PubMed Health⌕ Search

Biomedical subjects

R Førde

Publications and source records attributed to R Førde.

At least 19 recordsLinked to original sources
PubMed1998

Competing conceptions of diagnostic reasoning--is there a way out?

Diagnostic errors are more frequently a result of the clinician's failure to combine medical knowledge adequately than of data inaccuracy. Diagnostic reasoning studies are valuable to understand and improve diagnostic reasoning. However, most diagnostic reasoning studies are characterized by some limitations which make these studies seem more simple than diagnostic reasoning in real life situations actually is. These limitations are connected both to the failure to acknowledge components of knowledge used in clinical practice as well as to acknowledge the physician-patient relationship's influence on clinical knowledge and on the reasoning process itself. In addition the modes of reasoning described in these studies frequently is oversimplified. In this paper three simplistic and competing models of diagnostic reasoning are analyzed and criticized, followed by an evaluation of two alternative models proposing a combined view.

Decision Support Techniques↗
PubMed1997

[Ending life by medical means. Do attitudes of physicians differ from those of the population?].

The paper presents the Norwegian population's attitude to euthanasia and to legal abortion in 1982, 1990 and 1995, and compares the responses given in 1995 with the attitudes of a representative sample of 1,260 Norwegian physicians. The acceptance of legal abortion in the population seems to have remained constant, while the population's attitude towards euthanasia has become more liberal. Social criteria and a potential handicapped baby were less accepted as causes for abortion in 1995 than in 1990. The physicians are more liberal towards abortion and more sceptical towards euthanasia. The physicians are more reluctant, however, to accept a potential handicapped offspring as a reason for abortion.

Abortion, Legal↗
PubMed1997

[A course in medical ethics--a pain in the neck for the clinicians?].

Last year, a course in clinical medical ethics for paediatricians had to be cancelled owing to lack of interest. To find the reason for this, and to learn what ethical problems the physicians encountered in the course of their work, how they solved them, and their attitude towards education in medical ethics, a questionnaire was sent to all members of The Norwegian Paediatric Association, to be answered anonymously. The most frequent excuses for not attending the course were pressure of work and lack of time. 37% claimed that they very often or often encountered ethical problems during their work. 20% often solved these problems alone, and two out of three after discussing them with colleagues. 51% felt a need to improve their competence to solve ethical problems. Only 16% reported having no such need. The authors discuss the form and content of the education in medical ethics.

Education, Medical, Continuing↗
PubMed1997

The ethics of euthanasia--attitudes and practice among Norwegian physicians.

The ethical guidelines of the Norwegian Medical Association strongly condemn physician participation in euthanasia and assisted suicide. A previous study on attitudes towards euthanasia in the Norwegian population, however, indicates that a substantial part of the population is quite liberal. This study explores Norwegian physicians' attitudes towards and experience with end of life dilemmas. Sixty-six percent of a representative sample of 1476 who received postal questionnaires responded. They confirmed that Norwegian physicians actually seem to hold quite restrictive attitudes towards euthanasia. Seventeen percent answered yes to a question of whether a physician should have the opportunity to actively end the life of a terminal patient in great pain who requests this help, while 4% agreed that the same could be done to a chronically ill patient with great pain and a poor quality of life who otherwise would have several more years to live. Six percent of the physicians had performed actions intended to hasten a patient's death, while 76% said that they at least once had treated patients even if they had felt that treatment should have been discontinued. A multiple logistic regression analysis showed that internal medicine specialists, surgeons and psychiatrists were significantly more restrictive than their colleagues in laboratory specialties, and that physicians educated abroad and those with negative attitudes towards patient autonomy had more liberal attitudes towards euthanasia, when gender and time since graduation from medical school were controlled for.

Adult↗
PubMed1996

[General practitioners, community physicians and hospital physicians--how different are they?].

In 1993, 9,226 practising physicians in Norway received extensive questionnaires about their health, working and living conditions. In this article we compare municipality employed community physicians (n = 972), general practitioners in private practice (n = 869), and hospital physicians (n = 3,160) with regard to demographic variables and their experience of stress, professional autonomy and job satisfaction. General practitioners report higher job satisfaction and more autonomy than community and hospital physicians, whereas community physicians seem to have a somewhat higher stress level than the two other categories. The experience of general well being, however, is the same in the three groups. General practitioners also spend more time with patients, and are much more satisfied with their income.

Burnout, Professional↗
PubMed1996

Inclusion of psychosocial conditions in clinical practice and the problem of medicalization.

It is generally accepted today that the biomedical model's exclusive focus on the patient's somatic condition is too narrow. The biomedical model, however, has additional shortcomings. In the first place, resources are left out of the diagnostic perspective. Secondly, the automatic interpretation of symptoms and deviations from normal as present or potential threats to the individual's health. In this paper it is claimed that these characteristics of the biomedical model can lead to medicalization. To elucidate these claims, an alternative approach to antenatal care, is presented in which the psychosocial conditions of pregnant women are integrated. Some practical problems that follow from this approach are discussed.

Adaptation, Psychological↗
PubMed1994

[Prioritization of fertilization in vitro--a systematic analysis].

Who should be offered medically assisted conception treatment within a public health care system? This article discusses medical and ethical selection criteria in relation to general political guidelines for prioritization. Our tentative conclusion is that it is possible to differentiate between groups of patients according to disease criteria, the severity of disease, medical efficacy and cost-efficiency. We note that there is a great need for data to enable well-founded decisions when prioritizing applicants for in vitro fertilization within a public health care system.

Cost-Benefit Analysis↗
PubMed1994

[Children and health. A questionnaire survey of 12-year-old children].

Medicalization, implying that solutions to everyday or existential problems are being sought within the framework of the health care system, seems to be increasing. Morbidity has been related to socioeconomic status. This study aims at finding out how children perceive their own health condition and whether this is related to socioeconomic conditions. 192 pupils aged 12 years from a rural district and from two districts of Oslo with different socioeconomical conditions reported their health condition during the last school term by means of a questionnaire. There was a high prevalence of complaints from the children. 33% reported insomnia, and 14% had frequent episodes of headache. Nearly 50% reported the presence of one or more chronic diseases. The health problems were not related to gender or nationality. Except for dental health, we found no relation between reported sickness and the children's socioeconomic background.

Child↗
PubMed1993

[Do we need new guidelines on iron supplementation during pregnancy?].

Studies have shown that the present official Norwegian recommendations on iron supplementation during pregnancy are not followed. A meeting was arranged in February 1993 to discuss the need to change the recommendations. The article describes the conclusions of the panel. It was proposed that the iron status of the pregnant woman, determined as serum ferritin concentration, should be measured early (before the 15th week of gestation) and iron supplement should be given as selective prophylaxis based on the serum ferritin level. The Directorate of Public Health has been asked to issue new recommendations.

Female↗