| 1. |
- Gerdner, Arne, et al.
(författare)
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Abscondance and length of treatment in locked wards for compulsorily committed alcoholics in relation to treatment program and legal changes
- 1997
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Ingår i: Scandinavian Journal of Social Welfare. - 0907-2055. ; 6:4, s. 310-316
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Tidskriftsartikel (refereegranskat)abstract
- Describes a study of alcoholics compulsorily committed to a locked ward in a coercive treatment setting in Sweden. Finds that the introduction of an Alcoholics Anonymous - oriented programme in a coercive treatment setting reduced the time spent on a locked ward without increasing the number of times patients absconded. Increase in length of coercion increased both the time spent at the locked ward and the number of times absconded.
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| 2. |
- Gerdner, Arne, et al.
(författare)
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Mortality after 8 years in relation to short-term outcome of treated alcoholics
- 1997
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Ingår i: Alcohol & Alcoholism. - 0735-0414. ; 32:5, s. 573-579
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Tidskriftsartikel (refereegranskat)abstract
- This study concerns the relation between mortality and the short-term outcome of inpatient treatment for alcoholism. A total of 121 patients (87 men, 34 women) of whom 89 were voluntary and 32 compulsorily committed. They had a mean age of 41 ±7 (sd) years and attended a 5-week programme at Runnagården, Örebro, Sweden. Most patients were socially unstable and severely alcohol dependent. Ten months (mean) after discharge, 96% of the patients and their referring social workers were contacted with mail questionnaires. Of these patients, 13% had been totally abstinent and a further 42% were improved but had had relapses. After a mean of 8.5 ±0.27 (sd) years, 27 patients (24%) had died. All abstainers survived, but non-abstainers had a 9 times higher mortality than expected. Non-abstinent improved women tended to survive longer than non-improved women, but among non-abstinent improved men no such tendency was found. In conclusion, a reduction in the frequency and quantity of abusive drinking was not enough to reduce the higher risk of death. Only abstinence seemed to be preventive.
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| 3. |
- Gerdner, Arne, et al.
(författare)
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Mortality of treated alcoholics after eight years in relation to short-term outcome
- 1997
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Ingår i: Alcohol and Alcoholism. - 0735-0414 .- 1464-3502. ; 32:5, s. 573-579
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Tidskriftsartikel (refereegranskat)abstract
- This study concerns the relation between mortality and the short-term outcome of inpatient treatment for alcoholism. A total of 121 patients (87 men, 34 women) were included, of whom 89 were voluntary and 32 compulsorily committed. They had a mean age of 41±7 (SD) years and attended a 5-week programme at Runnagården, Örebro, Sweden. Most patients were socially unstable and severely alcohol-dependent. Ten months (mean) after discharge, 96% of the patients and their referring social workers were contacted with mail questionnaires. Of these patients, 13% had been totally abstinent and a further 42% improved but had had relapses. After a mean of 8.5±0.27 years, 27 patients (24%) had died. All abstainers survived, but non-abstainers had nine-fold higher mortality than expected. Non-abstinent improved women tended to survive longer than non-improved women, but among non-abstinent improved men no such tendency was found. In conclusion, a reduction in the frequency and quantity of abusive drinking was not enough to reduce the higher risk of death. Only abstinence seemed to be preventive.
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| 4. |
- Gerdner, Arne, et al.
(författare)
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Prediction of outcome in coerced and voluntarily treated alcoholics
- 1996
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Ingår i: Scandinavian Journal of Social Welfare. - : Wiley. - 0907-2055. ; 5:2, s. 106-112
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Tidskriftsartikel (refereegranskat)abstract
- The study concerns multivariate prediction of the short-term outcome of alcoholism in a coercive treatment setting in Sweden. One hundred and twenty-one patients (87 men, 34 women) with a mean age of 41 (range 26-63) years attended a 5-week programme. They were for the most part severely alcohol-dependent and socially unstable. Compulsorily committed patients (n=32) were less socially stable but did not differ from the voluntary patients (n=89) in the type of drugs abused or the severity of their dependence. Nine months (mean) after treatment, a follow-up was performed by mailing questionnaires to the patients and to the referring social workers. The improvement data in the questionnaires were checked with other data. Data on alcohol abuse were available for 116 (96%) of the patients. Fifty-five percent improved. Of these, 13% had remained entirely abstinent. Using multivariate logistic regression, participation in a self-help group and first-time admission were found to be significant factors for overall improvement, while having a family and more than primary education were significant for abstinence. Compulsory commitment to treatment was not related to the short-term drinking outcome. Undergoing voluntary treatment and having previous treatment experience were significant factors for participation in self-help groups.
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| 5. |
- Gerdner, Arne, et al.
(författare)
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Social workers and significant others as collaterals of non-responding alcoholics in follow-up studies using mail questionnaires and telephone inteviews
- 1998
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Ingår i: Scandinavian Journal of Social Welfare. - : Wiley. - 0907-2055. ; 7:1, s. 34-41
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Tidskriftsartikel (refereegranskat)abstract
- The subject of this study is non-response to mail questionnaires and supplementary telephone interviews in evaluation of outcome of treatment for alcohol dependence. The study is based on two clinical populations (n= 121 and 603) from Runnagården, Sweden, a coercive care setting with both voluntary and compulsorily committed patients. The populations differed regarding size, treatment and background factors. Replies were obtained from two- and one-third of the patients in the two populations respectively. Replies from social workers were obtained in 67% and 57% of the cases respectively, and from significant others in 59% of a smaller sub-sample of the second population. With respect to the combination of patient and collaterals, we received at least one questionnaire reply concerning 96% and 79% of the two populations respectively. In this study we analysed non-response and evaluated two methods to remedy this, i.e., prediction of the outcome in non-responders from additional telephone follow-up and questionnaires to collaterals. About two-thirds of patients who replied had improved, compared with about one-third of non-responders. Significant others replied more often if patients had improved, while social workers replied more often if patients had not improved. Patients who did not reply to mail questionnaires, but answered the same questions in a telephone interview, differed in drinking outcome from non-responders, but not from mail respondents. The method of using questionnaires addressed to social workers as an additional source of data can be used in countries with a general system of social welfare services and is better than the use of significant others as collaterals. In conclusion, replies obtained by additional telephone interviews were not representative for patients who did not return mail questionnaires. Non-response groups were highly selected in each of the three questionnaires (addressed to patients, significant others and social workers). Since the selectivity had opposite tendencies, the combination of questionnaires to patients and to social workers seems to be the most representative.
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| 6. |
- Gerdner, Arne, et al.
(författare)
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Social workers and significant others as collaterals of nonresponding alcoholics in follow-up studies using mail questionnaries and telephone interviews.
- 1998
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Ingår i: Scandinavian Journal of Social Welfare. - 0907-2055. ; 7, s. 34-41
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Tidskriftsartikel (refereegranskat)abstract
- The subject of this study is non-response to mail questionnaires and supplementary telephone interviews in evaluation of outcome of treatment for alcohol dependence. The study is based on two clinical populations (n= 121 and 603) from Runnagården, Sweden, a coercive care setting with both voluntary and compulsorily committed patients. In this study we analysed non-response and evaluated two methods to remedy this - i.e., prediction of the outcome in non-responders from additional telephone follow-up and questionnaires to collaterals. About two thirds of patients who replied had improved, but only about one third of non-responders had. Significant others replied more often if patients had improved, while social workers replied more often if patients had not improved. Patients who did not reply to mail questionnaires, but answered the same questions in a telephone interview, differed in drinking outcome from non-responders, but not from mail answerers. The method of using questionnaires addressed to social workers as an additional source of data can be used in countries with a general system of social welfare services and is better than the use of significant others as collaterals. In conclusion, replies obtained by additional telephone interviews were not representative for patients who did not return mail questionnaires. Non-response groups were highly selected in each of the three questionnaires (addressed to patients, significant others and social workers). Since the selectivity had opposite tendencies, the combination of questionnaires to patients and to social workers seems to be the most representative.
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| 7. |
- Gerdner, Arne, et al.
(författare)
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Tvångsvård vid missbruk – effekt och kvalitet
- 2011
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Ingår i: SOU 2011:6; Missbruket, Kunskapen, Vården - Missbruksutredningens Forskningsbilaga. - Stockholm : Socialdepartementet. - 9789138235256 ; , s. 653-770
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Gerdner, Arne, 1950-, et al.
(författare)
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Översikt om tvångsvård vid missbruk – effekt och kvalitet.
- 2009
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Tvångslagstiftning som möjliggör vård av vuxna personer med tungt missbruk är vanligt internationellt. I en studie av 24 europeiska länder hade 21 en sådan lagstiftning år 1999 och 19 år 2009. En begränsad litteratur finns internationellt och nationellt vad gäller randomiserat kontrollerade studier och kvasiexperimentella studier om effekt av socialt tvång. Dessutom finns ett antal förloppsstudier. Baserat på dessa studier är det möjligt att dra följande slutsatser. Tvångsvård där samtycke om frivillig vård ej finns ökar förutsättningarna för att vård skall komma till stånd och förbättrar fullföljandet av vården. Tvångsföreskrift kan också öka fullföljande av eftervård. Utfall av vård och eftervård som ges med tvångsföreskrift är lika bra eller bättre än utfall av motsvarande frivillig vård för motsvarande patientgrupper. Personernas problemnivå samt vårdens och eftervårdens innehåll och omfattning är avgörande för resultaten i tvångsvård, precis som i frivillig vård. Strukturerade behandlingsmetoder som i frivillig vård visat sig ge vara effektiva, kan användas även inom tvångsvården. Initiativ till utbildningar har tagits under senare år och det är viktigt att studera implementeringen av dem. Vårdens kvalitet är också av stor betydelse för att minska de negativa upplevelserna av tvånget som förekommer hos de flesta intagna. Denna upplevelse kan vara starkare och mer långvarig än hos dem som vårdas enligt psykiatrisk tvångslag. Flera stora projekt har de senaste åren inriktats på en förbättrad integrering av initial institutionsvård och strukturerad eftervård. Resultaten är lovande men ännu ej konklusiva. Studierna visar positiva behandlingsresultat. ESS-projektet är en randomiserad studie vilket ökar möjligheterna till slutsatser. Vårdkedjeprojektet och Ett kontrakt för livet är andra omfattande men ej randomiserade projekt med betoning på eftervården
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| 9. |
- Stenström, Nils, 1958-
(författare)
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Sprutbyte vid Intravenöst Narkotikamissbruk : En longitudinell studie av deltagarna i sprutbytesprogrammet i Malmö
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis is to describe the users visiting the syringe exchange clinic in Malmö with respect to what characterises the group, how they utilize the services of the clinic and how their patterns of participation relate to risk behaviour, physical and mental health and social development. The heterogeneity of the group has been captured by the use of Stimsons dimensions “integration in majority society” and “involvement in sub-culture”, yielding four different groups of syringe exchangers: “stables”, “loners”, “two-worlders” and “junkies”. The study rests on two sources of data: a register from the clinic including all syringe exchangers that have visited the clinic between 1989 and 2003, altogether 3660 individuals, and an interview of visitors at the clinic during 1995, including 496 persons.The results show that syringe exchangers, compared to other persons with severe addiction in Malmö, to a larger extent use amphetamine as their drug-of-choice, are older and inject more irregularly. The population visiting the clinic is heterogeneous with respect to integration in society and involvement in sub-cultures. The group classified as junkies do, as expected, display the highest inclination to share syringes and needles with other and hence have the most advanced risk behaviours. As to utilization of the programme, the results show that the longer the syringe exchangers stay in the programme, the more frequent they visit it. Also with respect to utilization-patterns, we find substantial variations within the studied group. Five categories are discernible: drop-in visitors with only one or two visits, sporadic visitors who in spite of contacts over a number of years never really establish a regular contact, intermittent visitors who have had contact over several years but display a very irregular visiting pattern, regular visitors who relatively fast establish a consistent contact with visits between uniform time intervals and frequent visitors who tend to stay longer than others and visit the clinic more often. Another aspect of utilization is to what extent the distribution of needles and syringes cover the needs of the visitors. With a strict definition of need, only a minority manages to cover their needs, but if we accept a more extensive individual re-use, around 90 percent of the average need is covered. Data also reveals that a very high proportion of the users on at least one occasion have visited the programme without syringe exchange taking place or any complementary service delivered. Basically these visits seem to be of a more social nature, reinforcing the contacts between the staff and the visitors.Data do not give any clear support for the basic assumption that syringe exchange reduce the incidence of HIV or hepatitis. Recent sharing of utensils or low coverage of syringe need through the programme do not predict a higher infection risk. Instead we find that the social contacts with the staff (without syringe exchange) function as a predictor of lower incidence. This indicates that the mechanisms may be more complex than just related to the provision of clean needles and syringes. The result shows that integration increase over time while sub-cultural involvement decreases. However, the patterns for different groups are very diverse and we find no evidence that more frequent contacts as such are related to increased integration. There is however, some evidence that social visits are positively related to increased integration. No support could be found for the assumption that the programme increases the number of severe addicts.
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