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Biomedical subjects

I Wiklund

Publications and source records attributed to I Wiklund.

At least 127 records · Page 7Linked to original sources
PubMed1992

Long-term effect of transdermal hormonal therapy on aspects of quality of life in postmenopausal women.

The long-term effect on aspects of quality of life (QoL) of treatment with transdermal oestrogen for 2 weeks followed by transdermal oestrogen/progestogen norethisterone acetate/oestradiol TTS 0.25/0.05 mg/day for the next 2 weeks was investigated in postmenopausal women within the framework of a 1-year seven-centre trial. Of the 136 women who were included (mean age 53 +/- 4.8 years), 110 completed the study. Aspects of QoL that are of relevance in the perimenopause and postmenopause were evaluated using the Psychological General Well-Being (PGWB) index, the Women's Health Questionnaire (WHQ) and the Sleep Dysfunction Scale before and after 3 and 9 months of therapy in the oestrogen phase. Climacteric complaints were also assessed by means of the Kupperman Index. Improved well-being, i.e. less anxiety and depression, increased vitality and better self-control (P less than 0.0001) were observed, as well as reduced sleep disturbance (P less than 0.0001). The WHQ showed decreased vasomotor and somatic symptoms, and improved sex life, emotions and cognitive function (P less than 0.0001). Improvement was the same at 3 and 9 months. According to the Kupperman Index, climacteric symptoms were alleviated (P less than 0.0001). Relief of vasomotor symptoms was correlated with improvement in the WHQ (r = 0.82), the PGWB index (r = 0.58, P less than 0.0001) and sleep (r = 0.51, P less than 0.0001). Because of the absence of a placebo control group, the results must be regarded with caution until confirmed in a placebo-controlled trial.

Administration, Cutaneous↗
PubMed1992

Perceived health in hip-fracture patients: a prospective follow-up of 100 patients.

We report the impact of the treatment and rehabilitation in hip-fracture patients by using self-assessment instruments of perceived health and relate them to objective outcome assessments, such as ADL (personal hygiene/dressing), walking ability and technical complications. Subjective and objective status for 100 hip-fracture patients admitted from their own home, and rehabilitated in primary health care, were registered over 1 year after fracture. Mean age was 74, and 80% of the patients were women. Two self-assessment questionnaires: the Nottingham Health Profile (NHP part 1) and the Mood Adjective Checklist (MACL) were answered by the patients 6 and 12 months after fracture and compared with functional status (ADL, and walking ability) 4 months after fracture. Problems related to the hip fracture such as pain and physical mobility had most effect on the self-assessment questionnaire (NHP) and were in accordance with the district physiotherapists' evaluation of function. Patients with complications (resulting in nail extraction and total hip replacement) after the primary hip osteosynthesis and patients with a poor function 4 months after fracture had scores in the self-assessment questionnaires indicating a more pronounced and distressing impact of the disease. Small changes in subjective mood (MACL) were found. In an acute, curable, disease such as hip fracture the objective outcome seems as informative as the subjective evaluations of patients' self-assessment.

Activities of Daily Living↗
PubMed1992

A comparison of different psychosocial questionnaires in patients with myocardial infarction.

In a consecutive study of 140 patients investigated one month after myocardial infarction (MI), a battery of American and English questionnaires was used to measure depression, anxiety, sleep problems, health locus of control and perceived health. These measures were compared with a well-documented generic questionnaire, the Nottingham Health Profile (NHP), and a similarly well-documented mood scale, the Mood Adjective Check List (MACL). There was close agreement among all measures depicting anxiety and tension. The concordance between the measures of anxiety states and depression was lower. Depression and sleep problems seem to constitute separate concepts, since they are not as highly related to the other measures of anxiety. Because psychosocial factors are important measures for the outcome after an infarction, accurate assessments of these variables are required. Further research is clearly warranted to clarify the complicated interaction between psychosocial constructs and to improve the methods used for their evaluation.

Female↗
PubMed1992

Evaluation of long-term functional status in first-ever stroke patients in a defined population.

Medical, social and ADL variables were registered within 48 hours of stroke onset and 6 and 12 months later in 346 first-ever stroke patients. One year after stroke onset 27% of the patients were dead. 78% of the surviving patients were living in their own homes, 10.6% in old people's homes with no medical facilities and 9.5% in nursing homes. A health index was used for ADL evaluation and the quality of life was estimated according to Nottingham Health Profile (NHP). 16% of the patients had domestic social service assistance before stroke onset. The help given by relatives and friends far exceeded that given by the society before as well as after stroke onset. Right hemispheric stroke patients had a worse outcome than left-sided with respect to ADL and life satisfaction.

Activities of Daily Living↗
PubMed1991

The relationship between exercise tolerance and quality of life in angina pectoris.

The relationship between exercise tolerance assessed by a conventional exercise stress test using a standard Bruce protocol and quality of life (QoL) was studied in 50 patients with stable angina pectoris (AP). Before the exercise test, patients completed three self-administered QoL questionnaires, the Psychological General Well-Being Index, an Angina-Specific QoL Questionnaire, and Jenkins' Sleep Dysfunction Scale. Total exercise time (r = -0.40) and time until onset of pain (r = -0.44) were significantly correlated with perceived physical limitations. Somatic symptoms were related to total time (r = -0.38). Apart from a significant correlation between depressed mood and total exercise time (r = 0.36), there was no corresponding correlation with well-being and sleep disturbance. These results suggest that exercise stress tests do not reflect quality of life in patients with AP.

Activities of Daily Living↗
PubMed1991

Function of the hip after femoral neck fractures treated by fixation or secondary total hip replacement.

Two matched groups of 28 patients each, with femoral neck fractures treated by primary internal fixation or by secondary total hip replacement after a complication of primary treatment, were evaluated and compared five years or more after primary pin fixation or secondary total hip replacement. The Nottingham Health Profile questionnaire was sent and returned by mail and the patient groups were matched with regard to age, sex, health, and social situation. Patients with healed fractures had less problems with sleep, housework and hobbies, and thus functioned better than patients who had required a secondary total hip replacement.

Activities of Daily Living↗
PubMed1991

Aspects of quality of life on treatment with felodipine.

Quality of life has been assessed in a double-blind four week study comparing felodipine 5, 10, 20 mg and placebo added to metoprolol by adding two self-administered questionnaires to the conventional procedure for the evaluation of adverse events. None of the aspects related to general well-being was affected by felodipine. The subjective symptoms reported were mostly dose-related and so here mainly observed at the highest dose. Some of them, e.g. headache, were transient. It is concluded that felodipine in combination with metoprolol CR did not negatively influence the feeling of well-being of the patients. When the drug was given in low, individually adjusted doses, the symptoms normally associated with Ca antagonists were likely to be minimised.

Adult↗
PubMed1991

Evaluation of three methods of symptom reporting in a clinical trial of felodipine.

251 patients from 23 primary health care centres were recruited to a clinical trial in which either felodipine or placebo was added to baseline metoprolol treatment. Three methods of symptom reporting were used in 191 patients, namely two previously documented self-administered questionnaires and an adverse event monitoring system (spontaneous reports to treating physician). Higher frequencies of symptoms were seen with the questionnaires compared to spontaneous reporting. However, the overlap between the methods was moderate and they were found to complement one another. The questionnaires were completed twice during the study and the adverse event monitoring system was applied on five occasions. The rate of application had consequences for the ability of each method to detect transient, dose-related symptoms, e.g. headache and dizziness. Regardless of method, the possibility of detecting dose-related symptoms was enhanced when symptoms were measured not only during active treatment but also during a run-in or other baseline period, and both phases were considered in the analyses.

Adult↗
PubMed1991

Cross-cultural adaptation of health measures. European Group for Health Management and Quality of Life Assessment.

There is increasing interest throughout Europe in measuring health needs in the general population and in the 'quality of life' of patients. This has led to a demand for questionnaires capable of measuring health status in a reliable and valid manner. Most existing measures have, however, been standardised only in the U.S.A. and, to a lesser extent, in the U.K. The issue of translation and retesting of questionnaires prepared in the English language for use in other countries has received surprisingly little attention. This paper describes some of the technical, linguistic and conceptual issues raised by translation and the processes involved in producing acceptable country-specific versions of the Nottingham Health Profile according to a systematic method.

Cross-Cultural Comparison↗
PubMed1991

A summary index for the assessment of quality of life in angina pectoris.

When exploring the effects of anti-anginal therapy on quality of life (QL), it is essential to use concise, reliable, outcome measures which focus on those aspects of the disease which are affected by the anginal pain, and which are expected to be responsive to medical intervention. Analysis based on a single comprehensive index is preferable to the use of several indexes as it avoids the potential for conflicting inferences from multiple comparisons. In this paper, we describe the development of a QL index which summarizes the three questionnaires used in the North Karelian Quality of Life (KarQuol) study. The summary index (SI) will be used to compare transdermal and oral nitrate therapy in patients with angina pectoris, and represents the first stage in the construction of a disease-specific evaluative index for future trials.

Abstracting and Indexing↗
PubMed1991

Anti-anginal therapy and quality of life. A comparison of the effects of transdermal nitroglycerin and long-acting oral nitrates.

A total of 112 male patients with severe effort-induced angina pectoris (New York Heart Association functional classes II and III) participated in a randomized open trial consisting of a 6 month phase with 3 month treatment cross-overs. The aim of the study was to compare the effect of transdermal nitroglycerin (TN) patches and long-acting oral nitrates (LAON) on quality of life (QL). During the cross-over period 30 patients (20 on TN and 10 on LAON) withdrew from the study, over half of them within the first month. Although the results should be interpreted with some caution, they showed that improvement in QL was present for both treatments but greater during the transdermal therapy (unadjusted p = 0.07, adjusted p = 0.03). Anginal attacks were associated with improved QL scores, and fewer attacks occurred on TN (p = 0.06). Improvement in QL was most pronounced in patients whose recorded duration of angina was less than 8 years.

Administration, Cutaneous↗
PubMed1991

Evaluation of quality of life in clinical trials. Selecting quality-of-life measures.

The strategy for evaluating quality of life in clinical trials is an important and complex issue. By comparing the performance of different quality-of-life measures before and after estrogen replacement therapy, it was shown that disease-specific measures had obvious advantages. Although narrow in applicability to the particular patient group, they were the most responsive measures in detecting small, clinically important changes. In clinical trials more attention should be given to how side effects, which often have important implications with regard to quality-of-life, are recorded.

Administration, Cutaneous↗
PubMed1991

Long-term follow-up of health-related quality of life in patients with suspected acute myocardial infarction when the diagnosis was not confirmed.

This study describes the outcome in terms of health-related quality of life (QL) five years after onset of symptoms in 397 patients with an initial suspicion of acute myocardial infarction (MI) but in whom the diagnosis was not confirmed. The patients were approached by means of a postal inquiry that comprised two questionnaires. The most pronounced impairment in health-related QL was expressed as decreased energy, whereas social life was the least affected area. The overall QL was very similar to that in patients who had a confirmed MI. Subsets of patients with impaired QL were those given the diagnosis of angina pectoris or possible infarction.

Acute Disease↗
PubMed1991

Quality of life in cardiovascular diseases. Emphasis on beta-blocker treatment.

In this article, the issues involved in the measurements of quality of life in clinical trials of cardiovascular drugs are discussed with emphasis on beta-blocker treatment. The extensive documentation available for beta-blockers makes it possible to evaluate different aspects of this class of drugs. Generally, beta-blockers have been shown to be safe with a low frequency of serious side effects. However, results of different studies have shown that this class of drugs affects various aspects of well-being and psychomotor tests both negatively and positively. Adverse effects often associated with beta-blockers are the subjective symptoms that are considered to be related to the central nervous system. Today there is increasing evidence that these can be quantitatively as well as qualitatively reduced by using beta-blockers in a low dose and avoiding high plasma peak concentrations. Considering effects on well-being and psychomotor tests, there seems to be no clinical difference between hydrophilic and lipophilic beta-blockers, when administered in comparable therapeutic dosages, whereas beta 1-selective blockers in clinically relevant doses seem to produce fewer and less severe adverse effects than nonselective blockers. Compared with other classes of cardiovascular drugs, there is no clear evidence of differences in well-being between selective beta-blockers and angiotensin converting enzyme inhibitors or calcium antagonists.

Adrenergic beta-Antagonists↗
PubMed1991

A comparison of quality of life before and after arthroplasty in patients who had arthrosis of the hip joint.

Quality of life before and one year after total hip arthroplasty was evaluated in fifty-six patients who had arthrosis of the hip joint. There were twenty-one men and thirty-five women, and the median age was sixty-five years (range, thirty to seventy-nine years). Before and after total hip arthroplasty, a functional assessment was done with the Charnley-Merle d'Aubigné scoring system. The patients assessed quality of life using the Nottingham Health Profile. In the comparison of quality of life before and after the arthroplasty, significant improvement was observed regarding pain (p less than 0.0001), energy (p less than 0.0001), sleep (p less than 0.0001), and social isolation (p = 0.001). Similarly, there was a significant reduction in the frequency of health-related problems pertaining to housework (p less than 0.0001), holidays (p less than 0.0001), hobbies (p = 0.0001), social life (p less than 0.0001), sexual function (p = 0.001), and family life (p = 0.0005), and among patients who were sixty-five years old or less and who worked at paid employment (p = 0.04). Quality of life after total hip arthroplasty was in close agreement with that of a healthy reference group of similar age and sex distribution. It was concluded that quality of life after total hip arthroplasty is improved considerably. The Nottingham Health Profile is a valuable tool in the evaluation of the result of, as well as the indicators for, total hip arthroplasty.

Activities of Daily Living↗