| 1. |
- Ahlström, Gerd, et al.
(författare)
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Epidemiology of neuromuscular diseases, including the postpolio sequelae, in a Swedish county.
- 1993
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Ingår i: Neuroepidemiology. - 0251-5350 .- 1423-0208. ; 12:5, s. 262-269
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Tidskriftsartikel (refereegranskat)abstract
- The epidemiology of neuromuscular diseases was studied in the county of Orebro, Sweden (study population 270,000). Several different sources of data were utilized, compared and validated. On the prevalence of day (January 1, 1988) 474 patients were identified. The rate per 100,000 population was 92 for the postpolio sequelae (PPS) and 84 for the other neuromuscular diseases (motor neuron disease 9, hereditary neuropathies 9, myoneural disorders 16, myotonic disorders 19, muscular dystrophies 20 and myositis 11). Of the patients with the PPS, 80% reported late-onset symptoms. On the basis of an expanded survey including all medical records in one health care district, the prevalence of the PPS was estimated to be 186/100,000 population.
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| 2. |
- Ahlström, Gerd, et al.
(författare)
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Assessment of coping with muscular dystrophy : a methodological evaluation.
- 1994
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Ingår i: Journal of Advanced Nursing. - 0309-2402 .- 1365-2648. ; 20:2, s. 314-323
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Tidskriftsartikel (refereegranskat)abstract
- There is no published research on coping with muscular dystrophy among adults. In the present study, two questionnaires, the Reaction to the Diagnosis of Cancer Questionnaire (RDCQ) and the Mental Adjustment to Cancer scale (MAC), were modified in order to measure coping with muscular dystrophy (MD). A total of 60 people (16-64 years) with diagnosed MD answered the questionnaires in two interviews including semi-structured questions. The replies to these questions were analysed by two independent judges on the basis of the RDCQ and MAC categories for coping. The purpose was twofold: to investigate if cancer-coping categories could be used for the classification of interview answers concerning coping with MD, and to gain knowledge about specific coping with MD. Analysis indicated that 82% of replies to semi-structured questions concerned with emotion/appraisal-focused coping with MD can be described by means of RDCQ and MAC categories. Eight new categories were developed to classify the remaining 18%: Anticipation, Creation of new life values, Minimization, Establishment of control over everyday life, Secretiveness, Fear, Social comparison and Coping with heredity. In addition, 997 replies were classified to represent problem-focused coping. The judges reached good agreement with respect to the proportions of replies in the respective coping categories. However, kappa (kappa) values were within the range of fair to good agreement.
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| 3. |
- Ahlström, Gerd, et al.
(författare)
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Coping with illness-related problems and quality of life in adult individuals with muscular dystrophy.
- 1996
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Ingår i: Journal of Psychosomatic Research. - 0022-3999 .- 1879-1360. ; 41:4, s. 365-376
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Tidskriftsartikel (refereegranskat)abstract
- Illness-related problems and coping were examined in 60 individuals with muscular dystrophy (MD) identified in a population survey of the county of Orebro, Sweden. In addition, the extent to which coping is related to quality of life (QoL) was investigated as was the impact of impairment and disability on the relation between coping and QoL. Emotion/appraisal-focused coping was utilized by respondents more than twice as often as problem-focused coping. High QoL was significantly correlated to "Stoic acceptance" and "Tried alternative treatment." Low QoL was associated with "Helpless/hopeless," "Anxious preoccupation," "Minimization," "Social comparison," "Establishment of control over everyday life," "Performs the task with the aid of an appliance" and "Accepts help or leaves it to others." When measures of impairment and disability were included in the analysis, the impact of these measures explained the association between coping and physical QoL by 16% to 43%.
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| 4. |
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| 5. |
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| 6. |
- Ahlström, Gerd, et al.
(författare)
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Respiratory function, electrocardiography and quality of life in individuals with muscular dystrophy.
- 1994
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Ingår i: Chest. - 0012-3692 .- 1931-3543. ; 106:1, s. 173-179
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Tidskriftsartikel (refereegranskat)abstract
- All individuals in a Swedish county afflicted with any type of hereditary muscular dystrophy (MD) were identified and 57 (85 percent) of eligible individuals in the age range 16 to 64 were included in the study. Respiratory disturbances were estimated by means of spirometry and analysis of arterial blood gases, and 58 percent yielded abnormal results on at least one of these examinations. Elevated PCO2 was found more commonly than reduced forced vital capacity (FVC) and there was a moderate association between these parameters. Respiratory symptoms, most commonly breathlessness, were encountered in 79 percent. Pathologic ECG recordings were found in 21 individuals (37 percent). Conduction disturbances and affection of the myocard were most frequent in myotonic dystrophy. Quality of life was assessed by means of the Sickness Impact Profile instrument and the Kaasa test. The results showed that quality of life was significantly related to FVC and to the symptom of abnormal fatigue. Respiratory and cardiac parameters showed a greater number of significant correlations with measures of functional ability than with subjective well-being.
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| 7. |
- Arving, Cecilia, et al.
(författare)
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Individual psychosocial support for breast cancer patients : A randomized study of nurse vs. psychologist interventions and standard care
- 2007
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Ingår i: Cancer Nursing. - 0162-220X .- 1538-9804. ; 30:3, s. E10-E19
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Tidskriftsartikel (refereegranskat)abstract
- In a prospective, randomized study, an individual psychosocial support intervention performed by specially trained oncology nurses, or psychologists, were compared with standard care. Consecutive primary breast cancer patients about to start adjuvant therapy (n = 179) were included. Data were supplied by the questionnaires European Organisation for Research and Treatment of Cancer Quality of Life Study Group Core Quality of life questionnaire with 30 questions (EORTC QLQ-C30) and Breast Cancer Module with 23 questions (BR23), the Hospital Anxiety and Depression Scale, Spielberger's State-Trait Anxiety Inventory, and the Impact of Event Scale before randomization and 1, 3, and 6 months later. Patient files provided data on utilization of psychosocial support offered in routine care. Global quality of life/health status, nausea and vomiting, and systemic therapy side effects were the subscales showing significant Group by Time interactions, favoring the interventions. Intervention groups improved statistically significantly more than the standard care group regarding insomnia, dyspnea, and financial difficulties. Nurse patients experienced less intrusion compared with the standard care group. All groups showed statistically and clinically significant improvements with time on several subscales. The intervention groups, however, improved to a greater extent. Fewer patients in the intervention groups used psychosocial hospital support compared with the standard care group. In conclusion, psychosocial support by specially trained nurses using techniques derived from cognitive behavioral therapy is beneficial for breast cancer patients and may be a realistic alternative in routine cancer care.
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| 8. |
- Arving, Cecilia, et al.
(författare)
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Satisfaction, utilisation and perceived benefit of individual psychosocial support for breast cancer patients : A randomised study of nurse versus psychologist interventions
- 2006
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 62:2, s. 235-243
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Tidskriftsartikel (refereegranskat)abstract
- Objective: In a prospective, randomised study, individual psychosocial support performed by: (1) specially trained oncology nurses (INS) or (2) psychologists (IPS) were compared with respect to utilisation, satisfaction and perceived benefit. Methods: Between December 1997 and December 1999, consecutive breast cancer patients (n = 120) were included at start of adjuvant therapy (chemo-, endocrine and/or loco-regional radiotherapy). Data were collected by an extended version of the 'IPS-patient satisfaction questionnaire' within I week after termination of the support intervention. Questionnaires were also mailed to all patients 6, 12 and 18-24 months after inclusion. Levels of distress were collected with the Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale (IES) questionnaires. Results: The patients were highly satisfied with the individual psychosocial support intervention they received, irrespective of which profession provided the support. However, the patients in the INS group reported higher levels of benefit regarding disease-related problems, regardless if the patients at baseline reported low or high levels of distress. Conclusions: Patients were highly satisfied with an individual psychosocial support intervention. In areas dealing with somatic aspects, the group intervened by nurses were more satisfied than the one by psychologists. Practice implications: Individual psychosocial support by specially trained nurses is a realistic alternative in routine cancer care.
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| 9. |
- Berglund, Gunilla, et al.
(författare)
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"Between Men" : A psychosocial rehabilitation programme for men with prostate cancer
- 2007
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 46:1, s. 83-89
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the effect of psychosocial rehabilitation on newly diagnosed prostate cancer patients. The “Between Men” programme consisted of seven weekly sessions of physical training (Phys) alone, information (Info) alone or physical training plus information (PhysInfo). After diagnoses, patients (n =211) were consecutively included, stratified and randomised to one of four groups: Phys, Info, PhysInfo or standard care control (C). A nurse specialised in urology, an urologist and a physiotherapist performed the interventions. Patients were followed up during one year with mailed standardised questionnaires. It could not be assumed that the “Between Men” programme had any effect on patients’ anxiety and depression (HADS). Health-related quality of life (HRQOL) was associated with stage of disease but not with psychosocial intervention. Thus, Physical Function (PF), Role Function (RF) and Fatigue (FA) were inferior among patients with, than without, metastases of prostate cancer both at baseline and at the 12-month follow-up. This randomized study did not demonstrate any significant effect of psychosocial rehabilitation among prostate cancer patients. Considering the low rate (1/2), of included/eligible patients a less complicated design (intervention versus control) would have been preferred in order to increase power.
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| 10. |
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| 11. |
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| 12. |
- Frisk, Margot, et al.
(författare)
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Occupational therapy adaptation of the home environment in Sweden for people with asthma
- 2002
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Ingår i: Occupational Therapy International. - : Wiley. - 0966-7903 .- 1557-0703. ; 9:4, s. 294-311
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to evaluate changes of lung function, respiratory symptoms and indoor air quality after reducing allergens and indoor pollutants in the home environment of people with asthma (n = 21). A quasi-experimental pre-/post-test design with one group of participants was implemented. The interventions included removal of wall-to-wall carpets (n = 14) or improvement of indoor air exchange (n = 7). Participants' lung function, symptoms, medication and type-1 allergy were recorded before and after the intervention. The indoor environment was monitored at house calls by an occupational therapist using conventional physical, biological and chemical methods. There was an improvement of lung function evidenced by an increased mean Forced Expiratory Volume (FEV(1) %) and a reduction of airway obstruction (reversibility, % of baseline value), which indicate an improved asthmatic condition. Lung function assessed by vital capacity, bronchial hyper-responsiveness, mean of Peak Expiratory Flow, symptom score and medicine consumption did not change significantly. There was a tendency that the amount of airborne dust (p=0.06) was reduced in the indoor environment. Relative humidity, carbon dioxide, formaldehyde and house dust mite levels had decreased after the intervention, but not significantly. Asthma symptoms related to the home environment are probably caused by several factors. When people with asthma suffer from increased symptoms in the home, house calls should be performed routinely. Dust samples from beds and carpets for analysis of allergens give information about exposure, and environmental assessments should be performed before interventions. Occupational therapists can make a valuable contribution in evaluating the home environment and suggesting ergonomic adaptations for individuals with asthma.
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| 13. |
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| 14. |
- Gunningberg, Lena, 1954-, et al.
(författare)
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Implementation of risk assessment and classification of pressure ulcers as quality indicators for patients with hip fractures
- 1999
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 8:4, s. 396-406
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the study were (i) to investigate the prevalence of pressure ulcers in patients with hip fracture, on arrival at a Swedish hospital, at discharge, and two weeks post-surgery; (ii) to test whether clinical use of the Modified Norton Scale (MNS) could identify patients at risk for development of pressure ulcers; and (iii) to compare the reported prevalence of pressure ulcer in the experimental group, where risk assessment and classification of pressure ulcers was performed on a daily basis, with that of the control group, where it was not. The study design was prospective, with an experimental and a control group. The intervention in the experimental group consisted of risk assessment, risk alarm and skin observation performed by the nurse on duty, in the A & E Department, and daily throughout the hospital stay. To facilitate the nurse's assessment, a 'Pressure Ulcer Card' was developed, consisting of the MNS and descriptions of the four stages of pressure ulcers. On arrival at the hospital, approximately 20% of patients in both groups had pressure ulcers. At discharge, the rate had increased to 40% (experimental) and 36% (control). Clinical use of the MNS made it possible to identify the majority of patients at risk for development of pressure ulcers. Patients who were confused on arrival developed significantly more pressure ulcers than patients who were orientated to time and place. No significant difference was found in the reported prevalence of pressure ulcers between the experimental and control groups.
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| 15. |
- Gunningberg, Lena, 1954-, et al.
(författare)
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Reduced incidence of pressure ulcers in patients with hip fractures : a 2-year follow-up of quality indicators
- 2001
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Ingår i: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1353-4505 .- 1464-3677. ; 13:5, s. 399-407
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Tidskriftsartikel (refereegranskat)abstract
- In the framework of a quality improvement project, where research activities were integrated with practice-based developmental work, the incidence of pressure ulcers was reduced significantly in patients with hip fractures. The best predictor of pressure ulcer development was increased age.
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| 16. |
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| 17. |
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| 18. |
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| 19. |
- Halvarsson, Klara, et al.
(författare)
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A longitudinal study of the development of dieting among 7–17-year-old Swedish girls
- 2002
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Ingår i: International Journal of Eating Disorders. - : Wiley. - 0276-3478 .- 1098-108X. ; 31:1, s. 32-42
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:To examine the extent to which the prevalence of self-reported dieting and the wish to be thinner changed in 7-15-year-old girls over a 3-year period, and to explore potential differences between cohorts recruited in 1995 and 1999. In addition, changes in eating attitudes (Children's Eating Attitudes Test [ChEAT]) were compared between 1995 and 1999.METHOD:A three-wave longitudinal study including girls (n = 1,076-1,279) in five age groups (7, 9, 11, 13, 15, the Main Cohort) and an age-matched cross-sectional sample consisting of 1,759 girls (the Societal Cohort).RESULTS:A marked increase of the wish to be thinner was evident in the 10-14-year-old age range and significant increases in dieting attempts occurred mainly among 9-13-year-old girls. ChEAT scores were significantly higher among 11-year-olds in 1999 than in 1995. However, more 7-year-olds scored above the ChEAT cutoff (DISCUSSION:There was an increasing trend in the wish to be thinner and in dieting attempts among 9-14-year-olds. Attitudes and behaviors associated with disturbed eating had increased between 1995 and 1999 only among the 11-year- olds.
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| 20. |
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| 21. |
- Johansson, Birgitta, et al.
(författare)
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Hemsjukvård för äldre cancerpatienter : Utökad uppföljning och stöd i hemmet minskar behov av specialistsjukvård
- 2003
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 100:17, s. 1524-1531
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The effects of intensified primary health care were examined in the »Support-Care-Rehabilitation« project conducted in Uppsala county 1993-1997. Intensified primary health care was one part of an individual support intervention and comprised extended information about patients from the specialist clinics, and education and supervision in cancer care for GPs and home care nurses. The aim was to improve the ability of general practitioners and home care nurses to monitor and support cancer patients. A total of 485 newly diagnosed cancer patients were randomized to intensified primary health care or to a control group (standard care). The intervention group showed a marked increase in follow-up contacts. About 90% of intensified primary health care patients reported such contacts, compared to 26% of control patients. The number of days of hospitalization at the specialist clinics for elderly patients (Ž70 yr.) randomized to the intervention group were 393 less than for elderly controls three months after diagnosis. The conclusion is that intensified primary health care constitutes a cost-effective strategy for enhancing co-operation between home care, primary health care and specialist clinics.
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| 22. |
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| 23. |
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| 24. |
- Johansson, Birgitta, et al.
(författare)
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Intensified primary cancer care : A randomised study on home care nurse contacts
- 1999
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 30:5, s. 1137-1146
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Tidskriftsartikel (refereegranskat)abstract
- Newly diagnosed cancer patients (n=527) were randomised to intensified primary care or a control group. Intensified primary care comprised routines to improve general practitioners' and home care nurses' possibilities to support and monitor patients, i.e. increased information from specialist care, education and supervision in cancer care. The aims of this paper are to evaluate the effects of intensified primary care on cancer patients' home care nurse contacts, and to study if patients' use of home care services 6 months after diagnosis can be predicted. The intervention resulted in a marked increase of follow-up contacts. About 90% of intensified primary care patients reported such contacts, compared to 26% of control patients. The results indicate that standard care does not routinely include follow-up contacts, not even for the oldest (80+ years) or those with advanced disease. Only 27% and 36% of these groups of control patients reported follow-ups. Logistic regression analysis identified intensified primary care as the strongest predictor for reporting a continuing contact 6 months after diagnosis. Intensified primary care patients were 14 times more likely than controls to report a such contact. The strongest predictor of a continuing contact in the intensified primary care group was high age. Patients with advanced disease were more likely than patients with non-advanced disease to report a continuing contact, and living in a rural district was positively associated with reporting a contact. A majority of the patients (70%) assessed the time for the first contact as the 'right time' and estimated that the nurse gave expected support to a very large or large extent (67%). The results suggest that routines like those implemented through intensified primary care may be an effective strategy to increase the accessibility and continuity of care, especially for elderly people and for patients with a need for long-term contacts.
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| 25. |
- Johansson, Birgitta, et al.
(författare)
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Reduced utilisation of specialist care among elderly cancer patients : a randomised study of a primary healthcare intervention
- 2001
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Ingår i: European Journal of Cancer. - 0959-8049 .- 1879-0852. ; 37:17, s. 2161-2168
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the effect of an individual support (IS) intervention including intensified primary healthcare on the utilisation of specialist care among cancer patients, and to investigate if such an effect was modified by the patient's age (less than 70 years or 70 years and more). Newly diagnosed cancer patients (n=416) were randomised between the intervention and a control condition, and data were collected on the utilisation of specialist care within 3 months from inclusion. Intensified primary healthcare comprised extended information from the specialist clinics, and education and supervision in cancer care for general practitioners (GPs) and home-care nurses. The support given also included interventions designed to diminish problems of weight loss and psychological distress. The intervention reduced the number of admissions (NoA) and the days of hospitalisation (DoH) after adjustment for weight loss and psychological distress, but only for older patients. Older patients randomised to the intervention (n=82) experienced 393 fewer DoH than the older control patients (n=79). In addition, the proportion of older patients in the IS group who utilised acute specialist care was smaller compared with older control patients group. The conclusion is that older cancer patients' utilisation of specialist care may be reduced by intensified primary healthcare services.
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| 26. |
- Johansson, Birgitta, et al.
(författare)
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The role on the general practitioner in cancer care and the effect of an extended information routine
- 2000
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 18:3, s. 143-148
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe the role of the General Practitioner (GP) in the care of one specified cancer patient per GP, and to explore the GP's knowledge about that patient's disease and treatments, and what information she/he wanted versus received from the specialist clinic. A further aim was to evaluate the effects of an Extended Information Routine (EIR), including increased information from the specialist clinic to the GP.DESIGN:Semi-structured interviews with GPs about a patient randomised between an extended information routine and standard information from the specialist clinics.SETTINGS:Primary Health Care.SUBJECTS:20 GPs, 10 who received extended information about the specified patient and 10 who did not.MAIN OUTCOME MEASURES:The extent of GPs' contact with the patient, GPs' potential or actual possibilities to support the patient, desired and received information from the specialist clinic.RESULTS AND CONCLUSIONS: GPs are commonly involved in the care of cancer patients, particularly in the diagnostics of the disease but also during the periods of treatment and follow-up. The information from the specialist clinic to the GP is insufficient in standard care. The extended information routine increased the GPs' knowledge of the disease and treatments, and facilitated their possibilities to determine patients' need for support.
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| 27. |
- Johansson, Birgitta, et al.
(författare)
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Uppsalastudie av 20 husläkares roll i vården av cancerpatienter : Lättare att bedöma behovet av stöd om utförlig specialistinformation ges
- 2002
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 99:8, s. 771-773
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this study is to describe the role of the GP in the care of one specified cancer patient per GP and to explore the GP’s knowledge about that patient’s disease and treatments. A further aim was to evaluate the effects of an extended information routine, including increased information from the specialist clinic to the GP. Twenty GPs were selected for a semi-structured interview about a patient randomised either to an extended GP information routine or to standard information. The results suggest that GPs are commonly involved in the care of cancer patients, particularly in the diagnosis of the disease but also during the period of treatments and follow-up. The information from the specialist clinic to the GP is insufficient in standard care. The extended information routine increased the GPs’ knowledge about the disease and treatments and facilitated their possibilities to determine patients’ need for support. However, this did not affect the extent of contacts with the patient.
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| 28. |
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| 29. |
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| 30. |
- Lampic, Claudia, et al.
(författare)
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Anxiety and depression in hospitalized patients with cancer : agreement in patient-staff dyads
- 1996
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Ingår i: Cancer Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0162-220X .- 1538-9804. ; 19:6, s. 419-428
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Tidskriftsartikel (refereegranskat)abstract
- Patient and staff perceptions of patient anxiety and depression were determined in 53 dyads of hospitalized cancer patients and their nursing staff Patient anxiety and depression were assessed with the Hospital Anxiety and Depression Scale. In addition, anxiety was measured by a numerical (0-10) scale. A staff person who had been caring for a certain patient the previous 3 days assessed that patient's anxiety and depression with staff versions of the same instruments. For one subsample (n = 18), staff were also asked to estimate their own hypothetical anxiety were they to have the same disease as the patient. Results indicate that staff overestimated patient anxiety systematically and showed limited ability to adequately assess patient anxiety and depression in terms of rank. Patients and staff agreed about individual patients' levels of anxiety and depression only to a limited degree. Discrepancies between patient and staff ratings of patient anxiety predominantly concerned patients reporting low anxiety levels. Several explanations for these findings ave discussed. One possible explanation, the ''requirement of mourning'' hypothesis, is supported by our findings that staff estimation of patient anxiety was strongly associated with their estimation of their own hypothetical anxiety if they were to be in the patient's situation.
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| 31. |
- Lampic, Claudia, et al.
(författare)
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Attainment and importance of life values among patients with primary breast cancer
- 2003
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Ingår i: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 26, s. 295-
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Tidskriftsartikel (refereegranskat)abstract
- The main aims of this study were to investigate the extent to which women with recently diagnosed primary breast cancer (N = 29) and matched control subjects without cancer (N = 29) differ in perceived attainment and importance of life values and to study prospectively life value ratings during 1 year in a large group of recent attendees at mammography screening (N = 706). Life values were assessed by a study-specific version of a life value questionnaire, including ratings of the perceived attainment and importance of seven life value dimensions. Women with a recent diagnosis of primary breast cancer were found to attribute significantly more importance to positive relations than healthy controls. No other differences between these groups were found regarding the attainment or importance of life values. Perceptions of life values were found to vary as a function of age, marital or cohabitation status, and parenthood, and to be stable over a 9-month period in screening attendees. The implications of the current findings for the understanding of women's psychological adaptation to breast cancer are discussed.
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| 32. |
- Lampic, Claudia, et al.
(författare)
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Coping, psychosocial well-being and anxiety in cancer patients at follow-up visits
- 1994
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 33:8, s. 887-894
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Tidskriftsartikel (refereegranskat)abstract
- Coping, psychosocial well-being, situation-specific anxiety and cancer-related worry were assessed in 197 consecutive cancer patients attending follow-up visits. Participants completed questionnaire on three occasions: at the follow-up visit, some days later (n = 175) and three weeks later (n = 125). High levels of coping styles 'Anxious Preoccupation' and 'Helplessness/Hopelessness' were associated with low levels of psychosocial well-being, more situation-specific anxiety and more cancer-related worry. High levels of 'Fighting Spirit' and 'Fatalistic' were found to be associated with high psychosocial well-being and, for 'Fighting Spirit', also with less cancer-related worry. Patients with a 'dismal' prognosis were found to have higher levels of 'Helplessness/Hopelessness' than patients with a more 'favorable' prognosis. Clinical implications of these findings are discussed.
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| 33. |
- Lampic, Claudia, et al.
(författare)
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Life values before versus after a breast cancer diagnosis
- 2002
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Ingår i: Research in Nursing & Health. - : John Wiley & Sons. - 0160-6891 .- 1098-240X. ; 25, s. 89-
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Tidskriftsartikel (refereegranskat)abstract
- The main aim of this study was to investigate whether women's life values change with a breast cancer diagnosis. In addition, associations between life values and anxiety/depression ratings were investigated. Life value changes were prospectively studied in 517 women recalled for further examination after attending mammographic screening, 38 of whom were diagnosed with primary breast cancer. Life values were assessed by a study-specific version of a life value questionnaire, including ratings of the perceived attainment and importance of seven life value dimensions. Three months after being recalled, women diagnosed with primary breast cancer reported a reduction of the attainment and the importance of Health. In addition, these women reported changes in the perceived importance of Responsibility and Involvement. High levels of anxiety and depression in particular were associated with large discrepancies between attainment and importance for some life values. This suggests that changes in the perceived importance of some life values may constitute one part of women's psychological adaptation to a breast cancer diagnosis.
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| 34. |
- Lampic, Claudia, et al.
(författare)
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Patient and staff perceptions of cancer patients' psychological concerns and needs
- 2000
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 39:1, s. 9-22
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Tidskriftsartikel (refereegranskat)abstract
- This paper reviews patient and staff perceptions of cancer patients' psychological concerns and needs. An extensive literature search resulted in a total of 22 studies. Six of these concern staff ratings of hypothetical 'average' patients, and the main findings are that staff and patients are in relative agreement about the overall spectrum of concerns relevant to cancer patients, but less so regarding which concerns are of most importance to patients. Sixteen studies compare patient ratings with staff ratings of individual patients. The overall pattern of results indicates that staff tend to overestimate patient anxiety and emotional distress and show limited ability adequately to assess patient distress in terms of rank. Staff were able correctly to detect a majority of anxiety 'cases', while the identification of depression was less accurate. High detection rates for anxiety were obtained partly at the expense of staff also presuming anxiety in many non-distressed patients. Generally, there was better patient-staff agreement on the absence than the presence of patient anxiety and depression. Many studies were found to have serious methodological deficiencies and there is no clear evidence that patient-staff agreement is markedly better in studies fulfilling important methodological criteria. Several explanations of patient-staff discrepancies are discussed. Future research should be aimed at critically testing possible reasons for patient-staff disagreement and at investigating the consequences of such discrepancies.
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| 35. |
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| 36. |
- Larsson, Gunnel, et al.
(författare)
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Are importance-satisfaction discrepancies with regard to ratings of specific health-related quality-of-life aspects valid indicators of disease- and treatment-related distress among patients with endocrine gastrointestinal tumours?
- 2007
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Ingår i: European Journal of Cancer Care. - : Hindawi Limited. - 0961-5423 .- 1365-2354. ; 16:6, s. 493-499
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this study were to investigate: (1) whether ratings of importance of, satisfaction with, and symptom/function of specific health-related quality-of-life (HRQoL) aspects are related, and (2) whether an importance–satisfaction discrepancy with regard to ratings of a specific HRQoL aspect is a valid indicator of distress. Eighty-three patients with endocrine gastrointestinal tumours completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and answered questions about importance of, satisfaction with, and symptom/function of 12 HRQoL aspects. The patients reported a relatively high HRQoL in terms of physical, emotional and social function. Most of the HRQoL aspects were considered as important for a good quality of life. High satisfaction was related to fewer symptoms and a better function. Patients who assigned a higher importance than satisfaction rating to an aspect reported a lower quality of life for the same aspect. The findings suggest that importance–satisfaction discrepancies are valid indicators of patient distress and illustrate the importance of asking patients not only about frequency and level of symptoms, but also about importance of and satisfaction with when assessing patient quality of life.
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| 37. |
- Larsson, Gunnel, et al.
(författare)
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Cancer patient and staff ratings of the importance of caring behaviours and their relations to patient anxiety and depression
- 1998
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Ingår i: Journal of Advanced Nursing. - : Blackwell Publishing. - 0309-2402 .- 1365-2648. ; 27:4, s. 855-864
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Tidskriftsartikel (refereegranskat)abstract
- Patient and staff ratings of the importance of caring behaviours (Caring Assessment Instrument, CARE-Q) were studied and related to ratings of patient levels of anxiety and depression (Hospital Anxiety and Depression Scale) in 53 cancer patient-staff dyads. Both groups perceived anticipatory and comforting behaviours to be among the three most important. Patients considered staff explanation and facilitation as well as anticipation to be more important than did staff. Staff rated accessibility and comforting as more important than did patients. Patient and staff ratings of the importance of staff accessibility were negatively correlated. Thus, patient and staff 'did not agree strongly on the importance of several types of caring behaviours. Neither patient nor staff ratings of the importance of caring behaviours were associated with their ratings of the levels of anxiety or depression of specific patients. The results suggest that patient-staff communication requires specific knowledge and skills to make staff accurately judge what is important in making patients feel cared for.
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| 38. |
- Larsson, Gunnel, et al.
(författare)
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Health-Related Quality of Life, Anxiety and Depression in Patients with Midgut Carcinoid Tumours
- 2001
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Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 40:7, s. 825-831
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Tidskriftsartikel (refereegranskat)abstract
- In earlier studies it has been reported that patients with carcinoid tumours have a relatively good health-related quality of life (HRQoL) and low levels of anxiety and depression. The aims of this study were (a) to investigate the extent to which psychosocial function changes in patients with carcinoid tumours with time from diagnosis and its possible relation to tumour markers, and (b) to compare the HRQoL of patients with carcinoid tumours with that of healthy Swedish adults. Twenty-four patients reported on HRQoL (the EORTC QLQ-C30), anxiety and depression (the Hospital Anxiety and Depression Scale) five times during their first year of treatment. After one year, improvement in nausea/vomiting, flush and anxiety was reported, but there was deterioration of physical function, an increase in muscular pain and problems with dry skin. Levels of tumour markers were not associated with psychosocial function. Patients reported a lower HRQoL compared with healthy Swedish adults. Thus, deterioration of physical function was not accompanied by a deterioration of emotional function, and levels of tumour markers were not related to patients' HRQoL.
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| 39. |
- Larsson, Gunnel, et al.
(författare)
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Health-related quality of life in patients with endocrine tumours of the gastrointestinal tract
- 1999
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 38:4, s. 481-490
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Tidskriftsartikel (refereegranskat)abstract
- Health-related quality of life (HRQOL) (EORTC QLQ-C30) and levels of anxiety and depression (HADS) were investigated in patients with endocrine tumours of the gastrointestinal tract treated with interferon and/or a somatostatin analogue. In addition, patient perceptions of the importance of and satisfaction with some HRQOL aspects were studied. QOL was perceived as quite good, but more than half of the patients reported diarrhoea. The levels of anxiety and depression were low. Patients perceived physical HRQOL aspects as most important for a good QOL and stated the highest satisfaction with some social aspects. Patients who reported high levels of anxiety or depression were less satisfied with several HRQOL aspects, had more health problems, and a lower level of functioning on several of the EORTC QLQ-C30 scales and single items. Neither demographic nor medical background variables seemed to have an influence on the results. The relatively high QOL could be explained by the fact that most patients had had their treatment for a long period and thus had time to adjust to the situation.
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| 40. |
- Larsson, Gunnel, et al.
(författare)
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Importance-satisfaction discrepancies are associated with health-related quality of life in five-year survivors of endocrine gastrointestinal tumours
- 1999
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Ingår i: Annals of Oncology. - 0923-7534 .- 1569-8041. ; 10:11, s. 1321-1327
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Tidskriftsartikel (refereegranskat)abstract
- Background: Little is known about the health-related-quality of life (HRQoL) of patients with endocrine gastrointestinal tumours. In this study, HRQoL was investigated in long-term survivors of endocrine GI tumours. Patients and methods: A questionnaire including the EORTC QLQ-C30 and ratings of importance of and satisfaction with a variety of HRQoL aspects was mailed to patients with carci-noid tumours (n = 64), or endocrine pancreatic tumours (EPT, n = 55). Median time since diagnosis was 120 months (range 60–360). The majority of patients (77 of 119) had ongoing treatment. Results: The EORTC QLQ-C30 ratings suggest that in spite of a long disease duration and treatment, patients perceived their HRQoL as relatively good. There were no major differences in HRQoL ratings between patients with carcinoid tumours and those with EPT. Patients whose ratings of importance was higher than their ratings of satisfaction with a specific HRQoL aspect also evidenced a low HRQoL for that aspect. Conclusions: The results indicate that survivors of endocrine GI tumours enjoy a relatively good HRQoL and suggest that importance < satisfaction discrepancies identify patients with a low quality of life.
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| 41. |
- Larsson, Gunnel, et al.
(författare)
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Quality of life in patients with endocrine tumors of the gastrointestinal tract : Patient and staff perceptions
- 1998
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Ingår i: Cancer Nursing. - 0162-220X .- 1538-9804. ; 21:6, s. 411-420
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Tidskriftsartikel (refereegranskat)abstract
- Patient and staff perceptions regarding the importance of selected quality-of-life (QoL) aspects and patient ratings of their present QoL (EORTC QLQ-C30) were investigated The study comprised 17 patients with endocrine tumors of the gastrointestinal tract and their staff paired in dyads. Both patients and staff rated physical aspects of life (e.g., "wash yourself; dress, eat, etc.," "have a good health," "not have pain") as most important for experiencing a good QoL. Staff considered work as more important for experiencing a good QoL than did patients. Patients rated their QoL as relatively good and were more satisfied with certain QoL aspects than staff perceived them to be. Staff did not accurately judge a certain. patient's satisfaction with various QoL aspects, which suggests that there is room for staff to improve their understanding of these aspects. There were no significant mean value differences between patient and staff ratings of patient anxiety and depression, but no significant correlations within dyads. This suggests that the communication between patients and staff could be improved in this respect.
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| 42. |
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| 43. |
- Lindstedt, Helena, et al.
(författare)
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Mentally disordered offenders' abilities in occupational performance and social participation
- 2004
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 11:3, s. 118-127
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Tidskriftsartikel (refereegranskat)abstract
- The major aim was to describe occupational performance (OP) and social participation (SP) of mentally disordered offenders (MDO), and to compare professionals’ and MDOs’ appraisals of these abilities. Also, diagnostic groups and groups with/without substance related disorders were compared with regard to OP and SP. Self-report instruments (Capability to Perform Daily Occupations, Self-Efficacy Scale, Importance scale, Interview Schedule for Social Interaction), observations (Allen Cognitive Level Screen), and register data (Psychosocial and Environment Problems—Axis IV; Global Assessment of Functioning Scale—Axis V; Assessment Concerning Support and Service for Persons with Certain Functional Impairments) were utilized. Demographic and register data were collected from the Swedish National Board of Forensic Medicine. Seventy-four out of 161 incarcerated subjects (46%), selected consecutively after informed consent during a period of 16 months, were interviewed on their hospital wards. The MDOs reported some disability in performing occupations and participating in community life. However, they were satisfied with their performance and participation, implying limited awareness of their disabilities. The professionals judged the MDOs as having problems with social participation, and major, longstanding disablements in several areas. Subjects with schizophrenia scored lower in some OP and SP variables than did subjects with personality disorders and other mental disorders. The results suggest that a large proportion of MDOs need support to enable their community living.
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| 44. |
- Lindstedt, Helena, et al.
(författare)
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Personality traits as predictors of occupational performance and life satisfaction among mentally disordered offenders
- 2005
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 59:5, s. 357-364
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Tidskriftsartikel (refereegranskat)abstract
- The study investigated to what extent personality traits, e.g. socialization, proneness for anxiety, aggression and hostility were associated with and predictive of self-reported and observed occupational performance and perceived life satisfaction among male mentally disordered offenders (MDOs). Also, subjects with psychopathic-related personality traits were compared with subjects without such traits regarding demographic data and dependent variables. The MDOs were included from the Swedish National Board of Forensic Medicine. A total of 55 subjects were visited at their hospital ward for data collection with the Karolinska Scales of Personality (KSP), Capability to Perform Daily Occupation (CPDO), Allen Cognitive Level Screen (ACLS) and the Manchester Quality of Life Scale (MANSA). Seven KSP scales and two KSP factors correlated significantly with the dependent variables. Regression analyses revealed that the KSP Socialization scale, the KSP Anxiety-proneness and Psychopathy factors were the most important predictors. Subjects with psychopathy differed from remaining groups by having more conduct disorders before 15 years, being more often brought up in outcasted families and less subjected to measures of pupil welfare activities. The life history was concluded to be important influencing occupational performance and life satisfaction. Subjects with high anxiety proneness should be given attention in treatment planning.
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| 45. |
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| 46. |
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| 47. |
- Lunner, Katarina
(författare)
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Restrained Eating : Development and Models of Prediction in Girls
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Body image concerns and dieting emerge at an early age among girls and become more pronounced with increasing age. Knowledge about risk factors for disturbed eating is crucial in order to develop theoretical models and to suggest new paths for preventive efforts. The aim of the present thesis was to investigate the development of disturbed eating and to evaluate a conceptual model of predictors of body dissatisfaction and disturbed eating in girls. The included studies are part of a seven-year longitudinal project employing an accelerated multi-cohort design, including several age groups (7, 9, 11, 13, 15 years at inclusion). Study I demonstrated a marked increase in the wish to be thinner and dieting attempts between the ages 10–14 and 9–13 years, respectively. In Study II, the Body Mass Index (BMI) predicted weight-related teasing and body dissatisfaction, and body dissatisfaction predicted restrained eating among Swedish girls in Grade 8 and Australian girls in Grades 7 and 8. Weight-related teasing partially mediated between BMI and body dissatisfaction in all three samples. Study III partially supported a conceptual model implying that BMI, weight-related teasing, and body dissatisfaction at 7–11 years predicted restrained eating among girls 12–14 years old. Study IV provided support for a conceptual model positing that BMI, body esteem, and to some extent weight-related teasing, predict body dissatisfaction and restrained eating during adolescence and young adulthood. In conclusion, there was partial support for a conceptual model including these risk factors for disturbed eating among girls.
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| 48. |
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| 49. |
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| 50. |
- Magnusson, Maria, 1973-
(författare)
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Consumer Perception of Organic and Genetically Modified Foods : Health and Environmental Considerations
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim was to study consumer attitudes to and perceptions of organic and genetically modified (GM) foods and factors influencing the purchase/non purchase of these two types of foods. Data were collected by two questionnaire surveys (random nation-wide samples of 2000 consumers, response rate 58% and 39% respectively) and one interview study (n=40).A majority of the consumers had positive attitudes towards purchasing organic foods but few reported purchasing organic foods regularly. The most common beliefs about organic foods were that they are more expensive and healthier. Choice of organic foods was related to the perceived consequences for human health and to environmentally friendly behaviour. Perceived positive health consequences appeared to be a stronger motive for purchasing organic foods than were environmental benefits.Attitudes towards genetic engineering (GE) appear to be dependent on the application area. Medical applications were generally more easily accepted than were food and agricultural applications. However, all medical applications were not equally accepted. Consumers had generally rather negative attitudes towards GM foods, which were perceived as not being healthy. GM of animals for food production was perceived more negative than GM of plants. Tangible benefits of GM foods, like being better for the environment or healthier, seemed to have a potential to increase willingness to buy.The results indicate that the attitudes to organic and GM foods differ: the attitude to organic foods is positive while the attitude to GM foods is more negative. Further, the perceptions of organic and GM foods are opposed in relation to health. The purchase of organic foods and the potential willingness to purchase GM foods appear to be related to positive consequences for health and the environment.
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