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Biomedical subjects

G Nordström

Publications and source records attributed to G Nordström.

At least 19 recordsLinked to original sources
PubMed1995

Acceptance of ostomy surgery--a Swedish pilot study.

The main purpose of this pilot study was instrument development, focused on personal adjustment following ostomy surgery. Two instruments were used: a translated and revised version of the Acceptance of Disability Scale, Modified (ADM), and Antonovsky's Sense of Coherence (SOC) questionnaire. A sample of 26 patients enrolled consecutively at the Ostomy Care Centre at a Swedish hospital were included in the study. A Cronbach's coefficient alpha of 0.95 was obtained for the ADM Scale, Swedish version, which is consistent with the results of similar studies. A significant difference between the ADM scores and type of ostomy surgery indicated that persons with a continent ostomy had a greater acceptance of ostomy surgery than had subjects with conventional ostomy surgery. A close correlation between ADM and SOC was obtained, indicating that persons who accept ostomy surgery will also have a good sense of coherence. The result of this pilot study indicates that further research using both measures may be useful in order to identify which factors are of relevance for nursing practice.

Adaptation, Psychological↗
PubMed1995

Moral sensitivity in nursing practice.

This study reports results of an inquiry into ethical decision making in nursing, focusing on moral sensitivity. The Moral Sensitivity Questionnaire (MSQ), an instrument constructed to measure moral sensitivity in nursing practice was used. The main dimensions of this questionnaire are; interpersonal orientation, structuring moral meaning, benevolence, modifying autonomy, experiencing moral conflict, and trust in medical knowledge and principles of care. The questionnaires were distributed to a total of 419 nurses and completed by 145 nurses employed in psychiatric settings and 150 nurses employed in medical-surgical nursing areas. The results show significant differences in the two groups and differences concerning age, length of experience and previous education as mental health care workers.

Adult↗
PubMed1995

The use of the Modified Norton Scale in nursing-home patients.

Patients in three nursing-home wards in Sweden were in 1991 assessed by the Modified Norton Scale (MNS). Of the 71 patients, 38 (49%) were considered to be at risk of developing pressure sores. Six of the patients had a total of eight pressure sores. Five sores were assessed as stage II, two sores as stage III and one sore as stage IV. Only two of the six patients with pressure sores had any preventive equipment in their beds. The nursing and medical documentation of the existing pressure sores was not satisfactory. Individual programs for skin care and routine assessment with a pressure sore prediction instrument, such as the MNS, would serve the dual purpose of directing the relevant measures to the patient groups at the greatest risk and would aid in assessing the efficacy of pressure sore treatment strategies.

Aged↗
PubMed1994

The course of psychiatric illness in primary care patients. A 1-year follow-up.

The aim of the study was to investigate the course of psychiatric illness in primary care patients. A 12-month follow-up study was conducted using a subsample of 93 patients, assessed by interviewing with the aid of the Present State Examination (PSE), from an original cohort of 388 primary care patients in a Swedish health district. The relationships of the course of illness to psychosocial stress, perceived health, utilization of care and health insurance, and patient satisfaction with primary health care services were investigated. The results showed that at index contact, 32.1% of the follow-up sample were psychiatric cases in need of treatment according to the screening procedure with the Hopkins Symptom Check List (HSCL-25). The continuing cases constituted 19% of the total follow-up sample, remitting cases, 13.1%, new cases, 4.8% and non-cases, 63.1%. Continuing cases had a significantly higher utilization of ambulant care during follow-up. They also had 3 times more days of sick-leave. Poor perceived health at index contact, measured using the Nottingham Health Profile (NHP), predicted that the patient became a continuing case during follow-up. Continuing cases, to a greater extent, showed psychosocial stress concerning unemployment, private economy and loneliness/social isolation. Continuing cases also showed a lower satisfaction with primary health care services in all areas measured.

Adolescent↗
PubMed1994

Screening for psychiatric illness in primary care. A cross-sectional study in a Swedish health district.

A sample of 388 primary care patients in a Swedish health district were screened for psychiatric illness using the Hopkins Symptom Check List HSCL-25. General practitioner (GP) ratings of psychiatric illness and patient ratings of psychosocial problems were also included. Data concerning the patients' utilization of care and health insurance were recorded. According to the HSCL-25, 30.2% of the patients were probable psychiatric cases and 19.2% were psychiatric cases in need of treatment. According to GPs' independent ratings, 12.3% of the patients suffered from psychiatric illness requiring treatment. Psychiatric cases according to HSCL-25 were more often women, divorced, unemployed and living alone. During the year preceding index contact, psychiatric cases showed a higher utilization of primary care, as well as other somatic care. They also had more sick leave. Psychiatric cases perceived higher levels of psychosocial problems in areas of unemployment, work situation, private economy, child care and social isolation. The results of the study point to the interaction of psychological impairment, environmental stress and lack of social support in producing psychiatric illness.

Adolescent↗
PubMed1994

Longitudinal changes in craniomandibular dysfunction in an elderly population in northern Sweden.

Longitudinal changes and cohort differences in craniomandibular dysfunction (CMD) were studied in a 79-year-old cohort (n = 65) and in 70-year-old cohorts in 1981 (n = 62) and 1990 (n = 60) by means of interview and clinical examination. Although the frequency of reported CMD symptoms decreased, many clinical signs of CMD increased during the 9-year observation period. Women reported more symptoms and showed more signs of CMD than men, and a great many of the clinical signs registered in 1981 still persisted in 1990. The 70-year-old cohort studied in 1990 showed a lower frequency of reported symptoms of CMD and of temporomandibular joint pain on palpation and a higher frequency of muscle pain and mandibular deviation than the 70-year-olds examined in 1981.

Age Factors↗
PubMed1994

Economic aspects of capacity for work after severe traumatic brain lesions.

During 1981-84,310 patients with severe traumatic brain lesions were treated at the Department of Neurosurgery in Lund, Sweden. A total of 161 patients were treated after the introduction of a more aggressive management protocol in 1983. In this first part of a long-term follow-up study we concentrate on the economic aspects. Two questions were addressed: first, what was the vocational outcome after severe head injuries? and second, what were the long-term effects of the new protocol? Out of 147 patients classified as good recovery/moderate disability (GR/MD) 6-months after injury, 106 patients agreed to participate in the study. Five to 8 years after injury 70 patients were classified as capable of working: 57 of these patients were actually at work, nine were studying and four were unemployed. Twenty-two patients had received disability pension and 14 patients had retired because of old age. In the age groups up to 60 years, 70% of patients had returned to work or school. The number of patients who returned to work was significantly higher after introduction of the more aggressive management protocol: 38 of 57 patients who had returned to work were in the group treated between 1983 and 1984. Mean income for patients who had returned to work was close to the average for the corresponding age groups in Sweden. Mean sick leave 5-8 years after severe head injuries was only slightly higher than average in Sweden. Our data show that a majority of the patients classified as GR/MD 6 months after severe traumatic brain lesions have the capacity to return to work. The improvements in the primary management of patients with severe head injuries introduced in 1983 increased the number of patients who work and thus increased the number of patients who favourably contributed to the economy of the community.

Absenteeism↗
PubMed1994

Psychosocial outcome 5-8 years after severe traumatic brain lesions and the impact of rehabilitation services.

This study addresses three questions. First, what is the long-term psychosocial outcome for severely head-injured patients? Second, is an increased survival rate associated with an increase in the number of patients with a poor quality of life? Third, do rehabilitation services affect the final outcome? The long-term outcome was assessed by means of questionnaires for self-ratings, interviews with patients and relatives and neurophysical examinations. One hundred and six patients initially judged as good recovery/moderate disability (GR/MD) 6 months post-injury participated in the study. Forty to 50% of these patients showed co-ordination disturbances; more than 20% had speech disorders and cranial nerve deficits. Twenty-eight per cent had psychiatric symptom scores on the Hopkins Symptom Checklist (HSCL) indicating need of treatment. Social function according to the Social Adjustment Scale--Self-Report (SAS--SR) showed that 40% had problems concerning interpersonal relations and 20-30% had problems within the field of leisure activities, but few problems were reported on work activities and economy. The Comprehensive Psychopathological Rating Scale (CPRS) revealed that hostile feelings, failing memory and fatiguability were common symptoms and were reported by relatives in 71%, 52% and 48%, respectively, but the mean distress levels were moderate. A correlation was seen between quality of life reported by relatives and the degree of mental and social disability according to the Bond Outcome Scale, but the correlation to neurophysical handicap was rather weak. The majority of patients were able to return to a productive social life. The proportion of patients with a poor long-term outcome did not increase after introduction of an aggressive management protocol for head injuries. Data indicated that improvements in facilities for rehabilitation may positively affect psychosocial adjustment.

Adolescent↗
PubMed1994

Indicators of changes in weight and eating behaviour in severely obese patients treated in a nursing behavioural program.

To assess some possible reasons for the changes of weight and eating behaviour at a one year follow up in 33 severely obese subjects (mean BMI, 39.9 s.d. 5.2) treated in a nursing behavioural-treatment program, three instruments were used; the Self Motivation Inventory (SMI), the Sense of Coherence Scale (SOC) and the Karolinska Scales of Personality (KSP). The Three Factor Eating Questionnaire (EI) measuring restrained eating, disinhibition and hunger, was used to register the change of eating behaviour. The weight lost at the one year follow-up was significantly (P < .01) correlated to the restrained eating score at the time for the follow-up as well as to the difference value (P < .01) of the restraint score before and one year after treatment and to the number of participated booster sessions (P < .05). The SMI score, as measured before treatment, correlated significantly to all the EI subscales scores at the one-year follow-up (P < .05, P < .01, P < .01). Thus, the greater the self motivation, the more restraint and the less disinhibition and hunger. In turn, the SOC score correlated significantly (P < .01) to the SMI score. Thus, the stronger the sense of coherence, the more perceived self-motivation. Finally, there was a significant negative correlation between the KSP subscales Somatic Anxiety (P < .01), Muscular Tension (P < .05), Psychic Anxiety (P < .001), Psychasthenia (P < .01), Hostility (P < .001), and Inhibition of Aggression (P < .001) and a positive correlation between Socialization (P < .05) and the SOC score.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Test characteristics of the Hopkins Symptom Check List-25 (HSCL-25) in Sweden, using the Present State Examination (PSE-9) as a caseness criterion.

The Hopkins Symptom Check List-25 (HSCL-25) is a screening instrument designed to identify common psychiatric symptoms. It has been widely used in different settings outside Sweden and also compared to assessment of psychiatric illness made by general practitioners. The aim of the present study was to validate the HSCL-25 against a psychiatric interview using the Present State Examination (PSE-9) in a Swedish sample of patients in general practice. Validity coefficients of the HSCL-25 were calculated for two different thresholds of caseness, > or = 1.55 and > or = 1.75, respectively. When > or = 1.75 was chosen as a cutoff point, the validity coefficients obtained by the HSCL-25 in this study were comparable to those obtained in other studies.

Adult↗
PubMed1993

Perceived health and high consumers of care: a study of mental health problems in a Swedish primary health care district.

Many patients with mental health problems are treated in primary health care services. They are often multi-users of care. In the present investigation we have studied patients visiting primary health care clinics who have been assessed for mental health problems according to the Hopkins Symptom Check List (HSCL-25). Two quality-of-life instruments (the Nottingham Health Profile and the Mood Adjective Check List) were applied to describe further the perceived health of the sample. A random sample of 93 patients was chosen out of 388 patients visiting a primary health care clinic in a Swedish health care district during four weeks in January and February 1990, and these patients were followed prospectively during one year. High consumers of health care during the follow-up period scored a poor perceived health. 'Feeling worthless', predicted a high number of days of sickness absenteeism. Hidden cases, not detected by the GPs, consumed more resources than those identified by the GPs. The importance of training and educating general practitioners in the early detection of patients with mental health problems is discussed.

Attitude to Health↗
PubMed1992

Clinical outcome and cognitive impairment in patients with severe head injuries treated with barbiturate coma.

This study reports on clinical outcome in 38 patients with severe head injuries (posttraumatic coma for 6 hours or more) treated with barbiturate coma because of intracranial hypertension. Eighteen patients died, 4 patients remained in a severely disabled or a chronic vegetative state, and 16 patients reached the levels good recovery/moderate disability. Six of these patients returned to work or school full time, 4 for half time and 3 were in a rehabilitation program. Fourteen patients were subjected to a comprehensive neuropsychological assessment. All patients except one exhibited varying degrees of cognitive dysfunction and 6 patients had signs of personality change. The quality of life for the majority of surviving patients was relatively good but the positive effects of barbiturate coma therapy in the age groups over 40 years appeared to be limited.

Adult↗
PubMed1992

Psychosocial adjustment and general state of health in patients with ileal conduit urinary diversion.

The psychosocial adjustment and general state of health were investigated in 66 patients (40 males, 26 females) who had been subjected to an ileal conduit urinary diversion on account of bladder cancer (44 patients) or incontinence or bladder dysfunction (22 patients). Seventy per cent of the patients reported unchanged, overall, social activity (OSA) after the operation. Twenty per cent reported less and 10% more activity. Bladder-cancer patients were more likely to curtail their social activities compared with the patients with incontinence or bladder dysfunction. Appliance-related problems were mentioned by half of the patients who reported decreased OSA. One-third of the patients considered accidental leakage or fear of such leakage as the most negative aspect of surgery. Factors related to an altered body image were the most common negative aspect reported by females. Despite psychosocial problems, the majority of the patients (80%) considered their health to be good. Males, individuals working full-time and patients with unchanged OSA scored higher on a Health Index, i.e. considered themselves healthier than the rest of the patients.

Adaptation, Psychological↗
PubMed1990

The impact of socio-medical factors and oral status on dietary intake in the eighth decade of life.

The impact of different background factors on dietary intake was studied in a representative sample of 94 men and 89 women (mean age 74.6 years). More women than men in the sample felt lonely, lived alone and felt ill. The women also had more frequent and more severe mandibular dysfunction problems. Many individuals showed an unsatisfactory dietary intake according to the Recommended Dietary Allowance in Sweden (RDA-S). A multivariate analysis showed that sex, age, education, general living conditions, anamnestical and clinical dysfunction indices and dental status influenced dietary intake. Subjective chewing problems were strongly connected with dental status and constituted one of the most important single variables explaining the differences in dietary intake. This study shows the importance of asking elderly patients about their living conditions and chewing problems, as well as evaluating dental status and function from a "masticatory performance perspective" and offering adequate dietary advice.

Aged↗
PubMed1990

Effects of ischemia and reperfusion on protein synthesis in livers with different glutathione levels.

The role of oxygen-free radicals for metabolic derangements in the ischemic and reperfused liver is controversial. The effect on hepatic protein synthesis of a 60-minute period of ischemia followed by two hours of reperfusion was studied in four groups of rats with different hepatic contents of the oxygen free radical scavenger glutathione (GSH): group 1, fed rats; group 2, fed rats treated with diethylmaleate (DEM) one hour before use (0.69 mL/kg, i.p.); group 3, 48-hour fasted rats; and group 4, 48-hour fasted rats treated with cobalt-chloride (45 mg/kg, s.c.) ten hours before use. Protein synthesis rates were determined by measuring incorporation of U-14C-leucine into protein in incubated liver slices. Treatment of fed rats with DEM and fasting for 48 hours significantly reduced liver GSH content. The effect of fasting on liver GSH was reversed by treatment with cobalt-chloride. The protein synthesis rate was reduced to approximately 30% of initial value at the end of the ischemic period and recovered to 70% to 100% of initial value after two hours of reperfusion with no differences between the experimental groups. Thus the effect of liver ischemia and reperfusion on protein synthesis was similar in groups of rats with different hepatic GSH contents at the onset of ischemia. The data suggest that oxygen free radicals do not play a major role for the impairment of protein synthesis in the ischemic and reperfused liver.

Animals↗
PubMed1990

Influence of pentobarbital and chloralose on metabolic and hemodynamic changes in liver ischemia.

Hemodynamic and metabolic consequences of a 90-minute period of liver ischemia followed by 120 minutes of reperfusion were studied in rats that were awake during most of the experiment and in rats anesthetized with either pentobarbital (40 mg/kg body weight) or chloralose (30 mg/kg X hour) during the complete length of the experiment. Ischemia was induced by occluding the blood vessels to the left and median liver lobes with a small vascular clamp, which was removed after 90 minutes. Protein synthesis rate was determined by measuring incorporation rate of 14C-leucine into protein in incubated liver slices. At the end of the ischemic period, adenosine triphosphate levels in liver tissue and protein synthesis rate were reduced by 80% to 90%, with no significant differences among groups. During reperfusion, energy levels and protein synthesis rate remained depressed in the anesthetized animals, but improved, although not to normal values, in the awake rats. Hepatic tissue water increased during ischemia, probably reflecting hepatocellular membrane injury. The increase in hepatic tissue water was more pronounced in the chloralose group than in the other groups of rats. During reperfusion hepatic tissue water remained increased in the anesthetized rats but was normalized in the awake group. Mean arterial blood pressure was stable during ischemia and reperfusion in the pentobarbital anesthetized rats, while a progressive decrease in blood pressure during the experiment was noted in the chloralose group. The results suggest that hemodynamic and metabolic responses to liver ischemia and reperfusion can be influenced by anesthetics. Chloralose may be less suitable than pentobarbital for anesthesia when liver ischemia is inflicted.

Adenine Nucleotides↗
PubMed1990

Hemodynamic effects in dogs of nitrous oxide-meperidine and meperidine, respectively, in comparison with nitrous oxide.

The aim of this investigation on dogs, was to examine the hemodynamic effects of nitrous oxide (N2O) plus meperidine and of meperidine with room air ventilation, respectively, compared with those of N2O on its own. When meperidine (bolus dose 3 mg.kg-1 and continued infusion 4 mg.kg-1.h-1) was added to 80% N2O, mean arterial blood pressure fell from about 20 to 10 kPa (150 to 75 mmHg), as a result of a decrease in peripheral vascular resistance, but no compensatory changes in cardiac output were seen. When N2O was withdrawn, during continued meperidine infusion, cardiac output and stroke volume increased, while peripheral resistance remained low. Coronary vasodilation was noted when meperidine was added to N2O, and persisted when N2O was withdrawn. In the pulmonary circulation a different response was found. Here, no effects were observed when meperidine was added to N2O, while pressure and resistance decreased when N2O was withdrawn and meperidine continued.

Animals↗