Biomedical subjects

G Kvale

Publications and source records attributed to G Kvale.

At least 19 recordsLinked to original sources

PubMed2003

Behavioral treatment of insomnia in older adults: an open clinical trial comparing two interventions.

Fifty-five insomniacs, 60 years or above, participated in a behavioral treatment program, comparing two interventions (sleep hygiene+stimulus control vs sleep hygiene+relaxation tape). Half of the subjects were randomized to a waiting-list condition prior to treatment. No significant changes were observed during the waiting-list period. During the treatment period however, the subjects improved on several sleep parameters, and treatment gains were maintained at a 6-month follow-up. The effects of treatment were greater for nocturnal measures (e.g. sleep onset latency and total sleep time) as compared to daytime measures (e.g. life satisfaction, daytime alertness) and not-targeted behavior (medication use). There were no differences in treatment effects for the two interventions.

Aged↗

PubMed2003

A videotaped intervention to enhance child control and reduce anxiety of the pain of dental injections.

AIM: While the psychological literature shows that perceptions of uncontrollability contribute to anxiety and other pathologies, interventions that enhance perceived control have been shown to reduce anxiety. This study attempted to assess a brief videotape to enhance child perceived control in a dental setting. METHODS: 101 children aged 7-9 years completed warm-up procedures and viewed either: a) the experimental intervention, a 2 minutes video of a dentist explaining what an injection will feel like and proposing hand raising as a signal mechanism; or b) the control condition, a 2 minutes video of Disneyland. Fear of dental injections was assessed on a 10 cm visual analogue scale before and after the intervention. RESULTS: In the experimental group there was a significant fear reduction from pre- to post-intervention, while this was not the case in the control group. Children with higher pre-existing levels of fear benefited more from the intervention than children with lower levels of fear. CONCLUSION: The results of this pilot study suggest that intervention packages that impact child control have promise in lowering anxiety.

Analysis of Variance↗

PubMed2003

An intervention program to reduce dental avoidance behaviour among adolescents: a pilot study.

AIM: To develop and test the methodology of an intervention to reduce avoidance of dental care among adolescents, and to measure the respondents' beliefs regarding the intervention (credibility and cognitions). METHODS: Based on a group comparison design a sample of 18 year olds (n=50) with dental non-attendance behaviour was randomly selected to three experimental and one control group. Subjects were surveyed with one baseline questionnaire and one post-intervention questionnaire, to evaluate their beliefs regarding the program. Two different instruments were tested: 1) cards representing different statements related to previous dental experiences, possible reasons for attending (pros) and not attending (cons) dental appointments, and preferences for future treatment. Cards were selected based on individual priority; 2) a brief, structured telephone interview based on Motivational Interviewing. The instruments were tested separately (groups I and II) and in combination (group III). Subjects in the control group (group IV) were given conventional health education. RESULTS: Subjects in the experimental groups had significantly higher credibility scores to the statement "How much easier do you perceive dental treatment to be for you, based on this program", compared with the control group (p<0.05). They had also more positive beliefs to the statement "I think the interviewer liked to talk to me" (p<0.05) than controls. CONCLUSION: A questionnaire sent to non-attending adolescents followed by a brief telephone call based on Motivational Interviewing appears to be a credible intervention for adolescents avoiding dental care.

Adolescent↗

PubMed2002

Relationship between caries prevalence at 5 years of age and dental anxiety at 10.

AIM: The aim of this study was to explore a possible relationship between the individual prevalence of caries in 5-year-old children and dental anxiety in the same children when they became 10 years of age. MATERIALS AND METHODS: A group of 217 children was examined clinically and radiographically for caries at 5 years of age when initial, as well as manifest caries lesions, were recorded. A total of 180 children were available for follow-up at 10 years of age, and dental anxiety was measured by the use of the psychometric questionnaire CFSS-DS. RESULTS: The mean dmfs at 5 years of age was 5.4 (SD+/-7.3) and the mean CFSS-DS at 10 years of age 22.5 (SD+/-6.8). The correlation coefficient between dmfs and CFSS-DS was 0.255 (p < 0.001). Children with high dental anxiety (CFSS-DS sum score higher than one SD above the mean) (N = 22) had a mean dmfs of 10.7, while those with lower dental anxiety had dmfs of 4.7 (p < 0.001). The majority (68%) of the children with high dental anxiety had more than five carious lesions at 5 years of age. CONCLUSION: Children with many carious lesions at the age of 5 years are at high risk for being dentally anxious at 10 years of age. Classical conditioning, including procedural pain and other negative experiences during dental treatment as the unconditioned stimuli, is the most likely reason for this.

Journal Article↗

PubMed2001

Prevalence of insomnia in the adult Norwegian population.

A representative adult sample (18 years and above) of the Norwegian population, comprising 2001 subjects, participated in telephone interviews, focusing on the one-month point prevalence of insomnia and use of prescribed hypnotics. Employment of DSM-IV inclusion criteria of insomnia yielded a prevalence rate of 11.7%. Logistic regression analysis performed on the different insomnia symptoms revealed that somatic and psychiatric health were the strongest predictors of insomnia, whereas gender, age, and socioeconomic status showed a more inconsistent relationship. Use of prescribed hypnotic drugs was reported by 6.9% and was related to being female, elderly, and having somatic and emotional problems. Sleep onset problems and daytime impairment were more common during winter compared to summer. Use of hypnotics was more common in the southern (rather than the northern) regions of Norway. For sleep onset problems a Season x Region interaction was found, indicating that the prevalence of sleep onset problems increased in southern Norway from summer to winter, while the opposite pattern was found in the northern regions. The importance of clinically adequate criteria and seasonal variation in the evaluation of insomnia is briefly discussed.

Adolescent↗

PubMed2000

Reliability and validity of the Dental Indifference Scale in a population of 18-year-olds in Norway.

OBJECTIVES: The aims of this study were to estimate the reliability and validity of the Dental Indifference Scale (DIS) (Nuttall, 1996) in a population of 18-yr-olds in Norway. METHODS: The DIS-scale was mailed to a sample of 1119 18-yr-olds in two Norwegian counties. Nearly 87% completed the questionnaire and consented to the collection of data from their dental records. Ten percent of the sample, drawn at random, was asked to complete the questionnaire a second time, after a time delay of 15 weeks (response rate 83%). The reliability estimation of the sum-scores of DIS was based on Pearson's correlation between test-retest scores and internal consistency (Cronbach's alpha). The frequency of missed appointments from age 12, recorded in the dental treatment records, was used as the validating criterion. The validity was analyzed by Pearson's correlation, and step-wise multiple regression. RESULTS: The correlation coefficient (Pearson) for the test-retest comparison was 0.43. The correlation coefficient between the DIS-scores and the frequencies of missed dental appointments was 0.24. The Cronbach's Alpha coefficient for the eight DIS-questions was 0.35 (n=868). Only two of the eight DIS-questions entered the stepwise regression model and explained 15% of the variance of the frequency of missed appointments. CONCLUSIONS: The Dental Indifference Scale (DIS) was found to have a low reliability and validity in this study population, and it is recommended that it should not be used without further investigation. It may be necessary to design an alternative instrument if further work into the hypothesized trait of dental indifference is to be undertaken.

Adolescent↗

PubMed2000

Factors related to missed and cancelled dental appointments among adolescents in Norway.

The aim of this study was to explore possible explanatory factors related to high frequency of missed/cancelled dental appointments during the age group 12-18 yr. A total of 754 20 yr olds completed a questionnaire including variables measuring demographics, occupation (school/job), attendance pattern, attitudes to dentists, opinion about importance of dental treatment, and the psychometric scales Dental Fear Scale (DFS), Dental Beliefs Survey (DBS) and Geer Fear Scale (GFS). Based on written consents, the following data were recorded from their dental records: the total number of scheduled appointments, the number of missed and cancelled appointments and the individual caries experience of those in the age group 12-18 yr. A total of 124 subjects who had missed/cancelled 20% or more of their dental appointments during this age were defined as a target group. A stepwise regression model indicated that the likelihood of being included in the target group increased by a factor of 6.0 if the subject had forgotten dental appointments during the last 5 yr, by a factor of 3.5 for working or without specified occupation (as opposed to attending school), by a factor of 2.7 for negative beliefs of dentists, and by a factor of 2.1 for high caries experience.

Adolescent↗

PubMed2000

The Maudsley Obsessional-Compulsive Inventory and OCD in a Norwegian nonclinical sample.

The 30 item Maudsley Obsessional-Compulsive Inventory (MOCI) was given to 294 under graduate students. The inventory achieved an acceptable internal consistence, but somewhat low reliability. There were no sex difference in total MOCI score, or in any of the subscales. 31% of the variance seemed to be explained by item 18: "attending too much to details", and more than 65% of the variance is explained by the checking subscale. The data give some interesting indications of the prevalence of OCD in the population.

Adult↗

PubMed1999

Dental anxiety and dental avoidance among 12 to 18 year olds in Norway.

The aim of this study was to explore the prevalence and possible explanatory factors of dental avoidance due to dental anxiety among 12 to 18 year olds treated within the Norwegian Public Dental Service. A total of 754 20-yr-olds completed a questionnaire and three psychometric scales, the Dental Fear Scale (DFS), the Dental Beliefs Survey (DBS) and the Geer Fear Scale (GFS), and gave their consent to collect data from their dental records. A total of 169 subjects (22.4%) had high dental anxiety (DFS>59 or DBS>47 at age 20 yr), and 124 subjects (16.4%) had high frequency of missed/cancelled appointments (20% or more) during the period 12-18 yr. Forty-seven subjects (6.2%) fulfilling both of the above criteria constituted the dental avoidance group. An analysis using a stepwise regression model indicated that having had more than one painful or unpleasant treatment experience increased the risk of being included in the avoidance group by a factor of 10.9. Equally, adolescents who were not attending school (working or without specified occupation) increased the risk by a factor of 6.9, having a high caries experience by a factor of 5.0, and not having their dental treatment completed at the age of 18 yr by a factor of 4.4.

Adolescent↗

PubMed1998

Dental anxiety among 18-yr-olds in Norway. Prevalence and related factors.

The aims of this study were to determine the prevalence of dental anxiety at the time when adolescents are leaving the public dental service, and to explore the relationship at this stage between dental anxiety and some possible etiologic factors. The sample consisted of 571 18-yr-olds in high school who completed a questionnaire and three psychometric scales, the Dental Fear Scale (DFS), the Dental Beliefs Survey (DBS) and the Geer Fear Scale (GFS), in the classroom. The relationship between dental anxiety (DFS and DBS) and a total of nine possible etiologic factors was explored by the use of stepwise regression analyses, and risk estimates (odds ratio) were calculated in cross-tables. There were significant sex differences for DFS and for GFS, but not for DBS. Nineteen percent of the total sample were classified as having high dental anxiety (DFS > 59). Previous experiences of pain, phobic anxiety indexed by GFS and pain at the last dental visit entered into the stepwise regression models of both dental anxiety indices explaining 50% of the variance of DFS, but only 18% of DBS. Students who reported more than one previous experience of pain were 9.9 times more likely to report high dental anxiety as recorded by DFS than the rest of the group. The corresponding risk factor for DBS was 3.4.

Adolescent↗

PubMed1998

Missed and cancelled appointments among 12-18-year-olds in the Norwegian Public Dental Service.

The aims of this study were to evaluate the prevalence and distribution of missed and cancelled dental appointments in the Norwegian Public Dental Service during the age period from 12 to 18 yr, and to explore possible relationships with demographics and individual caries experience (DMFT). A total of 968 patients (86.5% of the sample) gave their consent to collect data from their dental records. Forty-seven % of the group had missed and 26% had cancelled one or more dental appointments. A total of 13.6% had missed more than 20% of their appointments. Missed and cancelled appointments were to a great extent related to different individuals. The frequency of individuals with missed and cancelled appointments showed an almost linear increase from age 12 to 18 yr, and the mean individual frequency increased from 1.1 to 11.8% for missed appointments and from 0.7 to 4.8% for cancelled appointments. Subjects with missed appointments had a significantly higher mean DMFT at the age of 18 compared with the rest of the group. Individuals with missed and cancelled appointments may represent a risk group for future dropout from dental care which should be further analyzed.

Adolescent↗

PubMed1998

The ability of Corah's Dental Anxiety Scale and Spielberger's State Anxiety Inventory to distinguish between fearful and regular Norwegian dental patients.

The purpose of this study was to test the ability of Corah's Dental Anxiety Scale (DAS) and Spielberger's State Anxiety Inventory (STAI-S) to distinguish between fearful (n = 145) and regularly attending (n = 156) Norwegian dental patients. The reliability of both instruments was high (Cronbach's alpha indices > 0.95). With DAS, 90% of the fearful patients and 85% of the reference patients were correctly assigned to their appropriate group. Thus it may be concluded that, when used on a Norwegian population, DAS is a valid instrument for distinguishing fearful patients from those regularly attending dental treatment. The corresponding figures for STAI-S were 80% for the fearful patients and 79% for the reference patients. Although not developed specifically for this purpose, this instrument may therefore still validly be used to distinguish between the groups. The correlation between the instruments was 0.76, indicating that to some extent they measure the same phenomenon.

Adult↗

PubMed1997

Validation of the Dental Fear Scale and the Dental Belief Survey in a Norwegian sample.

The aim of this study was to validate the Kleinknecht's Dental Fear Scale and the Getz's Dental Belief Survey in a Norwegian sample by 1) testing their ability to discriminate between fearful (n = 151) and regular (n = 160) patients, and 2) correlating them. Both instruments were highly reliable (Cronbach's alpha > 0.90). Between 81% and 95% of the fearful and regular patients were correctly assigned to their appropriate groups with both instruments. It may thus be concluded that both instruments are valid. Also, the correlation between the instruments was 0.68, indicating that they to a large extent seem to measure the same concept. The most important predictor items for both instruments were related to avoidance of dental treatment.

Adult↗

PubMed1996

Environmental conditions, health behavior, and mortality in siblings as risk indicators of night blindness.

The purpose of the study was to estimate the association of environmental factors (water and sanitation), health behavior (breast feeding practice and vaccination), and mortality among siblings with night blindness. A total of 5,420 children were enrolled in a cross-sectional study from 2,101 households in the northern part of Bangladesh, a high risk area for night blindness. One hundred twenty-four children were reported by parents to have night blindness. Our results indicated that environmental factors, health behavior, and the death of siblings were significantly associated with the occurrence of night blindness in crude analyses, as well as in analyses with adjustment for a number of potential confounding variables. The strongest association was noted for sibling death. The findings support the notion that night blindness should not be viewed as an isolated health problem and that approaches aimed at improving vitamin A status should also include interventions directed to environmental and health-associated behavioral factors.

Adolescent↗

PubMed1995

Information to and communication with cancer patients: improvements and psychosocial correlates in a comprehensive care program for patients and their relatives.

Between 1987 and 1989, 177 cancer patients who were to receive intensive chemotherapy with curative intention, participated in a comprehensive care project with the aim of improving their total situation, and that of their relatives (n = 120). A number of steps were taken to improve, among other things, the information to, and communication with, patients and their relatives. Compared with a pre-project evaluation in 54 patients and 24 relatives, significantly lower problem scores were seen in most aspects relating to interaction with medical staff. Strong associations were seen between, on the one hand, various aspects of patient- and relative-staff interaction and, on the other, psychosocial problems, although they were weaker for problems relating to information, than for communication and control problems.

Communication↗

PubMed1994

Cardiovascular conditioning and anticipatory nausea and vomiting in cancer patients.

Explanations of individual differences in susceptibility to learning of anticipatory nausea and/or vomiting (AN/V) in cancer patients have focused mainly on the patients who develop AN/V. On the basis of conditioning theory, however, one would expect that all patients who experience post-treatment nausea and/or vomiting (PN/V) should develop AN/V. Consistent with findings demonstrating that conditioned responses are more easily established in autonomic-reactive individuals, we have previously reported that patients who do not develop AN/V (noAN/V) are less autonomic reactive than the AN/V patients. Thus, we hypothesized that the noAN/V patients might not show classical conditioning to the same degree and extent as the AN/V patients and that conditioning may be the mediating mechanism in AN/V. This study presents data from 36 patients. Among the 28 patients who experienced PN/V, 16 developed AN/V. We found no systematic group differences in severity of PN/V or antiemetic treatment. Before chemotherapy, all patients were tested in a signaled reaction-time paradigm. We used two different tones (CSs), one of which was always followed by a noise (UCS) as a button-press signal. The patients who later developed AN/V demonstrated significantly shorter reaction times, and also showed enhanced cardiovascular reactivity to the tone followed by the UCS (CS+) in comparison with the nonsignal tone (CS-). The noAN/V patients did not show differential cardiovascular responses to the CS+ and CS-.

Adolescent↗

PubMed1992

Hemisphere differences in event-related potentials (ERPS) to monaural presentations of simple speech sounds.

The aim of the present study was to compare ERPs over the left and right hemispheres to monaural consonant-vowel (CV) syllables. It was predicted that, if the contralateral auditory representation is stronger than the ipsilateral one, then ERPs over the left hemisphere should be larger for right-ear stimulus input. Furthermore, if the hemispheres differ in efficiency in processing of speech sounds, then ERPs recorded at any given site should vary as a function of the ear to which the sound is presented. Twelve right-handed subjects participated. The CV-syllables used were /Ba/ and /Pa/ with 15 presentations of each syllable to each ear in a randomized order. EEG was recorded from F3, Fz, and F4 with linked ears as reference. The results showed no significant asymmetry in the ERP-leads. N1- and N2-amplitudes were, however, larger at Fz than at F3 and F4, and N1-latency was shorter for right-ear presentations, which also interacted with the /Pa/-syllable presentations. P3-latency was longer to the /Pa/-syllable compared to the /Ba/-syllable, while N4-latency was longer to the /Ba/-syllable. N4-amplitude was more negative for the /Pa/-syllable presented to the left ear. The results are discussed in terms of phonemic differences between the unvoiced /Pa/ and voiced /Ba/, and early versus late stages of processing. The results are also seen in relation to ear differences in dichotic listening.

Adult↗

PubMed1992

Improved care of patients with small cell lung cancer. Nutritional and quality of life aspects.

A comprehensive cancer care project was carried out in Uppsala with the aim of improving the overall situation for patients treated with intensive chemotherapy with curative intent. This report gives the results in 58 patients with small cell lung cancer (SCLC), focusing on the nutritional aspects of the care and chemotherapy-related adverse effects. Responses, survival and simple nutritional parameters were compared with a historical control group (n = 81), and quality-of-life parameters with a pre-project group (n = 22). Groups were comparable with respect to pre-treatment characteristics. In contrast to the historical control group, weight, body mass index and S-albumin did not decrease during treatment in patients diagnosed during the project period. Yet, food intake in the study group was low, and for most patients below what is recommended. Survival, proportion of responses and response duration did not differ from those of the control group. Compared with the pre-project quality-of-life controls, a number of scores were more favourable for study patients (n = 36) interviewed in association with the 8th treatment course by a Swedish version of the Cancer Inventory of Problem Situations (CIPS). The global score was lower in the study group than in the pre-project group (0.80 vs 1.20, p < 0.001). Significant differences in a favourable direction were also seen in several higher order factors and miscellaneous subscales constituting the CIPS. On individual items, the study group expressed less problems with appetite/food taste in hospital, nervousness before chemotherapy and worry about adverse effects. The greatest differences in positive direction for the study group were seen within areas where the project focused on caring activities. We therefore conclude that a cancer care project with the present goals and means of intervention can improve the quality of life in patients with SCLC treated with intensive chemotherapy.

Adult↗