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Biomedical subjects

M Ojanen

Publications and source records attributed to M Ojanen.

16 recordsLinked to original sources
PubMed2006

Baseline psychosocial predictors of survival in localised breast cancer.

Despite the large number of studies on the impact of psychosocial factors on breast cancer progression, there is no certainty about the contributing factors or processes involved. We investigated the relative impacts of socioeconomic, psychological, and psychosocial factors on survival in breast cancer. A consecutive sample of 102 patients (participation 82%) under 72 years of age with locoregional breast cancer completed validated questionnaires on coping with cancer, emotional expression (anger), perceived available support, noncancer life stresses, and quality of life 3-4 months after diagnosis. Survival times were measured from the date of diagnosis to the date of relapse and further to the date of death or date of last follow-up. Cumulative Cox regression analyses were carried out. After controlling for biological prognostic factors, age, and baseline treatment, longer survival was predicted by a long education and a minimising-related coping, while shorter survival was predicted by emotional defensiveness (antiemotionality), behavioural-escape coping, and a high level of perceived support. A shorter event-free time was also predicted by unemployment and depressive symptoms. Cancer survival is affected by a complex combination of psychosocial factors, among which minimising predicts a favourable prognosis and anger nonexpression and escape behaviour an unfavourable prognosis. Higher socioeconomic status is associated with longer survival. High scores in well-being scales may reflect emotional nonexpression.

Adaptation, Psychological↗
PubMed2005

Predictors of quality of life in newly diagnosed melanoma and breast cancer patients.

BACKGROUND: Quality of life (QoL) is a multidimensional construct, and several psychosocial and medical factors can predict a patient's QoL. We investigated the impact of factors in the psychological stress processes on QoL 3 months after diagnosis of melanoma or breast cancer. PATIENTS AND METHODS: In consecutive melanoma and breast cancer patients with localized disease, cancer-specific social support, coping with cancer, personality trait anger expression, non-cancer stress, sociodemographic variables, cancer and treatment variables, and QoL (evaluated as self-reported psychological and physical symptoms, self-perceived QoL, and depression) were assessed with validated quantitative questionnaires. The associations between QoL and the other factors were investigated with multivariate methods. RESULTS: Only a few factors differed between melanoma and breast cancer, in terms of treatment modalities and gender. The amount of received social support was higher among breast cancer patients. The predicting power of psychological stress factors on all the QoL measures was strong, but differed between the treatment groups (surgery only versus adjuvant treatment). Psychosocial factors were the strongest predictors of QoL, not cancer type or treatment. Behavioral Escape-Avoidance coping was associated with worse QoL. However, non-cancer life stresses showed the strongest QoL-decreasing influence. QoL-enhancing factors, including social support, were seen clearly only within the breast cancer patients receiving adjuvant treatment. CONCLUSIONS: QoL of newly diagnosed cancer patients is highly associated with psychosocial factors. Non-cancer life stresses seem to be very important in the QoL of newly diagnosed cancer patients. Adjuvant treatment may comprise supportive psychosocial factors that enhance QoL in cancer.

Adaptation, Psychological↗
PubMed2000

Empty nests in the great tit (Parus major) and the pied flycatcher (Ficedula hypoleuca) in a polluted area.

Great tits (Parus major) are sometimes found to incubate in their nests even though the nests contain no eggs. This phenomenon has been observed in different parts of Europe (Sweden, Finland, UK, Netherlands, Germany) and it has become more common during the 1980s. We analysed the occurrence of empty nests in P. major and in pied flycatcher (Ficedula hypoleuca) in SW Finland from 6-year data collected in a polluted area around a copper smelter which emits large quantities of sulphuric oxides and heavy metals. Among first broods 3.3% of P. major females incubated in empty nests. Incubation on empty nests was not observed in F. hypoleuca, but in this species 2.4% of the nests remained without eggs. In both species empty nests were more common close to the pollution source than farther away. Histopathological analyses in P. major suggest that there are diverse reasons for the incapability of a female to lay. One out of five P. major females captured from incubating in an empty nest had dark cysts in her oviduct. Two P. major females had very scanty medullary bone tissue in their tibiotarsus and tarsometatarsus and one female showed exceptionally high concentrations of lead in her bone tissue. We conclude that air pollutants enhance the number of empty nests especially in F. hypoleuca, but cannot wholly explain the phenomenon in P. major.

Journal Article↗
PubMed1998

The Finnish National Schizophrenia Project 1981-1987: 10-year evaluation of its results.

This study reports the 10-year evaluation of the Finnish National Schizophrenia Project. The aims of the national project were achieved. The number of long-stay schizophrenic patients in psychiatric hospitals decreased by 63% between 1982 and 1992. Both the treatment of schizophrenic patients and the structure of mental health services have changed greatly in Finland. Psychosocial treatment methods in particular have developed. The major innovations of the Project are the acute psychosis teams now serving over 50% of the country, and social skills training programmes. The 10-year evaluation of the Finnish National Schizophrenia Project shows that it is possible to conduct successfully nation-wide projects to develop the treatment of schizophrenic patients and psychiatric practices across an entire country.

Activities of Daily Living↗
PubMed1993

Psychosocial changes in patients participating in a chronic obstructive pulmonary disease rehabilitation program.

Changes in physical competence, respiratory symptoms, well-being, emotional state, level of depression, every-day coping skills, and general activity and independence were studied in 40 chronic obstructive pulmonary disease patients participating in an intensive 3-week rehabilitation program. Both patient and staff ratings were used. Expectations and attitudes prior to rehabilitation were also measured. The study design included a 3-week basal period, a 3-week rehabilitation period and a 6-month follow-up. The immediate effects of rehabilitation on the variables which described subjective experiences were positive: well-being, emotional state and respiratory symptoms improved significantly (p < 0.001, p < 0.01 and p < 0.01, respectively). By the end of the follow-up period, however, all the treatment effects had dissipated. No significant effects of rehabilitation could be seen in every-day coping skills, general activity and independence or level of depression. It was not possible to predict the rehabilitation response on the basis of the patients' attitudes, expectations, level of depression or age. We conclude that pulmonary rehabilitation causes transient improvement in respiratory symptoms and some subjectively characterized psychosocial variables and that this improvement is unpredictable by attitude and expectation variables.

Adaptation, Psychological↗
PubMed1992

Attitudes towards mental patients.

A study of attitudes towards mental patients was made using a questionnaire developed by Lehtinen and Väisänen. Five hundred and fourteen persons from different parts of Finland filled in the questionnaire. The attitudes were generally positive, although, as in other studies, the attitudes of those older and less educated were more negative compared with the other groups. This result was interpreted as a generational effect, which will vanish as the educational level of the population increases. The questionnaire also included questions about the attitudes and behaviour of 'other people'. The attitudes of 'other people' were thought to be very negative compared with one's own attitudes.

Adolescent↗
PubMed1991

The need for social support among out-patients suffering from functional psychosis.

From an original sample of 177 patients in community care and suffering from functional psychosis, the psychiatric teams involved in the treatment of these patients interviewed 136 patients and 103 relatives. The interviews aimed at determining the patient's problems in social-role behaviour, as evaluated both by the patients themselves and by their relatives, and to measure the stress caused to the relatives. According to the patients themselves, over 60% had considerable difficulties in at least one area of social-role behaviour; the same conclusion was reached by over 50% of the relatives. The patients had a more positive view of their abilities to cope with housework, self-care, and managing money than their relatives. One-third of the relatives said they were dissatisfied with the situation, and more than 40% displayed a resigned attitude to the amount of support required by the patient. Problems in social-role behaviour were commonest in patients who were dissatisfied with their treatment, in male patients, and in patients who lived together with their spouse, and among the relatives dissatisfaction with the situation as a whole was also highest in these cases. On the basis of these findings it is stressed that the treatment of psychotic patients should be based on a broad approach involving not only the patients themselves but also their relatives.

Activities of Daily Living↗
PubMed1991

Need for community care among psychotic outpatients.

Psychiatric teams examined a representative sample of 177 psychotic patients in community care. The patients' need for care was assessed using a standardized method. The need for alternative, noninstitutional forms of care (i.e. day and residential services) was greater than the actual use of these services. The same was true of the need for support in social activities, for occupational therapy, training in domestic skills, counselling for relatives and psychotherapy. Unmet needs for care were commonest among patients who were young, who drank heavily, and who suffered from many psychotic symptoms and drug side effects. Outpatient care based primarily on visits to the community mental health centres did not provide adequate services for the most disabled patients. It is concluded that decrease of hospital care has brought a growing need for psychiatric day and residential services among outpatients suffering from psychotic disorders.

Adult↗
PubMed1989

Psychosocial effects of continuous oxygen therapy in hypoxaemic chronic obstructive pulmonary disease patients.

Twenty six hypoxaemic patients with severe and stable chronic obstructive pulmonary disease (COPD) were treated with continuous domiciliary oxygen for a six month period. The patients were evaluated 1, 3 and 6 months after the start of oxygen therapy. In addition to blood gas analysis, 15 coping skills were evaluated by the patient and by the nurse, who also rated the general activity of the patients. Depression was measured by Beck Depression Inventory (BDI) at the start of the trial and after six months' oxygen therapy. The general psychosocial response was meagre; no significant changes were observed in any psychosocial measures. The response was slightly better in younger and less hypoxaemic patients. We conclude that the psychosocial response to oxygen therapy in severely hypoxaemic COPD patients is limited.

Adaptation, Psychological↗
PubMed1985

Progressive integrated system for the rehabilitation of long-term schizophrenic patients.

An integrative stepwise rehabilitation model for schizophrenics, especially those hospitalized for long periods, is described. The basic entities of this model are rehabilitation homes. The client moves from one step to the next according to their particular needs. The steps for living are: small homes, supported lodgings, rented quarters and own apartments. The steps of activities are: day care homes and day clubs, therapeutic sheltered workshop, test working, vocational training and labour market. The central rehabilitative aspects are the therapeutic community, living learning experiences, supporting of selfesteem and integrating with the social network. The psychiatric care system on the other hand and an important work of volunteers and friend services on the other support the rehabilitation. This work has shown during 14 years that the majority of clients can be rehabilitated to live as fairly independent and responsible persons.

Combined Modality Therapy↗