Biomedical subjects

L R Hallberg

Publications and source records attributed to L R Hallberg.

At least 19 recordsLinked to original sources

PubMed2000

Model of the dentist-patient consultation in a clinic specializing in the treatment of dental phobic patients: a qualitative study.

Thirty semi-structured interviews were conducted with 5 dentists (3 male and 2 female) after first and second consultations with 15 newly enrolled dental phobic patients (2 male and 13 female) in a clinic specializing in the treatment of odontophobia. Analysis of the transcribed interviews was influenced by the principles of grounded theory. Five concepts/higher-order categories were grounded in the data: 1 core category: 'Relatedness, based on affective resonance and concordant roles' and 4 additional higher-order categories: 'the dental phobic patient's emotions'; 'the patient's verbal and non-verbal cues'; 'the dentist's role as a clinician: professional interpersonal skills'; and 'the dentist's role as a fellow-being: general interpersonal skills'. The model developed describes the dynamics of the dentist patient interaction and has a theoretical application.

Adult↗

PubMed2000

Harmonizing dilemmas. Siblings of children with DAMP and Asperger syndrome's experiences of coping with their life situations.

The aim of this qualitative study was to describe, from their own perspective and experiences, how siblings of children with deficits in attention, motor control and perception (DAMP) and Asperger syndrome cope with their life situations in their families. Fifteen adolescent females 12-18 years old, siblings of boys with DAMP (8 subjects) and Asperger syndrome (7 subjects), were interviewed. The method used in sampling and analysis of interview protocols was the constant comparative method for grounded theory. The inductive categorization of data produced two core concepts, one about the siblings' life situations in DAMP and Asperger syndrome ('dilemma of requirements and concerns') and one about the siblings' coping processes ('harmonizing'). Of the six categories identified, four were categories of the processes of coping ('gaining understanding', 'gaining independence', 'following a bonding responsibility' and 'balancing'). The qualitative differences between coping processes were related to the two categories of context to cope within the experienced dilemma 'requirements' and 'concerns'. The findings contribute to a deeper understanding of the siblings' life situations, and may be important for health personnel in encounter families and for identifying siblings with special needs. The findings may also aid in the development of preventive programs for siblings of children with DAMP and Asperger syndrome.

Adaptation, Psychological↗

PubMed2000

Coping with fibromyalgia. A qualitative study.

This study aims to describe, from the perspective of patients with fibromyalgia themselves, their experiences of having to live with chronic pain and how they manage their situation. The sample consists of 22 female patients (22-60 years). Open-ended in-depth interviews were analysed by a method directed by the tradition of Grounded Theory. Three descriptive categories were grounded in the data, labelled subjective pain language, diversified pain coping, and pain communication. These descriptive categories formed the higher-order, or core, concept preoccupied with pain. Having to live with chronic pain seems to include that the sufferer becomes self-centred and preoccupied with the pain: the pain is mostly present and affects every aspect of life, leading to a continuous awareness of and coping with the pain. Pain tends to interrupt normal life, demands attention and is difficult to disengage from. Although coping should not be evaluated in terms of good and bad, passivity, escape behaviours, and resignation/catastrophizing, which dominated in the present study sample, might affect social and psychological functioning negatively. Patients with fibromyalgia might benefit from psychological support in coping with their pain and from reinforcement of healthy behaviours.

Adaptation, Psychological↗

PubMed2000

Coping with post-lingual severe-profound hearing impairment: a grounded theory study.

The purpose of this study was to describe the experiences of coping with demanding auditory situations in everyday life from the perspective of individuals with severe-profound hearing impairment. Seventeen individuals (11 women and 6 men), with post-lingual severe-profound hearing impairment participated in the study. All were patients at the Department of Audiology, Sahlgrenska University Hospital in Göteborg, Sweden. Inclusion criteria were a hearing impairment exceeding 70 dB HL at the frequency of 1 kHz in the better ear, and full-time employment. Data were assessed by in-depth interviews lasting about one hour. The interviews were transcribed verbatim and analysed line-by-in line in accordance with the grounded theory tradition. Six theoretical constructs, or categories, were grounded in the data. These categories were labelled 'coaching', 'belonging to two worlds', 'self-efficacy', 'hardiness' and 'directing coping strategies'. In a grounded theory the central phenomenon on which all the other categories are integrated is known as the 'core category'. The core category, which emerged in the present study, was labelled 'finding flow and entering a positive circle'. This was described as a condition necessary for successful coping with the demanding situation of being a profoundly hearing-impaired person working full-time. According to the core category, there is a small 'margin' within the positive circle (a space where smaller mistakes may occur). However, if mistakes are too severe, or too many, individuals will no longer find flow in the positive circle, rather they enter a negative circle. In the present study subjects' personalities were characterized by hardiness. It is suggested that coaching behaviour and the hearing-impaired individuals' personality dispositions of hardiness and self-efficacy function as resistance resources, buffering stressful events in everyday life.

Adaptation, Psychological↗

PubMed2000

Prediction of quality of life in patients with tinnitus.

According to epidemiological studies of tinnitus prevalence, 0.5-1% of respondents report that tinnitus severely affects their ability to lead a normal life. In the present investigation quality of life and its association with tinnitus-related factors: psychological, psychosomatic and audiological, was studied based on a sample of 122 patients, who attended the hearing clinic for distress due to tinnitus. A stepwise regression analysis was performed with quality of life as a dependent variable. Six of 13 variables included in the model proved to be significant regressors and to explain 65% of the variance. The six predictor variables were: impaired concentration, feeling depressed, perceived negative attitudes, hypersensitivity to sounds, average hearing level (best ear) and tinnitus duration (the shorter the duration of tinnitus the more negative impact on quality of life). The three most significant predictors were directly related to perceived psychological distress and explained most of the variance in quality of life in tinnitus patients included in this study. An unexpected finding was that fluctuations in tinnitus, vertigo, headache or perceived social support did not prove to belong to the significant regressors. The results are discussed in view of the construct of quality of life, depressive cognitions and social support in general, as well as in tinnitus-specific life circumstances.

Attitude to Health↗

PubMed2000

Oral health care--a low priority in nursing. In-depth interviews with nursing staff.

In this study we examined how nursing home staff experienced assisting patients with oral health care. The results of a previous questionnaire indicated that oral health care is a low priority in nursing. The 22 in-depth interviews administered in this study showed that the quality of the oral health care received by the patients depended on several factors. It was found that often there were no specific routines for assisting oral health care in the nursing homes and that other activities were given higher priority. Assisting oral health care was described as passing a barrier, where the main problem was to gain access to the oral cavity. It was concluded that nursing staff working with geriatric patients need to be better educated in oral health care and should be seen by themselves and others as part of a team, where oral health care is clearly defined and included among other daily nursing activities.

Aged↗

PubMed1998

Evaluation of a Swedish version of the Hearing Disabilities and Handicaps Scale, based on a clinical sample of 101 men with noise-induced hearing loss.

The aim of this study was to evaluate, in terms of descriptive statistics, factor analysis, corrected item-total correlations, and internal consistency reliability, a Swedish translation of the Hearing Disabilities and Handicaps Scale (HDHS). The HDHS is shortened and modified version of the Hearing Measurement Scale. Data from 101 men having noise-induced hearing loss, with the pure-tone audiometric data showing a median value of 53.3 dBHL (R = 81.6; Q = 12.5) over the frequencies 3, 4, and 6 kHz better ear, were assessed at the Department of Audiology, Sahlgrenska University Hospital, Göteborg. A principal component analysis followed by a varimax rotation was conducted giving four emerging factors, accounting for 64.6% of the variance. Two of the factors, "speech perception" (alpha = 0.89) and "non-speech sounds" (alpha = 0.85), appear to measure perceived disability, whereas two factors, "interpersonal distress" (alpha = 0.79) and "threat to self-image" (alpha = 0.84), appear to measure dimensions related to the process of creating a handicap. The four-factor HDHS needs to be further tested in order to find out its usefulness for clinical assessment of perceived disability and handicap.

Adolescent↗

PubMed1998

Psychosocial vulnerability and maintaining forces related to fibromyalgia. In-depth interviews with twenty-two female patients.

The aim of this qualitative study was to describe, from the perspective of 22 women (aged 22-60 years) with fibromyalgia, their experiences and beliefs of the pain and its origin and how the pain affects family and social life. Open-ended interviews were analysed via a method influenced by grounded theory. Seven descriptive categories were grounded in the data, forming two higher-order concepts: psychosocial vulnerability and maintaining forces. The first of these core concepts, psychosocial vulnerability, comprises the categories: traumatic life history, over-compensatory perseverance, pessimistic life view, and unsatisfying work situation. In the interviews, there are abundant examples of early loss, high degree of responsibility early in life, and social problems with feelings of helplessness and hoplessness later in life. The second core concept, maintaining forces, consists of the categories professional care, pain benefits and family support, which seem to contribute to the persistence of pain. Our results indicate intrapsychic and psychosocial dimensions, which support the hypothesis that individuals with insecure attachment styles are overrepresented among patients with chronic pain.

Adaptation, Psychological↗

PubMed1996

Women with noise-induced hearing-loss: an invisible group?

The aim of this qualitative study was to describe, from the perspective of women with noise-induced hearing loss (NIHL), their experiences of noise as a threat to health and their having to live with a hearing disability, i.e. behaviours, thoughts and emotions in auditory demanding situations. Ten women, patients with NIHL at the Department of Audiology, Borás' Hospital in Sweden, were selected to form a heterogeneous sample. A taped in-depth interview, lasting from 45 minutes to 1 hour, was conducted with each woman. The verbatim transcribed interviews were consecutively analysed using a method influenced by the tradition of grounded theory. Four categories emerged in the process of analysis. These categories were labelled: lack of awareness, ambivalence, controlling and avoiding coping strategies and stigmatization. The category 'lack of awareness' concerned the women's perceptions of the risks of noise on hearing, the lack of efforts on the part of the women to apply for financial compensation for their NIHL, the lack of an awareness of individual's right to have healthy work-place and to receive professional help for hearing impairment. Also lacking was the concept that hearing impaired individuals have the right to participate in the community on similar conditions as non-hearing impaired people. This lack of awareness was identified as a core category relating to the other categories: ambivalence, controlling and avoiding coping strategies and stigmatization. The women's expressions indicated ambivalence concerning the cause of the hearing disability and, also, how to manage the consequences of it: the women in the study seemed to alternate between feelings of hopelessness/resignation and a state of acceptance of the hearing disability. Furthermore, the women alternated between blaming themselves and blaming others for the cause of the hearing loss, indicating a change between internal and external locus of control. Also, the women alternated between controlling and avoiding strategies in coping with demanding auditory situations. The coping strategy chosen by the women in a specific situation intended to prevent or minimize stigmatization, i.e. 'to pass as normal' and thereby to maintain a positive self-image of normality. Despite this, the women often perceived negative and stigmatizing attitudes from others, which reinforced their feelings of ambivalence in how to manage the situation. The hypothesis based on the present pilot study, that women with NIHL are more likely to pass themselves off as normal hearing and therefore might be less likely to be reported in studies of NIHL than men, needs to be further tested in a larger sample.

Aged↗

PubMed1996

Occupational hearing loss: coping and family life.

Too many individuals still unnecessarily develop noise-induced hearing loss (NIHL). Interviews with men with NIHL showed their lack of awareness of noise as a threat to hearing. Also, most men were unwilling to acknowledge, or even denied, their hearing problems. Interviews with spouses of men with NIHL showed that the husband's hearing loss often caused misunderstandings and irritation within the family, which had a negative impact on the couple's intimate relationship. The purposes of our group rehabilitation programme, designed for men with NIHL and their spouses, were to give psychosocial support, adequate information and practice in effective coping strategies. A professional approach to treat men with NIHL is to take a patient-centered global perspective, which encourages the patient to identify, describe and acknowledge problems related to his impaired hearing. In the next step, the patient needs professional help to solve experienced hearing related problems. In this process of identification of and solution to problems, family involvement is important and vital.

Adaptation, Psychological↗

PubMed1995

Coping with noise-induced hearing loss: experiences from the perspective of middle-aged male victims.

The primary aim of this study was to describe coping with noise-induced hearing loss (NIHL) from the perspective of middle-aged men. An additional aim was to gain a deeper insight in their experiences of suffering from NIHL. Taped interviews were conducted with 53 consecutive patients. The interviews focused on the subjects' own descriptions of demanding auditory situations and what they did, thought and felt in these situations. The verbatim transcribed interview protocols were analysed by a method influenced by the tradition of grounded theory (Glaser and Strauss, 1967). The first important finding was that the coping model, consisting of controlling and avoiding strategies, described by Hallberg and Carlsson (1991), was validated by the present data. Second, it was shown that avoiding strategies dominated among men with NIHL, although situational circumstances, interactional conditions, social closeness and degrees of priority, awareness and acceptance sometimes changed the behaviour towards the more controlling strategies. Identification of these five factors should be regarded as an extension of the original model of coping, a third important contribution of this study. The driving force for coping was the hearing impaired person's striving to avoid definition as a deviant in social interactions in order to maintain a positive (normal) self-image. Health professionals are requested to encourage men with NIHL to recognize, confirm and actively seek solutions to problems caused by their hearing loss rather than to reinforce their denial of hearing difficulties.

Adaptation, Psychological↗

PubMed1994

Group rehabilitation of middle-aged males with noise-induced hearing loss and their spouses: evaluation of short- and long-term effects.

This study aims at evaluating the short- and long-term effects of a group rehabilitation programme, designed for males with noise-induced hearing loss and their spouses. The rehabilitation programme, including four 3 h group sessions per week, intended to offer adequate information, psychosocial support and training in effective coping strategies. Fifty-three males were consecutively selected and randomly divided into an experimental and a control group. Twenty-seven males were invited to participate in the group sessions together with their spouses. Although an informed consent to participate was given by the males initially, 15 couples (55.6%) refused to participate, and 12 couples agreed to participate in the group sessions. The short-term effects of the programme showed that the couples felt supported by meeting other couples in the same position. Further, the spouses' awareness of the effects of the hearing impairment was increased, which facilitated the understanding of problems related to their husbands' hearing disability. A reduction in perceived handicap, measured by the handicap sections of the Hearing Measurement Scale (P = 0.017) and by the disability/handicap factor of the Hearing Handicap and Support scale (P = 0.054), was found immediately after the rehabilitation programme in the participants compared to the controls. Four months later, no significant difference in any of the variables measured was found. Interestingly, both from a short-term and a long-term perspective, the drop-outs from the experimental group (n = 15) scored significantly higher on perceived handicap (P = 0.034 and P = 0.031, respectively) compared to the participants in the group rehabilitation programme.

Adaptation, Psychological↗

PubMed1993

Structure of perceived handicap in middle-aged males with noise-induced hearing loss, with and without tinnitus.

By using a modified stepwise regression analysis technique, the structure of self-perceived handicap and tinnitus annoyance in 89 males with noise-induced hearing loss was described. Handicap was related to three clusters of variables, reflecting individual, environmental, and socioeconomic aspects, and 60% of the variance in self-perceived handicap was explained by the representatives of these clusters: i.e. 'acceptance of hearing problems', 'social support related to tinnitus' and 'years of education'. Tinnitus had no impact of its own on self-perceived handicap and only a modest portion (36%) of the variance in tinnitus annoyance was explained by 'sleep disturbance' and 'auditory perceptual difficulties'.

Adaptation, Psychological↗

PubMed1993

Living with a male with noise-induced hearing loss: experiences from the perspective of spouses.

The aim of this inductive study was to describe, from the perspective of the spouses, their experiences of living close to a male with severe noise-induced hearing loss. An additional aim was to generate the first step of a theory of how these spouses managed their daily life. The study sample consisted of 10 strategically selected females who differed in age, educational status, number of children and years of marital relationship. Verbatim transcribed thematized interviews were analysed according to a method influenced by the constant comparative method for grounded theory. Two main variables, or core concepts, were identified: the husband's reluctance to acknowledge hearing difficulties and the impact of hearing loss on the intimate relationship. Combinations of these main variables were related to four qualitatively different strategies used by the spouses: co-acting, minimizing, mediating and distancing strategies. It is suggested that the type of strategy chosen by the spouse influences the outcome of the audiological rehabilitation.

Activities of Daily Living↗

PubMed1993

Tinnitus characteristics in tinnitus complainers and noncomplainers.

The aim of this study was to describe the characteristics of tinnitus in 87 patients (mean age = 53.7 years); 43 patients seeking professional help (complainers) and 44 patients who do not seek help for their tinnitus (noncomplainers). 'Left-sided or mostly left-sided' tinnitus was reported by 42% of complainers and 30% of noncomplainers, whereas 'right-sided or mostly right-sided' tinnitus was equally prevalent in the two groups (26 v. 25%); the differences between groups were not significant. Tinnitus 'in the head' was reported by 14% of the complainers and 6% of the noncomplainers, a nonsignificant difference, whereas noncomplainers perceived tinnitus in 'both ears equally' significantly more frequently than complainers. Complainers had significantly more often 'combined' (tonal plus buzzing) tinnitus sounds (51 v. 30%) and 'non-fluctuating tinnitus' (49 v. 25%) than had noncomplainers, whereas 'tonal' tinnitus was significantly more frequent in noncomplainers than in complainers (43 v. 16%). Further, noncomplainers had worse hearing than complainers: pure-tone averages over vocal as well as high frequencies were significantly higher. Complainers scored significantly higher than noncomplainers on the psychological variables concentration difficulties, irritability and sleep disturbance. Patients with 'combined' tinnitus sounds scored significantly higher on irritability and sleep disturbance than subjects with 'tonal' tinnitus. Patients with 'non-fluctuating tinnitus' scored significantly higher on the three psychological variables than patients with 'fluctuating tinnitus'. A conclusion to be drawn is that 'combined' tinnitus sounds and 'non-fluctuating tinnitus' might be determinants of psychological problems.

Adaptation, Psychological↗

PubMed1992

Psychometric evaluation of a Swedish version of the communication strategies scale of the communication profile for the hearing impaired.

The Communication Strategies scale of the Communication Profile for the Hearing Impaired (CPHI) was translated into Swedish and used in several studies of people with hearing impairment (Hallberg & Carlsson, in press; Hallberg, Erlandsson, & Carlsson, 1991). In this study the scale was evaluated in terms of descriptive statistics, corrected item-total correlations, principal component analysis, and internal consistency reliability. Agreement with results from American studies is surprisingly good. Normative data based on three samples are presented: a general Swedish hearing-impaired sample with predominantly sensorineural hearing loss (N = 199), a subgroup of 105 younger subjects with noise-induced hearing loss, and a subgroup of 39 older subjects with sensorineural hearing loss due to heredity and/or old age. A significantly more frequent use of maladaptive behaviors (p less than .001) and verbal communication strategies (p less than .01) was reported by older subjects with age-related and/or hereditary hearing loss than by younger subjects with noise-induced hearing loss. The Communication Strategies scale seems to be an adequately reliable and clinically useful instrument for assessing adaptive and maladaptive strategies in hearing-impaired subjects.

Adaptation, Psychological↗

PubMed1992

Psychological and audiological correlates of perceived tinnitus severity.

Beliefs and attitudes towards tinnitus have been found to play an important role in the process of rehabilitation. The relationship between audiological, psychological and psychosomatic factors (self-assessment of vertigo and headache and the perceived severity of tinnitus) was investigated in a clinical population of 163 subjects. Audiological descriptives comprised pure-tone average (dB HL), etiology of hearing loss, duration of tinnitus and tinnitus localisation. Perceived severity of tinnitus was assessed with a questionnaire focusing on tinnitus impact on aspects of quality of life, concentration and sleep. A 28-item handicap and support questionnaire was used and factor analysed, resulting in three factors: perceived attitudes, social support and disability/handicap. Tinnitus severity was significantly related to perceived attitudes. The influence of social support on tinnitus severity did not seem to be crucial. The results showed that significantly more women than men complained about vertigo. Unilateral tinnitus localisation was also more prevalent in females. The subjects with multiple tinnitus localisations were older and had significantly more sleep disturbance than subjects with tinnitus localized to the ears only. In accordance with previously reported observations, the frequency of headaches was strongly correlated with the severity of tinnitus.

Adaptation, Psychological↗

PubMed1991

Hearing impairment, coping and perceived hearing handicap in middle-aged subjects with acquired hearing loss.

Coping strategies are presumed to be modifying factors between a hearing impairment and the perceived handicap. The focus of this investigation was to explore audiological and psychological factors affecting the perceived handicap in hearing-impaired middle-aged subjects. The Hearing Measurement Scale, supplemented by a subjective estimation of the perceived handicap, was used as the dependent variable in a study of 62 subjects, heterogeneous as to type and severity of hearing loss and to hearing aid use. In a stepwise regression analysis, maladaptive communication strategies as well as active and constructive coping behaviours were found to increase the self-perception of hearing handicap. Other significant variables were severity of hearing loss and years of education. Tinnitus symptoms did not contribute to the explained variance in the perceived handicap, which was an unexpected finding. A conclusion that may be drawn from the present study is that active coping strategies tend to focus attention on disability and thereby increase perceived handicap.

Adaptation, Psychological↗