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Reidun Førde

Publications and source records attributed to Reidun Førde.

At least 19 recordsLinked to original sources
PubMed2006

[Enough resources to the care of the elderly?].

BACKGROUND: The increasing numbers of elderly in need of basic medical and nursing care challenges prioritization and quality assurance within the Norwegian health care system. MATERIAL AND METHODS: A questionnaire on health care to patients aged 75 years or older was sent to 2103 doctors and nurses employed in hospitals and primary community care. RESULTS: 67% returned the questionnaire. 92% of the nurses and 79% of the doctors stated that lack of resources related to all levels of medical and nursing care for ill elderly patients cause personal strain. Personnel shortage, lack of time and lack of money were the three most frequently mentioned causes of unsatisfactory coverage of basic needs. 29% said they experience reduced quality of medical treatment weekly or daily, while 25% stated that they meet reduced quality of diagnostics just as frequently. Even more often, the respondents experienced unsatisfactory coverage of hygiene and nutrition, but social needs and exercise were the most neglected areas. Nurses and doctors employed in nursing care institutions most frequently expressed that lack of resources have serious consequences for patients aged 75 years or older. INTERPRETATION: Basic medical care for elderly ill patients is not sufficient with respect to diagnostics and medical treatment. In particular, nursing care and meeting the individuals' psychosocial needs are not prioritised highly enough. Both doctors and nurses frequently describe shortage of time as a problem. Poorly organized medical care, including lack of coordination, seems to be a continuous problem in health care for the elderly.

Aged↗
PubMed2006

[Palliative sedation to the dying].

BACKGROUND: Guidelines for palliative sedation to dying patients were issued by the Council for Medical Ethics of the Norwegian Medical Association in 2001. This study is a follow up of these guidelines. MATERIAL AND METHODS: In 2002 an anonymous questionnaire was sent to 400 hospital departments. After two years, only 12 questionnaires had been returned. In addition to this survey we present data from a survey among a random sample of 1539 doctors. RESULTS: Ten of the 12 treatments which were registered in detail concerned patients with advanced cancer and in great discomfort. Average age was 49. Pain, nausea, convulsions and dyspnoea were the most common symptoms. Nine out of the 12 patients were in pain. In no case the sedation was assessed to have been avoidable with more health care resources. Relatively few patients had been examined psychologically. The decisions were taken by several caregivers, always in accordance with the family's wish. Six of the patients whose conscience level was raised were sedated again. Midazolam and morphine were the two mostly-used drugs; doses used varied considerably. 12% of the surveyed physicians said that one or more dying patients had been given palliative sedation in their department during the last 12 months. INTERPRETATION: Palliative sedation for dying patients is probably used infrequently in Norway, and not to hasten death. In the cases which we have registered, palliative sedation was given to patients in great discomfort.

Adult↗
PubMed2005

[What are the clinical ethics committees doing?].

BACKGROUND: Clinical ethics committees have recently been established in nearly all Norwegian hospital trusts. To assess the quality and function of the committees, a national research project was initiated in 2004. METHODS: A questionnaire on composition, resources, qualifications, tasks and routines was mailed to all committees. The response rate was 75% (21 out of 28). RESULTS: The committees are interdisciplinary and meet on average nine times per year. Only three (14%) chairs have been given dedicated time. Ten (48%) committees have separate budgets. Major tasks include getting the committee established, educating employees, deliberations (cases and more general questions), and guidelines. Main issues are withholding and withdrawing treatment, communication, patient autonomy, involuntary treatment, and priority setting. 16 committees have specific deliberation procedures. Minutes were taken in approximately half of the case deliberations. Systematic evaluation is scarce. INTERPRETATION: During a short period the committees have increased their competence and served over 2000 hospital employees, mainly through seminars. The committees probably already contribute to quality assurance in ethical decision making. The committees want more case consultations. Important challenges are obtaining sufficient resources, making the committees better known, and establishing routines.

Clinical Competence↗
PubMed2005

Unhappy doctors? A longitudinal study of life and job satisfaction among Norwegian doctors 1994-2002.

BACKGROUND: General opinion is that doctors are increasingly dissatisfied with their job, but few longitudinal studies exist. This study has been conducted to investigate a possible decline in professional and personal satisfaction among doctors by the turn of the century. METHODS: We have done a survey among a representative sample of 1,174 Norwegian doctors in 2002 (response rate 73 %) and compared the findings with answers to the same questions by (most of) the same doctors in 1994 and 2000. The main outcome measures were self reported levels of life satisfaction and job satisfaction according to the Job Satisfaction Scale (JSS). RESULTS: Most Norwegian doctors are happy. They reported an average life satisfaction of 5.21 in 1994 and 5.32 in 2002 on a scale from 1 (extremely dissatisfied) to 7 (extremely satisfied). Half of the respondents reported a very high level of general life satisfaction (a score of 6 or 7) while only one third said they would have reported this high level of satisfaction five years ago. The doctors thought that they had a higher level of job satisfaction than other comparable professional groups. The job satisfaction scale among the same doctors showed a significant increase from 1994 to 2002. Anaesthesiologists and internists reported a lower and psychiatrists and primary care doctors reported a higher level of job satisfaction than the average. CONCLUSION: Norwegian doctors seem to have enjoyed an increasing level of life and job satisfaction rather than a decline over the last decade. This challenges the general impression of unhappy doctors as a general and worldwide phenomenon.

Adult↗
PubMed2005

Job satisfaction among Norwegian general practitioners.

OBJECTIVE: To explore the level of job satisfaction among general practitioners (GPs) and to compare it with that of hospital doctors. DESIGN: Postal questionnaire among Norwegian doctors in 2002 and similar data from 1994 and 2000 for most of the respondents. MATERIAL: A total of 295 GPs out of 1174 doctors completed the questionnaire (73% response rate). Main outcome measures. Self-reported levels of job satisfaction according to the Job Satisfaction Scale (JSS). RESULTS: Norwegian GPs reported a high level of job satisfaction with a mean score on the JSS of 52.6 (10 is minimum and 70 maximum). The reported level of satisfaction was highest for their opportunities to use their abilities, cooperation with colleagues and fellow workers, variation in work, and freedom to choose own method of working. The GPs' level of job satisfaction remained stable in 1994, 2000, and 2004 in spite of major health reforms. GPs report a higher level of job satisfaction than hospital doctors. CONCLUSIONS: In spite of international discussions on unhappy doctors and doctors' discontent, Norwegian GPs do report a high and stable level of job satisfaction.

Adult↗
PubMed2004

[Physicians and drug industry: attitudes and practice].

BACKGROUND: There is a need for more knowledge on how doctors assess the relationship between the pharmaceutical industry and the medical profession. METHOD: Postal questionnaires survey in 2002 among a representative sample of 1606 Norwegian doctors. The response rate was 73%. RESULTS: 70% of the respondents indicated that continued medical education would suffer without participation from the pharmaceutical industry, and 40 % that the industry was important for their own updating of skills. 52% agreed that doctors were influenced by the pharmaceutical industry, but 40% claimed that this was not the case for them personally. Specialists in internal medicine, surgery and family medicine were more likely to travel abroad sponsored by the pharmaceutical industry, whereas specialists in family medicine and internal medicine more often attended industry-sponsored meetings in Norway. Psychiatrists were more likely to see the relationship between doctors and industry as too regulated. Young doctors were more sceptical towards the pharmaceutical industry than their older colleagues. INTERPRETATION: Norwegian doctors find that the pharmaceutical industry is important to their own professional development and this may complicate attempts to regulate this relationship. It is, moreover, a problem that doctors probably underestimate the influence of the industry.

Adult↗
PubMed2004

[The Council for Medical Ethics 1985-2001].

BACKGROUND: The Council for Medical Ethics of the Norwegian Medical Association was founded in 1961. The council, made up of five physicians, is elected by the Representative Body of the Association for four years. MATERIAL AND METHODS: This article presents the work of the council from 1985 to 2001. We examined all written reports; all cases were coded in the same manner as in a previous evaluation. RESULTS: The types of complaints and the council's response to them were not different from the pre-1985 period. 300 complaints of violations of physicians' code of ethics were reviewed, 60% of them brought before the council by physicians or by branches of the medical association. Issues related to medical certificates, confidentiality and advertisements were the most frequent. Eight physicians were expelled from the Association, all of them general practitioners, psychiatrists or gynaecologists. Financial or sexual exploitation were the most prevalent causes of expulsion.

Codes of Ethics↗
PubMed2004

[Medical certificates issued to help the patient].

BACKGROUND: Medical certificates form the basis for important decisions in society, e.g. the issuing of a driver's licence or the granting of a disability pension. We wanted to know how often doctors deliberately write favourable certificates as seen from the patient's point of view, and why doctors do so. MATERIAL AND METHODS: Questionnaire survey to a representative sample of 1605 Norwegian doctors. Doctors who answered yes to the question above gave information about the frequency of such writing of various types of certificates and their reasons for doing so. RESULTS: 1175 (73%) doctors responded. 39% confirmed deliberately writing in favour of their patients. For most types of certificates, a frequency of less than once a year was most common. 55% admitted writing favourably in disability pension certificates more than once a year, 69% so in referrals. The most common reasons given were securing just treatment and quick access to treatment. Many doctors emphasised that by answering yes, they meant that they were indeed writing expert judgments based on correct facts. INTERPRETATION: Medical certificates deliberately written in favour of the patient is not uncommon. This should lead to a critical discussion of the need for such certificates and medical diagnoses as a basis for resource allocation, rather than the tightening of control over the practice of doctors.

Attitude of Health Personnel↗
PubMed2002

[Parents' experiences with life-and-death decisions concerning their premature infants].

BACKGROUND: The study is concerned with parents' experience with life-and-death decisions concerning their premature infants in hospitals neonatal units. What are parents' attitudes towards their being involved in such decision-making? MATERIAL AND METHODS: During the 1997-2000 period, 20 qualitative interviews with 35 parents of 26 children were made. A qualitative, comparative method (grounded theory) was used for the analysis, which was carried out in parallel with data collection. RESULTS: Parents are exposed to great mental pressure, which may bring about a sense of ambivalence and a wish to avoid responsibility. Most parents do not wish to have the final word in decisions concerning their infant's life or death. Such a responsibility is likely to make parents feel guilty and puts too heavy a burden on the parents, but parents wish to be informed and taken seriously in the decision making-process. INTERPRETATION: Parents value health professionals' communication and information more than parent autonomy and right to choose.

Attitude to Death↗