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1.
  • Hansson, L, et al. (författare)
  • Utilization and patterns of care in comprehensive psychiatric care organizations. A review of studies and some methodological considerations.
  • 1992
  • Ingår i: Acta Psychiatrica Scandinavica. - 0001-690X. ; 86:4, s. 255-61
  • Tidskriftsartikel (refereegranskat)abstract
    • This article reviews and analyzes studies on the utilization of care and patterns of care in psychiatric care organizations with a defined catchment area responsibility. Eight studies fulfilled the inclusion criteria. The main results of the studies were reviewed with regard to distribution of utilization, typical patterns of care, sociodemographic characteristics, clinical characteristics and, when appropriate, organizational characteristics related to utilization. The results show that a small proportion of patients use a large proportion of resources. Sociodemographic factors such as living alone or having no occupation in some of the studies predicted a higher utilization. Only one study reported sex differences, men being more common among heavy users. In most of the studies a psychosis diagnosis predicted a higher utilization. A history of prior contacts with psychiatric care predicted a higher utilization in 2 studies. It is concluded that future studies should make efforts to develop standardized models of classification of patterns of care to enhance possibilities of comparisons. Cost, as a common unit for summarizing and comparing resource utilization, has not been used, but is viewed as a highly relevant measure. Furthermore, measures of utilization should be separated from evaluations of outcome or quality of care. However, the latter is a neglected area that should also be promoted in studies of utilization of psychiatric care to create knowledge of the relationship of utilization to outcome.
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  • Lynöe, Niels, et al. (författare)
  • Informed consent : study of quality of information given to participants in a clinical trial
  • 1991
  • Ingår i: BMJ. British Medical Journal. - 0959-535X. ; 303:6803, s. 610-613
  • Tidskriftsartikel (refereegranskat)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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  • Lynöe, N, et al. (författare)
  • The attitudes of patients and physicians towards placebo treatment--a comparative study.
  • 1993
  • Ingår i: Social Science and Medicine. - 0277-9536. ; 36:6, s. 767-74
  • Tidskriftsartikel (refereegranskat)abstract
    • Placebo treatment in clinical practice can be given either in order to comply with the wishes of the patient, or with the purpose of doing good and not causing harm. In the former instance, the procedure may be in accordance with the interests of the patient, yet be in conflict with the interests of the medical profession. In the latter instance, the procedure presupposes that in most cases the patient has not been informed of the nature of the treatment; this type of procedure may jeopardize a trusting patient-doctor relationship. Therefore, it is of interest to investigate both the extent to which patients and physicians feel they can accept placebo treatment and a paternalistic attitude, and in which particular situations. In order to shed some light on this matter, we compiled a questionnaire built around three case histories which problematize placebo treatment and paternalistic acts. The questionnaire was distributed to 100 patients and 100 physicians. 83 patients and 94 physicians responded. The results show that patients and physicians do not automatically follow specific group interests. Physicians are more inclined to respect the patient's option to refuse medical treatment than the patients are inclined to respect a physician's professional autonomy. Patients appear more to be paternalistic in their judgements than physicians, but one cannot rule out the possibility that the answers of the physicians reflect the fact that placebo treatment represent a socially undesirable behaviour. We conclude that theoretical and normative analyses of the perspective of the actors ought to be supplemented by empirical research.(ABSTRACT TRUNCATED AT 250 WORDS)
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  • Resultat 1-6 av 6
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tidskriftsartikel (6)
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refereegranskat (6)
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Lynöe, N (3)
Jacobsson, Lars, (2)
Lynöe, Niels (2)
Johansson, Eva (1)
Dahlquist, Gisela (1)
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Hansson, L (1)
Mattsson, B (1)
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Umeå universitet (6)
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Svenska (3)
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