Biomedical subjects

Gerd Ahlström

Publications and source records attributed to Gerd Ahlström.

29 records · Page 2Linked to original sources

PubMed2004

Using a novel exercise programme for patients with muscular dystrophy. Part I: a qualitative study.

UNLABELLED: Muscular dystrophy patients have often experimented with different alternative or complementary methods since there is at present no curative medical treatment. PURPOSE: To evaluate, through qualitative analysis of interview data, the subjective experiences of twenty-eight patients with muscular dystrophy practising a complementary method, qigong. METHODS: Semi-structured qualitative interviews were performed and data were analysed by a method inspired by Grounded Theory. The material was first coded into 119 categories, thereafter condensed to 59 categories through a constant comparison analysis. In the final analysis, six broad categories were formed out of these 59 categories. RESULTS: These broad categories were: (1) experience of health care and alternative methods; (2) expectations, acceptance and compliance; (3) qigong as an adaptable form of exercise; (4) stress reduction and mental effects; (5) increased body awareness and physical effects; (6) psychosocial effects of group training. CONCLUSION: Qigong was accepted as a novel exercise regimen and there was a wide variation of experience regarding it among the participants. Depending upon factors such as expectation of benefits, time available to do qigong and perceived effects doing it, compliance varied. One major advantage of qigong is the ability to adapt the different exercises to the physical capability of the person practising qigong. There were reports of mental, physical and psychosocial effects of the qigong, which reduced the feeling of stress and improved well-being.

Adult↗

PubMed2004

Using a novel exercise programme for patients with muscular dystrophy. Part II: a quantitative study.

PURPOSE: To quantitatively evaluate the effects of qigong in patients with muscular dystrophy. METHODS: Thirty-six patients with muscular dystrophy were assigned to either a treatment or comparison group, by means of a stratified randomization procedure. The intervention period lasted for 3 months. Balance and respiratory function were assessed by means of Berg's Balance Scale and an electronic spirometer, respectively. Health-related quality of life was tested by means of a Swedish version of the Medical Outcome Study Short Form Health Survey (SF-36), coping levels by means of a Swedish version of the Ways of Coping Questionnaire and depression levels by means of a modified version of the Montgomery åsberg Depression Rating Scale. RESULTS: Perceived general health was maintained in the treatment group whereas this was not the case in the comparison group (p=0.05). Positive reappraisal coping decreased in the treatment group but not in the comparison group (p=0.05). There was a tendency to maintain balance function during training and performance of qigong whilst there was a decline when not training. CONCLUSION: Qigong may be useful as an adjunct therapy regimen in patients with muscular dystrophy in that it can bring about a decreased rate of decline in general health. The change in coping pattern in this study needs more investigation. More research is also needed in order to more fully investigate the effects of qigong on such physical variables as balance function.

Adult↗

PubMed2004

Coping with long-term pain after a stroke.

The aim of this qualitative study was to describe pain, coping strategies, and experienced outcome of coping with long-term pain conditions after a stroke. Forty-three participants were interviewed: 15 with central post-stroke pain (CPSP), 18 with nociceptive pain, and 10 with tension-type headache. Analysis of the data was by content analysis. Pain-related problems described were incomprehensibility regarding the pain, disturbed sleep, fatigue, diminished capacity, mood changes, and stress in relationships. Different coping strategies were used; the most common were making the pain comprehensible, planning of activities, taking medications, communicating, and distractions. Changing body position, making comparison, and enduring the pain were common in central or nociceptive pain, rest and relaxation in tension-type headache. Communicating their pain gave a feeling of perplexity and resignation. Satisfaction was reported in the cases of consideration shown by others. Pain after a stroke requires specialized knowledge in order to understand the patient's experiences and to enhance coping.

Adaptation, Psychological↗

PubMed2004

Health-related quality of life in persons with long-term pain after a stroke.

BACKGROUND: No study has, to our knowledge, previously been published on health-related quality of life (HRQoL) in a group suffering from long-term pain after a stroke. AIM: The aim of the present study was to describe HRQoL in persons with long-term pain after a stroke, and to compare this with different types of pain conditions, age, gender and household status. DESIGN: This study has a design combining qualitative and quantitative methods. METHODS: Forty three participants suffering from long-term pain after a stroke were included. A qualitative interview was performed and then analysed by means of latent content analysis. In addition, two self-report questionnaires, SF-36 and the Hospital Anxiety and Depression Scale (HAD Scale), were used. RESULTS: The qualitative data revealed that physical and cognitive functioning, economic security and good relationships, support and having the ability to be together with family and friends were important factors with regard to experienced HRQoL. No significant differences were found in SF-36 and the HAD Scale with regard to the different types of pain. The older age group had decreased physical functioning in SF-36. The men had more decreased vitality than the women. CONCLUSION: The results show, that the participants in this study have a lower HRQoL due to their long-term pain than those in previous studies on stroke survivors. It is evident that further research is needed with longitudinal studies and larger populations to gain more knowledge and thereby provide better supportive care. RELEVANCE TO CLINICAL PRACTICE: Awareness and understanding of the patients' perceptions and transitions with regard to their life situation and suffering from long-term pain after a stroke is important in order to support a maintained or increased HRQoL. This is also important after the acute stage and rehabilitation, including quality of life of the relatives, especially to older and dependent persons.

Activities of Daily Living↗

PubMed2004

Problems experienced during the first year of an acute traumatic hand injury - a prospective study.

BACKGROUND: Evidence-based nursing of patients with acute traumatic hand injuries treated at the hand-surgical clinic calls for knowledge about long-term implications. AIMS AND OBJECTIVES: The aim of the study was to investigate consequences of an acute traumatic hand injury during the first year after the accident. Specifically, the objectives were to investigate changes in the experience of physical and psychological problems over time, frequencies of remaining problems and the impact of the injury on work situation and life situation 1 year after the accident. DESIGN: The study was prospective and followed the patients from the first weeks to 1 year after the accident. METHOD: Ninety-one patients were assessed three times during the year. Each time the patients answered study-specific questions, the Impact of Event Scale and the Hospital Anxiety and Depression Scale. RESULTS: Problems experienced decreased during the first 3 months but tended to remain unchanged during the rest of the year. In the 1-year follow-up, the majority of the patients experienced slight or moderate functional limitations in the hand, one-third had symptoms of trauma-related distress and one out of seven had troublesome pain. Half of the patients who had returned to work reported a worse work situation and 16% were still on the sick list. One-third of all patients considered their whole life situation to be worse as a result of the injury. Patients with amputations more often experienced a worse life situation. Blue-collar workers reported functional limitations and a worse life situation more often than white-collar workers. CONCLUSIONS: Patients with acute traumatic hand injuries requiring surgical treatment may experience problems, such as functional limitations, trauma-related distress and troublesome pain, with long-term implications for their work situation and life situation. RELEVANCE TO CLINICAL PRACTICE: Caring for hand-injured patients should include, not only surgical treatment and other actions for restoring the function of the hand, but also preventive action and follow-up of trauma-related distress and pain.

Absenteeism↗

PubMed2004

Psychiatric care staff's and care associates' perceptions of the concept of quality of care: a qualitative study.

Quality of care is a multidimensional concept and has been given different meanings in the literature. The aim in the present study was to describe how the psychiatric care staff and care associates perceived the concept of quality of care in the case of psychiatric care. Ten staff and 10 associates were interviewed. Qualitative method with a phenomenographic approach was used for the analysis. Four descriptive categories emerged: The patient's dignity is respected, The patient's participation in the care, The patient's recovery, and The patient's care environment plays an important role. Quality of care was perceived as a positive concept and as being of great importance for the patient's health and conditions of living. The results were of importance with regard to the forthcoming development of an instrument to measure the quality of psychiatric care.

Adult↗

PubMed2003

Pitfalls in the assessment of disability in individuals with low-grade gliomas.

In this study, the presence of motor and cognitive disability is described in a cohort of patients with low-grade glioma recruited from a geographical area with a well-defined population located in the middle of Sweden. The study group consisted of 35 patients, of which 24 were evaluated by both a neurologist and a neuropsychologist, and 11 only by a neurologist. The test battery according to EFIT (Edinburgh Functional Impairment Test) was used by the neurologist to measure impairments of limb function, memory and speech. Patients were asked to self-evaluate their deficits in motor function and cognition by responding to a specific questionnaire. In addition, a neuropsychological test battery was used by an experienced neuropsychologist who had no previous contact with the patients. In general, motor impairment was mild and predominantly found in the upper limb. Neuropsychological assessment revealed moderate or severe cognitive impairment in more than half of the patients. This impairment was not detected by neurological examination, and only to some extent reported by the patients them selves. The results show statistical differences in cognitive function, memory and language as recorded by the three assessors. In conclusion, this study demonstrates the usefulness of neuropsychological assessment as a complement to neurological examination to detect cognitive dysfunction in patients with low-grade gliomas.

Adult↗

PubMed2002

Disability after a stroke and the influence of long-term pain on everyday life.

Pain after a stroke is a symptom often forgotten, unnoticed although it is reported to be a great problem in care. The aim of this study was to describe disability after a stroke and how long-term pain influences everyday life according to the Multidimensional Pain Inventory - Swedish language version (MPI-S) and to test the reliability of this instrument. Forty-three persons were investigated 2 years after the stroke incident: 15 with central post-stroke pain (CPSP), 18 with nociceptive pain mainly in the shoulder and 10 with tension-type headache. Data collection was performed through the MPI-S and a questionnaire regarding assistive devices, also structured interviews based on the Activities of Daily Living (ADL) staircase and the Self-report impairment questionnaire. The results show that the persons suffered moderate to severe pain. Almost half were dependent in ADL. The most often reported impairments and use of assistive devices concerned mobility and/or motion. This was most frequent in persons with nociceptive pain. There were significant differences in persons with central pain and nociceptive pain compared with tension-type headache with regard to mobility- and/or motion-related activities. No statistical differences emerged between age, gender, different types of pain and the MPI-S scales, nor any significant differences in degree of pain as between different types of pain according to the Self-report impairment questionnaire. The reliability analysis of the MPI-S shows good homogeneity in all scales except Interference, Life Control and Affective Distress. This is the first study with MPI-S on mainly older persons and on stroke patients, thus further research is needed on this instrument as well as on which specific activities evoke the pain. This is in order to offer adequate treatment, care and support to persons with pain after a stroke.

Activities of Daily Living↗

PubMed2002

Coping with illness-related problems in persons with progressive muscular diseases: the Swedish version of the Ways of Coping Questionnaire.

One of the most widely used self-assessment inventories of coping is the Ways of Coping Questionnaire. The aims of the study were to describe coping with illness-related problems in persons with muscular diseases and to investigate the influence of demographic variables. Also, the reliability of the Swedish version of the Ways of Coping Questionnaire was to be evaluated. Forty-four persons with muscular dystrophy and 32 persons with postpolio syndrome, along with a comparison group of 214 students, completed the questionnaire. The findings of this study show that there are some different coping patterns in students as compared with persons with chronic disease. The coping strategy Distancing was used more and the strategy Accepting Responsibility used less frequently in the chronic disease groups and may be an expression of the inevitable physical limitations caused by the progressiveness of muscular dystrophy and postpolio syndrome. Furthermore, persons with muscular dystrophy also used less problem-focused coping in the form of Confrontive Coping and Planful Problem Solving when compared with the postpolio and student groups. In addition, women in the three groups employed the strategy of Seeking Social Support more often than did men. Regarding the psychometric properties of the Swedish version of the Ways of Coping Questionnaire, internal consistency was acceptable for the total score, but lower and not acceptable for several of the subscales. In the student group, but not in the chronic disease groups, there were low correlations between subscales, which indicate discriminative ability. More research is necessary to further investigate the reliability and validity of the Swedish version of the Ways of Coping Questionnaire before this instrument can be used routinely to assess coping patterns in patients with chronic disease.

Adaptation, Psychological↗

PubMed2002

Long-term pain conditions after a stroke.

The aim of this study was to classify and describe the characteristics of different long-term pain conditions after a stroke by clinical examination and pain assessment using the Pain-O-Meter and a Pain questionnaire. Pain was classified as central post-stroke pain (n = 15), nociceptive pain (n = 18), and tension-type headache (n = 10). In 65%, pain onset was within 1-6 months and the pain intensity revealed individual differences. Many pain descriptors was common, some were discriminating as burning in central and cramping in nociceptive pain, and pressing and worrying in headache. More than half with central or nociceptive pain had continuous or almost continuous pain. Cold was the factor mostly increasing the pain in central, physical movements in nociceptive pain, and stress and anxiety in headache. More than one-third had no pain treatment and two-thirds of those with central pain had no or inadequate prescribed pain treatment. The clinical findings support the classification of pain and describe discriminating and common pain characteristics in pain conditions after a stroke.

Adult↗

PubMed2002

A family's perspective on living with a highly malignant brain tumor.

The purpose of the study is to describe what it like to live with a highly malignant brain tumor from a family perspective. It is a qualitative study in which 3 families, 3 patients, and 5 next of kin have described their experiences in 15 interviews. The study is prospective, with interviews occurring 2-3 weeks after surgery and 3 and 6 months after the onset of the illness. Inductive content analysis has been employed. The results indicate that when a highly malignant brain tumor is diagnosed, the effect on the family is devastating and there is a state of crisis. Characteristically, there is distancing and a sense of helplessness. The members of the family live from day to day in a state of constant anxiety and fear of losing the patient. The affliction limits the patient's capacity regarding activities of daily life, which increases the burden of the next of kin. The next of kin attempt to cope with their grief by occupying themselves with practical tasks and activities that they believe are meaningful. The family members have only good words to say about their encounter with healthcare staff and about the information given. Negative information that the family have not asked for can cause a long period of frustration and anxiety, and they believe that their hope has been taken away from them.

Activities of Daily Living↗