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- Aziz, Adel, 1951, et al.
(författare)
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Differences in aspects of personality and sexuality between perimenopausal women making different choices regarding prophylactic oophorectomy at elective hysterectomy
- 2005
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Ingår i: Acta Obstet Gynecol Scand. ; 84:9, s. 854-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Retrospective studies have indicated differences in sexuality and general psychological well-being between women who have undergone hysterectomy only and those undergoing hysterectomy and oophorectomy. These differences may be the result of dissimilarities in the groups of women who choose the respective operation. OBJECTIVE: To compare the preoperative characteristics of women who choose to undergo prophylactic oophorectomy with the corresponding characteristics of those who choose to retain their ovaries when undergoing hysterectomy on benign indication. POPULATION: Perimenopausal women (aged 45-55), scheduled for hysterectomy on benign indication, were evaluated within 2 months before surgery. A total of 217 women chose hysterectomy only and 106 women chose hysterectomy with concomitant prophylactic oophorectomy. METHODS: Socioeconomic and health data, personality (Karolinska Scale of Personality), sexuality (McCoy's Female Sexuality Questionnaire), well-being (Psychological General Well-Being index), the prevalence of climacteric symptoms (modified Kupperman's index) and the women's attitude to hormone replacement therapy were investigated. RESULTS: Women who later underwent prophylactic oophorectomy in addition to hysterectomy had higher anxiety-related scores, lower sexual variable scores and poorer emotional partner relationships. This group was also characterized by more episodes of irregular bleeding, a greater prevalence of climacteric symptoms and a more extensive use of hormonal replacement therapy, in comparison with women who later underwent hysterectomy only. CONCLUSION: Personality, sexuality and the nature and severity of preoperative symptoms in women who chose prophylactic oophorectomy differ markedly from the same variables in those who chose to keep their ovaries at elective hysterectomy. These differences must be taken into consideration when evaluating studies comparing these aspects of quality of life after hysterectomy or hysterectomy with concomitant oophorectomy. Furthermore, psychosexual aspects such as sexuality and well-being can not be reliably studied with a retrospective design in these patient groups.
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- Larsson, Maria E H, 1969, et al.
(författare)
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Attitudes regarding responsibility for musculoskeletal disorders - Instrument development
- 2004
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Ingår i: Physiotherapy Theory and Practice. - 0959-3985. ; 20:3, s. 187-199
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Tidskriftsartikel (refereegranskat)abstract
- Impaired functional capacity and degenerative musculoskeletal disorders is one of the most prevalent causes for morbidity and suffering. With the consequent costs to individuals and society, it is important to consider possibilities for increased self-care. The question is to what extent people are prepared to take an active part in the prevention or treatment of musculoskeletal disorders? We believe that the attitudes people hold toward assuming responsibility will be an important factor. Thus, the purpose of this study was to develop an instrument - the Attitude Instrument Regarding Responsibility for Musculoskeletal Disorders (ARM) and establish validity and reliability for such a scale. Items were generated by interviews with a group of strategically chosen persons (n=10) reflecting different attributions of responsibility: to self, to employers, to health professionals, to fate. These items were then evaluated by a group of experts (n=8) to establish content validity. Construct validity was supported by the known groups technique (n=29) which compared the attitudes of physiotherapists and soccer players. A factor analysis (n=38) of the instrument supported the underlying theoretical rational. The final selection of 15 items suggested acceptable reliability using Cronbach’s alpha coefficient (n=36). Test-retest showed satisfactory stability of the scale (n=29). Correlations (n=38) to Multidimensional Health Locus of Control Scale (MHLC; Wallston, Wallston & DeVillis 1978) showed in general that ARM seemed to measure a different characteristic. The ARM instrument could therefore be used as an instrument measuring attitude regarding responsibility for musculoskeletal disorders.
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- Larsson, Maria E H, 1969, et al.
(författare)
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Is patient responsibility for managing musculoskeletal disorders related to self-reported better outcome of physiotherapy treatment?
- 2010
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Ingår i: Physiotherapy theory and practice. - : Informa UK Limited. - 1532-5040 .- 0959-3985. ; 26:5, s. 308-17
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Tidskriftsartikel (refereegranskat)abstract
- Musculoskeletal disorders are prevalent and a major burden on individuals and society. Information on relationships of patient involvement and responsibility to outcome is limited. This study aimed to explore relationships between self-reported outcome of physiotherapy treatment and attitudes toward responsibility for musculoskeletal disorders. A cross-sectional postal survey design was used. Patients (n=615) from an outpatient physiotherapy clinic, who had finished their physiotherapy treatment within the last 6 months were sent a questionnaire that included the Attitudes regarding Responsibility for Musculoskeletal disorders instrument (ARM), self-reported outcome of treatment and sociodemographic data. A total of 279 (45%) completed forms were returned. Multiple logistic regression analysis was used. The patients' scores on the four dimensions of ARM ("responsibility self active," "responsibility out of my hands," "responsibility employer," and "responsibility medical professionals"), controlled for age, sex, education, and physical activity as well as for number of treatments, main treatment, and physiotherapist, were associated with the patients' self-reported treatment outcome. Patients who attributed responsibility more to themselves were more likely (OR 2.37 and over) to report considerable improvement as the outcome of physiotherapy treatment. Because this study was conducted at only one physiotherapy outpatient clinic and had a cross-sectional design, the results should be replicated in other settings. Because patients' attitudes regarding responsibility for musculoskeletal disorders can possibly affect the outcome of physiotherapy treatment, it might be useful to decide whether to systematically try to influence the person's attitude toward responsibility for the management of the disorder or to match treatment to attitude.
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- Larsson, Maria E H, 1969, et al.
(författare)
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Patients' views on responsibility for the management of musculoskeletal disorders - A qualitative study.
- 2009
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Ingår i: BMC musculoskeletal disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Musculoskeletal disorders are very common and almost inevitable in an individual's lifetime. Enabling self-management and allowing the individual to take responsibility for care is stated as desired in the management of these disorders, but this may be asking more than people can generally manage. A willingness among people to take responsibility for musculoskeletal disorders and not place responsibility out of their hands or on employers but to be shared with medical professionals has been shown. The aim of the present study was to describe how people with musculoskeletal disorders think and reason regarding responsibility for prevention, treatment and management of the disorder. METHODS: Individual interviews with a strategic sample of 20 individuals with musculoskeletal disorders were performed. The interviews were tape-recorded, transcribed verbatim and analysed according to qualitative content analysis. RESULTS: From the interviews an overarching theme was identified: own responsibility needs to be met. The analysis revealed six interrelated categories: Taking on responsibility, Ambiguity about responsibility, Collaborating responsibility, Complying with recommendations, Disclaiming responsibility, and Responsibility irrelevant. These categories described different thoughts and reasoning regarding the responsibility for managing musculoskeletal disorders. Generally the responsibility for prevention of musculoskeletal disorders was described to lie primarily on society/authorities as they have knowledge of what to prevent and how to prevent it. When musculoskeletal disorders have occurred, health care should provide fast accessibility, diagnosis, prognosis and support for recovery. For long-term management, the individuals described themselves to be responsible for making the most out of life despite disorders. CONCLUSION: No matter what the expressions of responsibility for musculoskeletal disorders are, own responsibility needs to be met by society, health care, employers and family in an appropriate way, with as much or as little of the "right type" of support needed, based on the individual's expectations.
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- Larsson, Maria E. H., et al.
(författare)
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Responsibility for managing musculoskeletal disorders
- 2008
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Ingår i: BMC Musculoskeletal Disorders. - : BioMed Central Ltd.. - 1471-2474. ; 9:110
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Tidskriftsartikel (refereegranskat)abstract
- Background: Musculoskeletal disorders are a major burden on individuals, health systems and social care systems and rehabilitation efforts in these disorders are considerable. Self-care is often considered a cost effective treatment alternative owing to limited health care resources. But what are the expectations and attitudes in this question in the general population? The purpose of this study was to describe general attitudes to responsibility for the management of musculoskeletal disorders and to explore associations between attitudes and background variables. Methods: A cross-sectional, postal questionnaire survey was carried out with a random sample of a general adult Swedish population of 1770 persons. Sixty-one percent (n = 1082) responded to the questionnaire and was included for the description of general attitudes towards responsibility for the management of musculoskeletal disorders. For the further analyses of associations to background variables 683–693 individuals could be included. Attitudes were measured by the "Attitudes regarding Responsibility for Musculoskeletal disorders" (ARM) instrument, where responsibility is attributed on four dimensions; to myself, as being out of my hands, to employers or to (medical) professionals. Multiple logistic regression was used to explore associations between attitudes to musculoskeletal disorders and the background variables age, sex, education, physical activity, presence of musculoskeletal disorders, sick leave and whether the person had visited a care provider. Results: A majority of participants had internal views, i.e. showed an attitude of taking personal responsibility for musculoskeletal disorders, and did not place responsibility for the management out of their own hands or to employers. However, attributing shared responsibility between self and medical professionals was also found. The main associations found between attitude towards responsibility for musculoskeletal disorders and investigated background variables were that physical inactivity (OR 2.92–9.20), musculoskeletal disorder related sick leave (OR 2.31–3.07) and no education beyond the compulsory level (OR 3.12–4.76) increased the odds of attributing responsibility externally, i.e placing responsibility on someone or something else. Conclusion: Respondents in this study mainly saw themselves as responsible for managing musculoskeletal disorders. The associated background variables refined this finding and one conclusion is that, to optimise outcome when planning the prevention, treatment and management of these disorders, people's attitudes should be taken into account.
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| 10. |
- Larsson, Maria E H, 1969, et al.
(författare)
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Responsibility for managing musculoskeletal disorders--a cross-sectional postal survey of attitudes.
- 2008
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Ingår i: BMC musculoskeletal disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Musculoskeletal disorders are a major burden on individuals, health systems and social care systems and rehabilitation efforts in these disorders are considerable. Self-care is often considered a cost effective treatment alternative owing to limited health care resources. But what are the expectations and attitudes in this question in the general population? The purpose of this study was to describe general attitudes to responsibility for the management of musculoskeletal disorders and to explore associations between attitudes and background variables. METHODS: A cross-sectional, postal questionnaire survey was carried out with a random sample of a general adult Swedish population of 1770 persons. Sixty-one percent (n = 1082) responded to the questionnaire and was included for the description of general attitudes towards responsibility for the management of musculoskeletal disorders. For the further analyses of associations to background variables 683-693 individuals could be included. Attitudes were measured by the "Attitudes regarding Responsibility for Musculoskeletal disorders" (ARM) instrument, where responsibility is attributed on four dimensions; to myself, as being out of my hands, to employers or to (medical) professionals. Multiple logistic regression was used to explore associations between attitudes to musculoskeletal disorders and the background variables age, sex, education, physical activity, presence of musculoskeletal disorders, sick leave and whether the person had visited a care provider. RESULTS: A majority of participants had internal views, i.e. showed an attitude of taking personal responsibility for musculoskeletal disorders, and did not place responsibility for the management out of their own hands or to employers. However, attributing shared responsibility between self and medical professionals was also found. The main associations found between attitude towards responsibility for musculoskeletal disorders and investigated background variables were that physical inactivity (OR 2.92-9.20), musculoskeletal disorder related sick leave (OR 2.31-3.07) and no education beyond the compulsory level (OR 3.12-4.76) increased the odds of attributing responsibility externally, i.e placing responsibility on someone or something else. CONCLUSION: Respondents in this study mainly saw themselves as responsible for managing musculoskeletal disorders. The associated background variables refined this finding and one conclusion is that, to optimise outcome when planning the prevention, treatment and management of these disorders, people's attitudes should be taken into account.
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