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| 2. |
- Hertting, A, et al.
(författare)
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Physiological changes associated with downsizing of personnel and reorganisation in the health care sector
- 2002
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Ingår i: Psychotherapy and psychosomatics. - : S. Karger AG. - 0033-3190 .- 1423-0348. ; 71:2, s. 117-122
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> The objective of this study was to assess potential physiological changes associated with downsizing/reorganisation in the health care sector. The personnel reductions (1995–1997) in the studied regional hospital corresponded to one fifth of the personnel. <i>Methods:</i> In a longitudinal study, female personnel had blood sampled twice (8 a.m. and 4 p.m.) during a working day in 1997 (in connection with the last completed round of personnel redundancies) and 1 year later in 1998. The participants were 31 women (82% of those initially sampled ); there were 14 registered nurses, 11 assistant nurses and 6 medical secretaries. No additional drop outs took place during follow-up. Outcome variables were changes in the difference in serum cortisol levels between the morning and afternoon and in serum/plasma concentrations of immunoglobulin G (IgG), oestradiol, dehydroepiandrosterone sulphate (DHEAS), prolactin and apolipoproteins AI and B. <i>Results:</i> Significantly decreased serum/plasma concentrations of IgG (p < 0.001), apolipoprotein AI (p < 0.001) and oestradiol (p < 0.001) were found. The difference between morning and afternoon serum cortisol decreased, with a change at the significance level of p = 0.05. No significant changes were observed regarding prolactin, DHEAS and apolipoprotein B. <i>Conclusions:</i> These results could be an indication that protective and anabolic functions had suffered in these remaining ‘ageing’ female work groups. The circadian cortisol rhythm was possibly flattened, which could be a sign of physiological dysfunction associated with the long-lasting adaptation process. These conclusions are tentative, given the small size of the sample and the lack of a control group. However, the findings point to the significance of studies of physiological changes possibly associated with restructuring of the health care sector.
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| 3. |
- Jaeger, B, et al.
(författare)
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Body dissatisfaction and its interrelations with other risk factors for bulimia nervosa in 12 countries.
- 2002
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Ingår i: Psychotherapy and Psychosomatics. - 0033-3190 .- 1423-0348. ; 71:1, s. 54-61
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It is widely accepted that risk factors for bulimia nervosa, mainly body dissatisfaction, are dependent on cultural factors. However, to date few studies have compared data from different cultures with an appropriate methodology. Therefore we aimed to gather reliable information on body dissatisfaction and other risk factors for bulimia from different nations and to reveal their functional interrelations.METHODS: A series of 10 silhouettes, designed to be as far as possible free from cultural and other detailed aspects, was shown to 1,751 medical and nursing students in 12 nations. A functional model was applied to each sample and tested by structural equation methodology.RESULTS: The most extreme body dissatisfaction was found in northern Mediterranean countries, followed by northern European countries. Countries currently undergoing a process of westernization show an intermediate amount of body dissatisfaction, and non-western countries demonstrate rather low values. Body dissatisfaction is the most important influence on dieting behaviour in most countries.CONCLUSIONS: Despite ongoing adoption of western values worldwide, we observe remarkable differences in body dissatisfaction between different cultures. That body dissatisfaction seems disturbingly partly detached from the actual BMI, i.e. possible overweight, as well as from feelings of low self-esteem in some western countries, raises new questions about the possible origin of the pressure to be thin.
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| 4. |
- Lokk, CTJ, et al.
(författare)
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Impact of management change and an intervention program on health care personnel
- 2000
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Ingår i: Psychotherapy and psychosomatics. - : S. Karger AG. - 0033-3190 .- 1423-0348. ; 69:2, s. 79-85
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> There has been a major shift in the organization and responsibility for the provision of geriatric care in Sweden. This was believed to be stressful. We therefore decided to launch a controlled intervention program on health care personnel aimed at enhancing their adaptation and ability to cope. The purpose of this study was to assess the impact of management change on psychosocial parameters of health care personnel and the effects, if any, of a structured intervention program. <i>Methods:</i> Two separate wards were randomly allocated to be either intervention (I) or control (C) ward. The I-ward personnel were subjected to a psychologist’s structured 10-session intervention program for 20 weeks. The program consisted of an initial educational part followed by a practical problem-solving discussion part. A structured questionnaire on psychosocial issues was answered by the participants before (0 weeks), immediately after (20 weeks), and 10 weeks after the intervention (30 weeks). <i>Results:</i> There were no significant changes in the psychosocial parameters of the C-ward personnel. In the I-ward, however, there was a significant increase in work demand as well as in positive feelings about work, as compared to the C-ward at the 30-week follow-up. There was also significantly better work comfort in the I-ward. <i>Conclusions:</i> We did not find any anticipated negative psychosocial effects on health care personnel undergoing an organizational change. However, by offering a structured intervention program to one group of health care personnel, we found some positive psychosocial effects. Future research is needed to pinpoint which factor or factors in the intervention program were the most crucial for the effects to occur.
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| 5. |
- Ohlson, CG, et al.
(författare)
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Stress markers in relation to job strain in human service organizations
- 2001
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Ingår i: Psychotherapy and psychosomatics. - : S. Karger AG. - 0033-3190 .- 1423-0348. ; 70:5, s. 268-275
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Workers in human service organizations are often confronted with conflicting demands in providing care or education. The aim of this cross-sectional study was to relate levels of endocrine stress markers to perceived job strain in two human service organizations. <i>Methods:</i> Employees in two local units of the social insurance organization and two local units of the individual and family care sections of the social welfare in Sweden were selected and 103 employees participated (56% participation rate). The perceived job strain was assessed with a standardized questionnaire containing questions of the demand-control model. Questions specially designed to measure emotional demands were also included. The stress markers cortisol, prolactin, thyroid-stimulating hormone, testosterone and IgA and IgG were analysed in blood samples. <i>Results:</i> The main finding was an association between high emotional strain and increased levels of prolactin. The levels of cortisol, but none of the other four stress markers, increased slightly with emotional strain. <i>Conclusions:</i> Emotional strain experienced in human service work may cause psychological stress. The increase in prolactin was modest but consistent with findings in other published studies on stress-related endocrine alterations.
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| 6. |
- Sondergaard, HP, et al.
(författare)
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A longitudinal study of hormonal reactions accompanying life events in recently resettled refugees
- 2003
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Ingår i: Psychotherapy and psychosomatics. - : S. Karger AG. - 0033-3190 .- 1423-0348. ; 72:1, s. 49-58
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Refugees constitute a growing section of the general population in many countries. It is therefore important to study which factors in everyday life are important to recently resettled refugees after they have been granted residence. <i>Methods:</i> Life events from a checklist, as well as categories derived from written responses to open-ended questions were analysed (repeated-measures ANOVA). Changes over time in mean serum/plasma concentrations of cortisol, thyroxine, prolactin, and dehydroepiandrosterone sulphate (DHEA-S) were compared in subjects with and without the reported events. <i>Results:</i> Distress in significant others (close friends or first-degree relatives) and a perception of excessive demands in everyday life were associated with increases in serum cortisol. Events associated with decreased levels of prolactin were typically situations of strain in relation to authorities or individuals to which the subjects were in a position of dependency. DHEA-S changed in opposite directions in post-traumatic stress disorder (PTSD) and non-PTSD subjects. DHEA-S also changed with positive events. <i>Conclusions:</i> Distress in significant others and a too demanding everyday life lead to significant changes in the stress-responsive hormones cortisol, prolactin and DHEA-S. Since DHEA-S behaves differently in PTSD, this condition is a potential confounder in studies of DHEA-S with an unknown proportion of PTSD among participants.
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| 7. |
- Sondergaard, HP, et al.
(författare)
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Elevated blood levels of dehydroepiandrosterone sulphate vary with symptom load in posttraumatic stress disorder: findings from a longitudinal study of refugees in Sweden
- 2002
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Ingår i: Psychotherapy and psychosomatics. - : S. Karger AG. - 0033-3190 .- 1423-0348. ; 71:5, s. 298-303
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> The present study is part of a longitudinal study of recently resettled refugees with the aim of learning which factors in their daily life influence health as measured by self-report and stress-responsive hormones. <i>Methods:</i> In a group of recently resettled refugees with a high incidence of posttraumatic stress disorder (PTSD), diagnosed by structured interview, self-rated symptoms of PTSD were followed three times over a period of 9 months after inclusion in the study. Eighty-six individuals were included in the study and 58 subjects (67.4%) completed it. Blood samples were drawn at each examination for assessment of hormone levels. <i>Results:</i> After adjustment for age, dehydroepiandrosterone sulphate (DHEA-s) was observed to be higher in non-depressed PTSD cases than in non-PTSD without depression. There was an interaction between PTSD and depression regarding DHEA-s levels. DHEA-s correlated significantly with changes in self-rated symptoms of PTSD at last follow-up; the greater the increase in PTSD symptoms, the greater the increase in plasma DHEA-s. The variation of DHEA-s levels in relation to changes in self-rated health in non-PTSD showed the opposite pattern, although not reaching significance. <i>Conclusions:</i> The finding of changes in DHEA-s should encourage further studies of the role of altered steroid metabolism in PTSD.
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| 8. |
- Sondergaard, HP, et al.
(författare)
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Language acquisition in relation to cumulative posttraumatic stress disorder symptom load over time in a sample of re-settled refugees
- 2004
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Ingår i: Psychotherapy and psychosomatics. - : S. Karger AG. - 0033-3190 .- 1423-0348. ; 73:5, s. 320-323
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Tidskriftsartikel (refereegranskat)abstract
- <i>Objective:</i> To study the effects of symptoms of posttraumatic stress disorder (PTSD), depression and dissociation as well as cumulative symptom load on language learning during the introduction phase in resettled refugees. <i>Method:</i> Participants were resettled refugees of Iraqi origin. They were assessed by means of a structured interview for PTSD at baseline as well as self-rating questionnaires. Language acquisition was studied by means of register data from the school system. Five levels of language proficiency were recorded. Self-reported symptom scores for PTSD, depression and dissociation (Impact of Events Scale-22, Hopkins Symptom Checklist-25, Dissociative Experiences Scale) were measured at four time points during 9 months immediately after resettlement. In 49 participants in a longitudinal study, data regarding progress in language studies were accessible. <i>Results:</i> The results of the study indicate that the speed of language acquisition – the number of levels taken during the study, adjusted to hours of school presence – is related to the cumulative PTSD symptom load over time (Events Scale-22), but is not related neither to the symptom load of depression and dissociation, nor to the number of previous school years. <i>Conclusion:</i> The study shows that the symptom load of PTSD during the follow-up period is significantly inversely related to the speed of language acquisition in refugees. This implies that treatment as well as preventive measures against worsening of PTSD symptoms are important in order to minimise harmful post-migration stress for the facilitation of integration.
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| 9. |
- Theorell, T, et al.
(författare)
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Coping with unfair treatment at work--what is the relationship between coping and hypertension in middle-aged men and Women? An epidemiological study of working men and women in Stockholm (the WOLF study)
- 2000
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Ingår i: Psychotherapy and psychosomatics. - : S. Karger AG. - 0033-3190 .- 1423-0348. ; 69:2, s. 86-94
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> An important hypothesis in psychosomatic medicine is that exposure to psychosocial factors that arouse anger may accelerate the onset of hypertension, particularly if the subject is not allowed to show anger or to deal constructively with the factor that evoked it. For working men and women, being treated in an unfair way at work may be crucial. The present study was designed to answer the question whether the pattern of coping – primarily directed towards the aggressor (open) or directed inwards or towards others (covert) – is associated with hypertension among working men and women. <i>Study group:</i> Five thousand seven hundred and twenty working men and women aged 15–64 participated in the study. The participation rate was 76%. <i>Methods:</i> The coping pattern was studied by means of a Swedish version of a self-administered questionnaire that was originally introduced by Harburg et al. <i>Results:</i> Significant results were confined to the age group 45–54. All analyses were adjusted for age and body mass index. Smoking habits and social class had no effect on the relationships. Low scores (lowest quartile) for open coping tended to be associated with an elevated prevalence ratio (PR) of hypertension both among men (PR 1.3, 95% confidence interval, CI, 0.9–1.7) and women (PR 1.4, 95% CI 1.0–2.0). High scores for covert coping (highest quartile) were associated with an elevated PR of hypertension among men (PR 1.6, 95% CI 1.2–2.2) but not in women. If the analysis was confined to cases without medication, the relationship between a high level of covert coping and high blood pressure was still significant for men. For women, however, no significant findings were made after this operation. Accordingly, the relationship between a low level of open coping and hypertension in women was confined to women with medication. Coping patterns were correlated with psychosocial work environment factors, in particular decision latitude. <i>Conclusion:</i> In men, covert coping was associated with prevalence of hypertension. In women, there tended to be a relationship between low scores for open coping and hypertension.
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