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Biomedical subjects

I Wiklund

Publications and source records attributed to I Wiklund.

153 records · Page 9Linked to original sources

Psychosocial outcome one year after a first myocardial infarction.

Psychosocial outcome in terms of mental state, health preoccupation, leisure activity, avoidance behaviour, sexual activity and attitude towards life and the future one year after a myocardial infarction (MI) was studied in 177 consecutive male, able-bodied patients below 61 yr of age with a first MI. Questionnaires and a brief interview covered the psychological and social data while the somatic variables were recorded in a standardized medical examination. Emotional distress, self-reported symptoms, avoidance behaviour, overprotection, pessimism and a diminished sexual activity were frequent, indicating a poor adaptation. These disturbances were apparent two months after the MI and remained stable. Psychological factors were stronger determinants of maladjustment than smoking, angina pectoris and recorded somatic illness. Neither severity of the infarction nor social and demographic factors determined maladjustment. Intervention must take place early and be directed to psychological factors as well as to the cardiac condition.

Adaptation, Psychological↗

Emotional reaction, health preoccupation and sexual activity two months after a myocardial infarction.

Emotional reaction, health preoccupation and sexual adjustment two months after a first myocardial infarction (MI) were studied in relation to social, psychological and somatic factors prior to, during and after the MI in 201 consecutive male patients. Psychological and social data were covered by means of questionnaires and a brief interview and somatic data by a standardized medical examination. New concepts were introduced after factor analysis. The degree of preoccupation varied very much and was considered as a reaction to the diagnosis of MI. Seventy-nine percent of the patients complained about fatigue and 65% felt anxious and depressed. Fatigue and nervousness were regarded by the patients as more disabling than cardiac symptoms. Emotional distress was related to a previous history of emotional complaints and to psychological factors and self-reported coronary symptoms but was unrelated to severity of the infarction, medically rated cardiac symptoms, demographic and social data. Sexual maladjustment, mainly due to fear, was frequent and associated with both emotional and somatic variables. Emotional disturbance after MI is considerable and further measures ought to be taken in order to prevent future disability.

Adult↗

Sick-role and attitude towards disease and working life two months after a myocardial infarction.

Sick-role and attitude towards disease and work two months after a first myocardial infarction (MI) were studied in relation to social, psychological and somatic factors prior to, during and after the MI in 201 consecutive male patients. Questionnaires and a brief interview covered psychological and social data. Somatic data were registered in a standardized medical examination. New concepts were introduced after factor analysis of the psychological variables. Two out of three patients displayed avoidance behaviour. Seventy per cent had restricted their everyday activities. The leisure time was dominated by passivity. Over-protection was frequent. Sick-role behaviour was significantly related to emotional upset, preoccupation with the health and self-reported coronary symptoms while the shortage of relationships to somatic and cardiac factors was notable. The patients attributed the onset of MI to work-related factors. Work dissatisfaction was an aspect of a general negative attitude towards life and was more frequent among patients with emotional symptoms. The psychological care ought to be improved in order to prevent long-term disability.

Activities of Daily Living↗

Impact of a history of diabetes on the improvement of symptoms and quality of life during 5 years after coronary artery bypass grafting.

To describe the impact of a history of diabetes mellitus on the improvement of symptoms and various aspects of quality of life (QoL) during 5 years after coronary artery bypass grafting (CABG). Patients who underwent CABG between 1988 and 1991 in western Sweden were approached with an inquiry prior to surgery and 5 years after the operation. QoL was estimated with three different instruments: Physical Activity Score (PAS), Nottingham Health Profile (NHP) and Psychological General Well-Being (PGWB) index. 876 patients participated in the evaluation, of whom 87 (10%) had a history of diabetes. Symptoms of dyspnea and chest pain improved both in diabetic and non-diabetic patients. Diabetic patients scored worse than non-diabetic patients both prior to and 5 years after CABG, but without any major difference in improvement between the two groups with all three measures of QoL. PAS tended to improve more in non-diabetic than in diabetic patients, whereas improvement in NHP and PGWB was similar regardless of a history of diabetes. Diabetic patients differ from non-diabetic patients having an inferior QoL both prior to and 5 years after CABG. Both diabetic and non-diabetic patients improve in symptoms and QoL after the operation. In some aspects improvement tended to be less marked in the diabetic patients but on the whole improvement was similar compared to non-diabetic patients.

Activities of Daily Living↗

The norwegian version of the psoriasis disability index--a validation and reliability study.

OBJECTIVE: The aim of this study was to translate the Psoriasis Disability Index (PDI) into Norwegian and validate it in a Norwegian setting. The PDI is a measure that was developed to assess the impact of psoriasis on the patient's life. METHODS: Two hundred and eighty-two patients with psoriasis were included in the study (80% outpatients, and 20% hospitalized). RESULTS: Face and content validity were assessed as satisfactory. The PDI seems to capture issues of importance to patients. The results indicate that the PDI does not capture a unidimensional concept. A factor analysis (principal component with orthogonal rotation) resulted in three factors (physical, social, and hygienic) that were substantially different. All three factors had satisfactory internal consistency. Altogether they explained 58% of the variance. In addition, there were differing patterns of correlations with external criteria, such as dimensions of SF-36, as well as with sex, age, and education. CONCLUSIONS: The PDI has been found to have acceptable reliability in this study. However, further validation is necessary to estimate the sensitivity to change.

Journal Article↗

Measurement of functional status in juvenile chronic arthritis: evaluation of a Swedish version of the Childhood Health Assessment Questionnaire.

Few well-validated self-and/or parent-administered instruments are available for measuring functional status in children with rheumatic diseases. Parts of the Stanford Health Assessment Questionnaire (HAQ) have been adapted for use in children in the so-called Child HAQ. The aim of this study was to investigate the validity of this instrument in a Swedish setting. The Child HAQ was administered to 186 patients and 211 patients participating in a population-based follow-up study of juvenile chronic arthritis (JCA) in southwestern Sweden. The EULAR criteria were used for inclusion. Children who were 9 years of age or older self-reported. Reliability, evaluated by test-retest, inter-observer correlations and internal reliability, was excellent. Convergent validity was demonstrated by strong correlations of the disability index, pain, and morning stiffness with disease activity and the Steinbrocker functional classes. Discriminant validity was evidenced by the capacity of the instrument to evaluate patients as being active or in remission. Thus, the Child HAQ showed excellent measurement performance in a Swedish setting when using parents or children more than 9 years old as responders.

Activities of Daily Living↗