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Biomedical subjects

H Björvell

Publications and source records attributed to H Björvell.

At least 19 recordsLinked to original sources
PubMed2001

Coping strategies, pain, and disability in patients with hemophilia and related disorders.

OBJECTIVE: To analyze the use of various coping strategies in homogeneous groups of patients with hemophilia and von Willebrand's disease and to investigate the relationship between the state of the disease, the use of coping strategies, and management of the disease. METHODS: The coping strategies measured by the Coping Strategies Questionnaire were analyzed in 3 homogeneous groups of 224 patients. Psychosocial well-being (PWB) measured by the Rand 36-item Health Survey 1.0 was used as an indicator of management of the disease. The pain factor consisted of the following variables: pain intensity, use of analgesics, Functional Disability Index, and physical activity level. RESULTS: The groups of patients differed significantly only in the use of the catastrophizing strategy (CAT). In all pain groups, distraction was the most commonly used coping strategy. A significant interaction effect of pain factor and age on PWB (P = 0.04) was found. The mediating function of the CAT strategy was confirmed by the series of regression analyses. CONCLUSION: The coping strategy profile in hemophilia was found to be similar to those in other chronic pain states. The use of the strategies does not depend on the severity of the disease. We confirmed the role of age and the use of the CAT strategy as, respectively, moderator and mediator in the pattern of relationships between the clinical state of the disease and psychosocial well-being.

Adaptation, Psychological↗
PubMed2001

The applicability of the Antonovsky Sense of Coherence Scale to a group of Pentecostalists.

A methodological issue concerning the Antonovsky of Sense of Coherence (SOC) scale was raised in an earlier study questioning the applicability of the scale in different populations, and among these the Pentecostalists. The question was raised when a group of Pentecostalists had had difficulties in filling in another scale intended to measure the SOC. Therefore, the aim of this study was to test the applicability of the 29-item Antonovsky SOC scale in a group of people (n = 37) belonging to a church of the Pentecostal Movement and to compare the results with those of a randomized group (n = 145) from a general population. The Pentecostalists filled in the scale with no obvious difficulties. No significant differences were found between the Pentecostal group and the group of a general population regarding the total SOC scale scores (mean 152, SD 16 and mean 151, SD 18, respectively). The applicability difficulties found in the earlier study, however using an other SOC scale, could not be confirmed in the present study. To conclude, the Antonovsky SOC scale has so far not shown to have applicability weakness.

Adult↗
PubMed2000

Treatment decision-making and its relation to the sense of coherence and the meaning of the disease in a group of patients with colorectal cancer.

UNLABELLED: The aims of the present study were to describe the preferred and the actual participating roles in treatment decision-making in relation to patients with newly diagnosed, colorectal cancer and to relate this result to the sociodemographic data, the Sense of Coherence Scale (SOC) and the patients' meaning of the disease. Eighty-six patients were studied. The following instruments were used: the Control Preferences Scale (CPS); the eight Lipowski categories of the meaning of the disease (LCMD); and the SOC. The results showed that 62% of the patients preferred a collaborative role and 28% a passive role in treatment decision-making. Agreement between the preferred and the actual participating roles was achieved by 44% of the patients. Seventy-one per cent of the patients showed an optimistic understanding of their disease. The mean SOC score was 150. There was no statistically significant difference between the CPS groups as regarded the sociodemographic data, the SOC and the LCMD. CONCLUSION: Sociodemographic data, the perceived meaning of the disease as well as the patients' sense of coherence were not related to the decision-making preferences in the investigated group of patients. Therefore, further investigations are needed to get an understanding of influencing factors of the decision-making preferences.

Adult↗
PubMed2000

Perceptions of research utilization: comparisons between health care professionals, nursing students and a reference group of nurse clinicians.

The study reported in this paper was carried out to investigate a group of nursing teachers' (n=37), nursing students' (n=166), nursing administrators' (n=33) and physicians' (n=127) perceptions of barriers to and facilitators of nurses' use of research findings in clinical practice. The results were compared with the corresponding figures for a reference group of nurse clinicians (n=237). The Barriers Scale and a questionnaire for the demographic issues were used for data collection. The organization and the communication of research were seen as barriers to research utilization by the nursing teachers, students and administrators in agreement with the nurse clinicians. The nurses' research-related competence and awareness were seen as barriers by the nursing teachers, students and administrators to a greater extent than by the nurse clinicians themselves. The physicians perceived barriers to a lesser extent than the other groups did. The students' perceptions were closest to the nurse clinicians, while the physicians' perceptions differed most. Education to increase the nurses' knowledge of research and to develop their competence to evaluate research results, increased resources for education, more staff, support from the administration and research presented in a user-friendly way were the most frequently suggested facilitators. The nurses' isolation from knowledgeable colleagues with whom to discuss the research was seen as a barrier by the majority of the participants. This indicates a need for positions in clinical practice for nursing researchers, in order to promote a research-based, nursing practice.

Adult↗
PubMed1999

Two models of care as evaluated by a group of women operated on for breast cancer with regard to their perceived well-being.

The main aim of this study was to evaluate two different models of care for breast cancer patients with regard to the patients' perceived well-being. Twenty-nine patients were treated in an established care model and 115 patients were treated at a surgical breast clinic with an increased personnel continuity and a short hospital stay. Two questionnaires were used. The Sense of Coherence (SOC) Scale and a study-specific questionnaire concerning perceptions of the hospital stay, information received, body image, social support, pain, health and psycho-sociological well-being. Regression analyses were used to study the effects of the care models and the SOC on the patients' perceived well-being. The results showed that the care model with high personnel continuity had a significant positive effect on the patients' emotional state, mental well-being and perception of postoperative pain evaluated 1 year after surgery. The strongest predictors of the patients' well-being postoperatively were their perceived well-being before surgery. Furthermore, the stronger the SOC the more positive were the patients' emotional perceptions, perceived general health and mental well-being after surgery. The duration of the hospital stay did not show any effect on the patients' well-being. It is concluded that an early preoperative psycho-social assessment of the patients is of importance in planning the care, to help patients cope with the disease and its treatment. It is suggested that a care model with high personnel continuity for breast cancer patients could facilitate that assessment.

Adult↗
PubMed1999

Predialysis education helps patients choose dialysis modality and increases disease-specific knowledge.

UNLABELLED: The aims of this study were first, to evaluate the effects of a patient-education programme for a group of 28 uraemic patients (the Experimental (EG) group) with regard to their knowledge and perceived amount of information and to relate these effects to their sense of coherence and secondly, to study the patients' perception of their dialysis treatment. The results were compared with a comparison group (the Companion (CG) group, n = 28) which had received routine information only. The education programme seemed to have covered what the EG wanted to know. Significantly more patients in the EG group stated that they had acquired sufficient knowledge to enable them to participate in choosing dialysis modality compared with the CG group. The EG patients were significantly more informed in the post-educational evaluation compared with the pre-educational evaluation. In the EG, there was a significant relationship between the scores for knowledge and perceived amount of information. Men and younger patients perceived that they had received a greater amount of information than women and older patients. After having started dialysis treatment, there were no differences in the scores for knowledge and information between the EG and the CG. This indicates that other sources of knowledge and information were available to the CG patients. There was no significant correlation between the score of the Sense of Coherence (SOC) scale and the knowledge and information scores. Kidney transplantation, progression of renal failure, other patients' experiences of dialysis, dependence - independence, present and future wellbeing, how to cope with physical and psycho-social demands and continuity in their contacts with doctors and other health professionals were predominant concerns for the two groups of patients. CONCLUSION: the predialysis group education programme enabled patients to choose dialysis modality to achieve an understanding of their illness and its treatment. It also provided the possibility of informal support by fellow patients and health professionals. The study emphasizes the special needs of elderly patients and we recommend that education programmes are tailored to their requirements.

Adult↗
PubMed1999

Post-traumatic stress symptoms in patients undergoing autologous stem cell transplantation.

The aim of this explorative study was prospectively to evaluate the presence of post-traumatic stress symptoms (PTSS) in patients with hematological malignant disorders undergoing autologous stem cell transplantation (ASCT). The findings were related to sense of coherence and quality of life aspects. Twenty patients were evaluated with four standardized instruments before undergoing ASCT and then at two follow-ups. The patients participating in the study reported PTSS levels high enough to merit attention. Although PTSS declined over time, the levels were still high compared with other studied populations of cancer patients. Intrusive and avoidant symptoms correlated significantly to anxiety and depression but not to sense of coherence and physical dimensions. The high levels of PTSS and their relation to emotional distress emphasize the importance of psychosocial care for this group of patients.

Adolescent↗
PubMed1998

Barriers to and facilitators of research utilization, as perceived by a group of registered nurses in Sweden.

A survey was conducted to describe registered nurses' (n = 237), perceptions of the barriers to and the facilitators of research utilization at two hospitals in Sweden. A questionnaire, Barriers and Facilitators to Using Research in Practice developed by Funk et al., was used to collect the data. The major barriers to research utilization were that the research is not readily available along with inadequate facilities for implementation of research findings, lack of competent colleagues with whom to discuss research, lack of time for reading and implementing research findings and the nurses lack of authority in the organization. The nurses who had studied research methods in their basic nursing education, seemed to perceive fewer barriers than those who had not. The facilitating factors most frequently suggested by the nurses were diverse models of education to increase their knowledge of research methods and to develop skills in evaluating research findings. The allocation of resources for education and implementation of research findings in clinical practice, in addition to special positions in clinical practice for nurses with scientific qualifications, were also suggested.

Adult↗
PubMed1998

Predialysis patient education: effects on functioning and well-being in uraemic patients.

This study evaluated the effects of a predialysis patient education programme on functioning and well-being in 28 uraemic patients. The programme consisted of four group sessions with the following themes: renal disease and dietary restriction, active renal replacement therapy, physical exercise, and the impact of chronic renal failure on economy, family and social life. Three to 9 months after having started dialysis the patients were evaluated regarding symptoms, perceived health (Health Index), functional (SIP) and emotional (STAI) status. Twenty-eight patients already on dialysis treatment informed according to conventional routines constituted the comparison group. There were no significant differences between the groups regarding age, sex, educational or social background, duration of kidney disease, choice of dialysis treatment, cause of renal disease and laboratory tests except for s-urea. The patients who participated in the education programme scored significantly better mood, less mobility problems (HI), less functional disabilities (SIP) and lower levels of anxiety (STAI) compared to the comparison group. There were no significant differences between the two groups regarding symptoms and overall health. The differences between the groups prevailed during the first 6 months on dialysis treatment, after which the differences disappeared. In the comparison group age correlated significantly to anxiety and overall SIP, which was not the case in the experimental group. In conclusion, the experimental group that participated in a predialysis patient education programme, showed better functional and emotional well-being than the non-educated comparison group. The positive effects of participating in an education programme prevailed during the first 6 months of dialysis treatment. Moreover, the younger patients seemed especially to benefit from participation in a predialysis patient education programme. It is suggested that patient education should be ongoing for patients with end-stage renal failure initiated during the predialysis stage and continued after maintenance dialysis has been established.

Adult↗
PubMed1997

The use and efficacy of coping strategies and coping styles in a Swedish sample.

This paper presents Swedish reference values for the Jalowiec Coping Scale (JCS-60), a questionnaire measuring the use and efficacy of coping strategies. The strategies are grouped in eight coping styles. The sample used was randomly selected from a Swedish urban population. The sample consisted of 268 individuals (135 men and 133 women), divided into three age-groups, 26-40, 41-55 and 56-70 years. There were no significant differences between the three age-groups or between men and women when comparing the total scores for use and efficacy on the JCS-60. No significant differences were found between the genders within each age-group. The most commonly used coping styles were the confrontational, the optimistic and the self-reliant. The least used style was the fatalistic. Men, as compared with women, used the confrontational and self-reliant coping styles more while women used the supportive coping style more than men. The youngest age-group used the emotive coping style more, compared with the other age groups. Cronbach's alpha for the total scores indicates acceptable reliability. The results of this study may be useful as Swedish reference values for comparison with the research results of studies on patients.

Adaptation, Psychological↗
PubMed1997

Physical and psychosocial functioning in patients undergoing autologous bone marrow transplantation--a prospective study.

The main purpose of this study was to evaluate prospectively physical and psychosocial functioning in patients with malignant blood disorders undergoing autologous bone marrow transplantation (ABMT), and relate the findings to the patients' coping capacity. Twenty patients participated in the study before ABMT, 14 survivors at the 2-6 month follow-up and 12 at the 8-12 month follow-up. Three standardized questionnaires were used: the EORTC QLQ-C30, the Hospital Anxiety and Depression (HAD) scale and the Sense of Coherence scale. No significant changes over time were found in the scores of the QLQ-C30 and HAD. Impaired social function, fatigue, dyspnea, financial problems and emotional distress were the most frequently reported deficits. Functional limitations were related to less successful coping. The results indicate that the patients in this study perceive their physical and psychosocial functioning as rather good before, as well as up to 1 year after the ABMT, as measured with the instruments used.

Activities of Daily Living↗
PubMed1997

Tension neck and evaluation of a physical training course among office workers in a bank corporation.

The purpose of this study was to investigate the effects of a physical training course in a group of patients (n = 74) suffering from chronic tension neck. All participants in the course were employed by a bank corporation in Helsinki, Finland. A comparable control group (n = 77) consisted of office workers with tension neck from the same bank corporation who did not attend any training course. The outcome was analysed 6 months after the course. Pain and disability in the neck and shoulder region did not vary significantly between the group which participated in the training course and the control group. The experimental group had increased the amount of physical workout compared to the control group (83.7% vs 69.0%, P = 0.0448). Also, regarding the frequency of relaxation and stretching exercises the two groups differed significantly: the experimental group had continued to perform exercises more often (P = 0.0434). The frequency of sick leave days did not significantly differ between the groups, but the office workers in the experimental group had more periods of extended sick leave (> 10 days) and the controls had more frequent short sick leaves. The experimental group did increase their physical workout significantly compared with the controls, but no differences were detected regarding pain and disability. In order to gain more benefit more attention should be paid to the educational part of the training courses in order to enhance the patients' self-care abilities. Also, strategies to alleviate psychosocial problems and organized relaxation exercises could decrease muscle tension in the neck in office workers.

Absenteeism↗
PubMed1997

Living with dizziness: an explorative study.

A qualitative study was conducted for the purpose of exploring how patients with dizziness manage their daily living. Ten patients with history of dizziness were recruited from the out-patient clinic, Department of Audiology, in a hospital in Stockholm. Collection and analysis of data were inspired by the method of grounded theory. Four themes were developed that described the experience of living with dizziness: vulnerable reactions, affirmation and non-affirmation, finding ways to carry on daily living, and expressing the need for health care support. These themes seem to conceptualize these patients' difficulties and needs in relationship to living with dizziness and, given the small sample, have implications for nursing practice and provide a framework for a broader study.

Activities of Daily Living↗
PubMed1997

Needs as expressed by women after breast cancer surgery in the setting of a short hospital stay.

The aim of this study was to describe needs as expressed by a group of women after surgery for breast cancer in the setting of a short hospital stay. Ten days after surgery, 97 women answered an open-ended question about their perception of the care given. A content analysis inspired by the method of Grounded Theory was used. Satisfaction with the personal treatment and feelings of abandonment were identified as the two main themes. Expressed needs (n = 113) were classified in five categories: Trust, Information, Practical Assistance, Personal Treatment and Emotional Support, of which Trust appeared to be the core concept. In addition, time and space emerged as two dimensions that were interwoven with the categories of needs. The patients' perception of trust in the staff was interpreted as depending on whether the needs in the other categories were satisfied or not. It is hypothesized that, to fulfil the patients' need of trust, the patients have to be satisfied at least with information, practical assistance, personal treatment and emotional support. We consider that, in an organization with a high degree of continuity, when the patients are aware of the physician and nurse responsible, the possibilities for trust are increased, especially in short hospital stays.

Adult↗
PubMed1997

Neuropeptides of the autonomic nervous system in Sjögren's syndrome.

OBJECTIVE: To assess the activity level of the autonomic nervous system in Sjögren's syndrome (SS) and to correlate this with stress. METHODS: Patients with SS (n = 12) and healthy controls (n = 10) were analysed for the content of vasoactive intestinal peptide (VIP) and neuropeptide Y (NPY) in their stimulated saliva by radioimmunoassays and for stress by the use of a modified Jenkins Activity Survey (JAS). RESULTS: The data are expressed as median (interquartile range). Salivary VIP output (pg/min) and NPY output (pg/min) were high in SS compared with healthy controls (30.0 (15.6, 36.6) versus 12.3 (9.2, 24.0), p = 0.045, 4.8 (0.6, 24.1) versus 0.7 (0.0, 2.4), p = 0.038, respectively). Patients experienced only a little, but not significantly, more stress than the healthy controls (stress index -2.8 (-7.7, 6.9) versus -5.2 (-12.9, 2.7), p > 0.05). Stress in general was associated with high salivary VIP concentrations (r = 0.41, p = 0.05). CONCLUSIONS: These findings show that adequately processed saliva (containing aprotinin and EDTA as neuropeptidase inhibitors) contains measurable amounts of marker peptides of the autonomic nervous system. Secondly, VIP concentration but not output may be affected by stress, which may act by decreasing watery salivary flow. In patients with SS, VIP and NPY outputs are increased. This may indicate increased leakage into saliva or efforts to compensate for the diminished salivary flow, or both.

Adult↗
PubMed1996

Sense of coherence and outcome of low-back surgery: 5-year follow-up of 80 patients.

Eighty adult patients, 33 men and 47 women, mean age 46 years (SD 11.8, range 19-74 years), were evaluated 5 years after low-back surgery. The mean duration of symptoms before operation was 8.7 (SD 7.1) years. The purpose was to evaluate the 5-year outcome of low-back surgery, to find the best predictors for the outcome, and to find out if a correlation exists between the patient's sense of coherence and the outcome of low-back surgery. The mean Oswestry pain index for the whole group of patients improved from 3.8 to 2.7 (P < 0.001). The greatest improvement in pain was found in the group aged 35-50 years. In those over 50 years old, pain improved significantly more in women than men. Regarding walking ability, the mean Oswestry gait index for the whole group improved from 3.0 to 1.9 (P < 0.001), with men over 50 years old achieving the greatest improvement in their walking. The mean Oswestry total index for the whole group was 41% before surgery, reflecting severe disability, and 25% at follow-up, reflecting moderate disability (P < 0.001). There was no difference between the mean values for men and women. Patients who had undergone several previous operations fared less well in the Oswestry total index, though their improvement was still significant (P < 0.05). The postoperative Oswestry total index values correlated significantly with the sense of coherence (SOC) scale values (r = -0.23, P < 0.05). In all patients, the Oswestry total index before the index operation is suggested to be a predictor of the final outcome. In multiple regression analysis, the number of previous operations and the preoperatively recorded Oswestry total index appeared to be the best predictors for outcome of low-back surgery. We also found that the SOC scale correlated significantly with the Oswestry total index and seems to provide a possible explanation of ability to cope with the disability and pain associated with low-back disorders.

Adaptation, Psychological↗
PubMed1996

Quality of life in predialytic uremic patients.

This study describes and analyses how 38 predialytic uremic patients perceived their sense of well-being, functional ability, level of anxiety and sense of coherence. The patients in this study reported decreased sense of well-being, considerable functional disabilities, and a high level of anxiety when compared to a healthy reference group. These observations were independent of laboratory data with the exception of hemoglobin concentration which showed a significant negative correlation to the SIP scale work. There was a significant negative correlation between the scores of sense of coherence and anxiety. Patients with a weak sense of coherence and a high level of anxiety perceived their well-being as being worse than those with higher scores in the sense of coherence test and lower scores in the level of anxiety test. Sense of well-being in turn influenced functional ability in daily life. Social and marital status also affected the results. These results indicate that the investigated group of predialytic patients have a decrease in quality of life. The results obtained provide a useful instrument showing in which areas care should be concentrated and in what way patients' own resources need to be strengthened while preparing for dialysis treatment.

Activities of Daily Living↗