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Self-and physician-rated general health in relation to symptoms and diseases among women
Stockholm University, Faculty of Social Sciences, Department of Psychology. Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
Stockholm University, Faculty of Social Sciences, Department of Psychology. Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
2003 (English)In: Psychology, health and medicine, ISSN 1354-8506, Vol. 8, no 2, 123-135 p.Article in journal (Refereed) Published
Abstract [en]

Self-rated general health has been demonstrated as an important predictor of future morbidity and mortality, but the determinants of perceived good or poor general health are less clear. The aim of the present study was to investigate self- and physician-rated general health status in relation to self-reported symptoms and diseases (n = 488) as well as to physician-reported health problems based on medical examinations (n = 369) among 43-year-old women representing the general population of a Swedish community. Although most women had good general health as reflected by their own as well as by the physicians' ratings, the physicians rated about twice as many women (12%) to have poor health compared to the women themselves (6%). The agreement between the womens' self-reported general health and the physicians' ratings was significant but low (22%). Bivariate correlations showed that many of the symptoms and diseases in the present sample were significantly associated with both self- and physician-rated general health, but the explained variance was low, varying from 1 to 12%. The exception was for a self-reported sense of powerlessness that explained 20% of the variance in self-rated general health. When taken together and analysed by multivariate logistic regression, it was found that only self-reported symptoms predicted the self-rated general health of the women, contributing to 24% of the variance (p < 0.001). In contrast, both physician-reports of health problems (11%) and self-reports of symptoms (13%), respectively, significantly predicted the physician-rated general health of the women, together contributing to 24% of the variance (p < 0.001). Self-reported diseases did not predict either the self-rated or the physician-rated general health of the women. The findings from the present study support the notion that general health status, when rated by a physician or by the woman herself, is a complex and multidimensional concept that is only partly...

Place, publisher, year, edition, pages
2003. Vol. 8, no 2, 123-135 p.
National Category
Psychology
Identifiers
URN: urn:nbn:se:su:diva-22881OAI: oai:DiVA.org:su-22881DiVA: diva2:189674
Available from: 2004-04-23 Created: 2004-04-23 Last updated: 2011-01-04Bibliographically approved
In thesis
1. Women's subjective and objective health over time: the role of psychosocial conditions and physiological stress responses
Open this publication in new window or tab >>Women's subjective and objective health over time: the role of psychosocial conditions and physiological stress responses
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Today, health problems are likely to have a complex and multifactorial etiology, whereby psychosocial factors interact with behaviour and bodily responses. Women generally report more health problems than men. The present thesis concerns the development of women’s health from a subjective and objective perspective, as related to psychosocial living conditions and physiological stress responses. Both cross-sectional and longitudinal studies were carried out on a representative sample of women. Data analysis was based on a holistic person-oriented approach as well as a variable approach. In Study I, the women’s self-reported symptoms and diseases as well as self-rated general health status were compared to physician-rated health problems and ratings of the general health of the women, based on medical examinations. The findings showed that physicians rated twice as many women as having poor health compared to the ratings of the women themselves. Moreover, the symptom ”a sense of powerlessness” had the highest predictive power for self-rated general health. Study II investigated individual and structural stability in symptom profiles between adolescence and middle-age as related to pubertal timing. There was individual stability in symptom reporting for nearly thirty years, although the effect of pubertal timing on symptom reporting did not extend into middle-age. Study III explored the longitudinal and current influence of socioeconomic and psychosocial factors on women’s self-reported health. Contemporary factors such as job strain, low income, financial worries, and double exposure in terms of high job strain and heavy domestic responsibilities increased the risk for poor self-reported health in middle-aged women. In Study IV, the association between self-reported symptoms and physiological stress responses was investigated. Results revealed that higher levels of medically unexplained symptoms were related to higher levels of cortisol, cholesterol, and heart rate. The empirical findings are discussed in relation to existing models of stress and health, such as the demand-control model, the allostatic load model, the biopsychosocial model, and the multiple role hypothesis. It was concluded that women’s health problems could be reduced if their overall life circumstances were improved. The practical implications of this might include a redesign of the labour market giving women more influence and control over their lives, both at and away from work.

Place, publisher, year, edition, pages
Stockholm: Psykologiska institutionen, 2004. 66 p.
Keyword
health, medically unexplained symptoms, females, longitudinal, psychosocial, stress
National Category
Psychology
Identifiers
urn:nbn:se:su:diva-124 (URN)91-7265-853-3 (ISBN)
Public defence
2004-05-07, David Magnussonsalen (U31), hus 8, Frescati hagväg 8, Stockholm, 14:00
Opponent
Supervisors
Available from: 2004-04-23 Created: 2004-04-23Bibliographically approved

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