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See detailReversing social gradient: Impact of patients’ communication with their practitioners on adherence to preventive behaviours
Baumann, Michèle UL; Bucki, Barbara; Tchicaya, Anastase et al

in "Health Psychology across the Lifespan: Uniting Research, Practice and Policy” (2018)

Good communication with a physician has positive effects on the patients’ adopting preventive behaviours. Knowing social inequalities in health, we aimed at analysing in what extent financial situation ... [more ▼]

Good communication with a physician has positive effects on the patients’ adopting preventive behaviours. Knowing social inequalities in health, we aimed at analysing in what extent financial situation influences the associations between quality of communication and improved secondary preventive behaviours and limited risk factors - in cardiovascular diseases: hypertension, overweight, obesity, hypercholesterolemia, diabetes. Methods: 1,289 patients who underwent a coronary angiography in Luxembourg completed a self-administered questionnaire in 2008/09 and 2013/14. The association between improving each preventive eating behaviour (decrease of salt, sugar, fat consumption; increase of fruits/vegetables) and the quality of physician-patient communication (5-items scale) was evaluated using logistic regression models. Perceived financial situation (difficult, easy, and very easy) was introduced in interaction with the communication score. Findings: Patients declared in a difficult or easy financial situation had a higher probability of decreasing their salt intake when physician-patient communication quality was higher (OR [95% CI] respectively: 1.139 [1.045; 1.240], 1.105 [1.032; 1.182]). The pattern was similar for increased consumption of fruits/vegetables in patients with hypertension, diabetes, overweight and hypercholesterolemia. Reduced sugar consumption was associated with communication quality in hypercholesterolemia patients in financial difficulty (OR [95% CI]: 1.095 [1.009; 1.189]). Discussion: The quality of communication has a higher impact on adopting healthy behaviours in patients declaring themselves in financial difficulty. These findings raise awareness on the importance, in patients with perceived financial difficulties, of physician-patient quality to improve adherence to the secondary preventive recommendations. Across the lifespan, it highlights the role of physicians in reversing their patients’ social gradient. [less ▲]

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See detailLife Satisfaction and longitudinal changes in physical activity, diabetes and obesity among patients with cardiovascular diseases.
Baumann, Michèle UL; Tchicaya, Anastase; Lorentz, Nathalie et al

in BMC Public Health (2017), (17), 925

Patients with cardiovascular disease who underwent coronary angiography at the National Institute of Cardiac Surgery and Cardiological Intervention (INCCI) in Luxembourg were surveyed for cardiovascular ... [more ▼]

Patients with cardiovascular disease who underwent coronary angiography at the National Institute of Cardiac Surgery and Cardiological Intervention (INCCI) in Luxembourg were surveyed for cardiovascular risk factors (CVRF) (hypertension, hypercholesterolemia, diabetes, obesity, physical inactivity, tobacco consumption). In 2013/14, their life satisfaction (LS) was also assessed. Our aim was to analyse the relationships between LS on one hand and <br />longitudinal changes in CVRF between 2008/09 and 2013/14 and socioeconomic factors on the other. <br />Methods: 1289 patients completed a self-administered questionnaire. Life Satisfaction, originally recorded on a 1 to 10 scale of complete satisfaction was dichotomized into two groups: ≤ 7 and. >7. We then performed logistic multiple regressions. The event on which the probability was modelled, was LS > 7. Data were adjusted on age, sex and income. Longitudinal changes in CVRF were assessed by their presence or absence in 2008/09 and 2013/ 14 (categories: ‘no-no’; ‘no-yes’; ‘yes-no’; ‘yes-yes’). <br />Results: Physical activity in 2008/09 and 2013/14 was associated with a lower LS (OR = 0.469). The same pattern was observed for obesity and physical inactivity: lower LS was related to the presence of these risks (yes-yes; no-yes) in 2013/14 (mean OR for obesity and physical inactivity in 2013/14: 0.587 and 0.485 respectively), whereas their presence or absence in 2008/09 was not related to LS. Finally, patients who suffered from diabetes in 2008 <br />were more likely to experience a decline in LS, particularly if their diabetes was less severe in 2013/14 (OR = 0.462). <br />Conclusions: The lowest LS was observed when obesity or physical inactivity was present in 2013/14, newly or otherwise. The same trend was seen in diabetes among patients who had it in 2008/9, but were less severely affected in 2013/14. In secondary prevention, CVD-related upheavals could be minimised if professionals and patients ecame ‘Partners in Healthcare’ to better adhere to healthy lifestyles, as well as to reduce CVRF, and thereby enhance LS. [less ▲]

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See detailQuality of doctor-patient communication in cardiovascular diseases and secondary preventive adherence. The role of gender
Bucki, Barbara UL; Le Bihan, Etienne UL; Baumann, Michèle UL

in Innovative ideas in Health Psychology (2017)

The doctor-patient communication intervenes on the preventive behaviours of chronic patients by reducing their risk factors – in cardiovascular diseases: hypertension, overweight, obesity ... [more ▼]

The doctor-patient communication intervenes on the preventive behaviours of chronic patients by reducing their risk factors – in cardiovascular diseases: hypertension, overweight, obesity, hypercholesterolemia, diabetes. What are the associations between the quality of communication and the improvement of secondary preventive behaviours? How does gender influence these relationships? Methods: 1,289 patients who underwent a coronary angiography in 2008/09 in Luxembourg completed a self-administered questionnaire at the time of the visit, and at a five-year follow-up. The probability of improving each preventive eating behaviour (decrease of salt, sugar, fat consumption and increase of fruits/vegetables), and the quality of doctor-patient communication (5-item scale) were evaluated using logistic regression models. Sex was introduced in interaction with the communication score. Findings: Among hypertensive respondents, a higher quality of communication was associated with a higher probability of decreasing the salt intake in women (OR [95% CI]: 1.139 [1.060; 1.223]) whereas in men, the OR was only 1.086 [1.017; 1.159]. ORs were also higher in women among patients with hypertension, overweight and hypercholesterolemia regarding the increase of fruits/vegetables consumption; among patients with diabetes and hypercholesterolemia regarding sugar decrease or cessation; and among patients with overweight and hypercholesterolemia regarding fat reduction or stop. ORs were slightly higher among men only among diabetic and obese patients, regarding the increase of fruits/vegetables consumption. Discussion: The quality of the communication showed an effect on the adoption of secondary preventive eating behaviours, especially in women patients. Motivational interviews could encourage, especially men patients, to adhere to the recommendations about lifestyle change. [less ▲]

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See detailHealth capability of family caregivers: how different factors interrelate and their respective contributions using a Bayesian approach
Bucki, Barbara UL; Le Bihan, Etienne UL; Baumann, Michèle UL

in BMC Public Health (2016), 16

The lifestyles of family caregivers pose risks to their physical, mental and social health. The capability to stay healthy may be protective in the context of poor socioeconomic conditions and risk ... [more ▼]

The lifestyles of family caregivers pose risks to their physical, mental and social health. The capability to stay healthy may be protective in the context of poor socioeconomic conditions and risk behaviours, but the interrelations between its aspects and their respective influences remain unclear. The aim of this study was to evaluate the interrelations between the factors comprising health capability of family caregivers (HCFC) and the respective contributions of its components. Methods: All stroke patients admitted to all hospitals in Luxembourg were identified by the ‘Inspection Générale de la Sécurité Sociale’ using the national database system for care expenditure reimbursement, and asked to designate the main person caring for them. Sixty-two caregivers (mean age 59.3 years; 40 women and 22 men) responded face to face, to a questionnaire including 20 items measuring eight aspects of health capability (physical functioning, psychological functioning, lifestyle value, self-efficacy towards the use of health services, family support, social capital, material conditions/sense of security, and satisfaction with the interactions with health services). Using a Bayesian approach, significance values were estimated by comparing the test values to the posterior distribution of the parameters. Structural equation modelling with standard deviations was applied. Results: Female family caregivers had lower scores than men in physical and psychological functioning. Family caregivers with the lowest incomes had the least lifestyle value, social capital and material conditions/security. Self-efficacy towards health services increased with age. The material conditions/sense of security factor was positively correlated with almost all the others. The items that impacted health capability factors the most were - for physical functioning – fatigue, and - for family support - feeling abandoned by the family. Conclusions: During the chronic phase, relationships between risk behaviours can help guide social and health decision-makers to determine their priorities in improving the lives of family caregivers. Enhancing health capability involves implementing programs that relieve family caregivers physically, and foster family networking around the person being cared for. Special attention should also be paid to the socially disadvantaged in order to fight inequalities in health capability. [less ▲]

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See detailImpact of Patients’ Communication with the Medical Practitioners, on Their Adherence Declared to Preventive Behaviours, Five Years after a Coronary Angiography, in Luxembourg
Baumann, Michèle UL; Tchicaya, Anastase; Lorentz, Nathalie et al

in PLoS ONE (2016), 11(6), 0157321

Patients of the National Institute of Cardiac Surgery and Interventional Cardiology in Luxembourg who underwent coronary angiography were surveyed for hypertension, hypercholesterolemia, diabetes and ... [more ▼]

Patients of the National Institute of Cardiac Surgery and Interventional Cardiology in Luxembourg who underwent coronary angiography were surveyed for hypertension, hypercholesterolemia, diabetes and overweight/obesity between 2008/9 and 2013/4. For each cardiovascular risk factor (CVRFs), we analysed the associations between the quality of the patients' communication with the medical practitioner and their adherence declared to preventive behaviours. Methods 1,289 completed a self-administered questionnaire on communication with the medical practitioner (P’Com-5 items scale; Cronbach 0.87). 61.8%stopped smoking, 57.9% reduced or stopped their consumption of salt, 71.9% of fat, and 62.8%of sugar, and whereas 65% increased their consumption of fruit and vegetables and 19.8% increased their physical activity. Around 37% reported having made changes following their doctor's advice. 90% were followed by a cardiologist and 95.9% by an attending physician. Results No link was observed between declaration of physical activity, smoking, fats, and quality of communication. Significant associations: for increased consumption of fruit and vegetables was linked with the quality of doctor-patient communication when patients were overweight (OR = 1.081), obese (OR = 1.130), hypercholesterolemic (OR = 1.102), hypertensive (OR = 1.084) or diabetic (OR = 1.103). Reduction in salt intake was linked only to patients with hypertension (OR = 1.102), whereas reduction or cessation of sugar consumption was linked to overweight (OR = 1.093), and more so obese, (OR = 1.106), hypercholesterolemics (OR = 1.103) and diabetics (OR = 1.173). Conclusions Good doctor-patient communication was related to nutrition, particularly increased consumption of fresh fruits and vegetables. Accurate perception of CVRFs by both patients and medical practitioners is essential for CV protection. The aim of instructing patients is to encourage them to make informed decisions about how to change their lifestyle. In routinely, P’Com-5 scale can collect data to assess the improvement of the professional skills. It can be used in medical training to enhance the quality of the therapeutic communication, especially for nutritional coaching, and to evaluate its efficacy in reducing CVRFs. [less ▲]

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See detailLife satisfaction, five-years after a coronary angiography, between physical exercise and socio-economic inequalities.
Baumann, Michèle UL; Le Bihan, Etienne UL; Lorentz, Nathalie et al

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

Five-years after undergoing a coronary angiography, socioeconomic status and health related behaviours are known to affect life satisfaction (LS), but their respective influence remains unclear. Our aim ... [more ▼]

Five-years after undergoing a coronary angiography, socioeconomic status and health related behaviours are known to affect life satisfaction (LS), but their respective influence remains unclear. Our aim was to analyze patients’ LS and its relationships with cardiovascular diseases, risk factors and preventive behaviours developed in the last 5 years and socioeconomic conditions. Methods: Based on records from the National Institute of Cardiac Surgery and Cardiological Intervention in Luxembourg, 3632 survivors who underwent coronary angiography between 2008 and 2009 were contacted in 2013 by letter to complete a self-questionnaire assessing LS [1-10] and other cofounder factors. Data were analysed via multiple regression models. Results. Life satisfaction of 1289 volunteers (69.2 years) was 7.3/10. Majority were men, Luxembourgish, secondary education level, employees and manual workers, and those with an income of 36000 euros or more per year. Being a woman, not living in couple and having a low middle income were negatively associated with the LS level. Patients who suffered in the last 5 years from angina pectoris, diabetes, hypercholesterolemia, obesity, or who stopped smoking because of the disease were more likely to have lower LS, in contrast to those who participate in regular physical activity or exercise. Conclusions: Patients’ LS indicator was lower than the national life satisfaction in Luxembourg (7.8/10) which was higher than that from the European (7.0 for EU-27). Coaching patients with interventions that foster healthy attitudes can help sustain rehabilitation and enhance life satisfaction, adding beyond a reduction of socioeconomic inequalities. [less ▲]

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See detailLife satisfaction, cardiovascular risk factors, unhealthy behaviours and socioeconomic inequality, 5 years after coronary angiography.
Baumann, Michèle UL; Tchicaya, Anastase; Vanderpool, kyle et al

in BMC Public Health (2015), (15), 668-678

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. In 2013-2014, 3,635 patients who underwent coronary angiography in 2008-2009 at the National Institute of Cardiac Surgery and Cardiological Intervention in Luxembourg were asked to complete a self-administered questionnaire assessing LS [1-10] and other variables. 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, and those with a low to middle income. Patients who lived in a 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. The finding that LS was lowest among female patients calls for further research on symptoms, and potential risk factors. Also, certain patient profiles are linked with low LS: ‘inclined abstainers’ who intended to modify their behaviours, but could not do so, 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 low LS. ‘Disinclined 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 ▲]

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See detailDoctor-patient communication on nutrition and the related secondary preventive behaviours
Baumann, Michèle UL; Le Bihan, Etienne UL; Lorentz, Nathalie et al

in Cardiology (2015), 132

Doctor-patient relationship impacts on the compliance. For hypercholesterolemia, diabetes, overweight and obesity, our study’s aim was to analyse the associations between the quality of communication ... [more ▼]

Doctor-patient relationship impacts on the compliance. For hypercholesterolemia, diabetes, overweight and obesity, our study’s aim was to analyse the associations between the quality of communication, evaluated in 2013, and patients’ adherence to their general practitioner (GP)’s nutritional advice, between 2008 and 2013. Methods. Five years after a coronary angiography performed by the National Institute of Cardiac Surgery and Interventional Cardiology in Luxembourg, 4391 patients were contacted. 1289 completed a self-rating questionnaire assessing the GP’Com-5 items scale (Cronbach 0.87). The variables were analysed with a multiple logistic regression model. Results. Patients declared that they reduced or stopped their consumption 71.9% of fat, 62.8% of sugar and 65% increased their consumption of fruits and vegetables. Around 37% of the patients reported having made changes to their risk behaviours following the advice of their doctor. An increased consumption of fruits and vegetables was linked with the quality of doctor-patient communication when patients were overweight (odd ratio = 1.081, IC 95%, [1.013-1.155]), obesity (OR = 1.130 [1.056-1.209]), hypercholesterolemia (OR = 1.102 [1.033–1.175]) and diabetes (OR = 1.103 [1.029-1.181]). The reduction or cessation of sugar consumption was associated with the quality of physician-patient communication when the patient was overweight (OR = 1.093 [1.020-1.170]), and more so obese (OR = 1.106 [1.031-1.187]). The same held true for patients with hypercholesterolemia (OR = 1.103 [1.031-1.180]) or diabetes (OR = 1.173 [1.088-1.265]). Conclusion. In prevention of secondary CVDs, doctor-patient communication is a relevant determinant in obtaining a favourable behavioural outcome, especially with the consumption of fresh fruit and vegetables. [less ▲]

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See detailA social gradient in fatal opioids and cocaine related overdoses?
Origer, Alain; Le Bihan, Etienne UL; Baumann, Michèle UL

in PLoS ONE (2015), 4(10(5)),

To determine the existence of a social gradient in fatal overdose cases related to non-prescribed opioids and cocaine use, recorded in Luxembourg between 1994 and 2011. METHODS: Overdose cases were ... [more ▼]

To determine the existence of a social gradient in fatal overdose cases related to non-prescribed opioids and cocaine use, recorded in Luxembourg between 1994 and 2011. METHODS: Overdose cases 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. The study sample, composed of 272 cases and 1,056 controls, was stratified according to a Social Inequality Accumulation Score (SIAS), based on educational attainment, employment, income, financial situation of subjects and the professional status of their father or legal guardian. Least squares linear regression analysis on overdose mortality rates and ridit scores were applied to determine the Relative Index of Inequality (RII) of the study sample. 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 in the lowest socioeconomic group compared to the most advantaged group. In terms of the Relative Inequality Index, the overdose mortality rate of opioid and cocaine users with lowest socioeconomic profiles was 9.88 times as high as that of their peers from the highest socioeconomic group (95% CI 6.49-13.26). CONCLUSIONS: Our findings suggest the existence of a marked social gradient in opioids and cocaine related overdose fatalities. Harm reduction services should integrate socially supportive offers, not only because of their general aim of social (re)integration but crucially in order to meet their most important objective, that is to reduce drug-related mortality [less ▲]

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See detailThe Luxembourg Teacher Databank 1845-1939. Academic Research into the Social History of the Luxembourg Primary School Teaching Staff
Voss, Peter UL; Le Bihan, Etienne UL

in Lausen, Berthold; Krolak-Schwerdt, Sabine; Böhmer, Matthias (Eds.) Data Science, Learning by Latent Structures, and Knowledge Discovery (2015)

From 1845 to 1939 the pedagogical journal Der Luxemburger Schulbote published a comprehensive annual directory of the primary school teaching staff of the Grand Duchy. On the basis of this directory, we ... [more ▼]

From 1845 to 1939 the pedagogical journal Der Luxemburger Schulbote published a comprehensive annual directory of the primary school teaching staff of the Grand Duchy. On the basis of this directory, we have established a databank encompassing 75,000 entries relating to a total of approx. 4,700 primary school teachers, both male and female, who taught in the Grand Duchy during this period. With the assistance of IBM SPSS Statistics, we have been able to process the data and compile a collective biography or prosopography that provides a profound insight into the development of an occupational group over a period of nearly 100 years at a local, regional and national level. This paper presents an analysis of initial research findings relating to the number of teaching staff, length of service and the level of qualification and mobility among teaching staff for the first half of this period from 1845 to 1895. [less ▲]

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See detailAssociations between quality of life and socioeconomic factors, functional impairments and dissatisfaction with received information and home-care services among survivors living at home two years after stroke onset
Baumann, Michèle UL; Le Bihan, Etienne UL; Chau, Kénora et al

in BMC Neurology (2014), 14

Quality of life (QoL) assessment is important when monitoring over time the recovery of stroke-survivors living at home. This study explores the associations between QoL and socioeconomic factors ... [more ▼]

Quality of life (QoL) assessment is important when monitoring over time the recovery of stroke-survivors living at home. This study explores the associations between QoL and socioeconomic factors, functional impairments and self-reported dissatisfaction with received information and home-care services among survivors two years after stroke onset. This problem remains partially addressed though optimal information and services may improve survivors' QoL. 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, functional impairments, dissatisfaction with information and home-care services, and QoL (using the Newcastle Stroke-Specific QoL, newsqol) assessing 11 domains. Data were analyzed using multiple linear regression models. Results About 50% of survivors had low education and lower income. Functional impairments were common: sensory (45%), motor (35%), memory (32%), language (31%), and vision (20%). Survivors with education (<12th grade) or lower income had low values for most newsqol domains (sex-age-adjusted regression coefficient saRC, i.e. mean difference, between -23 and -8). Patients who were working had better values for pain, mental feelings and sleep domains than did retired people (saRC between -3.9 and 4.2). Various functional impairments were associated with markedly low values of nearly all domains (saRC between -33.5 and -7.5) and motor, language, memory and sensory impairments had the highest impact. The survivors' perceived QoL was markedly low, especially for the domains of interpersonal relationship, sleep, cognition, mental feelings, and pain. Various QoL domains were strongly related to dissatisfaction with information about stroke and its consequences/changes over time, accuracy of information obtained, help received, coordination between services, and the possibility of receiving help when necessary (saRC reaching -30). Conclusions Stroke-survivors had major alterations in QoL that reflected depressive symptoms, which should be appropriately treated. These findings may help with the development of public policies aiming at improving QoL among stroke survivors. The newsqol could be used routinely to measure the recovery of survivors over time and their needs in terms of information, help and care services [less ▲]

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See detailSocial and economic inequalities in fatal opioid and cocaine related overdoses in Luxembourg: A case–control study
Origer, Alain UL; Le Bihan, Etienne UL; Baumann, Michèle UL

in International Journal of Drug Policy (2014), 25

Background: To investigate social and economic inequalities in fatal overdose cases related to opioid and cocaine use, recorded in Luxembourg between 1994 and 2011. Methods: Cross-examination of national ... [more ▼]

Background: To investigate social and economic inequalities in fatal overdose cases related to opioid and cocaine use, recorded in Luxembourg between 1994 and 2011. Methods: Cross-examination of national data from law enforcement and drug use surveillance sources and of forensic evidence in a nested case–control study design. Overdose cases were individually matched with four controls, when available, according to sex, year of birth, drug administration route and duration of drug use. 272 cases vs 1056 controls were analysed. Conditional logistic regression analysis was performed to assess the respective impact of a series of socioeconomic variables. Results: Being professionally active [OR = 0.66 (95% CI 0.45–0.99)], reporting salary as main legal income source [OR = 0.42 (95% CI 0.26–0.67)] and education attainment higher than primary school [OR = 0.50 (95% CI 0.34–0.73)] revealed to be protective factors, whereas the professional status of the father or legal guardian of victims was not significantly associated to fatal overdoses. Conclusions: Socioeconomic inequalities in drug users impact on the occurrence of fatal overdoses. Compared to their peers, users of illicit drugs with lower socioeconomic profiles show increased odds of dying from overdose. However, actual and self-referred socioeconomic characteristics of drug users, such as educational attainment and employment, may have a greater predictive value of overdose mortality than the parental socioeconomic status. Education, vocational training and socio-professional reintegration should be part of drug-related mortality prevention policies. [less ▲]

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See detailAssociations between Psycho-Educational Determinants and Dynamic Career Attitudes among undergradutes students
Karavdic, Senad UL; Karathanasi, Chrysoula UL; Le Bihan, Etienne UL et al

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 ▲]

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See detailLife satisfaction two-years after stroke onset: the effects of gender, occupational status, memory function and quality of life among stroke patients (Newsqol) and their family caregivers (Whoqol-bref) in Luxembourg
Baumann, Michèle UL; Couffignal, Sophie; Le Bihan, Etienne UL et al

in BMC Neurology (2012), 12

Life satisfaction (LS) of cerebrovascular disease survivors and their family caregivers may relate to socioeconomic factors, impaired functions, health-related quality of life (QoL), but their respective ... [more ▼]

Life satisfaction (LS) of cerebrovascular disease survivors and their family caregivers may relate to socioeconomic factors, impaired functions, health-related quality of life (QoL), but their respective influences remain unclear. This study assessed, two years post-stroke onset, the effects of these factors on patients' LS and family caregivers' LS in Luxembourg. METHODS: All stroke patients admitted to all hospitals in Luxembourg were identified by the 'Inspection Général de la Sécurité Sociale' using the only national system database for care expenditure reimbursement. Their diagnosis was confirmed by medical investigator. The sample included ninety four patients living at home having given consent (mean age 65.5 years) and sixty two main caregivers (mean age 59.3 years). Questionnaires were completed during face-to-face interviews. LS was assessed via European single question (range 1-10), survivors' QoL via Newsqol (11 dimensions), and caregivers' QoL via Whoqol-bref (4 domains) (range 0-100). Data were analysed using multiple regression models. RESULTS: Two years after stroke onset, 44.7% of patients suffered from impaired sensory function, 35.1% from impaired motor function, and 31.9% from impaired memory function. Mean patient' LS was 7.1/10 (SD 1.9). It was higher in women (+12.4) and lower among unemployed socioeconomically active patients (-13.1, vs. retired people). Adjusted for sex, occupation, impaired motor and memory functions, LS positively correlated with scores of Newsqol feelings, sleep, emotion, cognition and pain dimensions (slopes 0.20 to 0.31), but did not correlate with those of caregivers' Whoqol-bref domains. Family caregiver' LS was 7.2 (SD 1.7). It was lower in those with patients suffering from impaired memory function (-12.8) as well as from feelings and emotion issues (slopes 0.22). It was associated with all caregivers' Whoqol-bref domains (physical health, psychological health, environment, and social relationships) (slopes 0.53 to 0.68). CONCLUSIONS: Two-year post-cerebrovascular disease patient' LS was associated with gender, occupation, and impaired memory function. It correlated with feelings, sleep, emotion, cognition, and pain issues. Family caregivers of patients with impaired memory function had lower LS. Family caregiver' LS correlated with dimensions of patients' feelings (less independent, yourself, life changed, depressed, useless, less control because of stroke) and emotion (get more emotional, fear of another stroke or to become dependent on others), and with their own QoL. LS, Newsqol, and Whoqol appeared to be appropriate tools. Our findings may be useful for policy makers in relation to family and medical-social issues of stroke home-based rehabilitation. [less ▲]

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See detailHarmony within stroke patient-caregiver pairs concerning psychological and social repercussions, two years post-stroke in Luxembourg and Portugal.
Baumann, Michèle UL; Lurbe-Puerto, Katia UL; Le Bihan, Etienne UL

in International Sociology Association. (2010)

This study aims to improve our understanding of the impact of stroke on the lives of patients & principal caregivers (PCs). The objective was to analyze agreement within patient-caregiver couples in ... [more ▼]

This study aims to improve our understanding of the impact of stroke on the lives of patients & principal caregivers (PCs). The objective was to analyze agreement within patient-caregiver couples in responses to statements concerning the psychological & social repercussions of stroke. Two years post-stroke, 97 patient-PC pairs were administered questionnaires at home. Logistic regression was used to analyze data on 50 couples of questionnaires from Luxembourg (Lux) & 47 from Portugal (Por); 60% of patients were men, with average ages of 65 years in Luxembourg & 71 years in Portugal; 75% of carers were women aged on average 61.5 years (Lux) & 61 years (Por). Responses to the question "Are you happy or not?" were more correlated with concordance within patient-caregiver couples’ statements concerning the psychological and social repercussions of stroke than were socioeconomic characteristics (nationality, age, having finished elementary school or not). Patients who considered themselves happy were more likely to give answers close to those of their caregivers. This was true particularly in the domain of stroke repercussions on relationships with friends: “sympathy shown by friends and relations”, “loss of friends”, “friends bothered by the handicap” & "ties maintained & even strengthened”. Conversely, PCs who described themselves as happy were less likely to agree with the patient they cared for. Patient-PC couples emphasised the consequences of a stroke on self-image in the face of the “loss of many friends" & the fact that "the patient feels devalued ". Family & social life is disrupted by stroke, and friendly relationships are put under stress. Patient-caregiver coherence is central, not least in its effect on quality of life. Do couples’ feelings about life have a decisive role in the reconstruction of the identities of patients and caregivers? What part will trust play in that process? [less ▲]

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See detailWhat Social Inequalities of Quality of Life (NEWSQOL domains) amongst patients does appear, two years after a stroke?
Baumann, Michèle UL; Lurbe-Puerto, Katia UL; Le Bihan, Etienne UL

in European Society for Health and Medical Sociology (2010)

The quality of live “capability” must be taken into consideration because it affects stroke patients’ ability to make health choices. We aimed to analyse the relations between their socio-demographic ... [more ▼]

The quality of live “capability” must be taken into consideration because it affects stroke patients’ ability to make health choices. We aimed to analyse the relations between their socio-demographic characteristics and their quality of life (domains selected: interpersonal relationship, emotions, feelings, pain, sleep, fatigue). Methods: Two years after their stroke, 72 volunteers participated to a Luxembourg national survey. Completed at their home, the questionnaire included the six NEWSQOL* domains that responded to the criterion of an absence of direct consequence of the injuries caused by the stroke. For each domain, a multiple regression model was fit and adjusted by impairments (motor, vision, sensory, language, and memory). We performed a backward selection discarding, in succession, variables associated with highest p-values, until we obtained a set of explanatory variables significantly linked at the 10% level. Results: To be a woman is positively linked to a better quality of life (interpersonal relationships, feelings, sleep). The older patients and the ones living in couple have a less good quality of life with regards to fatigue. The current professional situation does not have any impact on quality of life; which is not the case for the occupation at the time of the stroke. Compared to the executives’ ones, the patients who never had a job, employees, and manual workers have a worse quality of life in terms of feelings. The manual workers, employees and the ones who never had a job show a minor good quality of life in relation to fatigue. When the patients’ educational level is lower than the first cycle of secondary education, their quality of life deteriorates in terms of interpersonal relationship, emotion, feelings, pain. After the stroke, changes in the financial position resulted in a less good quality of life in relation to interpersonal relationship, feelings, pain, sleep, whilst the ones in the occupational situation only worsened patients’ feelings and fatigue. “Feelings” (depression, control, independent) is the most associated NEWSQOL-domain with the socio-economic factors. Conclusion: Patients’ level of education and the changes in their financial position are determinants of social inequalities of quality of life amongst stroke survivors. A better elementary health education on stroke would make upcoming patients to gain in quality of life capacity. They will better adhere to the advice given within the therapeutics framework and psychological counseling as well as to the social accompaniment provided and the administrative requirements they have to accomplish to obtain financial aids. [less ▲]

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See detailTwo years post-stroke, Luxembourgish informal caregivers’ life satisfaction and their couple and family repercussions
Lurbe-Puerto, Katia UL; Baumann, Michèle UL; Le Bihan, Etienne UL

in Sociology of Health (2010)

This study aims to improve our understanding of the changes in the couple and family lives of stroke survivors’ caregivers and to analyse the relationships between the Caregivers’ Life Satisfaction (CLS ... [more ▼]

This study aims to improve our understanding of the changes in the couple and family lives of stroke survivors’ caregivers and to analyse the relationships between the Caregivers’ Life Satisfaction (CLS) and the social and emotional repercussions of the caregiving role, two years after this event. Life satisfaction, optimism about the future, happiness and other subjective well-being aspects have attracted the European policymakers, leading to the Eurofund to introduce a “life satisfaction” dimension in the European Quality of Life Surveys (EQLS). The general subjective appraisal of one’s life is now an indicator next to objective measures of economic performance, such as GDP. How is life satisfaction for the main informal caregivers of stroke-survivors, at the Grand-duchy of Luxembourg (one of the smallest UE country, 502 500 hab. (01/2010), 2600 km2). Individual and family upheavals stroke-related have a major effect on the survivor’s life, and on the close relatives and friends’ ones. «The self-assertion on the harmony of the stroke survivor-caregiver pairs» is the strategy to approach the issue. The implications of these changes are determined by the partners’ trajectory. The CLS is disrupted by stroke, but a lack of information remains on caregivers’ needs, mostly on the repercussions on the couple and family relationships and projects. Over twelve months, 62 pairs (among them 51 couples) of stroke survivors (64.4 mean age; majors impairments: sensory 53.2% and memory 38.7%) and their main informal caregivers (62 mean age, 61.7% women) consented to participate at a National Survey. Research assistants interviewed them at home, with a face-to-face questionnaire. Caregivers evaluated, on a four-point scale, a list of repercussions; these assertions were built up from a qualitative exploratory study. The LS ten-point scaled was dichotomised in “low (<=7 of 10)” and “high (>7 of 10) life satisfaction” (LLS vs HLS)”. Our research protocol was approved by the National Committee of Research Ethics and the Committee for Data Protection. Stroke survivors’ LS were lightly inferior than the CLS (mean=8) and no significant differences were observed between their socio-demographic characteristics. Comparing the responses obtained on the couple repercussions, the caregivers with LLS had emphasised the impacts of the care provided to their recipients: « The stroke was experienced as a drama that our couple has never overcome” (54.2 LLS vs 17,2% HLS; p≤0.001);“I cannot leave anymore the stroke survivor alone for a long time” (60.7% LLS vs 17.4% HLS; p=0.001); « The stroke has ended with all the life projects that as a couple we made» (45.8 LLS vs 11.1% HLS ; p≤ 0.05); “The stroke has brought serious turnovers in my couple” (57.1 LLS vs 25.9% HLS ; p≤ 0.05). Regarding family repercussions, the caregivers with LLS had underlined the impacts of their caregiving role: "The stroke is often a cause of the distance problems we have with our children" (23.1% LLS vs 0.0% HLS; p≤0.01), and “The stroke has brought serious turnovers in my family” (82.8% LLS vs 51.7% HLS; p≤0.05). CLS and survivors LS were close. Inequalities regarding CLS were identified. Evaluating repercussions on CLS is needed in enabling stroke survivors to live at home. Long-term informal care sustainability has been overlooked; innovative accompaniment and counselling are developed to follow Helsingborg Declaration on European Stroke Strategies. [less ▲]

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See detailTandems patient-aidant face au retentissement familial et social deux ans après la survenue d’un AVC au Grand-duché de Luxembourg
Baumann, Michèle UL; Kovincic, P.; Le Bihan, Etienne UL

in Sociologie de la Santé (2009)

Notre problématique s’inscrit dans l’identification et la compréhension des conséquences que peut avoir la survenue d’un accident cérébro-vasculaire sur la famille et les proches de la personne qui en a ... [more ▼]

Notre problématique s’inscrit dans l’identification et la compréhension des conséquences que peut avoir la survenue d’un accident cérébro-vasculaire sur la famille et les proches de la personne qui en a été victime. En effet, l’AVC produit des effets sur l’organisation des relations entre les patients et les aidants, ce réaménagement dépendant en grande partie de la situation antérieure des liens affectifs. La personne atteinte de plein fouet par cet accident n’est pas la seule au centre de cette étude, nous avons fait le choix de privilégier également la personne désignée par le patient comme son « aidant principal ». Au sein des tandems patient-aidant qui partagent désormais le quotidien entaché des conséquences produites par un AVC, s’installe ou non une harmonie en fonction de la manière dont l’évènement est ressenti et intériorisé. La façon dont le patient et l’aidant vivent l’adaptation à cette nouvelle situation et la façon dont les personnes rencontrées réagissent devant les comportements de la personne atteinte font appels ou non à une complicité qui mérite d’être étudiée. Face au retentissement psychologique et social, aux activités culturelles et de loisirs abandonnées ou maintenues, aux aides, services et informations obtenus ou non depuis l’AVC, les objectifs de ce travail ont été de comparer les réponses fournies par les patients et les aidants et d’analyser les domaines dans lesquels elles sont concordantes au sein des diades. [less ▲]

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See detailMental health (GHQ12; CES-D) and attitudes towards the value of work among inmates of a semi-open prison and the long-term unemployed in Luxembourg
Baumann, Michèle UL; Meyers, Raymond UL; Le Bihan, Etienne UL et al

in BMC Public Health (2008), 8(214),

Aim: To analyse the relationships between mental health and employment commitment among prisoners and the long-term unemployed (LTU) trying to return to work. Method: Fifty-two of 62 male inmates of a ... [more ▼]

Aim: To analyse the relationships between mental health and employment commitment among prisoners and the long-term unemployed (LTU) trying to return to work. Method: Fifty-two of 62 male inmates of a semi-open prison (Givenich Penitentiary Centre, the only such unit in Luxembourg), and 69 LTU registered at the Luxembourg Employment Administration completed a questionnaire exploring: 1) mental health (measured by means of scales GHQ12 and CES-D); 2) employment commitment; 3) availability of a support network, selfesteem, empowerment; and 4) socio-demographic characteristics. Results: Compared with LTU, inmates were younger, more had work experience (54.9% vs 26.1%), and more were educated to only a low level (71.1% vs 58.0%). The link between employment commitment and mental health in the LTU was the opposite of that seen among the prisoners: the more significant the perceived importance of employment, the worse the mental health (GHQ12 p = 0.003; CES-D p < 0.001) of the LTU; in contrast, among prisoners, the GHQ12 showed that the greater the perceived value of work, the lower the psychic distress (p = 0.012). Greater empowerment was associated with less depression in both populations. The education levels of people who did not reach the end of secondary school, whether inmates or LTU, were negatively linked with their mental equilibrium. Conclusion: The two groups clearly need professional support. Future research should further investigate the link between different forms of professional help and mental health. Randomized controlled trials could be carried out in both groups, with interventions to improve work commitment for prisoners and to help with getting a job for LTU. For those LTU who value employment but cannot find it, the best help may be psychological support. [less ▲]

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