3 Ciclo de vida del sistema
3.2 Diseño
7.3.2 Associations between consultation at age 43 and later health management approaches
7.3.2.1 Associations between consultation at age 43 and women’s management of symptoms in midlife
Tables 7.8 and 7.9 show the associations between consultation at age 43 and women’s response to symptoms in midlife. The factor of consultation for trouble sleeping, vaginal dryness, nervous/emotional symptoms and urinary symptoms (previously described in section 5.2.8) was used as the outcome measure in Table 7.8 and the binary measure of consultation for HFNS was used in Table 7.9. Reporting conditions/symptoms and not consulting at age 43 was used as the reference category throughout. All tables include women who completed the questionnaire at age 43, 54 and 68 (N=1034).
179
Table 7.8 Associations between consultation for conditions/symptoms at 43 (reporting condition(s) and not consulting was used as the reference category) and latent measure of propensity to consult for symptoms in midlife in women who completed the questionnaire at age 43, 54 and 68
Management of conditions/symptoms at age 43 N=1034 Reported no conditions -0.08 (0.002) Consultation for Reported no symptoms -0.08 (0.007) Consultation for Reported no symptoms -0.01 (0.526)
Table 7.9 Associations between consultation for conditions/symptoms at 43 (reporting condition(s) and not consulting was used as the reference category) and a binary measure of consultation for HFNS in midlife in women who completed the questionnaire at age 43, 54 and 68
Management of conditions/symptoms at age 43 (N=1034) Reported no conditions 0.73 (0.50-1.08) Consultation for Reported no symptoms 0.64 (0.44-0.93) Consultation for Reported no symptoms 1.08 (0.79-1.47)
180
Compared to reporting conditions/symptoms at age 43 and not consulting, reporting any conditions, psychological symptoms or musculoskeletal symptoms and consulting a professional was associated with an increased likelihood of consulting for trouble sleeping, vaginal dryness, nervous/emotional symptoms or urinary symptoms in midlife (see Table 7.8). The strongest of these associations was between consultation for psychological symptoms at age 43 and consultation for symptoms in midlife. Also noteworthy are the associations seen between not reporting conditions/symptoms at 43 and a lower likelihood of consulting for midlife symptoms, although this may be explained by experiencing fewer symptoms in midlife. There was no evidence of an association between consultation for conditions/symptoms at 43 and consultation for HFNS (Table 7.9).
The associations between consultation at age 43 and women’s self-management of symptoms in midlife, using the latent measure of self-management of trouble sleeping, vaginal dryness, nervous/emotional symptoms and urinary symptoms (also described previously in section 5.2.8) (Table 7.10) and the binary measure of self-management of HFNS (Table 7.11), show that consultation at age 43 was not associated with self-management of any symptoms in midlife.
Table 7.10 Associations between consultation for any conditions at 43 (reporting condition(s) and not consulting was used as the reference category) and latent measures of propensity to self-manage symptoms in midlife in women who completed the questionnaire at age 43, 54 and 68
Management of conditions/symptoms at age 43 N=1034
Reported conditions and did not consult Reported no conditions -0.05 (0.057) Consultation for
psychological symptoms
Reported symptoms and did not consult Reported no symptoms -0.09 (0.001) Consultation for
musculoskeletal symptoms
Reported symptoms and did not consult Reported no symptoms -0.002 (0.917)
181
Table 7.11 Associations between consultation for any conditions at 43 (reporting condition(s) and not consulting was used as the reference category) and a binary measure of self-management of HFNS in midlife in women who completed the questionnaire at age 43, 54 and 68
Management of conditions/symptoms at age 43 N=1034
Reported conditions and did not consult Reported no conditions 0.85 (0.50-1.42) Consultation for
psychological symptoms
Reported symptoms and did not consult Reported no symptoms 0.83 (0.51-1.37) Consultation for
musculoskeletal symptoms
Reported symptoms and did not consult Reported no symptoms 1.53 (0.72-2.64)
7.3.2.2 Associations between consultation at age 43 and self-management of general health in midlife
Table 7.12 shows associations between consultation at age 43 and the binary measure of self-management of general health in midlife in women who completed the questionnaire at age 43, 54 and 68 (N=1034). Consultation for conditions/symptoms at age 43 was not associated with women’s general health self-management in midlife (see Table 7.12).
182
Table 7.12 Associations between consultation for any conditions, psychological symptoms and musculoskeletal symptoms at age 43 (reporting condition(s)/symptoms and not consulting used as reference category) and general health self-management in midlife in women who completed the questionnaire at age 43, 54 and 68
Consultation for conditions and symptoms at age 43 N=1034
Women’s self-management of general health in midlife
OR (95% CI) Any condition Reported conditions and did not
consult
(reference category)
1.00
Had condition(s) and did consult 1.10 (0.84-1.44) Did not have symptom 0.80 (0.55-1.16) Psychological
symptoms
Reported symptoms and did not consult
(reference category)
1.00
Had symptom and did consult 0.80 (0.45-1.41) Did not have symptom 0.77 (0.53-1.12) Musculoskeletal
symptoms
Reported symptoms and did not consult
(reference category)
1.00
Had symptom and did consult 1.18 (0.76-1.83) Did not have symptom 0.95 (0.70-1.30)
7.3.2.3 Associations between consultation at age 43 and health check non-attendance in later life
Table 7.13 shows the associations between consultation for conditions/symptoms at age 43 and health check non-attendance in later life; reporting conditions/symptoms and not consulting was used as the reference category. In women, consulting a health professional at age 43 was not associated with health check non-attendance in later life.
183
Table 7.13 Associations between consultation at age 43 (reporting condition(s)/symptoms and not consulting used as reference category) and the number of health checks not attended in later life in women who completed the questionnaires at age 43 and 68
Consultation for conditions and symptoms at age 43 N=1034
Reported conditions and did not consult Reported no conditions 0.95 (0.78-1.15) Consultation for
psychological symptoms
Reported symptoms and did not consult Reported no symptoms 0.86 (0.71-1.04) Consultation for
musculoskeletal symptoms
Reported symptoms and did not consult Reported no symptoms 0.98 (0.84-1.15)
7.3.3 Associations between symptom management in midlife and later health management approaches
7.3.3.1 Associations between management of symptoms and general health self-management in midlife
Tables 7.14 and 7.15 show the associations between management of symptoms in midlife and self-management of general health in midlife. (Although these measures are from the same age (54), they represent management of different health challenges;
symptoms compared to general health.) The latent measures of consultation for and self-management of trouble sleeping, vaginal dryness, nervous/emotional symptoms and urinary symptoms were used as explanatory variables in Table 7.14 and the binary measures of HFNS consultation and self-management were used in Table 7.15. The binary measure of general health self-management in midlife was used in both tables.
Given that these questionnaire responses were given at age 54, these results are essentially cross-sectional.
184
Table 7.14 Associations between latent measures of symptom management and general health self-management in midlife in women who completed the questionnaire at age 43, 54 and 68
Latent management variable Self-management of general health OR (95% CI)
Propensity to consult a professional 1.49 (1.15-1.93)**
Propensity to self-manage 2.83 (1.71-4.70)**
**p<0.05
Table 7.15 Associations between binary measures of symptom management and general health self-management in midlife in women who completed the questionnaire at age 43, 54 and 68
Binary management variable Self-management of general health OR (95% CI)
Consultation for HFNS 1.04 (0.81-1.35) Self-management of HFNS 3.95 (2.73-5.72)**
**p<0.05
Higher consultation for and self-management of trouble sleeping, vaginal dryness, nervous/emotional symptoms and urinary symptoms was associated with an increased likelihood of self-managing general health in midlife (see Table 7.14), suggesting that women who proactively managed their symptoms by any means were also more likely to self-manage their general health. However, whilst self-management of HFNS was strongly associated with general health self-management (see Table 7.15), no association was found between consultation for HFNS and general health self-management, illustrating a difference between consultation for HFNS and for other symptoms. Results from both tables suggest a stronger association between self-management behaviours than between consultation and self-self-management.
7.3.3.2 Associations between management of symptoms in midlife and health check non-attendance in later life
Tables 7.16 and 7.17 show the associations between management of symptoms in midlife and health check non-attendance in later life, using factor measures of consultation and self-management of trouble sleeping, vaginal dryness, nervous/emotional symptoms and urinary symptoms in Table 7.16 and binary measures of consultation and self-management of HFNS in Table 7.17. The count measure of health check non-attendance was used as the outcome measure in both tables.
185
Table 7.16 Associations between factors of management of symptoms in midlife and the number of health checks not attended in later life in women who completed the questionnaire at age 43, 54 and 68
Latent management variable Number of health checks not attended
IRR (95% CI) Propensity to consult a professional 0.011
Propensity to self-manage 0.39 (0.21-0.73)**
**p<0.05
1 Lower 95% confidence interval did not converge, upper confidence interval=100.54
Table 7.17 Associations between binary measures of management of HFNS in midlife and the number of health checks not attended in later life in women who completed the questionnaire at age 43, 54 and 68
Binary management variable Number of health checks not attended
IRR (95% CI)
HFNS consult 0.88 (0.77-1.01)
HFNS self-manage 0.86 (0.70-1.04)
Self-managing trouble sleeping, vaginal dryness, nervous/emotional symptoms and urinary symptoms was associated with a lower likelihood of health check non-attendance; no association was found between consultation for these symptoms and health check non-attendance (see Table 7.16). Consultation for HFNS was weakly associated with a lower likelihood of health check non-attendance and an even weaker association was found between self-management of HFNS and attendance (see Table 7.17).