Relaciones entre salud física y psicológica en mujeres de mediana edad^[1]

 

M.ª Pilar Sánchez‑López^{* [2]} Virginia Dresch^{** [3]} Violeta Cardenal‑Hernáez^***

 

Resumen: El objetivo central de este trabajo es analizar la relación entre los índices de salud física y psicológica de las mujeres de mediana edad frente a otros grupos de sujetos (mujeres jóvenes, hombres jóvenes y hombres de mediana edad). Además, específicamente, pretendemos verificar: a) cuáles son las variables psicológicas que predicen la salud física según se trate de índices objetivos o subjetivos y b) si entre las mujeres de mediana edad las variables demográficas (nivel socioeconómico, estado civil, tener o no hijos y situación laboral) influyen en los índices de salud. La investigación se ha llevado a cabo con 500 participantes, de 27 a 65 años, representativos de la Comunidad de Madrid (España). Los instrumentos utilizados como medida de las variables fueron el Inventario de Situaciones y Respuestas de Ansiedad – ISRA –, la Escala de Autoestima de Rosenberg – RES –, el Cuestionario de Satisfacción Autopercibida y Cuestionarios de Medida de la Salud Física (dos índices objetivos y dos índices de Salud percibida). Los resultados indican que las mujeres de mediana edad tienen peor salud frente a mujeres jóvenes, hombres jóvenes y hombres de mediana edad, puntuando más en Visitas al Médico, Enfermedades Crónicas, Dolencias Físicas, Ansiedad Fisiológica, Ansiedad Cognitiva y menos en Salud Física Percibida y Autoestima; y que las únicas variables demográficas que influyen en su salud son condición de trabajo y tener o no pareja. Las variables psicológicas empleadas en este estudio sólo explican la varianza de los índices de salud física subjetivos (Dolencias Físicas y Salud Física Percibida), sobretodo la Ansiedad Fisiológica, que es la responsable del mayor porcentaje de la varianza explicada. Las variables psicológicas predicen más la salud física de las mujeres que la de los varones, lo que parece indicar que la salud física de las mujeres está íntimamente relacionada con la salud psicológica. Futuras investigaciones deberían considerar otras variables psicológicas (personalidad, estrés, depresión) con el objetivo de encontrar si hay otras variables que expliquen partes de la varianza en salud física. Los resultados encontrados hasta ahora y los futuros ayudarán a diseñar programas más eficaces de intervención psicológica sobre la salud.

Palabras‑clave: ansiedad, autoestima, satisfacción vital, salud, mujeres mediana edad.

 

The relationships between physical and psychologial health in midlife woman

Abstract: The main target of this survey is to analyze the relation between the indicators of physical and psychological health in middle­‑aged women/female compared to other groups (young women/female, young men/male and middle­‑aged men/male). Besides, we specifically intend to verify: a) which the psychological variables that predict physical health are, depending on objective or subjective indicators; b) whether among middle­‑aged women, demographic variables (socio­‑economical level, marital status, children and working conditions) have an influence on health indicators. The survey has been carried out with 500 participants, aged 27­‑65, as a representative sample of the Community of Madrid (Spain). The instruments we have used to measure the variables are: Situations and Responses to Anxiety Inventory (ISRA), Rosenberg’s Self­‑esteem Scale (RES), Self­‑perception of Satisfaction Questionnaire and some Questionnaires of Physical Health Assessment (two objective indicators and two perceived health indicators). The results show that middle­‑aged women are less healthy than young women, young men and middle­‑aged men, obtaining a higher score in Visits to the Doc­tor’s, Chronicle Diseases, Physical Illnesses, Physiological Anxiety, Cognitive Anxiety and lower scores in Perceived Physical Health and Self­‑esteem; the only demographic variables that have influence on their health are working conditions and the fact of having or not a sentimental couple. The psychological variables that have been used in this survey can only explain the variance of the subjective physical health indicators (physical illnesses and perceived physical health), most of all, the physiological anxiety, which is responsible for the highest percentage of explained variance. The psychological variables predict physical health in women more than in men, what seems to indicate that physical health in women is closely related to psychological health. Future surveys should consider some other psychological variables (personality, stress, depression) in order to find out whether other variables can explain different parts of the variance in physical health. The results we have found so far and the ones to come will be helpful in order to design more efficient programs of psychological intervention within the health area.

 

Relações entre saúde física e psicológica em mulheres de meia‑idade

Resumo: O objectivo principal deste trabalho é o de analisar a relação entre os indicadores de saúde física e psicológica em mulheres de meia-idade face a outros grupos de sujeitos (mulheres jovens, homens jovens e homens de meia-idade). Acima de tudo, pretendemos verificar: a) quais as variáveis psicológicas que predizem a saúde física, quer se tratem de índices subjectivos ou objectivos; e b) se entre as mulheres de meia-idade as variáveis demográficas (nível socioeconómico, estado civil, ter ou não filhos e situação laboral) influenciam os seus índices de saúde. A investigação que apresentamos realizou-se junto de 500 participantes, com idades compreendidas entre os 27 e os 65 anos, representativos da comunidade de Madrid (Espanha). Os instrumentos utilizados como medida das variáveis em estudo foram o Inventário de Situações e Respostas de Ansiedade – ISRA –, a escala de auto-estima de Rosenberg – RES –, o Questionário de Satisfação Auto-Percebida e os Questionários de Medida da Saúde Física (dois índices objectivos de saúde e dois subjectivos). Os resultados indicam que as mulheres de meia-idade possuem uma saúde pior face às mulheres jovens, os homens jovens ou os homens de meia-idade, mostrando pontuações mais elevadas em visitas ao médico, doenças crónicas, dores físicas, ansiedade fisiológica, ansiedade cognitiva e menos saúde física percebida, e menor auto-estima; as únicas variáveis demográficas que influenciam a sua saúde são a situação laboral e ter ou não um par. As variáveis psicológicas utilizadas neste estudo explicam, apenas, a variância dos índices de saúde física subjectivos (dores físicas e saúde física percebida), sobretudo a ansiedade fisiológica que é responsável pela maior percentagem de variância explicada. As variáveis psicológicas predizem mais a saúde física das mulheres que a dos homens, o que parece indicar que a saúde física das mulheres está intimamente relacionada com a saúde psicológica. Em investigações futuras deverão considerar-se outras variáveis psicológicas (personalidade, stress, depressão), com o objectivo de encontrar se existem outras variáveis que expliquem partes da variância por explicar da saúde física. Os resultados encontrados até agora, bem como os futuros, ajudarão a conceber programas mais eficazes de intervenção psicológica na saúde.

 

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Referencias

Artistico, D., Baldasarri, F., Lauriola, M., & Laicardi, C. (2000). Dimensions of health­‑related dispositions in elderly people: Relationships with health be­haviour and personality traits. European Journal of Personality, 14 (6), 533­‑552.        [ Links ]

Argyle, M. (1987). The psychology of Hapiness. Londres: Methuen.

Baltes, M. Freund, A. M., & Horgas, A. L. (1999). Men and woman in the Berlin Aging Study. En P. B. Baltes & K. Ulrich (Eds.), The Berlin Age Study: Aging from 70 to 100. (pp. 259­‑281). Nova Iorque: Cambridge University Press.

Baron­‑Epel, O., & Kaplan, G. (2001). General subjective status or age­‑related health status: Does it make a difference? Social Science and Medicine, 53 (10), 1373­‑1381.

Caldwell, T. M., Rodgers, B., Jorm, A. F., Christensen, H., Jacomb, P. A., Korten, A. E., & Lynskey, M. T. (2002). Patterns of association between alcohol consumption and symptoms of depression and anxiety in young adults. Addiction, 97 (5), 583­‑594.

Castro Solano, A., & Sánchez López, M. P. (2000). Objetivos de vida y satisfacción autopercibida en estudiantes universitarios. Psicothema, 12 (1), 87­‑92.

Conroy, R. M., Smyth, O., Siriwardena, R., & Fernandes, P. (1999). Health anxiety and characteristics of self­‑initiated general practitioner consultations. Journal of Psychosomatic Research, 46(1), 45­‑50.

Creamer, P., Lethbridge­‑Cejku, M., Costa, P., Tobin, J. D., Herbst, J. H., & Hochberg, M. C. (1999). The relationship of anxiety and depression with self­‑reported knee pain in the community: Data from the Baltimore longitudinal study of aging. Arthritis Care and Research, 12 (1), 3­‑7.

Dear, K., Henderson, S., & Korten, A. (2002). Well­‑being in Australia: Findings from the National Survey of Mental Health and Well­‑being. Social Psychiatry and Psychiatric Epidemiology, 37 (11), 503­‑509.

Dienger, M. J. (1999). Anxiety and the performance of breast self­‑examination. Dissertation Abstract International: Section B: The Sciences and Engineering, 59, 5310.

Díez, M. A., Llorca, G., López­‑Sosa, C., Lanchares, J. L., & González­‑Tablas, M. M. (1999). Pathanalysis to depressed mood and anxiety in postmenopause. European Journal of Psychiatry, 13 (4), 247­‑256.

Friedman, H. S., & Booth­‑Kewley, S. (1987). The “disease prone” personality. American Psychologist, 42 (6), 539­‑555.

Gutmanis, I. A. (1999). The association of physical health and sociodemographic factors with well­‑being and alcoholism (stress). Dissertation Abstracts International: Section B: The Sciences and Engineering, 59, 5328.

Hagerdoorn, M., Sanderman, R., Ranchor, A. V., Brilman, E. I., Kempen G., & Ormel, J. (2001). Chronic disease in elderly couples: Are women more responsive to their spouses’ health condition then men? Journal of Psychosomatic Research, 51 (5), 693­‑696.

Hessel, A., Geyer, M., Ploettner, G., Schmidt, B., & Braehler, E. (1999). Subjective assessment of self health and subjective morbidity in Germany: Results of a representative demographic survey. Psychotherapie Psychosomatik Medizinische Psychologie, 49 (8), 264­‑274.

Jonas, B. S., & Lando, J. F. (2000). Negative affect as a prospective risk factor for hypertension. Psychosomatic Medicine, 62 (2), 188­‑196.

Jones, T. G. (2001). Cognitive and psychosocial predictors of subjective well­‑being in older adults. Dissertation Abstracts International, Section B, 62 (3B), 1582.

Junowitz, D. J. (2000). Effects of health and personality on subjective well­‑being in older adults. Dissertation Abstracts International, Section B, 61 (1B), 563.

Jurkovicoca, J., Aghova, L., Stefanikova, Z., Sevecikova, L., Ragan, J., & Dubrovova, I. (2000). Perception of risk in relation to prevalence of cardiovascular disease risk factors in selected population groups. Homeostasis in Health and Disease, 40 (3­‑4), 139­‑141.

Keyes, C. L. M., & Magyar­‑Moe, J. L. (2003). The measurement and utility of adult subjective well­‑being. In S. J. Lopez & C. R. Snyder (Eds.), Positive psychological assessment: A handbook of models and measures (pp. 411­‑425). Washington: American Psychological Association.

Kollingian Jr, J., & Sternberg, R. J. (1991). Perceived fraudulence in young adults: Is there an “impostor syndrome”? Journal of Personality Assessment, 56, 308­‑320.

Lennon, M. C. (1999). Work and unemployment as stressors. In A. V. Horwitz & T. L. Scheid (Eds.), A handbook for the study of mental health: Social contexts, theories, and systems. Nova Iorque: Cambridge Univ. Press.

Miguel Tobal, J. J., & Cano Vindel, A. R. (2002). Inventario de situaciones de respuestas de ansiedad (ISRA): Manual. Madrid: TEA.

Perrig­‑Chiello, P. (2000). Control beliefs, health and well­‑being in elderly. In W. J. Perrig & A. Grob (Eds.), Control of human behavior, mental processes and consciousness: Essays in honor of the 60^th birthday of August Flammer (pp. 411­‑423). Mahwah: Lawrence Erlbaum Associates, Pub.

Pinquart, M., & Soerensen, S. (2001). Gender differences in self­‑concept and psychological well­‑being in old age: A meta­‑analysis. Journals of Gerontology: Psychological Sciences and Social Sciences, 56B (4), 195­‑213.

Rhodes, A. E. (2000). Gender, type of mental disorder and use of outpatient mental health services. Dissertation Abstracts International. Section B: The Sciences and Engineering, 60 (9­‑B), 4515.

Roberts, G. J. (2000). Models of health appraisal in persons with multiple sclerosis. Dissertation Abstracts international. Section B: the Sciences and Engineering, 60, 3597.

Rosemberg, M. (1965). Society and the adolescent self­‑image. Princeton, NJ: Price­ton University Press.

Saboonchi, F., & Lundh, L. G. (2003). Perfectionism, anger, somatic health, and positive affect. Personality and Individual Differences, 35(7), 1585­‑1599.

Saks, K., Tuet, E., Kaeaerik, E., & Jaanson, K. (2002). Depressive symptoms in older Estonians: prevalence and models. Journal of the American Geriatrics Society, 50 (6), 1164­‑1165.

Sánchez‑López, M. P. (Ed.) (2003). Mujer y salud. Familia, trabajo y sociedad. Madrid: Díaz de Santos.

Sánchez­‑López, M. P., Díaz­‑Morales, & Cardenal­‑Hernáez V. (no prelo). Relation­ships between global health profiles and subjective wellbeing in women and men: comparisons between rural and urban people. Preliminary results.

Sánchez­‑López, M. P., & Cardenal, V. (2001). Diferencias en variables de personalidad en tres grupos de mujeres: 1. Mujeres que trabajan fuera del hogar, 2. Mujeres amas de casa y 3. Mujeres en paro. Influencia del nivel cultural. Comunicación Apresentada en XXVIII Congreso Interamericano de Psicología, Santiago de Chile.

Sandanger, I., Nygard, J. F., Ingebrigtsen, G., Sorensen, T., & Dalgard, O. S. (1999). Prevalence, incidence and age at onset of psychiatric disorders in Norway. Social Psychiatry and Psychiatric Epidemiology, 34 (11), 570­‑579.

Silverstein, B., & Lynch, A. D. (2002). Gender differences in depression: The role placed by paternal attitudes of male superiority and maternal modeling of gender­‑related limitations. In A. E. Hunter & C. Forden (Ed.), Readings in the psychology of gender: Exploring our differences and commonalities (pp. 85­‑99). Needham Heights: Allyn and Bacon.

Smith, J., Fleeson, W., Geiselmann, B., Settersten, R., & Kunzmann, U. (1999). Sources of well­‑being in very old age. In P. B. Baltes & K. Ulrich (Ed.), The Berlin Age Study: Aging from 70 to 100 (pp. 450­‑471). Nova Iorque: Cambridge University Press.

Stordal, E., Krueger, M. B., Dahl, N. H., Krueger, O., Mykletun, A., & Dahl, A. A. (2001). Depression in relation to age and gender in the general population: The Nord­‑Trondelag Health Study (HUNT). Acta Psychiatrica Scandinavca, 104 (3), 210­‑216.

Szadoczky, E., Rihmer, Z., Papp, Z., S., Vitral, J., & Fueredi, J. (2002). Gender differences in major depressive disorder in a Hungarian community survey. International Journal of Psychiatry in Clinical Practice, 6 (1), 31­‑37.

Van Os, J., & Jones, P. B. (1999). Early risk factors and adult person­‑environment relationships in affective disorders. Psychological Medicine, 29 (5), 1055­‑1067.

West, M., Rose, S. M., Spreng, S., Verhoef, M., & Bergman, J. (1999). Anxious attachment and severity of depressive symptomatology in women. Women and Health, 29 (1), 47­‑56.

Wilhelm, K., Roy, K., Mitchell, P., Brownhill, S., & Parker, G. (2002). Gender differences in depression risk and coping factors in a clinical sample. Acta Psychiatrica Scandinavica, 106 (1), 45­‑53.

Wittchen, H. U., & Hoyer, J. (2001). Generalized anxiety disorder: Nature and course. Journal of Clinical Psychiatry, 62 (11), 15­‑19.

Woodend, A. K. (2002). Do women with heart disease experience more distress than men? Dissertation Abstracts International: Section B: The Sciences and Engineering, 63 (6B), 2787.

Yang, B. (2002). Mental health of elderly women. Chinese Journal of Clinical Psychology, 10 (2), 132­‑133.

 

^[1] Parte de la investigación plurianual subvencionada por el Ministerio de Trabajo y Asuntos Sociales, REF: 51/99. Las tres autoras forman parte del Grupo de Investigación sobre Estilos Psicológicos (EPSY), que, con sede en la Universidad Complutense de Madrid, integra académicos, investigadores y profesionales del campo de la Salud de diversas instituciones españolas e iberoamericanas (www.ucm.es/info/estpsi).

^*  Dpto. de Personalidad, Evaluación y Tratamientos Psicológicos II, Universidad Complutense de Madrid.

^[2]  Correspondencia: M.ª Pilar Sánchez López, Campus de Somosaguas, 28223 Madrid – España, E‑mail: mpsanche@psi.ucm.es.

^**  Instituto de Ciências Humanas, Letras e Artes – Centro Universitario Feevale (Brasil).

^[3]  Con el apoyo del Programa AlBan, Programa de Becas de Alto Nivel de la Unión Europea para América Latina, número de identificación E03D01361BR (Supported by the Programme AlBan, European Union Programme of High Level Scholarship for America Latina. Identification number E03D01361BR).

^***  Dpto. de Personalidad, Evaluación y Tratamientos Psicológicos II, Universidad Complutense de Madrid.