This study elucidates the characteristics of social relationships of people with rheumatoid arthritis (RA), from the viewpoints of social difficulties attributable to RA, interpersonal difficulties, social support, physician satisfaction, and social participation. It also assesses their effects on anxiety, depression, and hope. The following results were obtained from an Internet survey of 20-59-year-old people suffering from RA in Japan (N=238). Experiences of negative social relationships, such as the deterioration of workplace (33%) and family relationships (13%) because of RA and misunderstanding (98%) or criticism (68%) were common. Receiving emotional and instrumental support and providing support were reported less by males than females. After controlling for demographic characteristics and physical disability, most variables related to social relationships were directly or indirectly associated with anxiety, depression, or hope. However, each social relationship variable directly affected anxiety, depression, and hope in different ways. The variables that indicated direct, independent associations with anxiety or depression were mainly negative social relationships, such as deterioration of family relationships (β=.248, p<.001 ; β=.192, p=.003), misunderstandings (β=.151, p=.021 ; β=.179, p=.006), criticism (β=.144, p=.041), and receiving emotional support (β=−.216, p=.006 ; β=−.215, p=.007). Meanwhile, variables indicating direct, independent associations with hope were positive or active social relationships, such as providing and receiving social support (β=.227, p=.003 ; β=.189, p=.014), physician satisfaction (β=.150, p=.017), and social participation (β=.213, p<.001). These results suggest that it is important to maintain social relationships of people with RA and focus on these from the perspective of the enhancement of hope in addition to the alleviation of anxiety and depression for the improvement of the psychological well-being.
Because smoking among young adults is a growing public health concern, the present study evaluated unhealthy behaviors related to smoking and attitudes toward smoking among Japanese paramedical students. Using a repeatedly measured cross sectional study, the optimal season for educating paramedical students on tobacco-related problems was determined. Two cross sectional surveys were repeatedly conducted at the University of East Asia in April and October, 2006. On both occasions, the questionnaires were administered to students on smoking habits, attitude toward smoking and lifestyle behaviors. We collected 295 questionnaires (244 males and 51 females) and 218 questionnaires (183 males and 35 females) during the respective periods. In the April survey, there were significantly more smokers among men than among women and significantly more in the higher than in lower grades, but these significant differences disappeared by the October survey. The smoking rates of students who felt fairly good or good in sense of well-being were significantly lower in both surveys. Adjusted odds ratios for smoking showed significant associations with skipping meals, eating out of home, sleeping status, and alcohol drinking in the April survey. Additionally, the October survey showed a significant association with skipping meals, eating out of home, sleeping medication usage and alcohol drinking. All statements regarding attitudes toward smoking showed higher scores of agreement among non-smokers than smokers and there were significant differences except for two of the statements in the April survey. There were with larger differences in October than April, but no significant differences between the April and October surveys. To formulate an effective tobacco control strategy in paramedical schools, it would work best to add smoking cessation topics to the curriculum in April for first grade students.