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Research ArticleResearch

Mental health and the relationship between health promotion counseling and health outcomes in chronic conditions

Cross-sectional population-based study

Fatima Al Sayah, Calypse Agborsangaya, Markus Lahtinen, Tim Cooke and Jeffrey A. Johnson
Canadian Family Physician February 2014; 60 (2) e113-e120;
Fatima Al Sayah
Research associate at the Alliance for Canadian Health Outcomes Research in Diabetes at the University of Alberta in Edmonton.
PhD
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Calypse Agborsangaya
PhD
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Markus Lahtinen
PhD
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Tim Cooke
PhD
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Jeffrey A. Johnson
PhD
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  • For correspondence: jeff.johnson@ualberta.ca
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Article Figures & Data

Tables

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    Table 1.

    General characteristics of participants, by anxiety or depression status: Of 1615 participants, 269 (16.7%) reported having anxiety or depression and 1346 (83.3%) reported not having anxiety or depression.

    VARIABLEOVERALL, N (%)*†PARTICIPANTS WITHOUT ANXIETY OR DEPRESSION, N (%)†PARTICIPANTS WITH ANXIETY OR DEPRESSION, N (%)†P VALUE‡
    Sex
      • Male729 (45.1)644 (47.9)85 (31.6)< .001
      • Female886 (54.9)702 (52.2)184 (68.4)
    Age group, y
      • 18–2443 (2.7)38 (2.8)5 (1.9).006
      • 25–44398 (24.6)323 (24.0)75 (27.9)
      • 45–64755 (46.8)614 (45.6)141 (52.4)
      • ≥ 65419 (25.9)371 (27.6)48 (17.8)
    Education level
      • Grade school or high school252 (15.7)211 (15.7)41 (15.5).944
      • High school diploma344 (21.4)289 (21.6)55 (20.8)
      • Postsecondary1010 (62.9)841 (62.7)169 (63.8)
    Income, $
      • < 30 000279 (20.0)204 (17.6)75 (31.3)< .001
      • 30 000–60 000377 (27.0)307 (26.5)70 (29.2)
      • 60 000–100 000380 (27.1)324 (28.0)56 (23.3)
      • > 100 000362 (25.9)323 (27.9)39 (16.3)
    Multimorbidity
      • ≤ 1 chronic condition747 (46.3)679 (50.5)68 (25.3)< .001
      • ≥ 2 chronic conditions868 (53.8)667 (49.6)201 (74.7)
    ED visit during the past year
      • Yes554 (34.5)431 (32.2)123 (46.1)< .001
      • No1050 (65.5)906 (67.8)144 (53.9)
    Hospitalization during the past year
      • Yes254 (15.8)195 (14.5)59 (22.0).002
      • No1358 (84.2)1149 (85.5)209 (78.0)
    Having seen a health care professional (ie, nurse or dietitian) during the past year
      • Yes231 (15.7)188 (15.4)43 (17.1).515
      • No1240 (84.3)1031 (84.6)209 (82.9)
    HPC item 1 (diet counseling by FP)
      • Yes731 (53.1)609 (53.5)122 (51.5).535
      • No646 (46.9)530 (46.5)116 (48.7)
    HPC item 2 (exercise counseling by FP)
      • Yes851 (61.5)704 (61.5)147 (61.3).933
      • No533 (38.5)440 (38.5)93 (38.8)
    HPC item 3 (needing physician’s help in making health changes)
      • Yes677 (49.3)518 (45.8)159 (66.3)< .001
      • No695 (50.7)614 (54.2)81 (33.8)
    HPC item 4 (encouraged by FP to talk about health concerns)
      • Yes911 (66.0)759 (66.5)152 (63.6).386
      • No469 (34.0)382 (33.5)87 (36.4)
    • ED—emergency department, HPC—health promotion counseling.

    • ↵* Not all respondents answered all questions.

    • ↵† Some percentages do not add to 100% owing to rounding.

    • ↵‡ Boldface indicates statistical significance (ie, P < .05).

    • View popup
    Table 2.

    Multivariate models of the relationship between HRQL (EQ-5D) and HPC

    PREDICTOR VARIABLEMODEL A*†‡ (PARTICIPANTS WITHOUT ANXIETY OR DEPRESSION)MODEL B*‡§ (PARTICIPANTS WITH ANXIETY OR DEPRESSION)
    β COEFFICIENTP VALUEβ COEFFICIENTP VALUE
    HPC item 1 (diet counseling by FP)0.027.048−0.016.651
    HPC item 2 (exercise counseling by FP)−0.002.881−0.004.920
    HPC item 3 (needing physician’s help in making health changes)−0.047< .001−0.052.095
    HPC item 4 (encouraged by FP to talk about health concerns)−0.008.518−0.028.359
    Seeing a nurse or dietitian0.008.5830.024.515
    Multimorbidity−0.045< .001−0.089.010
    • EQ-5D—Euro quality of life 5-dimensions, HPC—health promotion counseling, HRQL—health-related quality of life.

    • ↵* Adjusted for age, sex, education level, and income.

    • ↵† Model A: R2 = 0.08, overall model F test = 7.57 (P < .001).

    • ↵‡ Boldface indicates statistical significance (ie, P < .05).

    • ↵§ Model B: R2 = 0.13, overall model F test = 2.98 (P = .002).

    • View popup
    Table 3.

    Logistic regression models of the relationship between the use of health care services and HPC

    PREDICTOR VARIABLEED VISITS, OR*†‡ (95% CI)HOSPITALIZATIONS, OR*‡ (95% CI)
    HPC item 1 (diet counseling by FP)0.83 (0.60–1.14)1.11 (0.82–1.84)
    HPC item 2 (exercise counseling by FP)0.88 (0.63–1.22)0.88 (0.58–1.34)
    HPC item 3 (needing physician’s help in making health changes)1.43 (1.08–1.89)1.02 (0.70–1.43)
    HPC item 4 (encouraged by FP to talk about health concerns)0.69 (0.52–0.91)1.02 (0.70–1.80)
    Seeing a nurse or dietitian1.20 (0.85–1.70)1.18 (0.77–1.80)
    Multimorbidity1.24 (0.94–1.63)1.62 (1.13–2.31)
    Anxiety or depression1.13 (0.80–1.60)1.20 (0.79–1.82)
    EQ-5D score0.21 (0.09–0.45)0.21 (0.08–0.50)
    • ED—emergency department, EQ-5D—Euro quality of life 5-dimensions, HPC—health promotion counseling, OR—odds ratio.

    • ↵* Adjusted for age, sex, education level, and income.

    • ↵† Boldface indicates statistical significance (ie, P < .05).

    • ↵‡ Pseudo R2 = 0.05, likelihood ratio χ2 = 75.97 (P < .001).

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Canadian Family Physician: 60 (2)
Canadian Family Physician
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1 Feb 2014
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Mental health and the relationship between health promotion counseling and health outcomes in chronic conditions
Fatima Al Sayah, Calypse Agborsangaya, Markus Lahtinen, Tim Cooke, Jeffrey A. Johnson
Canadian Family Physician Feb 2014, 60 (2) e113-e120;

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Fatima Al Sayah, Calypse Agborsangaya, Markus Lahtinen, Tim Cooke, Jeffrey A. Johnson
Canadian Family Physician Feb 2014, 60 (2) e113-e120;
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