0 Eötvös Loránd University
Faculty of Education and Psychology Doctoral School of Education
Sports and Health Education Program
Katalin Nagyváradi
RESEARCH ON THE HEALTH STATUS OF HEALTHCARE PROFESSIONALS WORKING IN
AN INSTITUTE FOR CHRONIC PSYCHIATRIC PATIENTS
Theses of Doctoral (PHD) dissertation Consultant:
Prof. Dr. Zsuzsa Mátrai, DSc
2017
1 TABLE OF CONTENTS
I. THE ASPECTS OF TOPIC CHOICE AND THE STRUCTURE OF THE DISSERTATION 2 II. DESCRIPTION OF THE RESEARCH 5 II/A. The objectives and hypotheses of the research 5 II/B. The examined participants 6 II/C. Analytical instruments 6 II/D. The nature of the research 10 III. THE RESULTS OF THE RESEARCH 11 III/A. Empirical results 11 III/B. Methodological results 12 IV. FOR FURHTER CONSIDERATIONS 13 AUTHOR’S PUBLICATIONS IN THE TOPIC 15
OTHER PUBLICATIONS 17
2 I. THE ASPECTS OF TOPIC CHOICE AND THE STRUCTURE OF THE DISSERTATION
One of the aspects I kept in mind when selecting the research topic was to deal with the health status of a specific population. It is a widely accepted approach in the literature to gather data on the health status of individuals in a given work area or workplace.
Another crucial aim of the research was to examine health workers who are available for the research and work in a mentally and physically challenging environment.
The third point to consider was related to my previous research experience. I already performed instrumental assessment of health status of adults. Therefore, my aim was to base my research not only on subjective, but also objective data sources. This is important to highlight since most of the domestic and international literature on health status is based on subjective data, mostly questionnaires, where the conclusions on state of health are dawn purely from the self-assessment of the participants.
3 The dissertation consists of two larger parts. The first is a literature review where the first two points deal with the different interpretations of notions such as health care, quality of life, and health status. In a separate section, I describe the domestic and international research papers on health status, especially those, which due to their topic or target population, are relevant for comparing with my own research results.
In the second part of my dissertation, I present my own research. This section includes the description of the research, including the objectives and hypotheses, the scope and general characterization of the study participants, the tools of the study and the methods of data processing. This part also presents the data gained from base statistics on objective and subjective status of the target population, the influencing factors, the health behavior of the interviewees and the conditions they work in. After the introduction of base statistics, the results of the hierarchical cluster analysis will be outlined.
4 The characterization of the three subjective and three objective clusters was carried out based on the same parameters: the background data, health behavior, working conditions, satisfaction indicators and nutrition status indicators. The most important chapter in the research is the comparison of the subjective and objective results yielded by hierarchical cluster analysis. This is the chapter where the conclusions related to my hypotheses can be seen, drawn from both the questionnaire data, and from the results of my instrumental measurements.
5 II. DESCRIPTION OF THE RESEARCH
II/A. The objectives and hypotheses of the research One of the goals of my study was, to assess the state of health amongst those, who work under physically and mentally straining conditions. My first hypothesis is connected to this, in which I assume that those who participated in the study have their objectively measured health parameters out of the normal range, in a negative way.
The other aim of the research was methodological, namely to assess not only the self-reported subjective health indicators, but the objective health status as well, as this is an area missing in domestic and international research.
I hypothesized that the answers from the subjective questionnaires would largely coincide with the results of the objective health assessment.
The third goal was, to analyze state of health in a conceptual setting of social sciences, in which I could refer the objective and subjective factors of weal and well- being.
6 II/B. The examined participants
The examined psychiatric institute (Psychiatric Institute of Budapest, Szentgotthárd had 338 employees at the time, most of them were women. The research was conducted during summer 2012 and 131 workers accepted the request to fill in the questionnaires regarding their mental and physical health and to submit to objective body composition analysis. 70 % of the participants were nurses. Considering their age, more than two thirds of the interviewees were between the age of 30 and 60.
II/C. Analytical instruments
In order to assess the subjective state of health, the individuals had to fill out 3 functionally different questionnaires. The first one examined the mental well- being based on the answers to the five questions of the WHO WBI-5 international test. Using five point scale, the subjects had to indicate the frequency of the following feelings in the previous two weeks: happiness and joy, calmness and relaxation, activity and vitality, activeness and restfulness on waking; they were also asked to share if anything peculiar had happened.
7 The second questionnaire was also an international one, namely the WHOQOL-BREF26, which contained 2 general and 24 factual questions. The former concerned the interviewees’ satisfaction with their quality of life, and how they rate their health status. The factual questions explored physical, mental, social and environmental dimensions with the help of the five point scale. Since an internationally widely practiced survey was used, only a few examples will be mentioned to demonstrate the contents of the certain dimensions.
For instance, the questions concerning physical health included one about the extent to which physical pain interfered with their everyday activities and how much they were satisfied with their ability to work. Regarding psychological queries, there was one about how satisfied they were with life or how purposeful they think it was.
With respect to social interactions, there was a question whether they received support from others when needed and how satisfied they were with their own interpersonal relationships.
8 In the environmental dimension, individuals had to answer how satisfied they were with access to healthcare services or transportation opportunities.
Besides the already outlined international tests, I also applied an own, self–made questionnaire – containing 56 questions along the background questions – that explored the following dimensions: place of employment, working conditions, professional growth, health status, free time.
A few examples are hereafter listed. There was a question regarding why this particular place of employment was chosen.
In terms of working conditions, I was were interested in the individuals’ relationship with their supervisors, with the patients, and furthermore if they thought their efforts were appreciated financially, professionally and morally. With regards to professional growth, I asked if they had career development plans and if they would want one. Health status questions were aimed at the basic health behavioral habits (e.g. alcohol consumption, smoking, physical activity), and the amount of time spent on sick leave.
9 Free time was also under consideration, for instance if interviewees had any, and if yes what it was (e.g. cultural, sport activities).
During the objective health status check, I measured the height of the participants, the ratio of the main body components (water, protein, mineral matter and fat), the fat-muscle ratio, and the BMI (Body Mass Index) which is defined as the individual's body mass divided by the square of their height. In addition, the waist-hip ratio was also determined, which is one of the most commonly used indicators of central obesity, that may lead to increased risks of many metabolic and cardiovascular diseases.
The data was processed using the SPSS 17.0 mathematical-statistical software package. The answers gathered by the questionnaire on individual living- conditions were analyzed with the help of descriptive statistics (frequency, relative frequency). Following the descriptive statistics, I applied hierarchic cluster-analysis based on results of the WHO QOLD BREF26 life-quality questionnaire, the WHO WBI5 Well Being Index, and the body composition analysis. The individual groups were set up by the Ward process.
10 The quantitative results gained through the application of mathematical-statistical methods can be found in the appendices of the dissertation.
II/D. The nature of the research
Since the participants belonged to the same institute, my research qualifies as a case study with mathematical- statistical approach (descriptive statistics, cluster analysis). The narrower scope of the research refers to the institute the data was taken from.
The wider scope of the empirical data gained from the research can be taken into account only in those cases where my results are confirmed by other studies as well.
Apart from the case study nature of the research, it features a combination of existential and mental (welfare – well-being) components.
11 III. THE RESULTS OF THE RESEARCH
III/A. Empirical results
In the first hypothesis of my study, I assumed that those who participated in the study have their objectively measured health parameters out of the normal range, in a negative way. This is an important finding, because assessing the results of inland and foreign studies, Authors consider level of obesity one of the highest contributors of conditions such as Cardiovascular Disorders Locomotor Disorders (etc) which greatly affect mortality rate.
According to this, the examined population is not endangered, though if distribution of body fat is considered as well, almost 60% of them have some kind of fat surplus, and this is mostly concentrated on the visceral area.
In my second hypothesis I assumed that the subjective indicators, the answers from the questionnaires would largely coincide with the results of the objective health assessment. My results did not at all confirmed this hypothesis.
12 The objective and subjective indicators did not correspond for two thirds of the respondents. This was the least expected outcome.
According to the third hypothesis participants with better existential and mental environment would have good objective and subjective health indicators. This hypothesis was completely supported by the results.
III/B. Methodological results
The methodological outcome of the research is that the case study has satisfyingly demonstrated that the results of health status measurements cannot be considered to be definitely true if they are based on self-assessment only.
I realize that it is a serious coordination problem if we take objective measurements into account, however, based on my results it can be stated they are not irrelevant. It cannot be considered an occasional result that two thirds of the reviewed population deemed their own health status significantly different from the data yielded by objective measurements.
13 IV. FOR FURHTER CONSIDERATIONS
The direction of further research is basically suggested by the fact that the conclusions in the corresponding literature are based merely on subjective self-assessment.
Even if some of the works deal with some form of objective, measured data (instrumental measurement, statistics), there is no real comparison of the sets of data from the two different sources.
Therefore, it is worth conducting research in which the conclusions are based on the comparison of objective data and subjective indicators. My case study, the scope of which do not cover other populations, could not allow general conclusions to be drawn.
The next step would be to apply the already tested new methodology to other groups of people who work in a physically and mentally challenging environment. To do so, it would be practical to adapt the measuring instruments to the population in question, including the questions of domestic and international questionnaires, and the direction of instrumental measurements. For example, it could be beneficial to measure how stress affects the muscles.
14 It could be worth looking for comparable populations which are also linked to certain workplaces. In addition, the new national and international studies on health status need to be followed to enable the scope to be extended.
Thus, the data of current and planned case studies can be compared not only with each other but with other research findings.
15 AUTHOR’S PUBLICATIONS IN THE TOPIC
Nagyváradi K., Mátrai Zs. (2016): Egészségi állapot vizsgálata egy krónikus pszichiátriai betegekkel foglalkozó intézmény szakdolgozóinak körében. Magyar Sporttudományi Füzetek XIV. Különszám. 168-181pp.
Nagyváradi K. (2016): Életminőség vizsgálat nehéz fizikai és mentális körülmények között dolgozók körében.
Opus et Educatio 2016/3/3. 205-217pp.
Nagyváradi K. (2016): Jólét–jóllét mutatók segítő szakmában dolgozók körében. Neveléstudomány 2016/3.62-72pp.
K., Nagyváradi, Zs. Mátrai (2016): Subjective and objective indicators in the research on health status.
Journal of Human Sport & Exercise.
doi:10.14198/jhse.2016.11.Proc1.11. 207-217pp.
16 K. Nagyváradi, Zs. Mátrai (2015): Health Status of Healthcare Professionals Working in an Institute for Chronically Ill Psychiatric Patients. Physical Culture and Sport. Studies and Research. Volume 66, Issue 1, Pages 43–52, ISSN (Online) 1899-4849, DOI: 10.1515/pcssr- 2015-0016, July 2015
Nagyváradi K., Mátrai Zs.(2015) : Hazai és nemzetközi kutatások az egészségi állapotról. Neveléstudomány.
2015/3 70-78.
Nagyváradi K., Kiss – Geosits B. (2011): A munkahely, mint az egészségfejlesztés multiplikációs színtere Egészségfejlesztés, 2011/3.
H. Ekler, J., Nagyváradi, K., Csányi, T., Kiss-Geosits, B.
(2013): Szenior tanárok fizikai aktivitása - összefüggések napi rutintevékenységeik és egészségi állapotuk között.
Magyar Sporttudományi Szemle 14.évf. 55:17-23.p.
Fügedi B., Nagyváradi K., Kocsis Cs. (2010): Egészségi állapot és egészségmagatartás vizsgálata aktív korú munkavállalók körében. Egészségfejlesztés, 2010/5 – 6.
17 Suskovics Cs., Geosits B., Fügedi B., Nagyváradi K., Tóth O., Kocsis Cs. (2014): Szombathely és vonzáskörzetében élő nők tápláltsági állapotának elemzése. Folia Anthropologica 9. Nyugat-magyarországi Egyetem Természettudományi Kar, Szombathely ISSN 1786 56 54
OTHER PUBLICATIONS
Nagyváradi K, Pusztai T, Polgár T (2016): Aktívan nyugaton. RECREATION: A KÖZÉP-KELET-
EURÓPAI REKREÁCIÓS TÁRSASÁG
TUDOMÁNYOS MAGAZINJA 6:(2) pp. 5-8. (2016) Folyóiratcikk/Ismertetés/Ismeretterjesztő
18 Suskovics Csilla, Nagyváradi Katalin, Némethné Tóth Orsolya, Kocsis Csabáné, Bíróné Ilics Katalin, Kertész Áron, Krizonits István, Tóth Zsolt, Horváth Róbert, Reidl Rita, Tóth Gábor (2016): A nemi érés szekuláris változása a teljesítménytrendek függvényében. MAGYAR SPORTTUDOMÁNYI SZEMLE 17:(66) pp. 60-61.
(2016). Folyóiratcikk/Rövid közlemény/Tudományos Fritz Péter, Magyar M, Nagyváradi Katalin (2015):
Játékok, szokások In: Fritz Péter (szerk.): Szellemi rekreáció. 400 p. Budapest; Pécs: Dialóg Campus Kiadó, 2015. pp. 119-205. (Rekreáció mindenkinek; 2.) (ISBN:978-615-5376-51-1) Befoglaló mű link(ek):
OSZK Könyvrészlet/Könyvfejezet/Oktatási
Suskovics Cs, Nagyváradi K, Bíróné Ilics K, Kocsis Cs, Némethné Tóth O, Tóth Zs, Krizonits I, Horváth R, Kertész Á, Reidl R, Tóth G (2013): Közel 100 év változásai a 10-15 éves gyermekek növekedésében. Az előadás elhangzott: X. Országos Sporttudományi Kongresszus; Nyíregyházi Főiskola, Nyíregyháza, 2013, május 30 – június 1. (2013) Egyéb/Nem besorolt/Tudományos
19 Suskovics Csilla, Bíróné Ilics Katalin, Nagyváradi Katalin, Kocsis Csabáné, Némethné Tóth Orsolya, Tóth Zsolt, Krizonits István, Kertész Áron, Horváth Róbert, Reidl Rita, Tóth Gábor (2013): Adatok a kaposvári gyerekek biológiai fejlettségéről (előzetes adatok) In:
Mesterházy Beáta (szerk.): XII. Természet-, Műszaki és Gazdaságtudományok Alkalmazása Nemzetközi Konferencia. Előadások. Konferencia helye, ideje:
Szombathely, Magyarország, 2013.05.11 Szombathely:
Nyugat-magyarországi Egyetem, Természettudományi és Műszaki Kar, Természetföldrajzi Tanszék, 2013. pp. 130- 137. Könyvrészlet/Konferenciaközlemény/Tudományos Kiss - Geosits Beatrix, Nagyváradi Katalin, Polgár Tibor (2012): Minden "kő" a 2000 éves Saváriáról mesél a mai Szombathelyen. REKREACIO.EU 2:(4) pp. 6-9. (2012) Folyóiratcikk/Ismertetés/Nem besorolt jellegű
Polgár Tibor, Nagyváradi Katalin, Kiss-Geosits Beatrix, Tasnádi Fanni (2012): Miért jó idősnek lenni?:
REKREACIO.EU 2.:(1.) p. 39. (2012) Folyóiratcikk/Szakcikk/Tudományos
20 Nagyváradi K, Kissné Geosits B., Kocsis Csné (2011):
Analising the health status of secondary school students in Szombathely based on data of P.E. lesson categories.
In: The 6th INSHS International Christmas Sport Scientific Conference. Konferencia helye, ideje:
Szombathely, Magyarország, 2011.12.11-2011.12.13.p.
&. Egyéb konferenciaközlemény/Nem besorolt/Tudományos
Nagyváradi Katalin, Kiss - Geosits Beatrix, Németh Vivien (2011): Indicating the health behaviour among student of NYME Népegészségügyi Képző - és Kutatóhelyek V. Országos Konferenciája, Szeged, 2011.09.01-03. (2011) Egyéb/Nem besorolt/Tudományos Nagyváradi Katalin, Kiss - Geosits Beatrix, Polgár Tibor, Németh Vivien (2011): Healthy university?! The 6th International Christmas Post - graduate School, Szombathely, 2011.12.11-14. (2011) Egyéb/Nem besorolt/Nem besorolt jellegű
21 Nagyváradi Katalin, Kiss - Geosits Beatrix (2011): A munkahely, mint az egészségfejlesztés multiplikációs színtere. EGÉSZSÉGFEJLESZTÉS 52:(3) pp. 14-16.
(2011) Folyóiratcikk/Szakcikk/Tudományos
Nagyváradi Katalin, Kissné Geosits Beatrix, Kocsis Csabáné (2011): Analysing the health status of secondary school students in Szombathely based on data of P.E.
lesson categosies. The 6th International Christmas Sport Scientific Conference (2011). Egyéb/Nem besorolt/Nem besorolt jellegű
22 Polgár Tibor, Nagyváradi Katalin (2010): Sporting and sports equipment choice habits of the students from Szombathely. In: Mike Hughes, Dancs Henriette, Nagyváradi Katalin, Polgár Tibor, James, Nic, Sporis, Goran, Vuckovic, Goran (szerk.).Research Methods and Performance Analysis. 293 p. Konferencia helye, ideje:
Szombathely, Magyarország, 2010.12.13-2010.12.14.
Szombathely: Nyugat-magyarországi Egyetem Savaria Egyetemi Központ, 2011. pp. 20-24. (ISBN:978-963- 9871-43-3). Befoglaló mű link(ek): OSZK, Teljes
dokumentum, Teljes dokumentum
Könyvrészlet/Konferenciaközlemény/Tudományos Fügedi Balázs, Nagyváradi Katalin, Kocsis Csabáné (2010): Egészségi állapot és egészségmagatartás vizsgálata aktív korú munkavállalók körében.
EGÉSZSÉGFEJLESZTÉS 51:(5-6) pp. 21-29. (2010).
Folyóiratcikk/Szakcikk/Tudományos
23 Hughes, Mike, Dancs Henriette, Nagyváradi Katalin, Polgár Tibor, James, Nic, Sporis, Goran, Vuckovic, Goran (szerk.) (2010): Research Methods and Performance Analysis. Szombathely: University of West Hungary, 2010. 293 p. (ISBN:978-963-9871-43-4)
Link(ek): Teljes dokumentum.
Könyv/Szakkönyv/Tudományos
Nagyváradi K, Kocsis Csné, Kissné Geosits B. (2010):
Mozgás - a munkaadó és/vagy a munkavállaló haszna?
Népegészségügyi Képző- és Kutatóhelyek Országos Egyesületének IV. konferenciája, Szombathely, 2010.
szept. 03 (2010) Egyéb/Nem besorolt/Tudományos Polgár Tibor, Nagyváradi Katalin (2010): Sporting Habits of Hungarian and Italian University Students based on their knowledge of the concept of health.
Népegészségügyi Képző -és Kutatóhelyek IV. Országos Konferenciája, Szombathely 2010.09.02-04. (2010).
Egyéb/Nem besorolt/Nem besorolt jellegű
24 Polgár Tibor, Nagyváradi Katalin (2010): A rekreációs sportok szerepe a Vas megyei középiskolások és egyetemisták körében p. &. p. 'Sport-Kultúra- életminőség' Nemzetközi Sporttudományi Konferencia, Pécs, 2010.10.27-28. (2010). Egyéb/Nem besorolt/Tudományos
Barthalos I, Ihász F, Szakály Zs, Konczos Cs, Nagyváradi K, Bognár J, Nagy N (2009): Aged people and the physical activity: motion intervention in Social Care Center in Győr. In: Hughes M., Dancs, H., Nagyvaradi, K. (szerk.). Research in Sport Science. 346 p. Cardiff: Data2win Ltd., 2009. pp. 222-225. (ISBN:1- 901288-00-13) Befoglaló mű link(ek): OSZK, Egyéb URL Könyvrészlet/Szaktanulmány/Tudományos.
Független idéző: 1 Függő idéző: 1 Összesen: 2
Hughes M., Dancs, H., Nagyvaradi, K. (szerk.) (2009):
Research in Sport Science Cardiff: Data2win Ltd., 2009.
346 p. (ISBN:1-901288-00-13) Link(ek): OSZK, Egyéb URL Könyv/Szakkönyv/Tudományos
25 Polgár Tibor, Nagyváradi Katalin (2009): Comparison of health activity between Italian and Hungarian students (2009). Egyéb/Nem besorolt/Nem besorolt jellegű
Suskovics Csilla, Geosits Beatrix, Fügedi Balázs, Nagyváradi Katalin, Némethné Tóth Orsolya, Kocsis Csabáné (2009): Szombathely és vonzáskörzetében élő nők tápláltsági állapotának elemzése. In: Mesterházy Beáta (szerk.) VIII. Természet-, Műszaki és Gazdasági Tudományok Alkalmazása Nemzetközi Konferencia.
Előadások = 8th International Conference on Applications of Natural- Technological and Economical Science.
Presentations. Konferencia helye, ideje: Szombathely, Magyarország, 2009.05.20-2009.05.22. Szombathely:
Nyugat-magyarországi Egyetem, Természettudományi és Műszaki Kar, Természetföldrajzi Tanszék, p. &.. Egyéb konferenciaközlemény/Konferenciaközlemény/Tudomá- nyos
Nagyváradi Katalin (2007): A gyógytestnevelés helyzete Szombathelyen. Országos Sporttudományi Konferencia, Eger, 2007. (2007). Egyéb/Nem besorolt/Tudományos
26 Bokor Judit, Nagyváradi Katalin (2005): A turisztikai nevelés helyzete Vas megye általános iskoláiban.
ISKOLAI TESTNEVELÉS ÉS SPORT - ELMÉLETI MÓDSZERTANI ÉS INFORMÁCIÓS SZAKLAP (28) pp. 28-31. (2005). Folyóiratcikk/Szakcikk/Oktatási
