Biomedical subjects

Albert Westergren

Publications and source records attributed to Albert Westergren.

12 recordsLinked to original sources

PubMed2006

Initial validation of the Swedish version of the London Handicap Scale.

OBJECTIVE: To adapt and evaluate the unweighted version of the London Handicap Scale (LHS) for use in Sweden. MATERIALS & METHODS: Respondent burden, linguistic validity and patient perceived relevance was assessed in 16 neurologically ill patients. Internal consistency reliability and construct validity were evaluated among 89 stroke survivors six months after discharge. RESULTS: Patients perceived the LHS as relevant and easy to understand and complete. Mean time to complete the questionnaire was 10 min. Cronbach's alpha reliability was 0.85. The LHS differentiated between patients living at home and in special accommodations. As expected, scores correlated strongly and weakly with indices of related and more remote constructs, respectively. There were no floor-, but large ceiling effects. CONCLUSIONS: The observations reported here are in accordance with previous studies using the original British LHS and provide initial support for the reliability and validity of the instrument for use in Sweden. However, ceiling effects may limit its usefulness as an outcome measure.

Activities of Daily Living↗

PubMed2006

The significance of importance: an evaluation of Ferrans and Powers' Quality of Life Index.

Ferrans and Powers' Quality of Life Index (QLI) defines and assesses quality of life (QoL) in terms of importance-weighted life satisfaction. This study assessed the value of such weights and explored the relationship between weighted and unweighted (satisfaction only) scores and single-item rated overall life satisfaction (LS) and QoL. Data were collected by a postal survey to 81 Parkinson's disease patients (88% response rate). Correlations between weighted and unweighted QLI scores were >or=0.96, except for one subscale (r ( s ) = 0.85). Item non-response rates ranged between 4.2 and 45.1% and 1.4 and 38% for the weighted and unweighted QLI, respectively. Cronbach's alpha exceeded 0.7 for weighted and unweighted versions of two out of the four subscales and the total score. Scaling success rates were similar for weighted and unweighted scores and did not support the current subscale structure. Unexpectedly, weighted total scores correlated stronger with LS than with QoL, and unweighted scores displayed the opposite pattern. This study found no advantages by using importance-weighted satisfaction scores. The correlational pattern with overall LS and QoL challenges the QLI approach to QoL, although these observations may relate to the use of multiplicative item weights. This study has implications also beyond the QLI regarding, e.g., the use of multiplicative weights and the relationship between life satisfaction and QoL.

Aged↗

PubMed2006

Functioning and subjective health among stroke survivors after discharge from hospital.

AIM: This paper reports a study exploring functioning (functions, activities and participation) and subjective health among stroke survivors 6 months after discharge from hospital. A further aim was to investigate patterns of functions and activities, and associations between functioning and subjective health. BACKGROUND: Nurses tend to emphasize functional and activity outcomes and rarely look to people's participation in their social world. By integrating individual and social contextual factors in their assessments, nurses will have a powerful tool to broaden their outlook. The International Classification of Functioning, Disability and Health can be used as a framework for understanding the consequences of stroke. Studies are needed, however to make the International Classification of Functioning operational for practical use. METHODS: A cross-sectional and explorative design was used using structured interviews and assessments with a number of scales with 89 stroke survivors 6 months after their hospital stay. The measures used were Personal Activities of Daily Living, including cognitive ability, transfer, dressing, bathing, energy to eat, ingestion, swallowing, going to the toilet, faecal continence, and urinary continence; and Instrumental Activities of Daily Living, including washing clothes, cooking, cleaning, transport and shopping. Factor analysis was performed for functions and activities and the final solution had an explained variance of 70%. The data were collected during autumn 2003 and spring 2004. FINDINGS: Close associations (r(s) > 0.5) were found between Activities of Daily Living in relation to participation and subjective physical health. CONCLUSION: Existing Activities of Daily Living scales were expanded and found to relate to a participation scale and a subjective health scale. Using these scales in nursing care has the potential to correct current bias towards functions and activities by broadening the focus to include the social as well as the physical.

Activities of Daily Living↗

PubMed2005

Older women and men with urinary symptoms.

The aim was to compare urinary symptoms and their influence on daily life among elderly (75+) women and men in a sample that previously had reported difficulties controlling urine (urine incontinence (UI)) and/or other urinary symptoms (OU). A further aim was to find underlying structures of urinary symptoms and to identify symptoms that had an impact on seeking medical help and need of help in daily activities (dependency). In total, 771 persons (352 men and 419 women) over 75 years answered a questionnaire, addressed to those (n=1881) who in a previous population-based study had reported having symptoms of UI and/or OU using the Bristol Female Lower Urinary Tract Symptoms (BF-LUTS) questionnaire and International Continence Society male (ICSmale) questionnaire. The groups with UI, OU, women and men reported similar symptoms of frequency, day and night, as well as influence on social life, and avoidance of places and situations due to the urinary symptoms although they differed in storage and voiding symptoms. Feeling incomplete emptying of bladder differed between the UI, OU, and mixed symptoms (MS) groups but not between genders. Of the whole sample, 43.3% had sought medical help. Factor analysis of similar questions in BF-LUTS and ICSmale questionnaire resulted in the factors labeled voiding, storage, pain, frequency, and daily life. Predictors of the urinary symptoms for needing help in daily activities were frequent micturition day and night (OR 3.2) when aged was controlled for. Influence on daily life (OR 2.5), storage symptoms (OR 2.2), and pain symptoms (OR 2.1) predicted seeking medical help. The results show that urinary symptoms are equally bothersome among men and women. There is a need to encourage elderly to seek medical help and to obtain treatment or alleviations for symptoms that give most bother and indicate dependency, such as frequent micturition day and night and difficulties to reach the toilet in time without leakage.

Activities of Daily Living↗

PubMed2005

Statistical methods for assessing agreement for ordinal data.

Evaluation of various methods in clinical practice is often based on interpretations by two or more observers. Such data need to be analysed with correct statistics, or the results and conclusions may be misleading. In this study, the use of measures of agreement for ordinal data in five international nursing journals is reviewed and various methods for measuring agreement are presented and discussed. Analyses of agreement did not seem to be very common in nursing research, but a great variation was found regarding the choice of method for analysing agreement. Both acceptable and unacceptable methods were found in the articles reviewed. When choosing among various methods for agreement the weighted kappa-coefficient is probably the most useful for ordinal data, but several issues of concern arise and need to be taken into consideration when using these types of analyses.

Humans↗

PubMed2004

Symptoms of urinary and faecal incontinence among men and women 75+ in relations to health complaints and quality of life.

AIMS: The aim was to investigate the prevalence of self-reported symptom of urinary, faecal, and double incontinence (UI, FI, and DI) in men and women 75+ and to identify how other health complaints and Quality of Life (QoL) relate to incontinence symptoms. METHODS: A randomised sample, stratified for age, of eligible men and women from the population were included in the study and 4,277 out of 8,500 completed a postal questionnaire (61.6% women). The questions focused on difficulties in controlling urine and faeces, other health complaints, socio-economic background, and social relations. RESULTS: Among all respondents 39% reported symptom of UI (more so among women P < 0.001), symptom of FI in 16.9% (ns between sexes), DI, i.e., a combination of UI and FI, was reported among 14.5% (ns between sexes). Incontinence increased with age, and persons reporting incontinence also had significantly more of all other health complaints compared with persons without incontinence. Those reporting DI comprised an especially vulnerable group. Health complaints associated with UI were communicative and mobility problems, other urinary complaints, dizziness, cough, and fatigue. FI was associated with diarrhoea, stomach pain, fatigue, and other pain. Risk factors for DI were diarrhoea, communication, and mobility problems. CONCLUSIONS: UI and FI were common among elderly men and women and increased with age. Furthermore, incontinence was associated with many other co-existing health complaints, and the most frail were those with DI.

Activities of Daily Living↗

PubMed2004

Pain management in elderly persons who require assistance with activities of daily living: a comparison of those living at home with those in special accommodations.

OBJECTIVES: To describe and compare the methods of pain management used by elderly individuals with chronic pain and requiring assistance with activities of daily living, depending on whether they live alone, with someone, at home or in special accommodations. METHODS: This study comprised 294 people aged 76-100 years, identified as having chronic pain and requiring assistance with activities of daily living. Pain and pain management methods were compared using the Multidimensional Pain Inventory, Swedish version, and the Pain Management Inventory. RESULTS: Those living in special accommodations reported more pain than those living at home. Those living with someone reported more pain and interference in daily life than those living alone, despite using more pain-relief methods and having greater social support. The median number of pain-relieving methods used was 3.0 (75th-25th percentile: 5-2). Some (3.8%) did not use any method to relieve their pain. The most frequently used methods were prescribed medicine (20%), rest (20%) and distraction (15%). The methods rated most effective were using cold, exercise, hot bath/shower and consuming alcohol. CONCLUSION: Participants had only a small repertoire of pain management methods and these were mostly conventional in nature. Few non-pharmacological methods were used. The findings suggest the importance of thorough assessment, and the need to fully discuss pain management options with the elderly.

Activities of Daily Living↗

PubMed2004

Overall and health related quality of life among the oldest old in pain.

OBJECTIVES: To compare the oldest old (85 years and above) in pain with those with no pain across gender, regarding demographic data, living conditions, social network/support, walking/mobility problems, fatigue, sleeping problems, depressed mood and quality of life (QoL). The aim was also to test how these variables were related to QoL among the oldest old in pain. METHODS: The study comprised 1622 people aged 85-105 years, of whom 47% reported pain. SF-12 and the LGC questionnaire were used to measure QoL. Multiple linear regression analysis was used to identify factors associated with QoL. RESULTS: Functional limitations, fatigue, sleeping problem and depressed mood were significantly more prevalent and QoL was significantly lower among those in pain than those not in pain, and among women compared to men. These complaints, along with financial problems, living in sheltered housing and living alone, were associated with low QoL among those in pain. CONCLUSION: Pain is common among the oldest old and coexists with several other complaints that together negatively affect QoL. By identifying those in pain and coexisting factors, actions can be taken to contribute to QoL, also in late life.

Activities of Daily Living↗

PubMed2003

Old people in pain: a comparative study.

To investigate the prevalence of pain in older people (75+), compare those in pain to those without regarding demographics, social network, functional limitations, fatigue, sleeping problems, depressed mood and quality of life (QOL), and identify variables associated with pain, a cross-sectional, prospective survey was conducted in an age-stratified sample of 4,093 people aged 75-105 years old. Those reporting pain (n=1,654) were compared with those who did not (n=2,439). Pain was more common with higher age, as were all complaints among those in pain and among those without, except sleeping problems. Lower QOL was found with higher age, as well as with pain. Pain was found to be associated with functional limitations, fatigue, sleeping problems, depressed mood, and QOL. These data highlight the importance of identifying old people in pain. Those who are older and those affected by pain are at greater risk of also being troubled by other problems, such as functional limitations and lowered QOL.

Activities of Daily Living↗

PubMed2002

Eating difficulties, assisted eating and nutritional status in elderly (> or = 65 years) patients in hospital rehabilitation.

This study describes frequencies and associations between eating difficulties, assisted eating and nutritional status in 520 elderly patients in hospital rehabilitation. Eating difficulties were observed during a meal and nutritional status was assessed with Subjective Global Assessment form. Eighty-two percent of patients had one or more eating difficulties, 36% had assisted eating and 46% malnutrition. Three components of eating were focused upon ingestion, deglutition, and energy (eating and intake). Deglutition and ingestion difficulties and low energy were associated with assisted eating, and low energy associated with malnutrition. Underestimation of low energy puts patients at risk of having or developing malnutrition.

Aged↗

PubMed2002

Oral health and nutritional status in a group of geriatric rehabilitation patients.

The aims of this study were to evaluate the oral health status and nutritional status in a group of geriatric rehabilitation patients, and to analyse the relationship between these two parameters. Nurses at the ward performed structured assessments of oral and nutritional status using the Revised Oral Assessment Guide and the Subjective Global Assessment form in 223 newly admitted patients. Most oral health problems were found among patients who stayed longer at the hospital and were more dependent on help as compared with the healthier patients. Thirty-four per cent of the patients were either severely undernourished, at risk or suspected to be undernourished (UN). Oral health problems were more common among UN patients (p < 0.0005) compared with well-nourished patients. The most frequent oral health problem was found on teeth or dentures (48%). Problems related to the tongue and lips were also common among UN patients (56 and 44%, respectively). Oral health status was correlated (r = 0.32) to nutritional status. Problems with swallowing had the strongest association to the nutritional status (OR 6.05; 95% CI 2.41-15.18). This study demonstrated that poor oral health status was related to undernourishment.

Aged↗

PubMedDate not supplied

Patterns of health complaints among people 75+ in relation to quality of life and need of help.

This cross-sectional study aimed to investigate patterns, type and degree of health complaints and their relations to need of help and health-related quality of life (QoL) across gender among people aged 75-105 (n = 4277, mean age 83.6, S.D. 5.7) who answered a postal questionnaire covering health complaints, self-reported diseases socio-economy, QoL and need of help with personal and instrumental activities of daily living (PADL, IADL). A principal component analysis gave six categories of health complaints, of which communication (80.9%), mobility problems (66.6%), and psychosocial problems (61%) were most prevalent followed by elimination (42.5%), respiratory-circulatory (38.2%) and digestion-related problems (36.4%). Women reported significantly lower QoL than men. Those needing help with PADL and IADL had significantly lower QoL than those not requiring help. Mobility problems were the strongest predictor besides age, socio-economic factors and female gender for need of help with PADL, IADL and low physical QoL (OR 3.97, 3.67 and 7.47 respectively). Psychosocial problems (OR 3.60) were the strongest predictor besides age, socio-economic factors and female gender for low mental QoL. The findings indicate the importance of focusing on health complaints in coexistence patterns described as dysfunctions, and also the need for primary and secondary preventive actions related especially to mobility and psychosocial problems in geriatric care.

Activities of Daily Living↗