between kin and non-kin nominations of friends and how these may be related to the social and economic turbulence inherent in late modernity. Analyses of data from ten years of the British Household Panel Survey showed that kin nominations still form a significant proportion of all friends but increasingly so with age and over time as people age. Life events, such as divorce or death of a partner, have large effects on the likelihood of changes in friendship choices as did gender, age, marital status and social class. We frame these results in a discussion of the saliency and nature of friendship at stages of the life course and conclude that the case for a general secular shift to choosing non-kin friendships rather than kin-based friendship is not demonstrated.

Marital transitions and mental health.

Most research identifies marital disruption as a precursor for poor mental health but is generally unable to discount the potential selection effect of poor mental health leading to marital disruption. We use data from nine annual waves of the British Household Panel Survey to examine social selection and social causation as competing explanations. Mental health is measured using the general health questionnaire. We examine mental health at multiple time points prior to and after a marital transition through separation or divorce and compare this process to those who experience widowhood. All groups transitioning out of marriage have a higher prevalence of poor mental health afterwards but for those separated or divorced, poor mental health also precedes marital disruption, lending support to both social-causation and social-selection processes. The processes both preceding and after the transition to widowhood differ, with increased prevalence of disorder centering around the time surrounding the death itself

Cohabiting unions, repartnering and mental health.

BACKGROUND: A considerable body of research has established that transitions out of marriage are generally deleterious for mental health and some have examined transitions out of cohabitation. In this study we depart from these established areas to investigate the effects of poor mental health on the duration and outcome of cohabitations and on the time to, and likelihood of, repartnering after both cohabitation and marriage. METHOD: Samples came from the British Household Panel Survey, 1991--2001. These were: (1) 447 cohabiting spells; (2) 5571 paired person-years during cohabitation; (3) 508 spells after cohabitation; (4) 1197 person-year observations within those spells; (5) 869 spells after marriage; and (6) 2736 person-year observations within those spells. Life tables, log-rank tests, multinomial logit and proportional hazard models were used. Mental health was measured by the 12-item General Health Questionnaire. RESULTS: Poor mental health increased the risk of dissolving a cohabiting union for both men and women. Poor mental health reduced the risk of repartnering after a cohabiting union but had no effect on the risk of repartnering after a marriage. Other factors such as past marital status, age and parental status also had significant effects. CONCLUSIONS: This study provides evidence that poor mental health during a cohabiting union increases the chances of that union dissolving instead of turning into marriage and poorer mental health immediately after a transition out of a cohabiting union is associated with reduced chances of repartnering.

Precursors, consequences and implications for stability and change in pre-adolescent antisocial behaviors.

Although much of the evidence stresses the stability of dysfunctional behavior throughout the life cycle, other evidence suggests that stability of antisocial behavior is a matter of degree. In this work we determine the degree of stability of such behavior in preadolescence and how this is influenced by age, gender, social structures, and family processes. Also, we explore whether change in the level of antisocial behavior impacts upon other important developmental regimes such as health and educational performance. We use a large, 2 wave, nationally representative sample of preadolescent children, and focus on children 4-9 years of age at wave 1 (n=6,846). We employ a cluster analysis across a series of behavioral variables to determine levels of antisocial behavior and then examine the stability of antisocial behavior over time and identify the precursors and consequences associated with movement into and out of these behavioral clusters. Antisocial behavior is more stable in boys and older children. Structural factors--age of the mother, number of children in the household, and having a single parent--along with family factors--hostile parenting and maternal depression--raise the likelihood of increases in and lower the likelihood of decreases in antisocial behavior, although there are notable differences by gender of the child and initial level of antisocial behavior. Consequences of change in antisocial behavior include scholastic performance, high levels of school mobility, school-parent contacts, and health perceptions. The implications of these findings for prevention and intervention programs are discussed.

Social precursors to onset and recovery from episodes of common mental illness.

BACKGROUND: Social disadvantage and lack of social support have been identified as important risk factors for the onset and continuance of episodes of common mental illness. This study aimed to identify the social precursors to episodes of and recovery from common mental illness in a large, general population sample over eight yearly intervals. METHOD: The analytical samples were drawn from those aged > or = 16 in the British Household Panel Survey from 1991 to 1998. The samples were: (1) onset--over 42,000 paired years from 10,204 persons; (2) recovery--over 10,000 paired years from 4878 persons; and (3) 1812 spells with observed onset and recovery. Markov and discrete-time complementary log-log models were used. Common mental illness was measured using the 12-item General Health Questionnaire. RESULTS: Sex, age, changes in marital and employment status, physical health, family care and social support were all associated with differential rates of onset and recovery. Severity of disorder was associated with less likelihood of recovery and longer time to recovery. CONCLUSIONS: The study confirms many previous findings concerning social factors associated with onset and recovery. Low social support acted as expected by increasing chances of onset and decreasing chances of recovery. Other social factors such as separation or divorce, becoming and remaining unemployed, health limiting daily activities, caring for a sick relative all decreased chances of recovery. The chances of observing a change in state (either onset or recovery) decreased with the number of prior observations in that state. Reduced rates of recovery with increasing degrees of severity of distress was expected, but not previously demonstrated.

Emergence of gender differences in depression during adolescence: national panel results from three countries.

OBJECTIVE: Although the gender gap in depression among adults is well established, the age at which this phenomenon appears during adolescence is less clear. To address this, the authors present a cross-national examination of the emergence of the gender gap in depression during adolescence using national longitudinal panel data from Canada, Great Britain, and the United States. METHOD: The two-wave, 1994-1996 Canadian National Population Health Survey uses a diagnostic measure across a 24-month interval, providing 12-month prevalence rates of major depressive disorder. The British Youth Panel measures depressive symptomatology across five annual waves beginning in 1995. The two-wave, 1995-1996 National Longitudinal Study of Adolescent Health uses a measure of depressive symptomatology across a 12-month interval. RESULTS: Females have significantly higher rates of depression for each sample overall. When samples are decomposed by age, the gender gap in depression consistently emerges by age 14 across all three national samples, irrespective of the measure used or whether categorical cutoffs or untransformed scale scores are used to assess depressive symptomatology. CONCLUSIONS: There is a consistent pattern in the onset of the gender gap in depression at age 14 across all three countries and measures. This consistency provides important etiologic clues concerning underlying causes of depression and identifies at what age diagnosis, treatment, and intervention strategies should be directed.