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Sökning: LAR1:gu > Göteborgs universitet > Waern Margda 1955 > Engelska

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  • Ali, Lilas, 1981-, et al. (författare)
  • Person-centred psychosis care in the inpatient setting:Staff experiences of an educational intervention.
  • 2016
  • Ingår i: International Forum on Quality and Safety in Health Care. Gothenburg, Sweden 12-15 April 2016.
  • Konferensbidrag (övrigt vetenskapligt)abstract
    • Introduction: The key component in this research project is to test and implement a person-centred psychosis care approach that leads to an active partnership between health professionals and patients. Only by transforming the relationship between the patient and the care provider from the present state of dependency into an equal partnership can we achieve a more effective care model with enhanced financial efficacy and patient self-efficacy. Person-centred psychosis care means to shift away from a model in which the patient is the passive target of a medical intervention to a model where a contractual arrangement is made involving the patient as an active part in the care and the decision-making process. The patient illness narrative is the starting point for building a collaborative, equalitarian health professional-patient partnership that confirms capacities in patients. The patient narrative is the patient´s account of his/her illness, symptoms, and the impact on life. Finally the narrative and agreed partnership needs to be documented in order to secure further care. Methods: The person centered care intervention will be implemented at all four in-patient wards at the Psychosis clinic. An implementation group has been formed and representatives from the four wards are included in this group (section leaders, heads of the wards, and senior ward psychiatrists). The implementation group makes decisions regarding the organization and content of the staff education sessions. The research process has a participatory design which is structured by the foundation pillars in the gPCC model and composes of four workshops together with 33% of the staff in the psychosis care wards, at the department of psychosis, Sahlgrenska University Hospital. All workshops focus on person-centred care and how to implement this care approach at all four in-patient wards at the Psychosis clinic. Now that the educational intervention has been completed it is in our belief that the care offered on the ward is more person-centred. This project will explore this with a simple “before” and “after” design. The primary outcome will be patient empowerment as measured by the “Making Decisions Empowerment Scale”. This scale been validated and used internationally in studies involving persons with severe mental ill-health. Results: All the participants in this project have completed the second phase of the gPCC implementation model and they have agreed on person-centred tasks to implement in their units. Our hypothesis is that persons who receive inpatient treatment after the implementation of the intervention will score higher on ratings of empowerment and consumer satisfaction than those on the “pre-intervention” wards. Further, we hypothesize that shorter hospital stays and less use of involuntary treatments will be observed on the post-intervention wards. Discussion: A person-centered care approach can increase partnership between mental health service users and providers. A basic tenant of person-centered care is that the patient is seen as a capable person who has self-respect and self-esteem. A key element in person-centred care is the dialogue between the professional and the patient, a dialogue with the person, rather than talking to (or informing) a person. The staff education package in itself provides us with an excellent opportunity for transfer of research findings into the care setting. The members of the teaching staff are used as active researchers who will incorporate results from ongoing of the teacher’s results from our ongoing clinical projects on cognition, adherence, and stigma.
  • Allerby, Katarina, 1980-, et al. (författare)
  • Stigma and burden among relatives of persons with schizophrenia: Results from the Swedish COAST study
  • 2015
  • Ingår i: Psychiatric Services. - 1075-2730. ; 66:10, s. 1020-1026
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The aim was to apply a structured questionnaire, the Inventory of Stigmatizing Experiences (ISE), to study experiences of stigma (associated stigma) among relatives of persons with schizophrenia who attended outpatient clinics, using an approach based on assertive community treatment in a Swedish major city. A second aim was to explore the relationship between associated stigma and overall burden among these relatives. Methods: Relatives (N=65) of persons taking oral antipsychoticswho attended outpatient clinics completed a mailed questionnaire that included the ISE and the Burden Inventory for Relatives of Persons with Psychotic Disturbances. Associations were analyzed with ordinal logistic regression. Results: More than half of the relatives (53%) stated that their ill relative had been stigmatized, but only 18% (N=11) reported that they themselves had been stigmatized (responses of sometimes, often, or always). One-fifth of the relatives (23%) acknowledged that they avoided situations that might elicit stigma. Neither experienced stigma nor anticipated stigma was associated with overall burden level in ordinal logistic regression models. The impact of stigma on both the relative's personal quality of life and the family's quality of life were both significantly associated with overall burden after adjustment for patient age and level of functioning. Conclusions: Stigma had an impact on quality of life at the personal and family levels, and this was associated with overall burden. Increased awareness among service providers may decrease the impact of stigma on relatives, but associations need to be examined in larger studies in diverse cultures and treatment settings.
  • Andersson, Christina, 1955-, et al. (författare)
  • Drinking context and problematic alcohol consumption in young Swedish women Drinking context and problematic alcohol consumption
  • 2013
  • Ingår i: Addiction Research and Theory. - 1606-6359 .- 1476-7392. ; 21:6, s. 457-468
  • Tidskriftsartikel (refereegranskat)abstract
    • Previous research has indicated that a variety of contextual factors are involved in the development of drinking behavior. An integrated perspective can extend our understanding of the context and circumstances in which individuals drink. In this study, a person-oriented approach, cluster analysis, was used to identify drinking context clusters in a population of 20- and 25-year-old Swedish women. A further aim was to analyze how these clusters were associated with problematic alcohol consumption (high episodic drinking (HED) and alcohol use disorder (AUD)). A total of 760 respondents were interviewed, some in 1996 and some in 2001. Self-reported effects of drinking and situational factors associated with drinking alcohol were used in the cluster analysis procedure. Logistic regression models were used to analyze the associations with problematic alcohol consumption. The results revealed four distinct clusters of drinking patterns: coping drinkers, social drinkers, controlled drinkers, and moderate drinkers. Differences between clusters concerning problematic alcohol consumption were found. HED was significantly more common among the social drinkers and alcohol use disorder was more prevalent among the coping drinkers. Age differences and to a lesser extent secular trends in drinking pattern could be observed. The findings suggest that information on drinking context can help to explain differences in patterns of risky drinking and AUD. This highlights the importance of identifying groups of individuals with potentially harmful drinking patterns, which could be the target of specific preventive actions.
  • Beckman, Nils, et al. (författare)
  • Secular trends in self reported sexual activity and satisfaction in Swedish 70 year olds: cross sectional survey of four populations, 1971-2001.
  • 2008
  • Ingår i: BMJ (Clinical research ed.). - 1468-5833. ; 337
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To study secular trends in self reported sexual behaviour among 70 year olds. DESIGN: Cross sectional survey. Settings Four samples representative of the general population in Gothenburg, Sweden. PARTICIPANTS: 1506 adults (946 women, 560 men) examined in 1971-2, 1976-7, 1992-3, and 2000-1. MAIN OUTCOME MEASURES: Sexual intercourse, attitudes to sexuality in later life, sexual dysfunctions, and marital satisfaction. RESULTS: From 1971 to 2000 the proportion of 70 year olds reporting sexual intercourse increased among all groups: married men from 52% to 68% (P=0.002), married women from 38% to 56% (P=0.001), unmarried men from 30% to 54% (P=0.016), and unmarried women from 0.8% to 12% (P<0.001). Men and women from later birth cohorts reported higher satisfaction with sexuality, fewer sexual dysfunctions, and more positive attitudes to sexuality in later life than those from earlier birth cohorts. A larger proportion of men (57% v 40%, P<0.001) and women (52% v 35%, P<0.001) reported very happy relationships in 2000-1 compared with those in 1971-2. Sexual debut before age 20 increased in both sexes: in men from 52% to 77% (P<0.001) and in women from 19% to 64% (P<0.001). CONCLUSION: Self reported quantity and quality of sexual experiences among Swedish 70 year olds has improved over a 30 year period.
  • Billstedt, Eva, 1961-, et al. (författare)
  • Secular changes in personality: study on 75-year-olds examined in 1976-1977 and 2005-2006.
  • 2013
  • Ingår i: International Journal of Geriatric Psychiatry. - 0885-6230 .- 1099-1166. ; 28:3, s. 298-304
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: In order to study secular changes in personality factors neuroticism and extroversion, representative population samples of non-demented 75-year-olds underwent psychiatric examinations in 1976-1977 (total n = 223, 138 women, 85 men) and 2005-2006 (total n = 556, 322 women and 234 men). METHODS: Eysenck Personality Inventory was used at both occasions. Demographic factors (educational level, marital status, having children) were registered. RESULTS: Seventy-five-year-olds examined in 2005-2006 had higher values on extroversion and lower values on the Lie scale compared with those examined in 1976-1977. Neuroticism did not differ between the two birth cohorts. Neuroticism scores were higher in women than in men both in 1976-1977 and 2005-2006, and Lie score was higher in women than in men in 2005-2006. CONCLUSIONS: Our findings suggest that present cohorts of 75-year-olds are more extroverted and less prone to respond in a socially desirable manner than those born three decades earlier. Neuroticism levels remained unchanged, suggesting this trait may be less influenced by environmental factors than the other traits studied.
  • Bjerke, Maria, 1977-, et al. (författare)
  • Cerebrospinal Fluid Fatty Acid-Binding Protein 3 is Related to Dementia Development in a Population-Based Sample of Older Adult Women Followed for 8 Years.
  • 2016
  • Ingår i: Journal of Alzheimer's disease : JAD. - 1875-8908. ; 49:3, s. 733-741
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Increased fatty acid-binding protein 3 (FABP-3) levels have been reported in neurodegenerative diseases, including Alzheimer's disease (AD). Cerebrospinal fluid (CSF) FABP-3 has therefore been proposed as a putative marker for dementia. Population-based studies examining whether CSF FABP-3 predicts later development of dementia are lacking. OBJECTIVE: The aim of this study was to examine CSF levels of FABP-3 in relation to later development of dementia in elderly women and in relation to Aβ42, T-tau, P-tau181, and CSF: serum albumin ratio. METHODS: 86 non-demented women aged 70-84 years who participated in the Prospective Population Study of Women in Gothenburg, Sweden took part in a lumbar puncture in 1992-93. CSF-FABP-3, Aβ42, T-tau, P-tau181, and the CSF: serum albumin ratio were measured at baseline. Participants were examined with a neuropsychiatric exam at baseline and at follow-up in 2000. Dementia was diagnosed in accordance with DSM-III-R criteria. RESULTS: Between 1992 and 2000, 8 women developed dementia (4 AD, 3 vascular dementia, 1 mixed vascular dementia and AD). Higher levels of CSF-FABP-3 at baseline were related to development of dementia (OR 1.36 CI [1.05-1.76] p = 0.022) and the subtype AD (OR 1.38 CI [1.06-1.82), p = 0.019) during follow-up. FABP-3 correlated with CSF T-tau (r = 0.88, p <  0.001), P-tau181 (r = 0.619, p <  0.001), and CSF:serum albumin ratio (r = 0.233, p = 0.031), but not with Aβ42 (r = -0.08, p = 0.444)Conclusion: CSF FABP-3 may be an early marker for later development of dementia, probably related to neuronal degeneration, but independent of Aβ metabolism.
  • Bäckman, Kristoffer, 1979-, et al. (författare)
  • 37 years of body mass index and dementia: observations from the prospective population study of women in Gothenburg, Sweden.
  • 2012
  • Ingår i: Journal of Alzheimer's disease : JAD. - 1875-8908. ; 28:1, s. 163-71
  • Tidskriftsartikel (refereegranskat)abstract
    • Level of adiposity is linked to dementia in epidemiological studies. Overweight and obesity in mid- and late-life may increase risk for dementia, whereas decline in body weight or body mass index (BMI) and underweight in years preceding and at the time of a dementia diagnosis may also relate to dementia. Longitudinal studies with sufficient follow-up are necessary to estimate trajectories that allow better understanding of the relationship between adiposity indices and dementia over the life course. We evaluated the natural history of BMI in relationship to clinical dementia over 37 years in the Prospective Population Study of Women (PPSW) in Sweden. PPSW is a systematic sample of 1462 women born 1908, 1914, 1918, 1922, and 1930 and aged 38-60 years at baseline. Examinations occurred in 1968, 1974, 1980, 1992, 2000, and 2005. Statistical analyses were conducted using mixed effects regression models. Trajectories of BMI over 37 years as a function of age differed between women who did versus did not develop dementia. Women developing dementia evidenced a lesser increase in BMI from age 38 to 70 years. After age 70, the BMI slope decreased similarly (no "accelerated decline") irrespective of dementia status. A lower BMI before and during dementia onset was observed. Women with similar BMI at mid-life exhibited a different pattern of BMI change as they approached late-life that was related to dementia onset. BMI may be a potential marker of dementia-related neuropathologies in the brain. Dementia is related to a common risk factor, BMI, from mid-to late-life.
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