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Biomedical subjects

I Wiklund

Publications and source records attributed to I Wiklund.

At least 145 records · Page 8Linked to original sources
PubMed1990

Factors of importance when evaluating quality of life in clinical trials.

Quality of life (QoL) has during recent years become recognized as an important outcome in clinical trials. But it is not sufficient just to incorporate QoL measures in a trial. Several factors have important repercussions on the results of clinical trials using QoL as an outcome measure. Unless more attention is directed towards factors that may be important when evaluating QoL, the value of including these measurements in clinical trials will be minimized. Important issues pertain to trial design, duration of follow-up, the role of placebo effects, side effects, and confounding variables.

Attitude to Health↗
PubMed1990

What is it like to be a parent of twins?

A questionnaire was given to parents of twins concerning their perceptions of dependency and similarity in their twin children. Also, the parents were asked if they tried to influence their children to become more dissimilar. 70 same-sex twin pairs (35 MZ and 35 DZ) were included in the study and a questionnaire was sent both to the mother and the father of the twins. The twins were approximately 12 years old and attended grade 4, 5 or 6 in the Swedish compulsory school. Results indicated that parents consider MZ twins to be dependent upon each other and to spend more time together. This was especially evident for girls. If the twins had a free choice they would also tend to choose similarly. This trend was also more pronounced for the MZ girls. Irrespective of zygosity, most parents reported that they did not try to influence their children. In the case of MZ twins this will probably make them become more similar over time. Differences between maternal and paternal answers tended to be nonsignificant.

Attitude↗
PubMed1990

Measuring quality of life in medicine.

Quality of life has emerged as an important outcome in evaluating medical care. With an increasing number of patients with chronic disease, it is necessary not only to assess an intervention regarding its ability to effect cures, but also regarding its ability to improve the quality of life. Self-administered patient questionnaires provide a reliable and valid means of assessing how patients respond to therapy. Basically, there are two types: specific and general questionnaires. Whereas general questionnaires give a comprehensive evaluation of the quality of life summarized in a global score, specific questionnaires are focused on a particular problem or patient group. Benefits and disadvantages of generic compared with specific questionnaires are discussed.

Delivery of Health Care↗
PubMed1990

The Nottingham Health Profile--a measure of health-related quality of life.

Assessment of quality of life has attracted increasing interest in recent years. A standardized way of evaluating quality of life is by using questionnaires. One such, the Nottingham Health Profile (NHP), measures health-related quality of life within the sections of energy, sleep, emotions, pain, mobility and social isolation as well as the frequency of health-related problems pertaining to paid employment, housework, hobbies, family life, social life, sex life and holidays. The NHP is well-documented with regard to reliability and validity, and is useful in describing the impact of chronic disease. The NHP is, moreover, a useful evaluative tool in patients with more pronounced disability.

Adult↗
PubMed1990

Education of adult patients at an "asthma school": effects on quality of life, knowledge and need for nursing.

The effect of education of adult asthma patients at a special "asthma school" was studied with regard to knowledge of the disease and its treatment and quality of life measured by leisure activities, social interaction and psychological well being. We also studied if there were any differences in number of days in hospital and emergency visits before and one year after the asthma-school. Patients were randomised to an intervention group (7 men and 13 women) and a control group (7 men and 11 women). The age-range was 22-66 yrs. Both groups answered the same standardized and quantified questionnaires on three occasions, before the start of the asthma school, after five months and after twelve months. Both groups increased their knowledge of the disease and how to treat it, with slightly better results in the intervention group. The self-assessments all showed that patients in the intervention group felt better than those in the control group. The number of days in hospital as well as acute visits to out patients clinics were reduced significantly after the asthma school. The intervention did not influence spirometric variables.

Adult↗
PubMed1989

Quality of life five years after myocardial infarction.

In 539 patients 5 years after myocardial infarction (MI), quality of life and factors influencing life quality were studied. All patients originally participated in an early intervention trial with metoprolol. A cardiac follow-up questionnaire and the Nottingham Health Profile were answered by 82%. In the former, information about subjective symptoms, smoking, work and current medication was obtained; the latter described health-related quality of life in terms of energy, sleep, emotions, mobility, pain and social isolation. The rate of and the reasons for rehospitalization were registered in the patients' records. The MI patients reported a comparatively high quality of life. Compared with 'normal' population, a decrease was noted in energy, sleep and mobility, and in sex life, hobby-activity and holiday activity. A nonparametric multivariate analysis disclosed that dyspnoea, angina pectoris and anxiety were closely associated with decreased quality of life. In conclusion, 5 years after MI most patients seemed well-adjusted. Impaired quality of life was reported by patients suffering from angina pectoris, dyspnoea and emotional distress. No relationship was found between health-related quality of life and the beta blocker, metoprolol, which was the most frequently used drug.

Angina Pectoris↗
PubMed1989

CNS-related subjective symptoms during treatment with beta 1-adrenoceptor antagonists (atenolol, metoprolol): two double-blind placebo controlled studies.

1. Whilst a number of studies have investigated whether metoprolol and atenolol, the most widely used beta 1-adrenoceptor antagonists, differ with regard to CNS-related subjective symptoms, few placebo-controlled studies using standardised questionnaires have been performed. 2. In the present report, the findings of two randomised, double-blind, cross-over studies in healthy volunteers are presented. The subjects were treated with placebo and atenolol (100 mg once daily) (Study 1) and metoprolol (100 mg once daily) and placebo (Study 2). 3. Subjective experiences were evaluated using a standardised instrument, the Minor Symptoms Evaluation-profile (MSE-profile), which was filled in 4, 8 and 24 h after intake of the tablets. A Type A questionnaire was also completed by the subjects. 4. At 4 h both metoprolol and atenolol were found to affect negatively vitality and contentment, but these effects had declined after 8 h. A significant adverse effect on sleep was shown for atenolol compared with placebo, while no negative effect was observed for metoprolol. No significant differences were found in relation to Type A behaviour and beta-adrenoceptor blockade. The number of subjects with Type A personality was, however, low. 5. The results of the studies indicate that the subjective symptoms of the beta 1-adrenoceptor blockers are mild, and that the effects appear consistently with the recognised pharmacokinetic profiles of the two drugs.

Adrenergic beta-Antagonists↗
PubMed1989

Quality of life in postmyocardial infarction patients in relation to drug therapy.

Quality of life (QL) was assessed in relation to drug therapy in 539 patients who were still alive five years after myocardial infarction (MI), and the interaction between drug therapy and QL was investigated. The patients originally participated in a double-blind trial that evaluated the effect of early administration of the beta blocker metoprolol. A cardiac follow-up questionnaire (CFQ) and the Nottingham Health Profile (NHP) were answered by 82%. In the CFQ, sel-fassessed cardiac symptoms, medication (diuretics, digitalis, antiarrhythmics, long-acting nitrates, beta blockers, psychoactive drugs), smoking habits, and work status were described. NHP described QL within the sections of mobility, energy, pain, sleep, emotional reactions, and social isolation. The independent relation between morbidity, drugs, and QL was analyzed multivariately. Apart from symptoms of angina pectoris and dyspnoea, anxiety resulted in impaired QL. A relation between diuretics and decreased QL was found, but no indications of adverse effects of the beta blocker metoprolol.

Anxiety↗
PubMed1988

Physical inactivity as a risk factor for primary and secondary coronary events in Göteborg, Sweden.

Physical activity at work and during leisure time were studied by using a questionnaire in a random sample of 7495 middle-aged men from the Primary Prevention Study in Göteborg and in 1273 able-bodied male patients with a first myocardial infarction, registered in the Infarction Register in the same city over the period 1968-84. Data on coronary risk factors and socio-economic factors were recorded in the population sample as were data on risk factors and known somatic predictors for prognosis in the infarction group. An inverse and graded association was found between leisure time physical activity and mean diastolic blood pressure, total cholesterol, body mass index, tobacco smoking, socio-economic status and mental stress in the random sample. During the approximate 12-year follow-up, low physical activity during leisure time, but not at work, was associated with an increased risk of coronary deaths and non-fatal infarctions in univariate analysis. Inactive subjects had twice the incidence of total coronary events (9.4%) as physically active contemporaries (4.2%). After controlling for major coronary risk factors, occupational class, diabetes, family history of coronary heart disease and mental stress in a multivariate logistic regression analysis, the association between leisure time physical activity and total coronary events disappeared. Physical activity at work and during leisure time estimated for the 12-month period preceding the first infarction was not associated with long-term prognosis after infarction. Infarction patients assessed to be in need of additional rehabilitation due to somatic restrictions, work-related factors and emotional instability, resumed work later and had a higher mortality and non-fatal recurrence rate during follow-up than patients not considered to require additional rehabilitation. Physical inactivity was not a risk factor for primary and secondary coronary events in this study. The inverse direction of the association between leisure time physical activity and coronary risk factors suggests that increased physical activity alters the risk factor profile in a favourable direction.

Activities of Daily Living↗
PubMed1988

Prognostic importance of somatic and psychosocial variables after a first myocardial infarction.

The prognostic importance of somatic and psychosocial variables after a first myocardial infarction was studied in 201 consecutive Gothenburg, Sweden men below 61 years of age who had survived a first myocardial infarction between December 1976 and December 1978. The maximum follow-up time was 100 months. The prognostic importance of somatic, social, and psychological variables was related to the endpoints of death, nonfatal reinfarction, and total events. During follow-up, 48 deaths and 37 nonfatal recurrences occurred. Four variables, none of them significantly correlated with each other, were related to risk of an endpoint. Being single increased risk of death (p less than 0.01) and risk of all events (p less than 0.001), whereas an index reflecting infarct size was correlated to risk of death (p less than 0.001). A prognostic index based upon data available at three months after the myocardial infarction (angina pectoris, hypertension, serum aspartate aminotransferase (S-ASAT) maximum, and smoking) was correlated to risk of nonfatal reinfarction (p less than 0.05). Use of sedatives was also related to risk of reinfarction (p less than 0.05) and to risk of total event (p less than 0.05). The probability of death, reinfarction, and total event was estimated within two and five years after the infarction for all combinations of the variables that were related to risk of an endpoint. It was thus demonstrated that the predictive power increased over time and that the somatic and psychosocial variables independently added information.

Adult↗
PubMed1988

Morbidity and quality of life 5 years after early intervention with metoprolol in suspected acute myocardial infarction.

In 1,395 patients in the age range 40-74 years participating in a double-blind trial with metoprolol in suspected acute myocardial infarction morbidity and quality of life were assessed during the first 5 years after randomization. During the first 3 months patients were given 200 mg metoprolol daily or placebo. Thereafter the two groups were treated similarly. Mortality during 5 years was 24.2% in patients originally randomized to metoprolol versus 25.7% in patients originally randomized to placebo (p greater than 0.2). No difference was observed regarding reinfarction rate, stroke or occurrence of bypass surgery during the 5-year follow-up. During the first 3 months 10% of patients in the metoprolol group were rehospitalized for various reasons versus 13% in the placebo group. The corresponding figures for 5 years were 59 and 60%, respectively. Among patients surviving 5 years 84% in both groups were on some medication of which beta-blockade was the dominating one. Symptoms of chest pain, dyspnea, claudicatio, smoking habits and working capacity did not differ and neither did quality of life according to the Nottingham Health Profile. We thus conclude that morbidity and quality of life were not significantly affected 5 years after early intervention with metoprolol in patients with suspected acute myocardial infarction.

Adult↗
PubMed1988

Self-assessed disability in patients with arthrosis of the hip joint. Reliability of the Swedish version of the Nottingham Health Profile.

The study aimed to describe self-assessed disability, using the Nottingham Health Profile (NHP), in patients with arthrosis of the hip joint, to test the reliability of the Swedish version of the NHP, and to compare disability perceived by the patient with the Charnley/d'Aubignet score. The NHP was administered twice to 73 patients, waiting for total hip replacement. Pain, energy, sleep, and mobility were severely affected. The correlations between subjective and objective scores were, apart from pain, moderate. The two test administrations correlated highly. In conclusion, the NHP is a reliable instrument, which may provide valuable supplementary information in the assessment of disability.

Activities of Daily Living↗