| 1. |
- Carlsson, Marianne, et al.
(författare)
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Evaluation of quality of life/life satisfaction in women with breast cancer in complementary and conventional care
- 2004
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Ingår i: Acta Oncologica. - OSLO : TAYLOR & FRANCIS AS. - 0284-186X .- 1651-226X. ; 43:1, s. 27-34
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to study the perceived quality of life/life satisfaction in a sample of women with breast cancer who were treated in a hospital with alternative/complementary care and the same variables in individually matched patients who received only conventional medical treatment. A non-randomized controlled trial design with repeated measurements was used. Sixty women with breast cancer treated with anthroposophic medicine (ABCW) and 60 with conventional medicine (CBCW) were included and 36 matched pairs took part on all occasions. The quality of life was measured by the EORTC QLQ-C30 and the Life Satisfaction Questionnaire (LSQ). The comparisons were calculated as effect sizes (ES). The women in the ABCW group reported small or moderate effects, expressed as ES, on their quality of life/life satisfaction compared to their matched "twins'' in the CBCW group at the 1-year follow-up in 15 out of 21 scales/factors. It was concluded that the women who had chosen anthroposophic care increased their perceived quality of life/life satisfaction according to the methodology of the study.
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| 2. |
- Blomqvist, Kerstin, 1953-
(författare)
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Older people in persistent pain : nursing and paramedical staff perceptions and pain management
- 2003
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Ingår i: Journal of Advanced Nursing. - : Blackwell. - 0309-2402 .- 1365-2648. ; 41:6, s. 575-584
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Persistent pain is a common problem for older people. Knowledge about how nursing and paramedical staff perceive these people and what they do to relieve the pain seems scarce. AIM: To explore nursing and paramedical staff perceptions of older people in persistent pain and their day-to-day management of pain. METHODS: Interviews in Swedish with 52 nursing auxiliaries, Registered Nurses, physiotherapists and occupational therapists were collected from February to May 2000. The analysis was based on their stories (n = 150) about older people in persistent pain who received help in their own homes or in special accommodation. A typology of staff perceptions of pain in older people was developed. Activities to manage pain were examined using content analysis. RESULTS: Respondents perceived the pain as real, exaggerated, trivial, care-related, endured, concealed, self-caused or inarticulate. Older people perceived as exaggerating the pain, those with care-related and self-caused pain evoked frustration in the staff, while those perceived as enduring their pain evoked satisfaction. Various strategies to manage pain were used: no activity, medication, mediating contacts, distracting activities, physical therapies, mobility, work in a gentle way, rest or relieving pressure on body part, and communication concerning pain. The activities differed between the types, as well as between staff with different professional backgrounds. CONCLUSION: Care and treatment provided by staff should be based on older people's needs rather than on staff attitudes and preferences. The typology revealed that staff perceived older people in pain as a heterogeneous group and that their perceptions affected the pain-relieving activities that were offered. It seems urgent to address how to handle pain in older people who never complain and those who complain a great deal, as well as how to handle pain in people with impaired communicative ability. Reflective discussions on feelings related to different individuals are needed.
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| 3. |
- Heikkilä, Kristiina, 1958-, et al.
(författare)
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Elderly care for ethnic minorities : Wishes and expectations among elderly Finns in Sweden
- 2003
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Ingår i: Ethnicity and Health. - BASINGSTOKE : Taylor & Francis. - 1355-7858 .- 1465-3419. ; 8:2, s. 135-146
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Although elderly people from immigrant and minority groups utilise elderly care facilities to a lesser extent than elderly people from majority groups, there is a lack of research on how elderly people with different ethnic backgrounds wish and expect to be cared for when they are in need of institutional elderly care. This study aims to illuminate the role that culturally appropriate care plays in elderly Finnish immigrants’ wishes and expectations of institutional elderly care in Sweden. Design. Thirty-nine elderly Finnish immigrants in Sweden, aged 75 years or more, were interviewed in their homes. The data were analysed with latent qualitative content analysis. Results. The elderly Finnish immigrants in Sweden wished to be able to continue living in their current homes for as long as possible. Later on, when entering institutional elderly care, they wanted to feel continuity, familiarity, security and companionship with others. As immigrants, they had to choose to be cared for either in well-known physical environments close to their current homes, or in a culturally appropriate care setting with familiar socio-cultural conditions. Conclusions. To be able to provide institutional elderly care for minority groups it is important to ease the access to elderly care amenities by providing care that results in maintaining as much continuity and familiarity as possible in the lives of the elderly people. This includes the care providers and other residents who share the familiar aspects of their lives. This involves providing culturally appropriate elderly care close to the elderly people’s current homes.
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| 4. |
- Stjernberg, Louise
(författare)
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Epidemiological aspects of tick borne diseases with focus on risk and prevention
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The incidence and variety of diseases associated with ticks have increased world-wide and ticks are currently considered to be second only to mosquitoes as vectors of human infectious diseases in the world. In the northern hemisphere, Ixodes ricinus, the most common tick, transmits diseases caused by several infectious pathogens, including different types of bacteria, virus and protozoa. In Sweden, Lyme borreliosis, tick-borne encephalitis and erlichiosis are established, and more than 10.000 people are infected each year. This thesis focuses on aspects of risks associated with tick bites, the risk of contracting tick borne diseases including long-term outcome, and preventive measures and behaviour among people living in tick endemic areas. The first study describes the long-term outcome in patients treated with antibiotics due to neuroborreliosis. At the follow up, 75% of the patients had recovered completely and 25% (95% confidence interval; 17% - 33%) suffered from residual neurological symptoms such as facial palsy, concentration disorder, paresthesia and/or neuropathy. In order to avoid sequelae, early diagnosis and treatment are of great importance. The second study investigated the exposure and contraction of tick-bites with the risk of developing Lyme borreliosis from these tick-bites. Results showed that among people well aware of tick-borne diseases and who inspect their skin daily for ticks, the monthly rate of being tick bitten was 0.04 (95% confidence interval; 0.02-0.06) per 10 hours spent out of doors. Within six months, 3% had contracted Lyme borreliosis, i.e. the risk of developing this disease was 0.5% (95% confidence interval; 0.44-0.56) per tick-bite. The third (experimental) study was aimed at determining whether light-coloured or dark-coloured clothing had the least attractive effect on Ixodes ricinus. The overall found ticks between the both colours differed significantly, with 62% (95% confidence interval; 59% - 65%) of the ticks found on light-coloured clothing. Dark-coloured clothing seems to attract fewer ticks. The fourth study describes tick preventive measures, and their predictors, taken among highly exposed people. In total, 69% of the participants regularly took preventive measures, personally and/or in the environment. When analysing gender and preventive measure solely, women took more preventive measures compared to men. When analysing all risk variables together, spending less time in tick endemic area and being tick bitten the same tick season significantly increased the probability of taking any preventive measures. After being tick bitten, men increased their performance of preventive measures more than women.
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| 5. |
- Bennet, Louise, et al.
(författare)
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Clinical Outcome of Erythema Migrans after Treatment with Phenoxymethyl Penicillin
- 2003
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Taylor & Francis. - 0036-5548 .- 1651-1980. ; 35:2, s. 129-131
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Tidskriftsartikel (refereegranskat)abstract
- In a 5 y retrospective follow-up study in southern Sweden of 708 adult individuals with erythema migrans as the single manifestation of Lyme borreliosis, the clinical outcome and the antibiotic treatment were studied. 80%, were treated with phenoxymethyl penicillin, 15% with doxycycline and 5% with other antibiotics. Phenoxymethyl penicillin and doxycycline were extremely effective: 98 and 94% of the individuals reported complete recovery without complications. Few individuals reported the development of new symptoms following treatment and none developed any late manifestation of Lyme borreliosis during the observation period. Thus, in the area studied the treatment of the early localized manifestation of Lyme borreliosis (erythema migrans) with antibiotics was extremely successful. The current Swedish recommendation to use phenoxymethyl penicillin, when no sign of disseminated infection or coinfection with other tick-borne pathogens is present, seems excellent.
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| 6. |
- Bennet, Louise, et al.
(författare)
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Reinfection with Lyme borreliosis : A retrospective follow-up study in southern Sweden
- 2002
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Ingår i: Scandinavian Journal of Infectious Diseases. - OSLO : TAYLOR & FRANCIS AS. - 0036-5548 .- 1651-1980. ; , s. 183-186
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Tidskriftsartikel (refereegranskat)abstract
- In a 5-y retrospective follow-up study in southern Sweden that initially included > 1000 individuals with previously diagnosed erythema migrans, factors that influenced the risk of reinfection with Lyme borreliosis were elucidated. The total frequency of reinfection was 4% and the number of tick bites influenced the risk of reinfection: those bitten > 10 times during the observation period had a 4-8-fold increased risk compared with those bitten < 5 times. Women manifested to a greater extent than men although both genders were bitten equally by ticks, thus indicating that women may be more susceptible to reinfection. All reinfected women were > 44 y old. The county of Kalmar including Oland was found to be highly endemic for reinfection with Lyme borreliosis. Thus the number of tick bites, gender, age and study area influenced the risk of reinfection.
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| 7. |
- Berglund, Johan, et al.
(författare)
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5-y follow-up study of patients with neuroborreliosis
- 2002
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Taylor & Francis. - 0036-5548 .- 1651-1980. ; 34:6, s. 421-425
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this follow-up study was to determine the long-term outcome of strictly classified cases of neuroborreliosis treated with antibiotics. A one-year prospective population-based survey of Lyme borreliosis was conducted in southern Sweden, between 1992 and 1993. A total of 349 identified cases with suspected neuroborreliosis were followed up 5 years later. Medical records were reviewed and all participants filled in a questionnaire. Of those classified with definite neuroborreliosis 114/130 completed the follow-up, of whom 111 had completed the initial antibiotic treatment. Of the 114 patients followed up, 86 (75%) had recovered completely and 70 (61%) had recovered within 6 months. Residual neurological symptoms such as facial palsy, concentration disorder, paresthesia and/or neuropathy were reported by 28/114. No significant differences between different antibiotic treatments were observed in terms of occurrence of sequelae. To conclude, we found that 25% (95% confidence interval 17-33%) of the patients suffered from residual neurological symptoms 5 years post-treatment. However, the clinical outcome of treated neuroborreliosis is favourable as only 14/114 (12%) of the patients had sequelae that influenced their daily activity post-treatment. Early diagnosis and treatment would seem to be of great importance in order to avoid such sequelae.
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| 8. |
- Carlsson, Marianne, et al.
(författare)
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Perceived quality of life and coping for Swedish women with breast cancer who choose complementary medicine
- 2001
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Ingår i: Cancer Nursing. - PHILADELPHIA : LIPPINCOTT WILLIAMS & WILKINS. - 0162-220X .- 1538-9804. ; , s. 395-401
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study, which is part of a major clinical controlled study of the life situation of women with breast cancer, was to compare two groups of women concerning perceived quality of life and coping. The women were treated in two different cancer treatment programs: complementary treatment, which included anthroposophic therapy, and conventional cancer treatment. A total of 120 women were included, 60 women treated with anthroposophic medicine, and 60 individually matched women treated with conventional medicine only. Quality of life was measured by the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire, Core 30, and the Life Satisfaction Questionnaire. Coping was measured by the Mental Adjustment to Cancer scale. The results showed that the women who chose anthroposophic therapy perceived their quality of life to be lower on admission to the hospital and showed more anxious preoccupation than the women in conventional medicine. It can be concluded that, due to the careful matching procedure, the women in the two groups are comparable in a medical sense but not from the perspective of quality of life and coping.
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| 9. |
- Halling, Anders, et al.
(författare)
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Diagnosis and treatment of heart failure in primary health care among elderly patients with non-insulin-dependent diabetes mellitus, with special reference to use of echocardiography
- 2003
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Ingår i: Scandinavian Journal of Primary Health Care. - OSLO : TAYLOR & FRANCIS AS. - 0281-3432 .- 1502-7724. ; 21:2, s. 96-98
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Tidskriftsartikel (refereegranskat)abstract
- Objective-The aim of the present study was to describe how the diagnosis of heart failure (HF) was assessed, aetiology and management in elderly patients with non-insulin-dependent diabetes mellitus (NIDDM) in primary health care, with special reference to use of echocardiography. Design-Descriptive retrospective investigation. Setting-Ronneby and Karlskrona communities, both situated on the Swedish south-east coast, 28,600 and 60,600 inhabitants, respectively. Patients-279 patients with NIDDM, mean age 77 years (range 70-85). Main outcome measures-Prevalence, aetiology, diagnostic procedures and management of HF. Results-The majority of patients were given the diagnosis of HF mainly as a result of clinical examination, ECG and chest X-ray, or of hospitalisation for HF. The diagnosis of HF by the primary care physicians was based on an objective evaluation of cardiac function in 8% of the patients. Hypertension was the predominant associated disease, followed by ischaemic heart disease (IHD). Therapy included diuretics (91%), angiotensin-converting enzyme (ACE) inhibitors (43%) and digoxin (53%). Conclusion-There is still a gap between current management of HF in primary care and guidelines, particularly in the case of diagnosis that is not generally based on an objective evaluation of cardiac function.
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| 10. |
- Hamnerius, N., et al.
(författare)
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Pedal dermatophyte infection in psoriasis
- 2004
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Ingår i: Br J Dermatol. - : Oxford University Press (OUP). ; 150:6, s. 1125-1128
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Dermatophyte infections have been considered rare in psoriasis. However, there are data indicating that tinea unguium is as common or even more common in psoriasis compared with healthy controls. Tinea unguium is generally a secondary event to tinea pedis infection. OBJECTIVES: To study the prevalence of tinea pedis and tinea unguium in psoriasis compared with a control group. METHODS: Consecutive psoriasis outpatients aged 18-64 years attending a department of dermatology were examined. Samples for direct microscopy and culture were taken from the interdigital spaces, soles and toenails. Consecutive patients without signs of psoriasis or atopic dermatitis seeking examination of moles constituted the control group. RESULTS: In total, 239 patients with psoriasis and 245 control patients were studied. The prevalence of tinea pedis was 8.8%[95% confidence interval (CI) +/- 3.6%] in the psoriasis group and 7.8% (95% CI +/- 3.4%) in the control group. The corresponding figures for prevalence of tinea unguium were 4.6% (95% CI +/- 2.7%) and 2.4% (95% CI +/- 1.9%), respectively. The differences found in the psoriasis vs. the control groups were not statistically significant. CONCLUSIONS: This study does not support the hypothesis that the prevalence of tinea pedis and tinea unguium in patients with psoriasis differs from that in a normal population.
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