Exploring the Most Important Negative Life Events in Older Adults Bereaved of Child, Spouse, or Both.

Losing a child or a spouse is described as the worst of experiences. However, it is not known whether older adults bereaved of a child, spouse, or both child and spouse experience these losses as among the most important negative events in their lifetime. The aim of this study was to investigate whether the 1,437 older adults bereaved of a child, spouse, or both included in the southern part of the Swedish National Study of Aging and Care mentioned these losses when asked about their three most important negative life events. Gender differences in their choices of important negative life events were also explored. About 70% of those bereaved of a child or a spouse mentioned these losses as among their three most important negative life experiences. In the child-and-spouse-bereaved group, 48% mentioned both the loss of their child and spouse, while 40% mentioned either the loss of a child or a spouse. Gender differences were only found in the child-and-spouse-bereaved group, with a few more women mentioning the loss of the child but not the spouse, and the men showing the opposite pattern.

Depressive symptoms and parental stress in mothers and fathers 25 months after birth.

The aim of this study was to determine the prevalence of depressive symptoms, feelings of incompetence and spouse relationship problems and their mutual relations. Data from a Swedish parent-infant population-based cohort 25 months after childbirth was used. A questionnaire containing Edinburgh Postnatal Depression Scale (EPDS) and a modified Swedish Parental Stress Questionnaire (SPSQ) regarding depression and parental stress was answered by 646 fathers and 700 mothers. Parents with depressive symptoms experienced more feelings of incompetence and spouse relationship problems than parents without depressive symptoms. The prevalence of depressive symptoms (EPDS ≥ 12) was more than11% for mothers and nearly 5% for fathers in the sample, 25 months after childbirth. The result indicated that feelings of incompetence and spouse relationship problems could be important constructs for understanding parental stress and depressive symptoms in the parents of young children. In conclusion, it is important that Child Health Care is attentive to both mothers' and fathers' depressive symptoms and parental stress after the first year.

Effects on life satisfaction of older adults after child and spouse bereavement.

BACKGROUND: Few studies have compared the impact of different familial losses on life satisfaction (LS). Furthermore, there is a lack of research on the effect of having lost both a child and a spouse among older adults. SAMPLE: A random sample of 1402 individuals, 817 women and 585 men, aged 60-96 years from the Blekinge part of the Swedish National Study of Aging and Care (SNAC-B) participated in this cross-sectional study. AIMS: The first aim was to compare the effects of child or spouse or both child and spouse bereavement on LS and, the second aim, to investigate if there were gender differences within the bereaved groups. RESULTS: The results showed that having lost a child, spouse or both child and spouse had a negative association with LS, although this effect was small. Having experienced multiple losses did not predict more variance than a single child or spouse loss. Gender differences were found within all the bereaved groups with bereaved men having lower LS than bereaved women. Longer time since the loss was associated with higher LS. CONCLUSIONS: Bereaved older adults have somewhat lower LS than non-bereaved and bereaved men seem more affected than bereaved women. Future research needs to address older men´s experiences after the loss of a loved one.

The role of neuroticism and conscientiousness on mortality risk in older adults after child and spouse bereavement.

OBJECTIVE: Bereavement effects on mortality risk were investigated in 1150 randomly selected participants, aged 60-104, in the Swedish National Study of Aging and Care. METHOD: Cox proportional hazards models, controlling for age, gender, functional ability, the personality traits neuroticism and conscientiousness as well as time since the latest loss were used to predict mortality risk. RESULTS: Having lost a child, spouse or both child and spouse did not predict mortality risk. An indirect link between bereavement and mortality was found showing for each year since loss the mortality risk decreased by about 1%. Neuroticism, but not conscientiousness, was associated with mortality risk, with a small-effect size. CONCLUSIONS: The different bereavements did not predict mortality risk while an indirect link was found showing that mortality risk decreased with time.

The distribution of ''sense of coherence'' among Swedish adults: a quantitative cross-sectional population study.

BACKGROUND: Antonovsky's concept of ''sense of coherence'' (SOC) has been shown to be related to health. The aim of this study was to describe the distribution of SOC scores and their components in an adult Swedish population aged 20-80 years. METHODS: A random sample of 910 individuals from Jönköping, Sweden, aged 20, 30, 40, 50, 60, 70 and 80 years, of which 589 agreed to participate in an oral health examination. The participants answered Antonovsky's 13-item version of ''the life orientation questionnaire scale''. The response to the items and the distribution of the three components of comprehensibility, manageability and meaningfulness were analyzed for different age groups and genders using mean values and standard deviations, Student's t-test and ANOVA. RESULTS: A total of 526 individuals, 263 men and 263 women, answered all 13 questions and constituted the final material for the study (response rate 89%). The individual SOC score increased with age. The 20 year olds had a statistically significantly lower SOC score compared with the other age groups and 55% of them had a low SOC (< or = 66 points) compared with 17% of the 80 year olds. Men in the 60 and 70 year age groups had a statistically significantly higher SOC score compared with women of the same age. CONCLUSIONS: The individual distribution of SOC varied with age and gender. Twenty year olds had a significantly lower SOC score compared with elderly age groups. Elderly men had a statistically significantly higher SOC score compared with women of the same age.

The importance of psychological factors in the maintenance of oral health: a study of Swedish university students.

PURPOSE: The aim of this study was to investigate the predictive value of the traditional multidimensional health locus of control (MHLC) scale, a corresponding dental health locus of control (DHLC) scale and dental health values (DHVs) regarding students' dental health before and after a video programme that presented information about dental diseases and instructions on oral hygiene. MATERIALS AND METHODS: A group of 217 university students participated in this study. Before the video programme was presented, assessments were made of MHLC, DHLC and DHVs. Plaque and gingival indices were obtained in a clinical examination conducted before (plaque index [PLI] 1 and gingival index [GI] 1) and 10 weeks after (PLI 2 and GI 2) the presentation of the programme. RESULTS: The percentage of tooth surfaces exhibiting plaque and of sites involving gingivitis decreased and was statistically significant between baseline and re-examination for both males and females. The females exhibited statistically significant better PLI 1 and GI 1 values and stronger DHVs than males. Also, better GI 1 values were found to be statistically significant and related to stronger DHVs for females. A stronger trust in the dental health personnel regarding the dental health was related to more gingivitis at the initial examination (GI 1). For males, stronger internal DHLC was related to more plaque at the final examination (PLI 2). CONCLUSION: The only psychological scales that showed some relationship to the measures of dental health were DHLC and DHVs. Gender was the strongest related variable to dental health.

Relationships between psychosocial work environmental factors, personality, physical work demands and workload in a group of Swedish dentists.

The aim of the study was to investigate, in a group of 77 Swedish dentists (36 males, 41 females) working in dental clinics, possible effects of psychosocial work environmental factors, personality traits, and social desirability tendencies on their reporting of their workload and of the physical demands placed on them. Participants were given questionnaires for assessing their workload, the physical and psychosocial demands of their job, their social support at work, and their control over their work situation, using a 10-cm visual analogue scale (V.A.S.). The Eysenck Personality Questionnaire (EPQ) was also given to assess neuroticism and extraversion and the Marlowe-Crown SD-scale to measure tendencies to answer questions in a socially desirable manner. As in two earlier studies of ours, very high assessments were made of workload, physical work demands and social support. Higher assessments of workload and of physical work demands were found in those assessing the psychosocial work demands placed on them to be higher. Those assessing the work load of their job as higher also considered themselves to have less control over their work situation and were less extraverted. Despite these dentists perceiving themselves as being faced with a stressful work situation involving a high workload, strong physical and psychosocial demands being placed on them and their having a low degree of control over their work situation, the high degree of social support they experienced may have made their work situation less stressful.

Denial in patients with a first-time myocardial infarction: relations to pre-hospital delay and attendance to a cardiac rehabilitation programme.

BACKGROUND: Survival of a myocardial infarction and subsequent prognosis are highly dependent on the time between onset of symptoms and medical intervention. DESIGN: This cross-sectional study examines whether patients who used the psychological defence mechanism of denial when faced with symptoms of a first-time myocardial infarction tended to also show a prolonged delay in going to the hospital and to be less willing to participate in a cardiac rehabilitation programme. METHODS: One hundred and seven patients, 78 men and 29 women, were enrolled in this study. The sample was divided into two groups depending on whether the patients sought medical help within 4 h after they began experiencing myocardial infarction symptoms (non-delayers) or whether they waited longer (delayers). Denial was measured with the Hackett and Cassem semi-structured interview 3-5 days after the patients entered the hospital. Data on participation (attenders) or not (non-attenders) in the rehabilitation programme was also obtained. RESULTS: Forty-nine patients exhibited a prolonged delay and 76 patients did not attend the rehabilitation programme. Both prolonged delay and a lesser readiness to attend the rehabilitation programme that was offered were related to a greater use of denial. In addition, the great majority of the patients categorized as being high deniers were found to also be both delayers and non-attenders. CONCLUSIONS: The results suggest denial to increase the health risks of persons potentially prone to myocardial infarction. If our knowledge about this psychological defence mechanism is increased, we might be able to reach more patients in alternative and individually based cardiac rehabilitation programmes.

Stress management training as related to glycemic control and mood in adults with Type 1 diabetes mellitus.

Relationships between attending a stress management and relaxation-training program, glycemic control (HbA(1c)) and mood were examined in two randomised groups of 31 persons with Type 1 diabetes. The program involved group-education 2 h a week for 14 weeks. Whereas one group received the program, the other acted as a control group and received the program later. HbA(1c) was measured and subjects filled out a mood adjective checklist before the start of intervention and both 1 month and 1 year after completing it. In both groups, significant positive mood changes were obtained, but no significant changes in HbA(1c) values occurred. No significant relationship was found between measures of change in HbA(1c) and of changes in mood. For those attending the group-sessions less frequently, the HbA(1c) values were significantly worse on each of the three measurement occasions than the values of those attending more frequently. The effectiveness of the program, with its failure to improve glycemic control but enhancing the mood of participants, is discussed in terms of characteristics of the sample and various methodological issues as well as in comparison with results of similar studies involving Type 1 and Type 2 diabetes.

Validation of health locus of control patterns in Swedish adolescents.

The purpose of the present study was to investigate the relationships between Health Locus of Control (HLOC) questionnaire subscales (Internal, Powerful Others, Chance) and self-esteem in Swedish adolescents (N = 506). Results from traditional correlational analyses were compared with findings using an alternative method of clustering individuals according to their pattern of scores on the three HLOC subscales. One-way analysis of variance, with eight possible groupings of high and/or low scores on the three subscales, indicated that those with a combination of strong belief in internal control of health, high degree of belief that health is determined by powerful others, and low degree of belief that health is a function of chance/luck had better self-esteem than those with a quite opposite pattern, involving high belief in chance and low belief in internal control. The potential benefit to researchers and clinicians of using this method of combining the HLOC subscales, instead of the traditional correlational method, is discussed.