Ansa Ojanlatva

Non-response and related factors in a nation-wide health survey

Objective: To analyse selective factors associated with an unexpectedly low response rate. Subjects and methods: The baseline questionnaire survey of a large prospective follow-up study on the psychosocial health of the Finnish working-aged randomly chosen population resulted in 21,101 responses (40.0%) in 1998. The non-respondent analysis used demographic and health-related population characteristics from the official statistics and behavioural, physical and mental health-related outcome differences between early and late respondents to predict possible non-response bias. Reasons for non-response, indicated by missing responses of late respondents, and factors affecting the giving of consent were also analysed. Results: The probability of not responding was greater for men, older age groups, those with less education, divorced and widowed respondents, and respondents on disability pension. The physical health-related differences between the respondents and the general population were small and could be explained by differences in definitions. The late respondents smoked and used more psychopharmaceutical drugs than the early ones, suggesting similar features in non-respondents. The sensitive issues had a small effect on the response rate. The consent to use a medical register-based follow-up was obtained from 94.5% of the early and 90.9% of the late respondents (odds ratio: 1.70; 95% confidence interval: 1.49–1.93). Consent was more likely among respondents reporting current smoking, heavy alcohol use, panic disorder or use of tranquillisers. Conclusions: The main reasons for non-response may be the predisposing sociodemographic and behavioural factors, the length and sensitive nature of the questionnaire to some extent, and a suspicion of written consent and a connection being made between the individual and the registers mentioned on the consent form.

Will the role of family influence dental caries among seven-year-old children?

The present study analyzed the prevalence of dental caries as well as associations of dental health and family competence among 7-year-old children and their families. Dental caries status was the outcome variable of the 7-year prospective follow-up study. Pre-tested questionnaires were used to gather data individually from the parents at six points in time (at the public maternity health-care clinic during the mothers pregnancy and at childbirth, at the well-baby clinic at 18 months, and at ages 3, 5, and 7 years). Clinical examinations at dental health-care clinics were used to record dental status indicators of the child at ages 3, 5, and 7 years. A child had caries more often when the mother did not regard it as important to teach a healthy lifestyle right from birth; when the mother undervalued consistent action in child-rearing; when the father preferred merely to explain the causes and consequences during child-rearing (giving no examples); when the father had several new carious teeth per year; when the child consumed sweets several times a week; or when the childs toothbrushing was infrequent. The childs daily dental health behaviors and a strong influence of family competence emerged in the final logistic regression analysis. Dental and well-baby clinic staff members need to discuss consistency in child-rearing with the parents and there is a need for modeling adult dental health behaviors at the time of the mothers pregnancy if the childs future preventive dental health is to function properly.

Sense of coherence and health behaviour in adolescence

Aim:  To explore associations of Sense of coherence (SOC) with health behaviour and social competence among 15‐year‐old adolescents.

To Have or Not To Have a Pet for Better Health

Background Pet ownership is thought to have health benefits, but not all scientific explorations have been founded on proper applications of representative samples or statistically correct methodologies. Databanks have been too small for proper statistical analyses; or, instead of a random sample, participation has been voluntary. The direction of causality has been evaluated incorrectly or control of relevant factors noted deficient. This study examined the associations of pet ownership with perceived health and disease indicators by taking into account socio-demographic background factors together with health risk factors, including exercise. Methodology/Principal Findings The present study used baseline data from the 15-year Health and Social Support Study (the HeSSup Study). The Finnish Population Register Centre was used to draw population-based random samples stratified according to gender and four age groups (20–24, 30–34, 40–44, and 50–54 years). A total of 21,101 working-aged Finns responded to the baseline survey questionnaire of the 15-year HeSSup Study in 1998. Ordinal and binary logistic regression was used to analyze the cross-sectional data. Pet ownership was associated with poor rather than good perceived health. BMI surfaced as the risk factor most strongly associated with pet ownership. Conclusions/Significance Pet owners set in their ways and getting older were found to have a slightly higher BMI than the rest. Additional research is needed for the testing of hypotheses involving effects of pet ownership with various health dimensions within population groups that are composed of different kinds of background characteristics.

Social support, early retirement, and a retirement preference: a study of 10,489 Finnish adults.

The aim of the study was to examine associations of social support with early retirement and reported retirement preference. Logistic regression analyses of early retirement (retired before the age of 55) were based on a cohort of 10,489 respondents (5960 female, 4529 male) aged 40–55 years. Analyses of retirement preference (planning of early retirement) were based on a sub-cohort of 7759 full-time employees (4233 female, 3526 male). The measures for social support were the social network size (number of close personal relationships) and social network heterogeneity (number of different roles as sources of social support). Among women, early retirement was associated with small social networks (OR 5.1, 95% CI = 2.8–9.2) and low social network heterogeneity (OR 9.1, 95% CI =3.2–25.9). Among men, the corresponding associations were somewhat smaller (1.5; 0.9–2.6 and 8.0; 1.8–35.7, respectively). Adjustments for age, occupational training, and spouse at home did not considerably affect these associations. Among men, the association between social network heterogeneity and early retirement was not statistically significant after additional adjustments had been made for marital status and perceived health status. The characteristics of the social network were not associated with a retirement preference among employed men. Among women, the lack of social relations was associated with low retirement preference. Our findings suggested that social support is not independently associated with a retirement preference among men. Socially isolated women prefer retirement less often than other women do. Being retired before the age of 55 years may be predicted by limited social support or it may restrain one’s possibilities to establish and maintain social relationships.

Importance of and Satisfaction with Sex Life in a Large Finnish Population

This paper describes five sex life issues in a Finnish population–based random sample (n = 21,101) between 20 and 54 years of age. The associations were studied with the following demographic variables: gender, age, marital status, graduation from the 3 upper classes of high school, vocational education, degree of urbanization, and province or area of the country. Men considered sex life more important than women did. Women were more satisfied with their sex lives, found it easier to talk about sex life with an important other, had had a spouse or steady partner more often, but were also less satisfied with their present marriages or marriage-like relationships. The above findings were most consistently shown in the Northern Province.

Poor performance in the Mini-Mental State Examination due to causes other than dementia

Objective - The aim of this study was to examine the extent to which causes other than dementia contribute to poor performance on the Mini-Mental State Examination (MMSE). Design - Cross-sectional population-based study. Setting - Municipality of Lieto, Finland. Subjects - The study population consisted of all individuals residing in Lieto and born in or before 1926. A total of 1196 individuals, 93% of those eligible, participated. Main outcome measures - The MMSE was implemented following interviews and clinical examinations. Whenever an individual was unable to complete any individual item on the MMSE, the nurse recorded causes and assessed whether poor performance was mainly caused by dementia or other reasons. Results - Poor test performance due to causes other than dementia was recorded in 122 (10.2%) individuals (4% of those in the 64?74 years group, 15% in the 75?84 years group and 42% in the group of 85 years of age or older). The most common causes were poor vision and hearing, deficient schooling and consequences of stroke. Conclusion ? Ten percent of the elderly population had symptoms contributing to poor performance on the MMSE. Physicians should therefore consider and record co-morbidity in the testing situation, especially in very old individuals.OBJECTIVE The aim of this study was to examine the extent to which causes other than dementia contribute to poor performance on the Mini-Mental State Examination (MMSE). DESIGN Cross-sectional population-based study. SETTING Municipality of Lieto, Finland. SUBJECTS The study population consisted of all individuals residing in Lieto and born in or before 1926. A total of 1196 individuals, 93% of those eligible, participated. MAIN OUTCOME MEASURES The MMSE was implemented following interviews and clinical examinations. Whenever an individual was unable to complete any individual item on the MMSE, the nurse recorded causes and assessed whether poor performance was mainly caused by dementia or other reasons. RESULTS Poor test performance due to causes other than dementia was recorded in 122 (10.2%) individuals (4% of those in the 64-74 years group, 15% in the 75-84 years group and 42% in the group of 85 years of age or older). The most common causes were poor vision and hearing, deficient schooling and consequences of stroke. CONCLUSION Ten percent of the elderly population had symptoms contributing to poor performance on the MMSE. Physicians should therefore consider and record co-morbidity in the testing situation, especially in very old individuals.

Attitudes towards and perceptions about contraceptive use among married refugee women of Somali descent living in Finland

Objectives To assess attitudes towards and perceptions about contraceptive use among married refugee women of Somali descent living in Finland. Method A sample of 100 married refugee women of Somali descent (18–50 years of age) were invited to participate in a study on contraceptive use in Finland (30 women refused). Qualitative and quantitative methods were used to collect the data. Questionnaire of the first data set was written in the Somali language. Interviews were conducted in the Somali language. Results The attitudes and opinions of these women towards contraceptive use (73% did not use contraceptives, 27% did use them) were connected with religious beliefs and issues involving marital relations. Religious or gender issues did not seem to influence those who used contraception. Conclusions The findings indicated that the majority of the married refugee women of Somali descent living in Finland did not use contraception. The process of starting the use of contraception was possible because of an access to good reproductive health care and family planning services, changes in life situations, and adaptations to Finnish social and cultural norms.

Sexual activity and perceived health among Finnish middle-aged women

BackgroundAn increasing awareness of the need to address sexual and orgasm experiences as part of life quality and an understanding of the great individual differences between women play roles in womens health and medical care across the specialities. Information is lacking as to how negative attitude toward self (NATS) and performance impairment (PI) are associated with sexual activity of middle-aged women. We examined the associations of sexual experience, orgasm experience, and lack of sexual desire with perceived health and potential explanatory variables of NATS and PI.MethodsQuestionnaire was mailed to 2 population-based random samples of menopausal or soon-to-be menopausal women (n = 5510, 70% response) stratified according to age (42–46 and 52–56 years). In multivariate analyses of the associations with the outcome variables, perceived health, NATS, and PI were used as covariates in 6 models in which exercise, menstrual symptoms, and illness indicators were taken into account as well.ResultsSexual activity variables were associated with perceived health. When present, NATS formed associations with sexual and orgasm experiences, whereas strenuous exercise formed associations with orgasm among 42–46-year-old women alone. Strenuous exercise was not associated with orgasm experience among older women.ConclusionNATS and PI are closely tied to orgasm experiences and the meaning of the roles needs to be exposed. Sexual activity deserves to be addressed more actively in patient contact at least with perimenopausal women.

Sexual activity and background variables among Finnish middle-aged women.

OBJECTIVE To characterize the associations of sexual experience, orgasm experience, and lack of sexual desire with background variables. METHODS Questionnaire was mailed to population-based samples (n=5510, 70% response) of soon-to-be-menopausal (aged 42-46 years) and menopausal (aged 52-56 years) women. RESULTS Being married/having a spouse meant more sexual activity for both groups but also the likelihood to experience lack of sexual desire. Hormones emerged as the most important perceived reason for lack of sexual desire. CONCLUSION The findings indicated a discrepancy between the reported frequencies of sexual experiences/orgasms with spouse and lack of desire.