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Sökning: WFRF:(Middelboe T)

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1.
  • Hansson, L, et al. (författare)
  • Comparison of key worker and patient assessment of needs in schizophrenic patients living in the community : a Nordic multicentre study.
  • 2001
  • Ingår i: Acta Psychiatrica Scandinavica. - 0001-690X .- 1600-0447. ; 103:1, s. 45-51
  • Tidskriftsartikel (refereegranskat)abstract
    • It is concluded that key workers and patients disagree particularly concerning unmet needs and that this is potentially related to a number of factors associated with the key worker and patient. It is also concluded that further research is needed to increase the knowledge concerning the sources of this disagreement if need assessment is to become a valid basis for service planning and individual treatment planning.
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2.
  • Middelboe, T, et al. (författare)
  • The Nordic Study on schizophrenic patients living in the community. Subjective needs and perceived help.
  • 2001
  • Ingår i: European psychiatry. - 0924-9338 .- 1778-3585. ; 16:4, s. 207-14
  • Tidskriftsartikel (refereegranskat)abstract
    • In a community sample of 418 persons diagnosed with schizophrenia, subjective needs and perceived help was measured by the Camberwell Assessment of Need (CAN). The mean number of reported needs was 6.2 and the mean number of unmet needs 2.6. The prevalence of needs varied substantially between the need areas from 3.6% ('telephone') to 84.0% ('psychotic symptoms'). The rate of satisfaction estimated as the percentage of persons satisfied with the help provided within an area varied between 20.0% ('telephone') and 80.6% ('food'). The need areas concerning social and interpersonal functioning demonstrated the highest proportion of unmet to total needs. In a majority of need areas the patients received more help from services than from relatives, but in the areas of social relations the informal network provided substantial help. In general the patients reported a need for help from services clearly exceeding the actual amount of help received. In a linear regression model symptom load (BPRS) and impaired functioning (GAF) were significant predictors of the need status, explaining 30% of the variance in total needs and 20% of the variance in unmet needs. It is concluded that the mental health system fails to detect and alleviate needs in several areas of major importance to schizophrenic patients. Enhanced collaboration between the care system and the informal network to systematically map the need profile of the patients seems necessary to minimise the gap between perceived needs and received help.
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3.
  • Bengtsson-Tops, A, et al. (författare)
  • Subjective versus interviewer assessment of global quality of life among persons with schizophrenia living in the community: A Nordic multicentre study
  • 2005
  • Ingår i: Quality of Life Research. - : Springer Science and Business Media LLC. - 1573-2649 .- 0962-9343. ; 14:1, s. 221-229
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Few studies have investigated differences between subjective and externally assessed quality of life in individuals with a severe mental illness. In a sample of 387 patients with schizophrenia living in the community the present study investigated the association between subjective and interviewer-rated quality of life, clinical and sociodemographic factors related to the two assessments, and if discrepancies in the assessments were related to any clinical or social features of the patients. Method: The study was a Nordic multicentre study with a cross-sectional design. Instruments used were the Lancashire Quality of Life Profile, the Brief Psychiatric Rating Scale, the Interview Schedule for Social Interaction, Camberwell Assessment of Needs and General Assessment of Functioning. Results: The correlation between subjective and interviewer-rated quality of life was moderate (ICC=0.33). More severe affective symptoms, fewer emotional relations and a lower monthly income were related to poorer subjectively rated quality of life but in a stepwise multiple regression analysis accounted for only 14.1 of the variance. Poorer interviewer-rated quality of life was mainly related to a more severe psychopathology but also to a lower monthly income, fewer emotional relations and not being employed. Together these factors accounted for 45.5 of the variance. A greater discrepancy between the subjective and the interviewer rating was found in patients with less affective symptoms, unemployment, and a better social network. Conclusion: Only a moderate correlation between subjective and interviewer-assessed global quality of life was found, implying that the sources of assessment differed, as was also shown in subsequent regression models. It is concluded that both perspectives on the patient's quality of life may be valuable for treatment planning, especially in cases where differences in quality of life assessment related to the patient's psychopathology may be expected.
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4.
  • Hansson, Lars, et al. (författare)
  • Living situation, subjective quality of life and social network among individuals with schizophrenia living in community settings.
  • 2002
  • Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 106:5, s. 343-350
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To investigate the relationships between characteristics of the living situation in the community and subjective quality of life and social network among community-based individuals with schizophrenia. METHOD: A total of 418 individuals with schizophrenia from 10 sites were interviewed with regard to quality of life, psychopathology, social network and needs for care. Characteristics of the living situation investigated were: living alone or not, living with family or not, and having an independent or a sheltered housing situation. RESULTS: An independent housing situation was related to a better quality of life concerning living situation and living with the family to a better quality of life concerning family relations. An independent housing situation was associated with a better social network regarding availability and adequacy of emotional relations. CONCLUSION: People with schizophrenia with an independent housing situation have a better quality of life associated with more favorable perceptions of independence, influence, and privacy. Their social network is better irrespective of whether they live alone or not, or with family or not.
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5.
  • Hansson, L, et al. (författare)
  • Predictors of subjective quality of life in schizophrenic patients living in the community. A Nordic multicentre study.
  • 1999
  • Ingår i: International Journal of Social Psychiatry. - 0020-7640 .- 1741-2854. ; 45:4, s. 247-58
  • Tidskriftsartikel (refereegranskat)abstract
    • As part of a Nordic multi-centre study investigating the life and care situation of community samples of schizophrenic patients the aim of the present part of the study was to examine the relationship between global subjective quality of life and objective life conditions, clinical characteristics including psychopathology and number of needs for care, subjective factors such as satisfaction with different life domains, social network, and self-esteem. A sample of 418 persons with schizophrenia from 10 sites was used. The results of a final multiple regression analysis, explaining 52.3% of the variance, showed that five subjective factors were significantly associated with global subjective quality of life, together with one objective indicator, to have a close friend. No clinical characteristics were associated with global subjective quality of life. The largest part of the variance was explained by satisfaction with health, 36.3% of the variance, and self-esteem, 7.3% of the variance. It is concluded that the actual relationship between objective life conditions and subjectively experienced quality of life still remains unclear. Furthermore, it seems obvious that personality related factors such as self-esteem, mastery and sense of autonomy also play a role in the appraisal of subjective quality of life, which implies that factors like these are important to consider in clinical and social interventions for patients with schizophrenia in order to improve quality of life for these persons.
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6.
  • Hansson, L, et al. (författare)
  • The relationship of needs and quality of life in persons with schizophrenia living in the community. A Nordic multi-center study
  • 2003
  • Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 57:1, s. 5-11
  • Tidskriftsartikel (refereegranskat)abstract
    • The relationship between needs for care and support and subjective quality of life was investigated in a cross-sectional multi-center study including 418 individuals with schizophrenia from 10 centers in Nordic countries. Needs in 22 domains were investigated by interviews with key workers and their patients using the Camberwell Assessment of Need scale, and quality of life by the Lancashire Quality of Life Profile. The results showed that key workers rated slightly more needs than patients. To have more unmet needs, as rated by both key workers and patients, were correlated to a worse overall subjective quality of life, while met needs showed no such association. A regression analysis, controlling for clinical and social characteristics of the patients, showed more unmet needs to be associated with a worse quality of life, accounting for 6% out of a total of 41% explained variance in subjective quality of life. Regression analyses of the relationship of unmet needs in specific life domains and overall quality of life showed that unmet needs in five domains as perceived by patients accounted for 17% of the explained variance in overall quality of life. More than half of this variance was related to an unmet need in the domain of social relationships. It is concluded that unmet needs are of specific importance in needs assessment and that attention must be paid to separate met needs for care and services from unmet needs, since the latter seem more important to consider in order to improve outcome of interventions with regard to quality of life. Specific attention should in this context also be paid to unmet needs concerning social relationships and problems with accommodation.
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7.
  • Happel, E. M., et al. (författare)
  • Effects of allochthonous dissolved organic matter input on microbial composition and nitrogen-cycling genes at two contrasting estuarine sites
  • 2019
  • Ingår i: FEMS Microbiology Ecology. - : Oxford University Press. - 0168-6496 .- 1574-6941. ; 95:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Heterotrophic bacteria are important drivers of nitrogen (N) cycling and the processing of dissolved organic matter (DOM). Projected increases in precipitation will potentially cause increased loads of riverine DOM to the Baltic Sea and likely affect the composition and function of bacterioplankton communities. To investigate this, the effects of riverine DOM from two different catchment areas (agricultural and forest) on natural bacterioplankton assemblages from two contrasting sites in the Baltic Sea were examined. Two microcosm experiments were carried out, where the community composition (16S rRNA gene sequencing), the composition of a suite of N-cycling genes (metagenomics) and the abundance and transcription of ammonia monooxygenase (amoA) genes involved in nitrification (quantitative PCR) were investigated. The river water treatments evoked a significant response in bacterial growth, but the effects on overall community composition and the representation of N-cycling genes were limited. Instead, treatment effects were reflected in the prevalence of specific taxonomic families, specific N-related functions and in the transcription of amoA genes. The study suggests that bacterioplankton responses to changes in the DOM pool are constrained to part of the bacterial community, whereas most taxa remain relatively unaffected.
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8.
  • Sorgaard, KW, et al. (författare)
  • Schizophrenia and contact with health and social services: A Nordic multi-centre study
  • 2003
  • Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 57:4, s. 253-261
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In a Nordic multi-centre study investigating the life and care situation of persons with schizophrenia living in the community, factors explaining use of health and social services were examined. Method: Four hundred and eighteen individuals with schizophrenia from 10 sites were interviewed about their contact with different services (support functions within and outside the mental health services, general practitioners (GPs), physicians in the mental health, psychotherapy, day-care and inpatient treatment), psychopathology, social network and needs for care. Results: Physicians and support contacts within the mental health system were most used and GPs and psychotherapy least. Three groups of variables were stabile predictors of contact: rural-urban differences, diagnoses (hebephrenic schizophrenia associated with less contact with physicians in the mental services and more with GPs) and health needs as experienced by the patients. No differences between the centres with regard to total service use were found, but the patterns of contact reflected urban-rural variance. A low number of health needs predicted contact with physicians within the mental health services, whereas a high number of such needs was related to contact with GPs and support functions within the mental health services. Social relations exhibited the highest number of unmet needs. Conclusions: Contact with physicians working in the mental health services was much more common than contact with GPs. Based on a broad spectre of demographic, clinical and network variables, it was not possible to find models that explained substantial parts of the variance of service use. Patterns of contact were different in rural, town and city-surroundings, and with the exception of psychotherapy, the rural pattern was characterized by use of less specialized services. The importance of health needs and diagnosis as predictors of contact illustrate the profound and lasting effects on health of having a diagnosis of schizophrenia.
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9.
  • Sørgaard, KW, et al. (författare)
  • Self-esteem in persons with schizophrenia. A Nordic multicentre study
  • 2002
  • Ingår i: Journal of Mental Health. - : Informa UK Limited. - 1360-0567 .- 0963-8237. ; 11:4, s. 405-415
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Deinstitutionalisation has led to many people with serious mental illness spending most of their time outside psychiatric institutions. Not much is known about their subjective life. The paper presents the results of analysis of self-esteem in a group of non-institutionalised people with schizophrenia. Methods: Interviews were conducted with random samples of people with schizophrenia receiving out-patient services in ten psychiatric centres in the five Nordic countries. The following instruments were used: The Interview Schedule for Social Interaction (ISSI), Camberwell Assessment of Needs, Lancashire Quality of Life Profile and the Rosenberg self-esteem scale, GAF and BPRS. The Rosenberg scale provided the main data for this paper and three different measures of self-esteem were used (positive self-esteem, negative self-esteem and overall self-esteem). Results: A total of 418 people took part in the study. Total participation rate was 55%. Multiple regression analysis showed the three self-esteem measurements to be mainly related to mental health and other subjective variables, and to lesser extent to social network. Demography played a negligible role, only (female) sex being associated with positive and gross self-esteem. Anxiety/depression and affect balance were the strongest predictors of positive, negative and gross self-esteem, and having at least one close friend was associated with positive and gross self-esteem. Conclusion: variations in self-esteem were mainly explained by differences in anxiety/depression and affect balance, and to extent also with satisfaction with the relations to one's family. Having at least one friend was the strongest social network predictor and sex the only significant demographic variable.
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