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A first step in planning health promotion with respect to mental health is analysing the factors that influence mental health. Diagnosis of the relevant variables may contribute to the design of effective health promotion programmes. In this paper the relationship between psychosocial factors and mental health status of cancer patients is discussed. The study investigates the relation between psychosocial factors like social support, generalized self-efficacy, feelings of loneliness, social mobilization and mental health among cancer suruivors (n = 480). Results reveal that mental health in cancer survivors is slightly lower than in a reference group from the general population. Generalized self-efficacy and feelings of loneliness are the major psychosocial factors related to mental health in cancer survivors. The implications for the design of health promotion activities using self-efficacy theory are discussed.
Learning from a crisis: a qualitative study on how nurses reshaped their work environment during the COVID 19 pandemic,
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PURPOSE: To investigate the longitudinal association between the macronutrient composition of the diet and frailty.METHODS: Data were obtained from 5205 Dutch middle-aged and older adults participating in the Rotterdam Study. Frailty was measured using a frailty index based on the accumulation of 38 health-related deficits, score between 0 and 100, and a higher score indicating more frailty. Frailty was assessed at baseline and 11 years later (range of 23 years). Macronutrient intake was assessed using food-frequency questionnaires. The association between macronutrients and frailty over time was evaluated using multivariable linear regression, adjusted for the frailty index at baseline, energy intake, and other relevant confounders. All analyses were performed in strata of BMI.RESULTS: Median frailty index score was 13.8 points (IQR 9.6; 19.1) at baseline and increased by a median of 2.3 points (IQR - 2.0; 7.6) after 11 years. Overall, we found no significant associations between intake of carbohydrates or fat and frailty over time. We did observe a significant positive association between an iso-energetic intake of 10 g protein and frailty over time (β 0.31 (95% CI 0.06; 0.55)) which was mainly driven by animal protein (β 0.31 (95% CI 0.07; 0.56)). It did not depend on whether it was substituted fat or carbohydrates.CONCLUSIONS: Our findings suggest that a reduction in the intake of animal protein may improve the overall health status over time in a relatively healthy population. More research is needed on the optimal macronutrient composition of the diet and frailty in more vulnerable populations.