Geschlechtsdifferenzen in der subjektiven Gesundheit unter Marburger Medizinstudenten und jungen Erwachsenen der Allgemeinbevölkerung

Die subjektive Gesundheitseinschätzung durch den Patienten zeigt sich in der Literatur als konsistenter Prädiktor für die Mortalität und das langfristige Krankheitsoutcome. In der meisten Zahl der Fälle ist bei der subjektiven Gesundheitsbewertung ein Geschlechtereffekt festzustellen. Diese Untersch...

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Bibliographic Details
Main Author: Wesseler, Claas
Contributors: Mueller, Ulrich (Prof. Dr. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2009
Online Access:PDF Full Text
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Table of Contents: Self-rated health seems to be a consistent predictor for mortality and the long-term outcome of diseases. In most of the studies is a gender difference in self-rated health, this is well documented, but findings are inconsistent and mostly seen in older people. This study investigates the results of a questionnaire reported by Marburg (Germany) first-year medical students. The questionnaire contents topics with sociodemographic characteristics, partnership, self-rated health, self-rated fitness, smoking behaviour and type of health insurance. The students were also to prove a small fitness test to examine the objective fitness. After a selection for age and country of birth, the study includes 2936 students (60,1% women n=1766, 39,1% men n= 1170). The Students with another nationality than the German one, were selected as control group, because of the heterogeneity of their origin and following bias for the results. Results: In this high selected data were no findings about gender differences in self-rated health. Most of the students reported their health as good or very good. In Comparison with the representive German population data (ALLBUS), the students rated their health less than the same-age normal German people. The heterogenic group of not German students showed a gender effect, the men reported a significant better health than women. The objective fitness showed a high correlation with the self-rated fitness and the self-rated health. Students, who rated themselves as fit or athletic, had a better fitness index that was found for women and men. Overall men reported a better self-rated fitness than their female colleques. To measure the objective fitness, the students had to do a small body workout with self-measuring their own pulse in rest, directly after the exercise and one minute after. To extract one fitness index of the three pulse measurements a data reduction by factor analyze was made. The fitness of someone is in our opinion best represented, when the single pulse rates are different weighted. The Index is best represented by: 0.729 • (P rest) + 0.609 • (P exe) + 0.814 • (P rec) = Fitnessindex (P rest = pulse in rest; P exe = exercise pulse; P rec = recovery pulse). A good physical fitness is shown by a low index, a bad physical fitness by a higher index score. In this study the minimal (best) score was 110,8 and the worst score was nearly up to 300. A score near the mean of 184 characterizes normal fitness. Discussion: But in the study population of young German medical students there is no gender difference found in subjective health, so we suppose that gender differences in self-rated health (as reported in the literature) maybe an effect of older age or come through the bias (as some new articles suppose.) that men do not answer to the examination of self-rated health, when they are ill. Women do this and so they report more often worse health than men. Another possibility for the gender effect is, that women normally are more interested in health and in our study because of the medical studies, both sexes have the same interest in health and so report same subjective health. This is and must be the aim of future studies. We also found a strong connection between objective and subjective fitness and a connection of both to the self-rated health.