Lena Edén

Inequalities of quality of life in unemployed young adults: A population-based questionnaire study

BackgroundIt is well known that unemployment is a great problem both to the exposed individual and to the whole society. Unemployment is reported as more common among young people compared to the general level of unemployment. Inequity in health status and life-satisfaction is related to unemployment. The purpose of this population-based study was to describe QOL among unemployed young people compared to those who are not unemployed, and to analyse variables related to QOL for the respective groups.MethodsThe sample consisted of 264 young unemployed individuals and 528 working or studying individuals as a reference group. They all received a questionnaire about civil status, educational level, immigration, employment status, self-reported health, self-esteem, social support, social network, spare time, dwelling, economy and personal characteristics. The response rate was 72%. The significance of differences between proportions was tested by Fishers exact test or by χ2 test. Multivariate analysis was carried out by means of a logistic regression model.ResultsOur results balance the predominant picture of youth unemployment as a principally negative experience. Although the unemployed reported lower levels of QOL than the reference group, a majority of unemployed young adults reported good QOL, and 24% even experienced higher QOL after being unemployed. Positive QOL related not only to good health, but also to high self-esteem, satisfaction with spare time and broad latitude for decision-making.ConclusionEven if QOL is good among a majority of unemployed young adults, inequalities in QOL were demonstrated. To create more equity in health, individuals who report reduced subjective health, especially anxiety need extra attention and support. Efforts should aim at empowering unemployed young adults by identifying their concerns and resources, and by creating individual programmes in relation not only to education and work, but also to personal development.

Immigration and Socio-economy as Predictors of Early Retirement Pensions

The purpose of this study, performed in a Swedish municipality, was to obtain a view of early retirement pensioners, focusing on immigration and socio-economy as predictors of early retirement pensions. A questionnaire was sent to 453 early retirement pensioners with disorders of the musculoskeletal system. A corresponding questionnaire was sent to a randomly selected, age- and sex-matched control group of the same size. The response rate was 83%. The study concludes that immigration and low socio-economy are predictors of early retirement pension (ERP). The rate of immigrants was 19% among the ERPs compared to 5% among the controls. The early retired immigrants were comparatively young, and some of them were overqualified for their previous jobs. Of the ERPs 74% were blue-collar workers compared to 39% of the controls. Neither work satisfaction nor unemployment was found to predict ERP.

Predictors of positive health in disability pensioners : a population-based questionnaire study using Positive Odds Ratio

BackgroundDeterminants of ill-health have been studied far more than determinants of good and improving health. Health promotion measures are important even among individuals with chronic diseases. The aim of this study was to find predictors of positive subjective health among disability pensioners (DPs) with musculoskeletal disorders.MethodsTwo questionnaire surveys were performed among 352 DPs with musculoskeletal disorders. Two groups were defined: DPs with positive health and negative health, respectively. In consequence with the health perspective in this study the conception Positive Odds Ratio was defined and used in the logistic regression analyses instead of the commonly used odds ratio.ResultsPositive health was associated with age ≥ 55 years, not being an immigrant, not having fibromyalgia as the main diagnosis for granting an early retirement, no regular use of analgesics, a high ADL capacity, a positive subjective health preceding the study period, and good quality of life.ConclusionPositive odds ratio is a concept well adapted to theories of health promotion. It can be used in relation to positive outcomes instead of risks. Suggested health promotion and secondary prevention efforts among individuals with musculoskeletal disorders are 1) to avoid a disability pension for individuals <55 years of age; if necessary, to make sure rehabilitation actions continue, 2) to increase efforts to support immigrants to adjust to circumstances connected to ill-health and retirement, 3) to pay special attention to individuals with fibromyalgia and other general pain disorders, and 4) to strengthen ADL activities to support an independent active life among disability pensioners.

QUALITY OF LIFE AMONG EARLY RETIREES

Explanatory variables concerning poor quality of life (QL) were established among disability pensioners with musculoskeletal disorders and a control group. In both groups health status, leisure time activities, and social network were important for QL. Among the retirees immigration, employment before retirement and a negative attitude to the disability pension were related to poor QL.

Characteristics of disability pensioners returning to work: an interview study among individuals with musculoskeletal disorders.

Purpose. To explore adaptation patterns among disability pensioners with musculoskeletal disorders returning to work by means of the Swedish law on ‘resting disability pension’. Method. Qualitative analyses of interviews with 17 individuals going back to work. Results. Three adaptation patterns were identified: The Go-getter, the Realist and the Indifferent. These differed regarding influence factors, own expectations, motive, morals and mentality. Conclusion. Several actors may support a return to work for individuals who received a disability pension due to musculoskeletal disorders. In order to succeed, however, it is essential that the disability pensioner is motivated for a reconstruction of his/her life.

Health and health care utilization among early retirement pensioners with musculoskeletal disorders

OBJECTIVE To estimate subjective health status among early retired individuals pensioned due to disorders of the musculoskeletal system. DESIGN A survey of self-reported health status and health care utilization by means of a mailed questionnaire. SETTING Early retirees (cases) and a random sample (controls) of individuals from the municipality of Kristianstad, Sweden. SUBJECTS CASES all individuals aged 25-59 years granted a full-time early retirement pension during the period 1986-1990 due to disorders of the musculoskeletal system (n = 450). The response rate was 83.6%. CONTROLS An age- and sex-matched sample (n = 450). The response rate was 82.7%. MAIN OUTCOME MEASURES Self-reported health status and health care utilization. RESULTS Early retirement entailed a deterioration in self-reported health status among men, all ages, and women aged 25-54 years. Female retirees aged 55-64 reported an improvement in health status since retirement. Early retired female immigrants were less satisfied with their health status than the Swedish ones. Early retirees reported higher health care utilization than controls, but with a reduction since retirement. Drug consumption was high. CONCLUSION The beneficial effects of early retirement were evident among old women. Men and young and middle-aged women may need support to adjust to life as a retiree. Special attention should be given to the female immigrant retiree.

High Rates of Psychosomatic and Neurotic Symptoms Among Disability Pensioners with Musculoskeletal Disorders

Objectives: To describe the occurrence of psychosomatic and neurotic symptoms among early retirees compared to a control group, and to establish the relative importance of different explanatory variables. Methods: A questionnaire survey was performed among 450 early retired pensioners [ERPs] with musculoskeletal disorders and an age-and sex-matched control group. The response rate was 83%. By way of a factor analysis five symptoms were formed into a psychosomatic index [PSI] and seven into a neurotic index [NI]. Results: The ERPs had a higher PSI and NI than controls. Immigrants among the ERPs and the controls reported more symptoms than Swedes. Women were found to have a higher PSI than men and the female ERPs had a higher NI than the male ERPs. The younger ERPs [< 55 years] reported more symptoms than the older ones. Among female ERPs the retirees with inflammatory rheumatic disorders had a lower NI, while those with fibromyalgia had a higher NI than the remaining female ERPs. Conclusions: This study points out the importance of considering psychological aspects when dealing with individuals suffering from musculoskeletal disorders. Special attention should be paid to immigrants and individuals aged < 55 years when a disability pension is considered. The fibromyalgia patient might need increased therapeutic support.