Personal aptitudes, lifestyles, quality of life, use of services. Rural-urban differences in a health region

Maria Jose Fernandez Dominguez, Noemí López Rey, Ana Felipa Borges Jesús, Roberto Fernández Álvarez, Ruth Martí Lluch, Begoña Rodríguez Graña

Keywords: quality of life, primary care, personal aptitudes

Background:

Little is known of the role that personal determinants and skills (self-efficacy, activation, health literacy, resilience, locus of control and personality traits) have in the ability to adopt health promoting behaviors and to respond appropriately in the face of adverse situations.

Research questions:

Are there differences between rural and urban areas in personal skills related to behaviors, adoption of healthy physical and mental lifestyles, quality of life, health problems and use of health services?

Method:

Multicentre cohort study, 3083 participants, 35-74 years/old, from 9 Spanish Health Regions. Follow-up: 5 and 10 years. Main independent variables: a) Self-efficacy (Sherer's general self-efficacy scale); b) Activation (Patient Activation questionnaire); c) Resilience (10-item version of the Connor-Davidson abbreviated scale); d) Health Literacy (HLS-EU-Q16 literacy questionnaire); e) Locus of control; f) Personality (Big Five Inventory of 10 items for the determination of personality traits).

Results:

Basal data analysis from 346 patients in one health region, 47.4% rural and 52.6%urban. Higher level of education in urban areas (p=0.00). They arrive financially worse at the end of the month (p=0.03) and cannot afford to maintain an adequate temperature at home (p=0.008); greater patient activation in rural areas (p=0.00). Globally, 11% suffered maltreatment in childhood.
No differences in self-efficacy, resilience, quality of life (euroquol), work stress, adverse events, duke social support, life satisfaction, marital status, tobacco use, alcohol consumption, loneliness, trust in spouse, family and friends.
In lifestyles, more sedentary urban ones (p=0.00); in rural ones, greater consumption of more red meat (p= 0.03), more legumes (p=0.01), less chicken (p= 0.02).
VAS of 70% in both areas, 60% find their health to be very good/good.

Conclusions:

Socioeconomic and cultural differences are observed between rural and urban patients, but not in personal skills. Morbidity, mortality, life style, health resources utilization will be observed in the follow-up.

Points for discussion:

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