| 1. |
- Andræ, Margareta, 1943-
(author)
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Facing death : physicians' difficulties and coping strategies in cancer care
- 1994
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Doctoral thesis (other academic/artistic)abstract
- Even if the treatment of cancer has developed over the last decades 50% of the patients still die of their cancer. The doctor's way of dealing with his and his patient's anxiety must surely be of significance for the treatment the patient receives.In the first part of the thesis earlier studies of physicians' stress and ways of coping are reported. There is a lack of systematic studies which show how doctors working with cancer patients adjust to this work. The aim of this investigation is to study cancer doctors' difficulties and coping strategies. The theoretical frame of the study embraces parts of psychoanalytical theory and coping models, emphasizing that both unconscious and conscious psychological processes play their part in the coping process.The second, empirical part of the study includes 23 physicians strategically selected out of a population of physicians who work with institutional care and who have daily contact with adult cancer patients. The main method of data collection has been a series of recorded interviews. The focus of the interview was the physician's perception of how he reacts, thinks, talks and acts in different phases of the cancer disease. To illustrate the defence strategies of the interviewers, the projective percept-genetic test, the "Defence Mechanism Test" (DMT) is used. The "Structural Analysis of Social Behaviour" (SASB) has been used to study the doctors' self image.The results indicate that the stated difficulties deeply affect the doctor as a human being. The statements reflect conflicting feelings and wishes in relation to authority, conflicting feelings and wishes in relation to frightening and injuring, conflicting feelings and wishes in relation to intimacy/distance. Thirty themes of coping strategies frequently recur and they have been grouped into seven categories. Most of the doctors "seek knowledge" and support from scientific literature. The majority of them state that attempting to "solve a problem" is their main strategy. Most of the doctors "seek support " as a part of their coping strategy. An interesting observation is that the doctors to a higher extent "seek a relation" to their patients rather than to their colleagues. Almost one third use "denial of the severity of a situation" as their main strategy. All the doctors consciously or unconsciously use "diverting strategies", i.e. undertake tasks which are devoid of contact with patients, such as research and administration or other activities which allow them to avoid the patient. One third use "projective manoeuvres" but this is never a main strategy.In the third part of the study the credibility of the results and their pedagogical and practical implications are discussed.
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| 2. |
- Jacobsson, Lars, et al.
(author)
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Traditional perceptions and treatment of mental disorders in western Ethiopia before the 1974 revolution
- 1991
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In: Acta Psychiatrica Scandinavica. - 0001-690X .- 1600-0447. ; 84:5, s. 475-481
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Journal article (peer-reviewed)abstract
- This article describes the traditional concepts and treatment of mental disorders in the Oromo areas in western Ethiopia before the revolution in 1974. There are three traditional cultural influences operating: traditional Oromo thinking, the Coptic church and the Islamic culture. One important element in traditional Oromo thinking is that each person is believed to possess an ayana, which is a special divine agent that can descend upon people, but also means a person's character and personality. In the traditional Oromo society, the Kallu is the religious leader who, through an ecstatic ritual technique, can investigate the causes of the disorder and advise what to do. Mental disorders are generally explained as resulting from disturbances in the relationship between people and divinity. The second important cultural element in western Ethiopia is the orthodox Coptic church, which usually looks upon mental disorders as possession by evil spirits, which are thus treated by specially gifted priests and monks by praying and giving holy water or eventually exhortation. According to Islamic teaching in the area, mental disorders are caused by evil spirits sent by God to punish the unfaithful people. Some Muslim sheiks treat mental cases with prayers, but herbal remedies are also used. There is a great intermingling of these different cultural and religious elements and people attend different healers and religious leaders more depending on the reputation of the person than on cultural and religious affiliation.
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| 3. |
- Lynöe, Niels, et al.
(author)
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Informed consent : study of quality of information given to participants in a clinical trial
- 1991
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In: The BMJ. - 1756-1833. ; 303:6803, s. 610-613
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To determine whether the participants in a clinical trial had perceived adequate information about the trial according to the guidelines of the Declaration of Helsinki. DESIGN: About 18 months after the end of a gynaecological clinical trial the participants received a questionnaire by post, which focused on the quality of the information given to them before entering the trial. Neither researchers nor participants were aware in advance that the trial would become the subject of this follow up investigation. SETTING: Eight different centres in Sweden. SUBJECTS: 43 women out of the 53 who completed the trial (mean (range) age 23 (16 to 35) years) returned the questionnaire. MAIN OUTCOME MEASURES: Adequacy of the information (based on requirements of the Declaration of Helsinki) to enable the following: understanding of the aims of the study; awareness of what participation meant; and awareness of the possibility of withdrawing from participation at any time. Motives for agreeing to participate, and a subjective evaluation of the given information were also recorded. RESULTS: All but one of the participants had been aware that they were taking part in a research project. Five women stated that they had not been aware that a second laparoscopy was performed only for research reasons. Seven women reported that they had not been aware of the meaning of participating in the project and 17 that they had had no information about the possibility of withdrawing from the study whenever they wanted. In the subjective rating 22 women considered the information given as good or very good. There was a systematic variation in the quality of the given information among the eight centres. CONCLUSION: Although all but one of the participants had been aware that they were taking part in a clinical trial, the quality of the information understood and recalled by participants varied, and in many cases clearly did not meet the guidelines of the Declaration of Helsinki. Variations among centres in participants' perception of information suggest that deficiencies in perception may be caused by informers rather than the participants.
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| 4. |
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| 5. |
- Penayo, Ulises, et al.
(author)
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[Central American seminars for young psychiatrists of the region and training of leaders in community mental health. Sweden/PAHO-WHO collaboration program]
- 1994
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In: Acta psiquiátrica y psicológica de América latina. - 0001-6896. ; 40:3, s. 249-52
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Journal article (peer-reviewed)abstract
- The Swedish Psychiatric Association, in collaboration with the Department of Psychiatry, University of Umeå, Sweden, and the Pan American Health Organization/WHO, has obtained economic support from the Swedish Agency for International Development (ASDI), to organize training seminars for young psychiatrists from Central America. The program will continue until 1995 with an option to pursue further studies leading to a master or other post-graduate degrees. The overall purpose is to strengthen the knowledge in epidemiology and community mental health, along the lines set by the "Caracas Declaration" of a cadre of young leaders in the field of psychiatry in Central America.
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| 6. |
- Penayo, U, et al.
(author)
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[Mental disorders in Nicaragua : family perspective]
- 1992
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In: Acta psiquiátrica y psicológica de América latina. - 0001-6896. ; 38:3, s. 213-222
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Journal article (peer-reviewed)abstract
- In recent years the family perspective in Psychiatry has become more important a factor. Therefore this paper is aimed at examining the family structure of mentally disordered people in León, Nicaragua, as well as presenting the use of a Genogram in epidemiological research. 201 families were randomly selected, whose members were interviewed in two steps: a screening, and a diagnostic stage. The family map or Genogram for each family was analyzed with respect to adult and child cases, generations within the family, and other background variables.
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| 7. |
- Wasserman, D, et al.
(author)
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Parasuicide in the Nordic countries.
- 1994
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In: Scandinavian journal of social medicine. - 0300-8037. ; 22:3, s. 170-7
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Journal article (peer-reviewed)abstract
- This article gives an account of some findings of the WHO/EURO multicentre study on parasuicide from the five Nordic centres: Helsinki (Finland), Stockholm (Sweden), and the countries of Funen (Denmark), Sø-Trøndelag (Norway) and Västerbotten (Sweden). For parasuicide patients treated in hospital in these five Nordic centres, the parasuicide rates per 100,000 inhabitants per annum were 222 for women, 213 for men and 224 for both sexes combined. In all the Nordic centres except Helsinki, women had higher parasuicide rates than men. The female/male parasuicide ratio was 1.16 for all Nordic centres. The highest parasuicide rates in the whole material were found in Helsinki, Stockholm and Funen, and the lowest in Sør-Trøndelag and Västerbotten. The highest parasuicide rates lay in the 30-39 age interval, i.e. the peak of parasuicide rates was in older age groups than previously reported. Single people, especially divorcees and those who have never been married, constitute a high-risk group in both sexes. The risk of parasuicide for single men is three times that for married men in all the Nordic centres except Sør-Trøndelag, where the risk is five times higher. The parasuicide risk for single women is twice as high as for married women except for women in Funen, where the risk for single and married women is almost equal. Exceptionally high parasuicide rates are also reported for Finnish citizens in Sweden, compared with Finns from the Helsinki centre. Parasuicide rates appear to be correlated with population density, since the densely populated areas of Helsinki, Stockholm and Funen evince higher parasuicide rates than the sparsely populated areas of Sør-Trøndelag and Västerbotten.
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| 8. |
- Wikman, Marianne, et al.
(author)
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Ambivalence towards parenthood among pregnant women and their men
- 1993
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In: Acta Obstetricia et Gynecologica Scandinavica. - 0001-6349 .- 1600-0412. ; 72:8, s. 619-626
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Journal article (peer-reviewed)abstract
- 369 pregnant women and 345 expectant fathers visiting antenatal clinics were examined by a questionnaire concerning attitudes towards pregnancy and parenthood. Data were processed by factor analysis and the degree of agreement to important factors was estimated. Attitudes were dominated by two conflicting views: children mean existential satisfaction and children mean restriction of freedom for women as well as for men. There was a tendency to deny the items concerning the disadvantages of having children. An important factor in the women's as well as in the men's analysis was the importance of own parents as models in parenthood. The findings from this unselected population of pregnant women and their men are consistent with earlier in-depth interviews. It can be concluded that ambivalence should be regarded as a normal constituent of the adaptation to pregnancy and parenthood. Experiences of own parents play an important role in the transition to parenthood. An important task for the medical profession should be to inform about ambivalence as a normal phenomenon as it, left unaccepted, may cause unnecessary anxiety and feelings of guilt.
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| 9. |
- Wikman, M, et al.
(author)
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Attitudes toward reproduction in a nonpatient population
- 1992
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In: American Journal of Obstetrics and Gynecology. - 0002-9378 .- 1097-6868. ; 166:1 Pt 1, s. 121-126
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Journal article (peer-reviewed)abstract
- OBJECTIVE: A basic question to be answered in an attempt to understand human reproductive behavior as it manifests itself in clinical practice is, why do people want to have children? STUDY DESIGN: A psychometric instrument for the assessment of reproductive attitudes was developed. A total of 746 men and women at 20, 30, and 40 years of age, who were randomly selected from a nonpatient population, answered. Data were analyzed by factor analysis. Reproductive profiles were constructed. RESULTS: The two most important factors in both sexes were "children as existential satisfaction" and "children as lack of freedom," indicating a basic conflict. The third most important factor in both sexes was "the importance of one's own parents as examples in parenthood," supporting earlier findings that reproductive conflicts are transmitted from one generation to another. Reproductive profiles were uniform in the different age groups. CONCLUSION: The element of ambivalence may be a clue to a deeper understanding of human reproductive behavior.
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