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- Skoogh, Johanna, 1975, et al.
(författare)
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'A no means no'--measuring depression using a single-item question versus Hospital Anxiety and Depression Scale (HADS-D).
- 2010
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Ingår i: Annals of oncology. - : Elsevier BV. - 1569-8041 .- 0923-7534. ; 21:9, s. 1905-1909
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Tidskriftsartikel (refereegranskat)abstract
- Background: Depression often develops undetected; to make treatment possible, a single-item screening question may be useful. Patients and methods: We attempted to compare the accuracy of the single-item question ‘Are you depressed?’ with the seven-item Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) among 1192 Swedish testicular cancer survivors. Results: We obtained information from 974 men (82%). Fifty-nine men (6%) answered ‘Yes’ to the question ‘Are you depressed?’ while 118 (12%) answered ‘I don't know’ and 794 (82%) answered ‘No’. Among the 794 men who answered ‘No’ to the question ‘Are you depressed?’, 790 (99.5%) were not considered as depressed according to HADS-D 11+. Of those answering ‘Yes’, 34% (20/59) were identified as depressed according to the same cut-off. Sensitivity of ‘Yes’ compared with HADS-D ≥11 was 61%, rising to 88% when ‘Yes’ and ‘I don't know’ were combined. Conclusion: In a population of men with a prevalence of depression similar to that of the normal population, almost none of those responding ‘No’ to the written question ‘Are you depressed?’ were depressed according to HADS-D ≥11. Adding the category ‘I don't know’ increases sensitivity in detecting depression.
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- Skulason, B., et al.
(författare)
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Death talk: gender differences in talking about one's own impending death
- 2014
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Ingår i: Bmc Palliative Care. - : Springer Science and Business Media LLC. - 1472-684X. ; 13:8
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Tidskriftsartikel (refereegranskat)abstract
- Background: According to common practice based on a generally agreed interpretation of Icelandic law on the rights of patients, health care professionals cannot discuss prognosis and treatment with a patient's family without that patient's consent. This limitation poses ethical problems, because research has shown that, in the absence of insight and communication regarding a patient's impending death, patient's significant others may subsequently experience long-term psychological distress. It is also reportedly important for most dying patients to know that health care personnel are comfortable with talking about death and dying. There is only very limited information concerning gender differences regarding death talk in terminal care patients. Methods: This is a retrospective analysis of detailed prospective "field notes" from chaplain interviews of all patients aged 30-75 years receiving palliative care and/or with DNR (do not resuscitate) written on their charts who requested an interview with a hospital chaplain during a period of 3 years. After all study patients had died, these notes were analyzed to assess the prevalence of patient-initiated discussions regarding their own impending death and whether non-provocative evocation-type interventions had facilitated such communication. Results: During the 3-year study period, 195 interviews (114 men, 81 women) were conducted. According to the field notes, 80% of women and 30% of men initiated death talk within the planned 30-minute interviews. After evoking interventions, 59% (67/114) of men and 91% (74/81) of women engaged in death talk. Even with these interventions, at the end of the first interview gender differences were still statistically significant (p = 0.001). By the end of the second interview gender difference was less, but still statistically significant (p = 0.001). Conclusions: Gender differences in terminal care communication may be radically reduced by using simple evocation methods that are relatively unpretentious, but require considerable clinical training. Men in terminal care are more reluctant than women to enter into discussion regarding their own impending death in clinical settings. Intervention based on non-provocative evocation methods may increase death talk in both genders, the relative increase being higher for men.
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