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- Carlsson, Gunnel, 1950, et al.
(författare)
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A qualitative study of the consequences of 'hidden dysfunctions' one year after a mild stroke in persons <75 years.
- 2004
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Ingår i: Disability and rehabilitation. - 0963-8288. ; 26:23, s. 1373-80
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Increased mental fatiguability, concentration and memory difficulties, irritability, emotional instability, impaired stress tolerance, and sound and light sensitivity, in this paper operationalized through the astheno-emotional syndrome (AE syndrome) are known consequences of stroke. The aim of this study was to explore how persons with AE syndrome, one year after a mild stroke, experienced the consequences of the syndrome in everyday life. METHOD: A qualitative design was used. Fifteen respondents were chosen by strategic sampling and interviewed. The analysis was done using a grounded theory method. RESULTS: Data analysis yielded harmed/threatened self as the core category with four main categories covering the dimensions of: hidden-apparent dysfunction, predictability-unpredictability, independence-dependence and active life-passive life. The model grounded in data shows the structural properties and the processes that verify the dynamics and interactions of the everyday life consequences of AE syndrome. CONCLUSIONS: AE syndrome with mental fatiguability as the most common symptom affected many dimensions of everyday life, which in turn affected performance of activities and independence. The symptoms were 'hidden' in many ways, not only indetectable in the appearance of the person, but also on a more symbolic level not apparent to the patient and persons in their environment. The symptoms changed with environmental circumstances and were experienced as unpredictable.
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- Carlsson, Gunnel, 1950, et al.
(författare)
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Consequences of mild stroke in persons <75 years -- a 1-year follow-up.
- 2003
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Ingår i: Cerebrovascular diseases (Basel, Switzerland). - : S. Karger AG. - 1015-9770 .- 1421-9786. ; 16:4, s. 383-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Mild strokes can be neglected regarding subtle sequels as fatigue, and cognitive and emotional changes. We have addressed this topic by exploring late consequences of an initially mild stroke (Barthel score >or=50). Accordingly, we assayed impairment, disability and handicap data 1 year after the first-ever stroke in persons <75 years, focusing on symptoms as fatigue, concentration difficulties, memory disturbances, emotional lability, stress resistance, anxiety and uneasiness, symptoms comprised in the astheno-emotional disorder (AED), and its relation to life satisfaction. RESULTS: The mean value of the Barthel Index was 99.5 (SD 0.5) and 25% scored 0-1 on the Oxford Handicap Scale. AED was diagnosed in 71% of the patients, and fatigue was experienced by 72%. AED correlated significantly with life satisfaction, handicap and depression. Life satisfaction was significantly below that of norm values according to satisfaction with life as a whole, sex life and ability to manage selfcare. CONCLUSIONS: Our findings emphasize that 'hidden dysfunctions' not so easily discovered within the hospital context are common consequences of mild stroke. The concept of mild stroke as principally founded in motor function or ability in P-ADL therefore seems to be insufficient with respect to the patient long-term perspective.
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- Forsberg, Anna, 1969, et al.
(författare)
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Experiencing liver transplantation: a phenomenological approach.
- 2000
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Ingår i: Journal of advanced nursing. - 0309-2402. ; 32:2, s. 327-34
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Tidskriftsartikel (refereegranskat)abstract
- In order to promote health, nurses and other health care professionals need to discover and articulate the meaning that is implicit in experiencing life after liver transplantation. From such an understanding, appropriate nursing interventions can be based. The aim of this study was to investigate the subjective experiences of the meaning of having a liver transplant, 1 year after the transplantation. After approval from the ethics committee at Goteborg University, 12 patients, nine women and three men, were interviewed. The study sample was chosen strategically to represent common diagnoses preceding liver transplantation. A phenomenological approach was chosen for the study. Analyses of the interviews were based on a modified version of a phenomenological method by Karlsson. Seven categories emerged: facing the inevitable; recapturing the body; emotional chaos; leaving the experts; family and friends; the threat of graft rejection; and honouring the donor. Having undergone a liver transplant meant living in a paradoxical situation. Knowing that you survived, it was a struggle to regain physical strength under great emotional stress. The recipients had to self-administer life-long medication, recognize symptoms indicating a potential problem and monitor for the possibility of graft rejection. Social support was essential for recovery. Meeting others with the same experience helped liver-transplanted patients to deal with their identity crises as well as undergo a transformation from being utterly unique to a survivor among others. The clinical implications from this study are that interventions, such as patient education, and social and mental support, are important tools to optimize both self-care capacity and the ability to maintain a healthy perception of identity after having a liver transplant at least up to 12 months post-transplant.
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- Forsberg-Wärleby, Gunilla, 1953, et al.
(författare)
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Life satisfaction in spouses of patients with stroke during the first year after stroke
- 2004
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Ingår i: J Rehabil Med. - : Medical Journals Sweden AB. - 1650-1977. ; 36:1, s. 4-11
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aims of this study were to investigate whether spouses' life satisfaction changed between their life prior to their partner's stroke, and at 4 months and 1 year after stroke, and to study the association between spouses' life satisfaction and objective characteristics of the stroke patients. SUBJECTS AND METHODS: Sixty-seven consecutively enrolled spouses to first-ever stroke patients < 75 years of age participated. Life satisfaction was measured with the Life Satisfaction Checklist (LiSat-9). RESULTS: Compared with their life before stroke, the spouses' satisfaction with life as a whole, their leisure situation, daily occupation, sexual life, partner relationship and social contacts was lower 4 months after stroke. No significant change in life satisfaction was observed between 4 months and 1 year. Spouses of patients with sensorimotor impairment and low ability in self-care were less satisfied with their leisure situation, daily occupations, own ability in self-care, sexual life and partner relationship. Spouses of patients with cognitive or astheno-emotional impairments were less satisfied with their partner relationship, family life and sexual life. The associations were stronger at 1 year than at 4 months. CONCLUSION: There is a need for support over a long time period that focuses on the social, occupational and leisure situation of spouses as well as that of patients.
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- Forsberg-Wärleby, Gunilla, 1953, et al.
(författare)
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Psychological well-being of spouses of stroke patients during the first year after stroke
- 2004
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Ingår i: Clin Rehabil. - : SAGE Publications. - 0269-2155. ; 18:4, s. 430-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate whether spouses' psychological well-being changed between the first weeks after their partner's stroke and four months and one year later, and to study the relationship between spouses' psychological well-being and objective characteristics of the stroke patients. DESIGN: Prospective, longitudinal study. SETTING: Hospital care and follow-ups. SUBJECTS: Sixty-seven consecutively enrolled spouses to first-ever stroke patients < 75 years. MAIN MEASURES: The Psychological General Well-Being (PGWB) Index. Clinical examination of the stroke patients. The Barthel Index. RESULTS: The spouses' psychological well-being was significantly lower in the first weeks after their partner's stroke as compared with norms. At four months, it had increased significantly. Between four months and one year, individual changes were observed in both positive and negative directions; thus, the mean level of the group remained constant. The spouses' psychological well-being in the first weeks was significantly related to the patients' sensorimotor impairments, while it was related at four months to cognitive impairment and the patients' abilities in self-care. At one year, psychological well-being was related to remaining sensorimotor and cognitive impairments. A significant relationship was also seen between the spouses' and the stroke patients' emotional health. CONCLUSIONS: The spouses' psychological well-being increased after the first chaotic weeks. The presence of visible impairments initially seemed to affect spouses' emotional health, while cognitive and emotional impairments became more evident in everyday life. In the long term, however, the spouses' individual life situations and coping abilities seem to be of relatively increasing importance for their continued well-being.
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- Forsberg-Wärleby, Gunilla, 1953, et al.
(författare)
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Spouses of first-ever stroke patients: psychological well-being in the first phase after stroke
- 2001
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Ingår i: Stroke. - 1524-4628. ; 32:7, s. 1646-51
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: A stroke affects not only the patient but also the spouse. To better support the spouse during the acute phase of stroke, knowledge is needed about his or her experience with the situation. The aim of the present study was to study the well-being of the spouses of stroke patients during the acute state of stroke and to identify factors that may influence their well-being. METHODS: Eighty-three consecutively enrolled spouses of first-ever stroke patients <75 years old participated. Their psychological well-being, measured by the Psychological General Well-Being Index 10 days after the stroke, was compared with norm values. Multiple analyses of correlation were performed to investigate the effects on psychological well-being of (1) age and sex, (2) level of impairment of the stroke patient, and (3) intrapersonal variables such as previous life satisfaction and view of the future. RESULTS: The study group showed significantly lower psychological well-being compared with norm values except for the dimension of general health. The variables that correlated significantly with the Psychological General Well-Being total score were the sensorimotor impairment of the stroke patient and the "view of the future." This view of the future also correlated significantly with the level of functional ability of the stroke patients. CONCLUSIONS: During the acute phase of stroke, the severity of the stroke has an impact on the spouse's image of his or her future life, whereas the individual appraisal of personal consequences and of his or her own coping capacity seems to have a greater impact on the psychological well-being of the spouses than does the objective state of disability.
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- Forsberg-Wärleby, Gunilla, 1953, et al.
(författare)
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Spouses of first-ever stroke patients: their view of the future during the first phase after stroke
- 2002
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Ingår i: Clin Rehabil. - 0269-2155. ; 16:5, s. 506-14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A partner's stroke can be perceived as a critical event by a spouse. Previous studies have focused primarily on the impact of stroke on spouses' psychosocial well-being over the long term. However, the experience of spouses in the first phase after stroke is not well known. AIM: To investigate spouses' perception of their future daily life after stroke and the association between this perception and the objective characteristics of the stroke. METHOD: Eighty-three consecutively enrolled spouses of first-ever stroke patients < 75 years admitted to Sahlgrenska University Hospital in Goteborg, Sweden participated. The mean age of the spouses was 57 years. Sixty-two of the spouses were women and 21 men. Interviews about their experiences 10 days after onset were generally made at the hospital. The interviews were analysed, categorized and combined with statistical analyses of variables such as ages and sex of the spouses, type of lesion and presence of neurological impairments in the stroke patient. RESULTS: Four different categories of the concept 'view of the future' were developed on the basis of the interviews. Of the different characteristics of the stroke, the severity of the sensorimotor impairment seemed to have the greatest impact on the spouses' view of the future. The spouses of stroke patients with pure sensorimotor impairment were more likely to have an optimistic view of the future than when the sensorimotor impairment was combined with cognitive deficits. There was a broad distribution of the different characteristics of stroke between the four categories. CONCLUSIONS: Although the perception of future daily life varied, it was possible to categorize the spouses' cognitive image of future life according to degree of optimism. While the severity of stroke was of importance, the individual perception of the disease, impact on future activities and the spouses' own coping capacity was of great significance for the perception of future daily life.
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- Forsberg-Wärleby, Gunilla, 1953, et al.
(författare)
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Spouses of first-ever stroke victims: sense of coherence in the first phase after stroke
- 2002
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Ingår i: J Rehabil Med. - 1650-1977. ; 34:3, s. 128-33
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Tidskriftsartikel (refereegranskat)abstract
- According to Antonovsky, the individual's sense of coherence is assumed to be crucial in coping with stressful life events. The purpose of this study was to investigate the associations between the sense of coherence of the spouses of stroke victims, the objective severity of the stroke and the spouses' perception of life satisfaction, psychological well-being and cognitive image of life in the future in the first phase after stroke. Eighty-three consecutively enrolled spouses to first-ever stroke victims < 75 years participated. Multiple correlations were done to study the association between Antonovsky's 29-item Sense of Coherence scale and the objective impairments of the stroke victim, the Life Satisfaction Checklist, the "view of the future" and the Psychological General Well-being Index. The sense of coherence was significantly associated with satisfaction with life as a whole before stroke (p < 0.001), partnership (p = 0.002), sexual life (p = 0.005), family life (p < 0.001) and financial situation (p = 0.001). The severity of the impairments of the stroke victims was not significantly associated with the spouses' sense of coherence. However, the sense of coherence was significantly associated with the perception of the future life situation (p = 0.006). The sense of coherence was also significantly associated with the perception of positive well-being (p = 0.007), self-control (p = 0.009), general health (p = 0.009) and vitality (p = 0.002) at the present, whereas the association with anxiety and depressed mood were not statistical significant. In the experience of a stressful life event such as stroke, satisfaction with general life, close relationships and the socio-economic situation were significantly associated with the spouse's sense of coherence. Spouses with a low sense of coherence were more likely to have low psychological well-being and a more pessimistic view of their life in the future.
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- Wide Boman, Ulla, 1964, et al.
(författare)
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Psychological well-being in women with Turner syndrome: somatic and social correlates
- 2004
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Ingår i: J Psychosom Obstet Gynaecol. ; 25:3-4, s. 211-9
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Tidskriftsartikel (refereegranskat)abstract
- Our aim was to examine possible somatic and social correlates to psychological well-being in adult women with Turner Syndrome (TS), including hormone replacement treatment Sixty-three women with a diagnosis of TS (mean age, 31.5 years) participated in a cross-sectional study, using interview data, ratings on the Psychological General Well-being (PGWB) Index, and data from medical examinations and medical records. Statistical analysis was performed by bivariate and multivariate analyses. Lack of sex hormones during adult life and the presence of hearing impairment were related to lower psychological well-being, as were higher age at diagnosis, higher age at menarche or induced bleeding, higher chronological age and retrospectively reported difficulties with school subjects. Age at diagnosis and difficulties with school subjects explained 25% of the variation in psychological well-being. This study has identified some correlates to psychological well-being in women with TS, which are important when considering the clinical management of adult women with TS.
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