Biomedical subjects
Publications and source records attributed to H Sandvik.
The purpose was to describe the prevalence of incontinence pad use and individual consumption of pads. Data was collected at local Insurance Offices in a region of western Norway (population: 239,500). Overall prevalence was 1.6% for females and 0.4% for males, increasing sharply with age. Median daily consumption was 1.7 pads. Middle-aged persons (40-69 years) consumed fewer and smaller pads than the others.
OBJECTIVE: To investigate the psychosocial impact of urinary incontinence among men. DESIGN: Telephone interviews with men who had give their written consent to participate. SUBJECTS: 150 men were available for interviews out of 571 who had asked for information about urinary incontinence and free samples of pads by post. MAIN OUTCOME MEASURES: Questionnaire which mapped demographic data, occupational status, medical history, medication, and toilet habits. Duration, frequency, and amount of leakage were registered, and the incontinence was classified according to a symptom questionnaire. Consultations and other sources of help were also registered, together with use of control methods, emotional, practical, and social consequences. RESULTS: Twenty-four per cent stated that their incontinence was a negligible problem. Generally, increasing severity of the incontinence caused more mental distress and social restrictions. Younger men were more handicapped than the older men. Practical inconveniences and social restrictions increased with longer duration of the incontinence. A multiple regression analysis, using a severity index, duration, type, and age as explanatory variables for the degree of mental distress, practical inconveniences, and social restrictions could explain 7%, 12%, and 25% of the variation in these groups of consequences, respectively. CONCLUSION: Urinary incontinence is associated with negative psychosocial effects, the impact increasing with the severity of the incontinence and decreasing with age of the incontinent men.
During the 19th century leprosy was a serious health problem in Norway, especially in some western, rural districts. In 1856 it was decided that all leprous patients should be examined by the local doctor (District Health Officer), and registered in a national leprosy register. The patients' family relationships received special attention. Some patients tried to avoid registration, fearing that the data might be misused. After Armauer Hansen (1841-1912) discovered in 1873 that leprosy was an infectious disease, isolation of leprous patients was enforced. In 1884 Thomas Collett (1835-1898), the local doctor in a rural district of western Norway, carried out a survey of all leprous patients registered in his district, a total of 164 patients. The data from his survey provide convincing support for the view that hereditary factors play an important role in the development of the disease. Modern research has confirmed that an important gene controls the susceptibility to leprosy.
In 1987 there was an unexplained increase in severe streptococcal diseases in Norway and other western countries. In Norway this increase was not accompanied by a corresponding increase in acute rheumatic fever. This study investigated the occurrence of scarlet fever and acute rheumatic fever in a rural district (approximately 15,000 inhabitants) of western Norway during the years 1862-1884. Four epidemics of severe scarlet fever occurred during this period. The local doctor treated 1,155 patients (96% children), of whom 154 (13.3%) died. Acute glomerulonephritis with subsequent kidney failure seems to have been a major cause of death. During the same period 76 patients (96% adults) were treated for acute rheumatic fever. These cases were not related to the severe epidemics of scarlet fever. It is probable that different, co-circulating strains of streptococci caused the infections, which were followed by glomerulonephritis and rheumatic fever. It is possible that rheumatic fever was caused by the strain that induced the more benign "Angina tonsillaris".
139 general practitioners and 190 gynaecologists responded to a case-history questionnaire about female urinary incontinence. More gynaecologists than general practitioners reported more frequent use of leakage provocation test, neurological examination, frequency-volume chart, and measurement of residual urine. Among the less relevant procedures, use of blood tests was reported more frequently by general practitioners, and use of x-rays and ultrasonography by gynaecologists. General practitioners preferred urine microscopy to urine culture. The opposite was true for the gynaecologists. 50% of the gynaecologists would prescribe oestrogens for the postmenopausal women, as against 25% of the general practitioners. Young women were instructed in pelvic floor exercises, incontinence pads were prescribed for elderly women.
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Radøy, an island (4,500 inhabitants) in Western Norway, has traditionally accepted many psychiatric patients for care in foster homes. Since the end of the 19th century, 855 patients placed in foster homes have been registered. Only 7% of these were original inhabitants of Radøy. The mean duration of stay was 13 years (median: 9). The tendency has been towards longer periods of stay, older patients, an increasing number of female patients, and more schizophrenic patients. It takes on average nine months (median: 5) after cancellation of the foster contract before the patient receives alternative accommodation. The waiting period for a place in a nursing home is especially long. This problem must be solved if care in a foster home is to be a suitable alternative in the future.
In order to investigate how Norwegian gynecologists manage female urinary incontinence in their daily practice, a questionnaire about six typical case histories was sent to the members of the Norwegian Gynaecological Association. The questionnaire comprised questions about investigations, use of laboratory tests and treatment options. Of 268 questionnaires sent out, 190 were returned (71%). Frequency-volume charts were recommended by 42% of the doctors and pad-weighting tests by 12%. Urodynamic examination was recommended for 55% of the cases, but mainly in mixed incontinence (76 and 77%). Pelvic floor exercises were suggested more often to younger patients than to the elderly. Drugs were infrequently suggested, mainly following appropriate indications. Drugs and pads were recommended especially for the elderly. The recommendation rate for surgical repair was higher for young age and greater degree of stress incontinence. The modest therapeutic ambition on behalf of the elderly women lacks basis in clinical research. A general management program for female urinary incontinence would possibly standardize and improve the quality of incontinence care by gynecologists in Norway.
The investigators set out to find out how Norwegian general practitioners (GPs) manage women suffering from urinary incontinence by using responses to a questionnaire containing six typical case histories. Questionnaires were sent to 191 GPs, of whom 139 (73%) replied. In 93% of all case histories the GPs responded that they would conduct some kind of investigation or treatment. Gynaecological examination and microscopy of the urine were the most frequent investigations stated. Drugs were prescribed in 41% of cases, mainly following appropriate indications. Instruction in pelvic floor exercises was predominant for the younger patients, while old patients were prescribed incontinence pads. Thus it seems that the therapeutic ambitions of the practitioner are reduced as the patients get older. Bladder training was only stipulated in 14% of cases. Adequate treatment is defined as relevant drugs and exercises in combination with pads, or referral. According to this definition 46% of the patients were treated adequately, 28% by the GPs themselves. Twenty five percent of the patients were referred to a gynaecologist.
Six case histories concerning female urinary incontinence were mailed to 191 randomly selected general practitioners (GPs) in Norway, of whom 139 (73%) replied. Great variations in suggested investigations and treatment were found between individual doctors. Four explanatory variables were examined: doctors' sex, years since graduation, urban/rural location, and GP specialization. GP specialists treated fewer patients adequately than non-specialists. Experienced female doctors instructed more patients in pelvic floor exercises, prescribed more oestrogens, referred more patients, and also indicated the possibility of surgery more frequently than their colleagues. Nevertheless, patient management is largely independent of a doctor's sex and age, practice location, and GP specialization.
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