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Separate and joint effects of physical and mental health on participation of people with somatic chronic illness.

Jansen, D.L., Rijken, M. Separate and joint effects of physical and mental health on participation of people with somatic chronic illness. Journal of Nursing and Healthcare of Chronic Illness: 2011, 3(1), p. 61-72.
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Aim: To examine the extent to which people with a somatic chronic illness participate in paid jobs, volunteer work, informal care and social activities, and to investigate the separate and joint effects of physical and mental health on participation. Background. Compared with healthy people, people with a chronic illness experience more difficulties with respect to participation in several life domains. Methods: Data were collected within the National Panel of the Chronically Ill and Disabled by means of questionnaires. Data of 1456 panel members diagnosed with a somatic chronic disease(s) were used, and analysed using univariate, bivariate and multivariate analyses. Results: About half of the working age people with a chronic illness were in paid employment, 25% carried out volunteer work, 18% performed informal care and 58% of the people participated in social activities. Main effects were found for physical functioning and pain on paid work, pain and mental health on volunteer work and physical functioning on informal care. An interaction effect was observed for pain and mental health on both paid and volunteer work; as mental health is better, less pain is associated with a greater chance of paid work and more pain is associated with a greater chance of volunteer work. Conclusions: The findings emphasise the importance of mental health for participation in people with a chronic somatic illness, besides physical health. Relevance to clinical practice: In contrast with many of their physical limitations, the mental health state of patients with a chronic illness could be improved. Health care providers, including nurses, should take into account patients’ mental health states and make efforts to treat mental health problems.(aut. ref.)