PubMed Health⌕ Search

Biomedical subjects

J G Maeland

Publications and source records attributed to J G Maeland.

At least 19 recordsLinked to original sources
PubMed1992

[Health education in municipal health services--status 1991].

The organization and level of activity of health education were examined in a national survey among the Norwegian municipal health services in 1991. The results were compared with a similar survey conducted in 1987. In 1991, 32% of the municipalities had local health education committees compared with 24% in 1987, and 59% had budgets for health education (1987: 52%). Compared with 1987, more of the municipalities took part in national health education campaigns, but locally initiated activities had become less common. Health promotion initiatives involving the public as active participants were clearly more common than in 1987. Local health education did not depend on the size of the population or other features of the municipality. However, the level of health promotion planning and budgeting were reflected in the health education activities. Cooperation with non-governmental organizations seemed to be the most crucial factor for municipal health education for primary health personnel.

Community Health Services↗
PubMed1992

[Locally based health promotion. Meetings of citizens as a tool for population mobilization].

It is necessary to involve the local population to a greater extent in the work of health promotion and prevention of disease. In the municipality of Askvoll the results of a household survey were used as an educational tool at popular meetings in the different settlements. At these meetings, the local citizens themselves chose actual health promotion projects and elected committees to carry them out. The article describes our experiences from this way of mobilizing the community. The attendance rate varied from 3% to 29% of the local population aged over 15 years. More women than men participated. A total of 17 local projects were chosen. We conclude that popular meetings can be a useful tool in local health promotion work.

Adolescent↗
PubMed1992

[The Kvernevik Study. II. Satisfaction with the care among the population 5 years after the opening of a new health center].

Information from a survey conducted in 1984 among the adult population in a suburban area in Stavanger was applied in the planning of a new health centre. Five years later a similar survey was conducted to evaluate the innovations in primary care. Greater satisfaction was noted in regard to accessibility of the doctors. Compared with the general population, regular users of the new health centre were more satisfied with such aspects of service as accessibility by telephone, waiting time and opening hours. There was, a decline, however, in doctor-patient continuity. In general, satisfaction with primary care increased with age. There was no difference in satisfaction between males and females.

Adult↗
PubMed1990

Patterns of emotional reactions after a myocardial infarction.

In a prospective study of 283 myocardial infarction (MI) patients, state-dependent feelings of anxiety, depression, and irritability were assessed twice during hospital stay, and four times during a 3-5 yr follow-up. A K-mean cluster analysis identified six subgroups of MI patients with different pattern of emotional reactions. Two groups, containing nearly half of the sample, had low average levels of emotional upset at all assessments. Two groups showed an intermediate long-term outcome: one of these had a high level of initial emotional upset that subsided during the first six months after discharge, whereas the other group showed increasing levels of emotional distress long-term follow-up. Finally, two groups failed to achieve long-term emotional readjustment. For one of these, a high level of emotional upset was evident from the first in-hospital assessment, whereas the other one had a sharp increase in emotional distress after discharge. In a series of psychological, social and medical variables, the former pattern was associated with more pre-MI medical and psychosocial problems, whereas the delayed emotional reaction was related to lower levels of cardiac health knowledge. Furthermore, high levels of emotional upset preceded both failure in resuming work and increased long-term rehospitalization. The findings indicate that emotional reactions after a MI should be monitored during convalescence to identify patients at risk for a failure in emotional readjustment. Furthermore, effective treatment of initial emotional reactions could promote resumption of work and reduce long-term morbidity.

Adaptation, Psychological↗
PubMed1989

[Health and the quality of life. Concepts and definitions].

The concepts "health" and "quality of life" have multiple meanings and are both unsatisfactorily defined. At least three different meanings of health can be identified: as the absence of illness; as a personal characteristic; and as a state of equilibrium and well-being. Broadly speaking, quality of life has been conceived in four different ways: as satisfaction with life; as satisfaction of defined needs; as happiness; and as self-realization and growth. It is argued that health and quality of life should be viewed as complementary concepts with a considerable overlap, but also with distinct features. Both concepts are needed. However, they should be more precisely defined in relation to each other.

Health↗
PubMed1989

Use of health services after a myocardial infarction.

Short-term and long-term use of physician consultations and rehospitalizations were studied in 383 myocardial infarction (MI) patients in relation to demographic, medical, and psychological factors. Short-term (i.e. within 6 months post-MI) utilization of physicians was only related to patients' health locus of control. In comparison, a higher number of physician consultations 3-5 years after the MI was independently related to female sex, more non-cardiac limitations before the MI, more complications during hospitalization, less cardiac lifestyle knowledge, and higher levels of anxiety and depression short time after the MI. Every second patient was readmitted to the hospital before the 3-5 years follow-up but only 14% suffered a non-fatal reinfarction. More rehospitalizations were independently related to a higher number of previous hospitalizations for heart disease, more pre-MI cardiac limitations, less cardiac lifestyle knowledge, and higher initial level of emotional distress. Discriminant analysis identified female sex and patients' initial expectations of reduced emotional control as the best predictor variables for a rehospitalization caused by chest pain without a new infarction, whereas a reinfarction was best discriminated by the number of previous hospitalizations for heart disease. We conclude that psychological factors influence health services utilization to a comparable extent as medical factors. These findings may indicate a greater need for long-term professional support in patients with less initial cognitive and emotional control.

Cognition↗
PubMed1989

After the myocardial infarction. A medical and psychological study with special emphasis on perceived illness.

Each year, more than 10,000 persons are admitted to Norwegian hospitals for a myocardial infarction (MI). The purpose of this study was to examine the medical, psychological, and social consequences of a MI, with special emphasis on the role of cognitive factors for the readjustment and coping process. Three hundred and eighty-three MI-patients below 67 years of age were followed by means of self- administered questionnaires during hospitalization and 1-2 weeks, 6 weeks, 6 months, and 3-5 years after the MI. In addition, a quasi- experimental evaluation of an in-hospital educational program was carried out. A high participation rate, relatively high reliability coefficients for methods developed for this study, and good correspondence with proxy information indicate satisfactory quality of data. Special attention was given to patients' cardiac health knowledge and expectations; two central aspects of perceived illness. Knowledge was represented by three scales covering basic understanding, lifestyle related aspects, and common misconceptions about coronary heart disease. Expectations were represented by four scales, pertaining to the subjective estimates of, respectively, reduced physical ability, autonomy, emotional control, and work capacity. Knowledge and expectations were only moderately correlated. Level of cardiac knowledge among the MI patients was primarily determined by socioeconomic status and amount of standardized information received during hospitalization. More negative expectations were strongly associated with hopelessness and a worse self-rated pre-MI health status. Self-assessed health was clearly reduced after the MI compared with pre-MI levels. About two-thirds of the patients were limited in their physical activities by chest pain or breathlessness. Over the 3-5 years follow-up period, about half of the surviving patients were readmitted to hospital; in more than two-thirds of the cases for heart-related reasons. Almost one third had a major recurrence, either death (17%) or a non-fatal reinfarction (14%). However, long-term use of physician consultations did not exceed that of the general population. Within 6 months, 73% of previously employed patients had returned to work with a mean sick-leave period of 15 weeks. Of previous smokers, 41% had resumed smoking 6 months after the MI whereas 49% smoked at the 3-5 years follow-up.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Psychological↗
PubMed1988

Verbal denial and outcome in myocardial infarction patients.

In a prospective study of 367 myocardial infarction patients, in-hospital measures of three aspects of verbal denial were examined with regard to medical, social and psychological outcome during a 3-5 yr follow-up. A low level of Denial of Illness was associated with more problems related to work, sexual life, and physical activities; and with a higher mortality rate. Higher levels of Denial of Impact were related to better emotional outcome, but also weakly associated with increased mortality. In contrast, Suppression proved to be related only to self-reported emotional distress. The findings indicate that it is useful to distinguish among several forms of denial in medical patients according to what is being denied.

Adaptation, Psychological↗
PubMed1988

Self-assessment of health before and after a myocardial infarction.

Self-evaluated health represents an important aspect of quality of life that may influence the rehabilitation process after a major illness. However, health is a multi-dimensional concept and relatively little is known about the determinants of, and the interrelationships between the separate aspects of health. In a prospective longitudinal study of myocaridal infarction (MI) patients, two indices of self-evaluated health, maximal physical ability (MPA) and perceived global health (PGH), were used. On the average, both ratings were clearly reduced compared with pre-MI levels even as long as 3-5 yr after the MI. Females and older patients indicated lower MPA before and after the MI, whereas PGH was not related to any sociodemographic variable. The severity of the MI appeared to be of relatively limited importance for self-evaluated health. Heart-related symptoms before and after the MI were more strongly related to lower MPA, whereas non-cardiac health problems and psychological distress more clearly influenced PGH. However, initial illness perceptions were of some importance for both health perceptions. The data suggest that to some extent self-evaluated health can be influenced by educational or psychological support in order to faccilitate readaption and recovery after a MI.

Female↗
PubMed1988

Changes in smoking behavior after a myocardial infarction.

Among 383 participants in a longitudinal study of myocardial infarction (MI) patients, 230 smoked at the time of the MI. Posthospital smoking status was based on self-report for the day of follow-up, whereas information about length of continuous cessation was not available. Six months after the heart attack, 40.6% of the smokers had resumed smoking, whereas 49.4% smoked at a 3- to 5-year (M = 43-month) follow-up. Resumption of smoking within 6 months after the heart attack was associated with an increase in anxiety and depression during the first weeks after discharge, less cardiac health knowledge, and a less severe MI. In patients who relapsed at a later point, resumption of smoking was associated with a subsequent decline in general cardiac health knowledge, as well as in correct understanding of smoking at a risk factor. Long-term changes in smoking status were also related to previous heart disease, premorbid work instability, age, and severity of the MI. The results indicate that antismoking counseling of MI patients should not be limited to the health risks associated with smoking and that training in coping with negative affects without smoking may be valuable in promoting smoking cessation.

Adaptation, Psychological↗
PubMed1988

Predicting long-term mortality after a myocardial infarction from routine hospital data.

Among 528 patients under 67 years of age discharged alive after a myocardial infarction (MI), the cumulative survival rates after 3, 5, and 7 years were 84.1%, 75.9% and 68.6%, respectively. Compared with the "normal" population, the relative mortality risk was 4.8 for the first year, 3.1 for the second, and on average 2.1 for the next 5 years. Significant age differences were not observed for relative mortality. A multivariate Cox proportional hazards model showed long-term mortality to be independently related to higher age, a reduced working activity before the MI, previous cardiovascular disease, and a higher inhospital complication score, which was computed by summing eight defined clinical events weighted for severity. The results indicate that a reasonable prediction of long-term survival after a MI can be made from routine hospital data.

Adult↗
PubMed1987

Psychological predictors for return to work after a myocardial infarction.

The relationships between a return to work (RTW) 6 months after a myocardial infarction and selected personality traits, emotional reactions, health knowledge and beliefs, expectations and global health perceptions have been examined in a prospective study of 249 patients below 67 yr of age. Patients' in-hospital expectations of their future work capacity proved to be a strong predictor for RTW. In addition, level of anxiety and depression during hospitalization and level of cardiac lifestyle knowledge were independently associated with RTW. These effects could not be explained by demographic, work-related, or medical factors. It is concluded that patients' early illness perceptions and affective reactions influence later work resumption. Outcome-specific expectancy measures may be the most effective methods for early identification of patients needing rehabilitation efforts after an acute somatic disease.

Adaptation, Psychological↗
PubMed1987

The effects of an in-hospital educational programme for myocardial infarction patients.

The effects of a standardized audiovisual educational programme for myocardial infarction (MI) patients have been evaluated in 4 hospital departments using a time-sequential quasi-experimental design. Compared with controls, patients offered the educational programme were more knowledgeable and had less fear-provoking beliefs about the MI, expressed more optimistic expectations about future physical ability, resumed physical activities more rapidly, reported less initial emotional disturbances, and consulted physicians less often during the first 6 weeks after discharge. Six months mortality-rate was significantly lower in the educational group, but long-term survival was identical in the two groups. The educational programme had no effect on smoking, return to work, resumption of sexual activity, or number of re-hospitalizations. The results indicate that standardized patient teaching during hospitalization is feasible and improves short-term coping behaviour after a MI.

Audiovisual Aids↗