| 1. |
- Wickholm, Maritha, et al.
(författare)
-
Women's health after a first myocardial infarction : a comprehensive perspective on recovery over a 4-year period
- 2003
-
Ingår i: European Journal of Cardiovascular Nursing. - Amsterdam : Elsevier. - 1474-5151 .- 1873-1953. ; 2:1, s. 19-25
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Little attention has so far been focused on follow ups of women's long-term recovery after a myocardial infarction (MI), especially from a comprehensive perspective. AIM: The aim of this study was to prospectively determine women's self-rated health after a first MI from a comprehensive perspective on recovery over a 4-year period. METHODS: Consecutively chosen women (n=240) who had suffered a first MI were asked to complete a self-rated questionnaire regarding health (including not only biophysical, but also behavioral, emotional, social and working conditions) before being discharged from hospital as well as 1 and 4 years later. The results were analyzed by descriptive and inferential statistics. RESULTS: Health improvements, especially during the first year, could be observed in the women's behavioral condition regarding their attitude to diet consciousness, exercise, simultaneous capability and smoking behavior as well as in the emotional condition regarding their stressful life events, depressed mood and loss of control. In the social condition, the women considered that the healthcare professionals had improved their support over time as well as treating the women's complaints more seriously. Regarding the working condition, the women felt that they were being controlled at work, especially during the first year after the MI. CONCLUSIONS: Based on a comprehensive perspective on women's recovery after a first MI, a favorable development of the women's health was observed in the behavioral and emotional conditions while deterioration in the social and working conditions was observed over time. Thus, further efforts are needed in the two latter conditions by means of further studies in combination with greater support from healthcare professionals.
|
|
| 2. |
- Mårtensson, Jan, et al.
(författare)
-
Living with heart failure : Depression and quality of life in patients and spouses
- 2003
-
Ingår i: The Journal of Heart and Lung Transplantation. - Amsterdam : Elsevier. - 1053-2498 .- 1557-3117. ; 22:4, s. 460-467
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Although spouses are a key support for patients with heart failure, and help them remain in the community, no one has studied patient–spouse pairs to determine the nature of their experience. Therefore, we conducted a study of patients and spouses to compare their levels of depression and health-related quality of life (HRQOL), and to identify factors that contribute to depression and HRQOL in patient–spouse pairs. Methods: Forty-eight couples, in which all patients were men with heart failure, were recruited from a university-affiliated, outpatient heart failure clinic. Data were collected using the Beck Depression Inventory, the 12-item Short Form (that measures physical and mental components of QOL), and the 6-minute walk test. Results: Patients with heart failure were significantly more depressed and had poorer physical quality of life compared with spouses. Patients’ depression was correlated with their own functional status and mental quality of life, with the combination of 6-minute walk distance and mental QOL contributing 51% of the variance in patient depression. Spouse depression and HRQOL did not significantly influence patient depression. In contrast, spouses’ depression was related to their husbands’ functional status and employment, as well as their own mental QOL. The mental component of spouse QOL and the age of the patient accounted for 33% of the adjusted variance in spousal depression. Conclusions: Patients with heart failure and their spouses experience significantly different levels of depression and physical QOL. In developing interventions, it may be important to take these differences into account and focus on their unique needs as well as those issues that affect the couple together. Interventions that improve patient functional status may result in decreased depression and improved HRQOL on the part of both patients and spouses.
|
|
| 3. |
- von Bothmer, Margareta I. K., et al.
(författare)
-
Self-rated health among university students in relation to sense of coherence and other personality traits
- 2003
-
Ingår i: Scandinavian Journal of Caring Sciences. - Oxford : Blackwell Science. - 0283-9318 .- 1471-6712. ; 17:4, s. 347-357
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to determine students' self-rated health in relation to sense of coherence and other personality traits. A cross-sectional descriptive design was used with questionnaires as the means of data collection. The study population comprised a randomized stratified sample of students from a small university in southern Sweden. Ethical approval was obtained from the vice chancellor, and the issues of informed consent, confidentiality, privacy and self-determination were respected. Two instruments were used for data collection; the 29-item Sense of Coherence (SOC) scale, and an instrument created for this Study, named Personality and Health Instrument, containing 52 questions. Self-rated health was estimated by inverse number of health complaints. A factor analysis identified seven factors related to personality traits; the three most important were hardiness, positive affect/optimism and Type A personality. The personality trait variables were tested for correlation with each other as well as with self-rated health. The mean score for SOC was similar for female and male students, but a positive association between SOC and self-rated health was found only among women. Optimism was associated with less health complaints among female students. Type A personality was associated with poorer health both among women and men. The personality traits SOC, positive affect/optimism, hardiness and alienation showed high internal correlations. The SOC scale is discussed in relation to gender specificity and in relation to methodological and conceptual confounding. Further research is needed to explore the relation between SOC, optimism, hardiness, hostility and health. The significance of the study is that it raises questions about the validity and specificity of the SOC instrument and provides ideas for future research to develop the sense of coherence concept and instrument.
|
|
| 4. |
- Boström, Barbro
(författare)
-
Acute postoperative and cancer-related pain management, Patients´ experiences and perceptions in relation to health-related quality of life and the multidimensionality of pain
- 2003
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis describes patients in acute postoperative pain as well as patients with acute cancer-related pain in palliative care, and their experiences and perceptions of pain management in relation to HRQOL and the multidimensionality of pain. A combination of qualitative and quantitative methods was chosen. Data were collected using interviews and questionnaires; APS, SF:36 and a new developed questionnaire PC-PPQ measuring care related to pain management in palliative care. For assessing pain VAS and Pain-o-Meter were used. The study group consisted of 100 patients on their second postoperative day, and of 75 patients with cancer-related pain from two palliative care teams. The result showed that at the time of the interview 29 of the patients with postoperative pain reported a pain > 3 on VAS and 79 reported VAS > 3 as worst pain past 24 hours. The higher the intensity of pain the less satisfied the postoperative patients were with the nurses´ way of treating their pain. Thirty-three patients stated that they had received information regarding the importance of pain relief. Patients with postoperative pain as well as patients with cancer-related pain had been prescribed analgesics mostly a combination of Paracetamol, NSAID and opioid. Of the 75 patients with cancer-related pain and in palliative care 22 patients reported pain >3 on POM-VAS and 47 patients reported >3 on POM-VAS as worst pain past 24 hours. Twenty-eight patients reported an average pain > 3 on POM-VAS past 24 hours. Twenty-four patients used the words troublesome or tiring when describing their affective pain. Sensory pain was described as prickling or sore by 15 patients. The patients perceived their pain as “aching all over” and expressed a wish for pain relief as well as a fear for increased pain. HRQOL especially physical functioning decreased for patients with average pain > 3. Being cared for by a nurse-led or a physician-led palliative care team indicated no statistically significant differences for patients´ HRQOL or pain intensities. The patients had experienced a statistically significant better care after being referred to a palliative care team, despite that pain control had not been optimized. Patients expressed a need for communication, planning and trust in order to improve pain management. Continuity of care and the opportunity to talk increase the patients feeling of security, as well as improved their perceived pain control. Structured ongoing discussion concerning pain management from an early stage of the disease or already preoperatively can provide an important intervention to meet the results of this thesis. Pain assessment covering the multidimensionality of pain, and pain treatment plans including both pharmacological and non-pharmacological treatment are further important interventions.
|
|
| 5. |
- Boström, Barbro, et al.
(författare)
-
Pain and health-related quality of life among cancer patients in final stage of life : a comparison between two palliative care teams
- 2003
-
Ingår i: Journal of Nursing Management. - Chichester, West Sussex : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 11:3, s. 189-196
-
Tidskriftsartikel (refereegranskat)abstract
- A two-centred descriptive study was performed in order to describe and compare pain and health-related quality of life (HRQOL) among cancer patients, in their final stage of life. The patients were cared for by either a nurse-led palliative care team I (PCT I) or a physician-led palliative care team II (PCT II). Forty-six consecutive, stratified patients (PCT I, n = 21 and PCT II, n = 25) participated. The medical outcomes study short form 36 (SF-36) was used for evaluating HRQOL and the Pain-O-Meter for assessing pain. Patients' pain intensity, pain quality and HRQOL showed no significant difference between the two groups PCT I and PCT II. The patients from PCT I had significantly longer survival time (P = 0.017) than those from PCT II. The different composition of the teams being led by nurses or physicians is worth further research; both from the patient's and staff's viewpoint, there may also be cost-benefits worth examining.
|
|
| 6. |
- Bremander, Ann, et al.
(författare)
-
Validation of the Rheumatoid and Arthritis Outcome Score (RAOS) for the lower extremity
- 2003
-
Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 48:9 Suppl. S, s. 687-687
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with inflammatory joint diseases tend due to new treatments to be more physically active; something not taken into account by currently used outcome measures. The Rheumatoid and Arthritis Outcome Score (RAOS) is an adaptation of the Knee injury and Osteoarthritis Outcome Score (KOOS) and evaluates functional limitations of importance to physically active people with inflammatory joint diseases and problems from the lower extremities. The aim of the study was to test the RAOS for validity, reliability and responsiveness. METHODS: 119 in-patients with inflammatory joint disease (51% RA) admitted to multidisciplinary care, mean age 56 (+/-13), 73% women, mean disease duration 18 (+/-14) yr were consecutively enrolled. They all received the RAOS, the SF-36, the HAQ and four subscales of the AIMS2 twice during their stay for test of validity and responsiveness. Test-retest reliability of the RAOS questionnaire was calculated on 52 patients using the first or second administration and an additional mailed questionnaire. RESULTS: The RAOS met set criteria of reliability and validity. The random intraclass correlation coefficient (ICC 2,1) for the five subscales ranged from 0.76 to 0.92, indicating that individual comparisons were possible except for the subscale Sport and Recreation Function. Inter-item correlation measured by Cronbach's alpha ranged from 0.78 to 0.95. When measuring construct validity the highest correlations occurred between subscales intended to measure similar constructs. Change over time (24 (+/- 7) days) due to multidisciplinary care was significant for all subscales (p < 0.001). The effect sizes ranged from 0.30-0.44 and were considered small to medium. All the RAOS subscales were more responsive than the HAQ. Some of the SF-36 subscales and the AIMS2 subscales were more responsive than the RAOS subscales. CONCLUSION: It is possible to adapt already existing outcome measures to assess other groups with musculoskeletal difficulties in the lower extremity. The RAOS is a reliable, valid and responsive outcome instrument for assessment of multidisciplinary care. To fully validate the RAOS further studies are needed in other populations.
|
|
| 7. |
- Bäcklund, Johan, et al.
(författare)
-
Genetic control of tolerance to type II collagen and development of arthritis in an autologous collagen-induced arthritis model
- 2003
-
Ingår i: Journal of Immunology. - : The American Association of Immunologists. - 0022-1767 .- 1550-6606. ; 171:7, s. 3493-3499
-
Tidskriftsartikel (refereegranskat)abstract
- T cell recognition of the type II collagen (CII) 260-270 peptide is a bottleneck for the development of collagen-induced arthritis (CIA), an animal model of rheumatoid arthritis. We have earlier made C3H.Q mice expressing CII with glutamic acid instead of aspartic acid at position 266 (the MMC-C3H.Q mouse), similar to the rat and human CII epitope, which increases binding to MHC class II and leads to effective presentation of the peptide in vivo. These mice show T cell tolerance to CII, but also develop severe arthritis. The present investigation shows that non-MHC genes play a decisive role in determining tolerance and arthritis susceptibility. We bred MMC into B10.Q mice, which display similar susceptibility to CIA induced with rat CII as the C3H.Q mice. In contrast to MMC-C3H.Q mice, MMC-B10.Q mice were completely resistant to arthritis. Nontransgenic (B10.Q x C3H.Q)F(1) mice were more susceptible to CIA than either of the parental strains, but introduction of the MMC transgene leads to CIA resistance, showing that the protection is dominantly inherited from B10.Q. In an attempt to break the B10-mediated CIA protection in MMC-transgenic mice, we introduced a transgenic, CII-specific, TCR beta-chain specific for the CII(260-270) glycopeptide, in the highly CIA-susceptible (B10.Q x DBA/1)F(1) mice. The magnification of the autoreactive CII-specific T cell repertoire led to increased CIA susceptibility, but the disease was less severe than in mice lacking the MMC transgene. This finding is important for understanding CIA and perhaps also rheumatoid arthritis, as in both diseases MHC class II-restricted T cell recognition of the glycosylated CII peptide occurs.
|
|
| 8. |
- Kristén, Lars, 1956-, et al.
(författare)
-
Parents' conceptions of the influences of participation in a sports programme on their children and adolescents with physical disabilities
- 2003
-
Ingår i: European Physical Education Review. - London : Sage Publications. - 1356-336X .- 1741-2749. ; 9:1, s. 23-41
-
Tidskriftsartikel (refereegranskat)abstract
- Parents of children and adolescents with physical disabilities have an important role in strengthening and supporting their children in everyday life. Children and adolescents with physical disabilities do not ordinarily have natural access to club activities, nor do they receive the same support for physical activities as their peers without disabilities. The aim of this Swedish study was to describe parents' conceptions of the influences of participation in a sports programme on their children and adolescents with physical disabilities. The data were collected from 20 parents of children and adolescents with disabilities in the 9-15 year age group through interviews based on a holistic view. The method of analysis used was inspired by phenomenography. Three descriptive categories emerged: achieving good health, being part of a social group and learning a sporting activity. The findings show that the parents regarded sport as a form of health education and as a means for their children to achieve increased participation in society. The findings also show that the learning process was important for empowering the children to influence their life situation.
|
|
| 9. |
- Nandakumar, Kutty Selva, 1965-, et al.
(författare)
-
Collagen type II-specific monoclonal antibody-induced arthritis in mice - Description of the disease and the influence of age, sex, and genes
- 2003
-
Ingår i: American Journal of Pathology. - New York : Elsevier. - 1525-2191 .- 0002-9440. ; 163:5, s. 1827-1837
-
Tidskriftsartikel (refereegranskat)abstract
- Transfer of collagen type H (CH)-specific monoclonal antibodies induces an acute form of arthritis (collagen type H antibody-induced arthritis, CAIA) in nave mice. Arthritis was induced using a pair of monoclonal antibodies M2139 and CIIC1, binding to J1 and C1(I) epitopes of CH, respectively. Thereafter, lipopolysaccharide injection was used to increase the incidence and severity of the disease. This model was used to investigate the effect of genes, age, and sex as well as effector cells in the end-stage effector phase of arthritis pathogenesis. Injection of a single monoclonal antibody induced arthritis only after lipopolysaccharide stimulation. CAIA showed differences in disease penetration among the susceptible strains indicating the importance of non-major histocompatibility complex genes on the antibody effector pathway. B-cell-deficient mice were susceptible to CAIA and in some genetic backgrounds B-cell deficiency leads to enhanced arthritis. Histology of the affected paws revealed massive infiltrations of neutrophils along with bone and cartilage erosion, pannus formation, and fibrin deposition. Depletion of neutrophils significantly reduced the incidence and severity of the disease. CAIA susceptibility increased with age. Males were more susceptible than females and estrogen treatment decreased the development of arthritis. We conclude that CAIA is an acute arthritis triggered by antibody binding and neutrophils bypassing immune activation but with many characteristics in common with collagen-induced arthritis.
|
|
| 10. |
|
|
