Patients with cardiovascular risk factors were more likely to have lower life satisfaction.

in Circulation (2015), 132

Five years after coronary angiography, life satisfaction (LS) among patients may be related to incidents of cardiovascular diseases, risk factors and unhealthy behaviours and socioeconomic conditions but ... [more ▼]

Five years after coronary angiography, life satisfaction (LS) among patients may be related to incidents of cardiovascular diseases, risk factors and unhealthy behaviours and socioeconomic conditions but their respective influence remains unclear. Our aim is to analyze LS and its relationships with those factors. Methods. Among the 4,391 patients initially contacted, 547 deaths were reported and 209 had an invalid address. 3,635 patients who underwent coronary angiography in 2008-2009 at the National Institute of Cardiac Surgery and Cardiological Intervention (INCCI) in Luxembourg completed a self-questionnaire assessing LS [1-10] and other covariates. Data were analysed via multiple regression models adjusted initially on age, sex and income, and for a second time with the addition of all CVRF. Results. LS of 1,289 volunteers (69.2 years) was 7.3/10. Most were men, Luxembourgish, employees and manual workers, had secondary education and an income of 36,000 euros or more per year. LS was lowest in female patients, those with a low to middle income. Patients who live in couple had the best LS. Patients with a history in the previous 5 years of physical inactivity (regression coefficient: – 0.903), angina pectoris (rc -0.843), obesity (rc -0.512), diabetes, or hypercholesterolemia, were more likely to have lower LS. The previous associations were mostly maintained on the second analysis, with the exceptions of diabetes and obesity. In addition, patients who stopped smoking because of peer pressure (rc -0.011) had a lower LS. Conclusions. Profiles of patients are linked with least LS: ‘inclined abstainers’ who intended to modify their behaviours, but could not do it, and ‘disinclined abstainers’ who had no intention of changing and were insufficiently concerned to do so. Patients who stopped smoking and perceived it as unpleasant also had the lowest LS. ‘Declined actors’ were those patients who had to adjust their lifestyles, but were ambivalent about their intentions and the behaviour, which they continued. Health promotion programs would benefit from targeting factors that moderate the unfavourable intention-behaviour relationship and can help enhance LS. [less ▲]

Weight loss associated with socioeconomic status in patients with angina pectoris, 5 years after an angiography

in Cardiology (2015), (132 (suppl 1)), 60

The aim of the study is to assess the association between weight loss and socioeconomic status (SES) in patients with cardiovascular disease (CVD) such as angina pectoris. Method:In 2013-2014, 1,873 ... [more ▼]

The aim of the study is to assess the association between weight loss and socioeconomic status (SES) in patients with cardiovascular disease (CVD) such as angina pectoris. Method:In 2013-2014, 1,873 patients out of 4,391 that had undergone an angiography in 2008 -2009 participated in a follow-up study. Among these patients, 457 suffered from angina pectoris and were obese or overweight at baseline. A self-administered questionnaire was completed. Moderate weight loss was defined as the loss of 5%-10%, severe weigh loss as more than 10 % of baseline weight. Household-income was used as proxy for SES. Logistic regression was applied to assess the association between weight loss and SES. Results:During the reference period, 28% of the participants lost weight. A moderate weight loss was higher in patients with a household income between 3000€ and 4500€ per month (OR: 2.3; CI 95%: 1.0-5.2) and higher than 4500€ per month (OR: 3.0; CI 95%: 1.3-7.2) compared to the lowest income group (less than 3000€ per month). A severe weight loss was not associated with income. However, a severe weight loss was higher for retired patients (OR: 4.3; CI 95%: 1.1-17.0) compared to non-retired.Conclusion: The potential reduction of health inequality by an elimination of social inequalities in weight loss among patients with angina pectoris might be substantial. Moderate weight loss in overweight patients with angina pectoris at baseline could be associated with household income. Intervention strategies in secondary prevention should address these social inequalities in order to support equity in health. [less ▲]

Les aidants familiaux : Investir dans des programmes de promotion de leur« capabilité de santé »

Book published by L'Harmattan - Academia (2015)

Face aux changements démographiques (allongement de l’espérance de vie) et à la baisse de la croissance économique (augmentation des inégalités sociales), les répercussions du prendre soin à domicile sont ... [more ▼]

Face aux changements démographiques (allongement de l’espérance de vie) et à la baisse de la croissance économique (augmentation des inégalités sociales), les répercussions du prendre soin à domicile sont lourdes de conséquences sur la qualité de vie. Les aidants familiaux de personnes atteintes de maladie chronique présentent des risques pour leur santé physique et psychologique. Avec le temps, quelles sont les connaissances et les aptitudes requises pour être en mesure d’accompagner un proche tout en maintenant sa « capabilité de santé », c’est-à-dire en se préservant ou en adoptant un style de vie sain ? À partir de recherches menées au Luxembourg auprès d’aidants de victimes d’un accident vasculaire cérébral, huit domaines ont été identifi és: santé physique, santé psychologique, valeur accordée au mode de vie, sentiment d’auto-efficacité, soutien familial, capital social, conditions matérielles/sentiment de sécurité, satisfaction à l’égard des informations et des services de soins. Des entretiens menés en Lorraine (France) ont permis d’approfondir le contenu de ces domaines. Cet ouvrage fournit un guide utile à l’élaboration de supports innovants ainsi qu’un instrument pertinent pour l’évaluation d’actions de promotion de la capabilité de santé des aidants familiaux. [less ▲]

Fatal Opioid and Cocaine Related Overdoses: Prevention and Harm Reduction in the Light of Socioeconomic Inequality

in Addictive Behaviours (2015)

Objective. To explore socioeconomic inequalities in fatal overdose cases related to non-prescribed opioids’ and cocaine use. Methods. Overdose cases recorded in Luxembourg between 1994 and 2011 were ... [more ▼]

Objective. To explore socioeconomic inequalities in fatal overdose cases related to non-prescribed opioids’ and cocaine use. Methods. Overdose cases recorded in Luxembourg between 1994 and 2011 were individually matched with four controls, in a nested case-control study design, according to sex, year of birth, drug administration route and duration of drug use. 272 cases vs. 1,056 controls were analyzed. The study sample was stratified according to a Social Inequality Accumulation Score (SIAS), based on educational attainment, employment, income, financial situation and professional status of father or legal guardian of subjects. Least squares linear regression analysis on overdose mortality rates and ridit scores were applied to determine the Relative Index of Inequality (RII). Results. A negative linear relationship between the overdose mortality rate and the relative socioeconomic position was observed. We found a difference in mortality of 29.22 overdose deaths per 100 drug users between the lowest socioeconomic class compared to the most advantaged class. In terms of Relative Inequality Index, the overdose mortality rate of opioid and cocaine users with lowest socioeconomic profiles was 9.58 times as high as that of their peers from the highest socioeconomic class (95% CI ; 6.49 - 13.26).Conclusions. Our results suggest the existence of a social gradient in opioid and cocaine related overdose fatalities. Medical services, emergency and psychiatric wards should take due account of the socioeconomic situation of substance abusing patients and refer those at increased risk to socially supportive offers, thus contributing to reduce drug-related mortality. [less ▲]

Dynamic career attitudes among master students: Social disparities in employment capabilities.

in Pracana, Clara (Ed.) Social Psychology (2015)

The preparation of students’ future career trajectories is a dynamic process in relation with social and educational determinants, but their interactions must be further investigated. Our objective is to ... [more ▼]

The preparation of students’ future career trajectories is a dynamic process in relation with social and educational determinants, but their interactions must be further investigated. Our objective is to analyze the associations between generic employment capabilities, career attitudes and other related factors among postgraduate students. Method: All master's students recorded in the Centre for Documentation and Information on Higher Education from Luxembourg database were contacted by letter to participate in an online questionnaire. The online questionnaire (French and English) with five scales was scored: 1) Dynamic Career Attitudes (DCA- 13 items); 2) Employability Soft-Skills (ESS-14); 3) Search for Work Self-Efficacy (SWSES - 12 items); 4) Quality of Life domain Autonomy (QLA- 4 items); and 5) Socio-demographical characteristics. The data were analyzed using bivariate tests, correlations and multiple linear regression models. Results: Of the 481 volunteers (26.4 years; SD=5.5) a majority were women, Luxembourgish, unemployed, and had less than or equal to six months of job experiences. Higher the ESS, SWSES and QLA scores, higher was the DCA score. Nationality, being unemployed, having less than six months of job experiences and being in the first year of master were associated with lower Dynamic Career Attitudes score. Conclusion: Covering the whole period of the master’s degree, internship activities and proactive workshops may be developed to improve generic employment capabilities and quality of autonomy. The Dynamic Career Attitudes scale appears an appropriate instrument to evaluate the efficacy of the university career services programme. [less ▲]

The integration process of Non-EU citizens in Luxembourg From an empirical approach towards a theoretical model

in International Journal of Social Welfare (2015), 9(11), 3868-3875

Integration of foreign communities has been a forefront issue in Luxembourg for some time now. The country’s continued progress depends largely on the successful integration of immigrants. The aim of our ... [more ▼]

Integration of foreign communities has been a forefront issue in Luxembourg for some time now. The country’s continued progress depends largely on the successful integration of immigrants. The aim of our study was to analyze factors which intervene in the course of integration of Non-EU citizens through the discourse of Non-EU citizens residing in Luxembourg, who have signed the Welcome and Integration Contract (CAI). The two year contract, offers integration services to assist foreigners in getting settled in the country. Semi-structured focus group discussions with 50 volunteers were held in English, French, Spanish, Serbo-Croatian or Chinese. Participants were asked to talk about their integration experiences. Recorded then transcribed, the transcriptions were analyzed with the help of NVivo 10, a qualitative analysis software. A systematic and reiterative analysis of decomposing and reconstituting was realized through (1). The identification of predetermined categories (difficulties, challenges and integration needs) (2). Initial coding – the grouping together of similar ideas (3). Axial coding – the regrouping of items from the initial coding in new ways in order to create sub-categories and identify other core dimensions. Our results show that intervening factors include language acquisition, professional career and socio-cultural activities or events. Each of these factors constitutes different components, whose weight shifts from person to person and from situation to situation. Connecting these three emergent factors are two elements essential to the success of the immigrant’s integration – the role of time and deliberate effort from the immigrants, the community and the formal institutions charged with helping immigrants integrate. We propose a theoretical model where the factors described may be classified in terms of how they predispose, facilitate and / or reinforce the process towards a successful integration. Measures currently in place propose one size fits all programs, yet integrative measures which target to the family unit and those customized to target groups based on their needs would work best. [less ▲]

Besoins des professionnels sociaux et de santé de proximité face aux problèmes de santé mentale des communes rurales du Nord

Presentation (2014, August)

Les indicateurs de santé mentale existants restent partiels en Europe, et le système de surveillance sanitaire du Luxembourg ne semble pas y avoir échappé. Cette carence d’informations fiables bien connue ... [more ▼]

Les indicateurs de santé mentale existants restent partiels en Europe, et le système de surveillance sanitaire du Luxembourg ne semble pas y avoir échappé. Cette carence d’informations fiables bien connue est liée en partie aux difficultés méthodologiques inhérentes aux recueils de ces données et à la complexité des classifications. Par ailleurs, aucune information sur les besoins locaux des professionnels de première ligne n’existe. Avec l’appui du RE.SO.NORD (REseau du centre SOcial de la région du NORD), une équipe de l’unité de recherche INSIDE a mis en oeuvre d’un projet innovant, intitulé « diagnostic des professionnels sur les besoins associés à la santé mentale ». Ce diagnostic a eu pour objectifs d’identifier les problèmes de souffrance psychique et sociale des clients des communes rurales, décrits par les professionnels sociaux et de santé de première ligne et de déterminer leurs besoins pour maintenir/améliorer la qualité de leur travail au quotidien et l’efficacité des prises en charge. Cette approche s’inscrit dans une compréhension des processus présents dans la construction et l’amplification des souffrances mentales (angoisses permanentes, dépressions, etc.) ainsi que l’accumulation de facteurs psychosociaux (exigences du monde du travail, ruptures familiales, etc.) qui contribuent à leur émergence. Vingt-huit professionnels (médecins, assistants sociaux, psychologues) travaillant auprès d’adultes de 18 à 65 ans ont été interrogés. L’analyse des transcriptions de leurs discours met en évidence la nécessiter d’insister sur :1) la mise en place de démarches globales, et sur le fait d’associer les aidants aux échanges sur la connaissance de la maladie et de ses symptômes (lieux de parole, etc.) ; 2) la nécessité de faciliter et d’encourager la consultation médicale ou psychologique ; 3) l’engagement et le développement d’une responsabilisation clients-aidants. Les professionnels proposent également que l’on augmente : 1) les possibilités de rencontres entre les médecins, assistants sociaux, psychologues (synthèses, analyses de cas, etc.) qui permettraient à la communication d’être plus efficiente ; 2) la mutualisation des informations entre les professionnels de proximité en créant une plate-forme d’échanges interactifs qui faciliteraient le suivi des parcours ; 3) les formations interdisciplinaires pour actualiser les connaissances (dépression, suicides, etc.), renforcer le respect réciproque clients-aidants-professionnels et la déstigmatisation. ____________________________________ Mental Health & Recovery Luxembourg 23 & 24 Octobre 2014 2 Needs of local social and health professionals addressing the mental health problems of rural communities in the North. The existing mental health indicators remain partially developed in Europe, and Luxembourg’s system of health surveillance does not seem to have escaped. This lack of reliable information is well known partly due to the methodological difficulties inherent to the collections of data and complexity of the classifications. Moreover, any information on the needs of local frontline professionals exists. With the support of RE.SO.NORD (REseau du centre SOcial de la région du NORD), a research unit INSIDE team has implemented an innovative project " diagnostic des professionnels sur les besoins associés à la santé mentale ». The aim of this diagnostic was to identify problems of psychic and social suffering of clients in rural towns, described by the social and health frontline professionals, and to define their needs to maintain / improve the quality of their daily work and effectiveness of their care. This approach is part of an understanding of the processes occurring in the construction and amplification of mental suffering (permanent anxiety, depression, etc.) and the accumulation of psychosocial factors (demands of the workforce, family separation, etc.) that contribute to their emergence. Twenty-eight professionals (doctors, social workers, psychologists) working with adults 18 to 65 years were interviewed. The analysis of transcripts highlighted the need to focus on: 1) the development of comprehensive approaches, associating caregivers to exchange knowledge of the disease and its symptoms (place of dialogue, etc.); 2) the need to facilitate and encourage medical or psychological counseling; 3) commitment and a growing accountability of clients -caregivers. The professionals also propose to increase: 1) the possibilities of meetings between the doctors, social workers and psychologists (syntheses, case studies, etc.) allowing communication to be more efficient; 2) the sharing of information between local professionals by creating a platform for interactive exchanges which would facilitate the follow-up of the trajectory ; 3) interdisciplinary training to update knowledge (on depression, suicide, etc.), enhancing mutual client-family caregivers-professional respect and destigmatization. ____________________________________ [less ▲]

Les problèmes que rencontrent les professionnels pour prendre en charge les souffrances et les recommandations qu’ils préconisent pour répondre à leurs besoins.

Conference given outside the academic context (2014)

2ème partie Les problèmes que rencontrent les professionnels pour prendre en charge ces souffrances et les recommandations qu’ils préconisent pour répondre à leurs besoins. _________________________ Les ... [more ▼]

2ème partie Les problèmes que rencontrent les professionnels pour prendre en charge ces souffrances et les recommandations qu’ils préconisent pour répondre à leurs besoins. _________________________ Les problèmes que rencontrent ces professionnels des communes rurales du nord pour prendre en charge ces souffrances et les recommandations qu’ils préconisent pour répondre à leurs besoins. [less ▲]

Quality of life and positive person-centred rehabilitation.

in Positive Psychology and Well-being (2014)

Quality of life (QoL) assessment is important when monitoring over time the recovery of survivors living at home, two years after stroke onset. The associations between Newcastle Stroke-Specific Quality ... [more ▼]

Quality of life (QoL) assessment is important when monitoring over time the recovery of survivors living at home, two years after stroke onset. The associations between Newcastle Stroke-Specific Quality of life (newsqol) domains, socioeconomic factors and satisfaction with information and home-care services were analysed. This problem remains partially addressed though positive and optimal supports may improve post-stroke’ quality of life. Methods. Stroke-survivors admitted to all hospitals in Luxembourg 18 months or more previously were identified using the only care-expenditure-reimbursement national system database. The clinical diagnosis was confirmed. Ninety four patients aged 65 years and living at home were interviewed to gather socioeconomic characteristics and satisfaction with information and home-care services, and newsqol assessing 11 scores. Data were analyzed using multiple linear sex-age-adjusted regression models. Results. About 50% of patients had low education and lower income. Functional impairments were common: sensory (45%), motor (35%), memory (32%), language (31%), and vision (20%). Patients with education (<12th grade) or lower income had low values for most newsqol domains. In opposite, patients who were working had better values for pain, mental feelings and sleep domains than did retired people. The self-rate quality of life was markedly low, especially for the domains of interpersonal relationship, sleep, cognition, mental feelings, and pain. Patients who were dissatisfied with information and home-care received had rather low values for several newsqol domains. Dissatisfaction with accuracy of information received, information about stroke and its consequences/change over time; help received, lack of coordination between services, and possibility of receiving help when necessary were related with low values for most domains. Dissatisfaction with the possibility of receiving help was also associated with mobility and self-care. Dissatisfaction with information about consequences/change over time of stroke linked with the vision domain. Dissatisfaction with information received about help correlated with mental feelings, interpersonal relationships, emotion, and fatigue. Being confident about where to get information about stroke, looking after someone who has had a stroke if needed, or about financial help, and being confident about who to contact from community services if needed were slightly associated with communication, mental feelings and interpersonal relationships only. Conclusions. Post-stroke patients had major alterations in quality of life that reflected depressive symptoms, which should be appropriately treated. Our results further raise the question concerning the needs and satisfaction of stroke-survivors living at home in terms of information and care services as well as interactions with social and medical carers according to recovery stage and possible relapse over time. The changing nature of needs at different stages of recovery may not be paid sufficient attention. A telephone service could help. Use of IT technology has been proposed to promote positive person-centred rehabilitation. It has been shown, with Telestroke, that videoconference calls can help to reduce stress, provide reassurance about the secondary effects of treatment, improve compliance with prescriptions, and yield valuable information about services. [less ▲]

Associations between Psycho-Educational Determinants and Dynamic Career Attitudes among undergradutes students

in Pracana, Clara (Ed.) Psychology Applications & Developments - Advances in Psychology and Psychological Trends Series (2014)

Monitoring and assessment of career attitudes are critical for the student’s preparation for an adapted university-to-work transition. This problem remains partially addressed though optimal services ... [more ▼]

Monitoring and assessment of career attitudes are critical for the student’s preparation for an adapted university-to-work transition. This problem remains partially addressed though optimal services proposed by universities which may enhance students’ generic career capabilities. Our study explored the relationships between the psycho-educational and socio-demographic factors, and the perception of their career attitudes. Bachelor students in social sciences, engineering, applied management from University of Luxembourg were invited to complete a paper pencil questionnaire. Data were analyzed using correlation and multiple linear regression models. Of 278 students, 124 participated. The majority studied applied management, were women, unemployed and with six months or less of job experiences. The search for work self-efficacy score is linked to the employability soft-skills and job search techniques scores which are, in parallel, with the quality of life autonomy associated to the dynamic career attitudes. Greater are employability, search for work and quality of life autonomy, the higher are dynamic career attitudes. Students who were in their final academic year also had greater career capabilities. These findings may help to elaborate interventions aiming at improving psycho-educational determinants. It must be stimulated at the entry to university with appropriately collaborative supports, pedagogical workshops and interpersonal trainings. [less ▲]