Biomedical subjects

Torbjørn Moum

Publications and source records attributed to Torbjørn Moum.

At least 19 recordsLinked to original sources

PubMed2006

[Training in mindfulness for patients with stress and chronic illness].

BACKGROUND: Training based on mindfulness has developed into a method for managing stress and health problems over the last 25 years. MATERIAL AND METHODS: 144 patients (88% women), troubled by stress and chronic illness, used the method (8-week course) in a randomised controlled study in general practice. Effects on quality of life (QoL) were measured using the WHOQOL-BREF questionnaire (WHO). Subjective health was measured using the Subjective Health Complaint (SHC) inventory and the Hopkins Symptom Checklist (SCL-5). RESULTS: 92% of the patients completed all 8 weeks of the course. The participants rated its importance to 8.5 on a scale from 1 to 10. An increase in QoL and subjective health from start to finish of the course (p < 0.001) was observed, while the control group remained unchanged. The changes in QoL were maintained at 3 and 6 months follow-up, while subjective health continued to improve during that period. Changes were independent of age, sex, education and marital-, work- and health insurance status. Improvements were positively correlated with the self-reported amount of mindfulness training. Effect sizes (Cohen's d) were in the range of 0.5-0.6 and were highest for mental symptoms and mental function. INTERPRETATION: The method gives the patients a tool they can use to improve their health and QoL. By increased understanding and ability to deal with ones own health the patients seem to see themselves and their lives in a new way. The method may be suitable for schools and universities in addition to patient education centres.

Adolescent↗

PubMed2006

Global quality of life in primary caregivers of patients with cancer in palliative phase staying at home.

GOAL OF WORK: Research on global quality of life (GQOL) in primary caregivers (PCGs) of cancer patients is limited. This study measured significant domains of GQOL in PCGs and their association with the patients' disease trajectory and the PCGs' background and life situation. This study also explored differences in their GQOL compared to a normative sample from the general population (NORM). PATIENT AND METHODS: In a cross-sectional design, 71 PCGs (aged > or = 50 years) of cancer patients in palliative phase rated their GQOL by the Quality of Life Scale (QOLS) and provided information concerning demography, experienced social support, and caring situation. Associations between the QOLS scores and variables of the patients' medical history were assessed, and comparisons of QOLS scores were made between the PCGs and age- and gender-adjusted NORM. MAIN RESULTS: Long duration of the curative phase for patients and holding a job for PCGs were significantly associated with a favorable GQOL in PCGs. The mean total GQOL score did not differ significantly between the PCGs and NORM groups, though subanalyses revealed significantly more favorable mean score of the relational domain in PCGs compared to NORM. CONCLUSIONS: GQOL in PCGs of cancer patients in palliative phase staying at home was as good as that of the NORM. For PCGs not employed or caring for patients with a short curative phase, getting some recreation could be of importance for improvement of GQOL.

Adaptation, Psychological↗

PubMed2006

Changes in health status, psychological distress, and quality of life in COPD patients after hospitalization.

The purpose of this paper was to describe quality of life (QoL) following an acute exacerbation of chronic obstructive pulmonary disease (COPD), and to examine possible relationships between QoL, health status, psychological distress and QoL. This prospective longitudinal study examined data from hospitalization and two subsequent phases, collected over a 9-month period. The sample consisted of 51 COPD patients aged 48-87 years. Health status was assessed with the St George's Respiratory Questionnaire (SGRQ); psychological distress with the Hopkins Symptom Checklist (HSCL); and quality of life using the World Health Organization Quality of Life - Bref (WHOQOL - Bref). Health status improved significantly over the 9 months; from 65.95 to 59.40 (p = 0.001) in the SGRQ total score. Psychological distress improved significantly from hospitalization to the 1-month assessment (T2) (p = 0.001). QoL remained stable except for a significant increase in the physical domain from hospitalization to T2, and in the environmental domain from hospitalization to T2 and T3. Test-retest correlations of the WHOQOL - Bref were high. The results suggest an improvement in the health status over a 9-month period from being discharged after an exacerbation of COPD in spite of high levels of psychological distress and reduced QoL.

Aged↗

PubMed2006

Patient experiences with information in a hospital setting: associations with coping and self-rated health in chronic illness.

The structural relations between patient experiences with information provided by hospital staff, coping behaviour and changes in self-rated health were studied in a cohort of people with chronic illness (n=556) over a period of 2 years. A structural equation approach was applied to model cross-sectional and longitudinal effects. Positive experiences with information were cross-sectionally but not longitudinally associated with improved self-rated health. Patient experiences with information are not related to avoidance coping, but positive experiences contribute to more frequent use of supportant coping. The findings in the present study indicate that measures of patient experiences with information are not merely a reflection of patients' health or coping behaviour. More theoretical work is required to describe the relationships between different patient reported outcomes. The insight into mechanisms underlying changes in physical and mental health in chronic illness could be further improved by evaluating the effects of specific educational and psychosocial interventions in a longitudinal design.

Adaptation, Psychological↗

PubMed2006

Methodological issues concerning lifetime medically unexplained and medically explained symptoms of the Composite International Diagnostic Interview: a prospective 11-year follow-up study.

OBJECTIVE: The objectives of this study were (a) to elucidate the methodological problems arising when examining lifetime symptom data by exploring the accuracy of recall of medically unexplained symptoms (MUS) and medically explained symptoms (MES) in the general population, based on interviews using the Composite International Diagnostic Interview (CIDI) Somatoform Section C, in 1990 and 2001, and (b) to find predictors for failure at follow-up to recall symptoms reported previously at baseline (i.e., symptoms "lost"). METHODS: Four hundred twenty-one persons (response rate, 69.6%; 242 women and 179 men) were reinterviewed in 2001 from a baseline population of 605. Thirty-eight clinically significant MUS and MES were assessed. Linear multiple regression analyses with the numbers of MUS-lost (medically unexplained symptoms lost to recall) and MES-lost (medically explained symptoms lost to recall) as dependent variables were undertaken to find factors affecting symptom loss. RESULTS: A wide range of individual symptoms (22-100%) were lost to recall at follow-up, indicating a large degree of measurement error, mainly due to faulty recall. The number of symptoms recalled when they were grouped was better (approximately 50% for "1-3" symptoms). Recall variability and MUS/MES transition over time undermined the credibility of this distinction. Gender and age emerged as significant (P<.01) predictors for MUS-lost, and a decrease in physical morbidity for MES-lost. Men tended to forget more symptoms than women, and younger respondents with high levels of baseline MUS remembered slightly better at follow-up. CONCLUSION: Lifetime symptom data elicited in community surveys by such instruments as the CIDI should be viewed with caution. Methodological errors weakening data credibility could lead to false impressions of true change over time. A MUS/MES distinction is difficult to maintain.

Adult↗

PubMed2006

Changes in quality of life in persons with eczema and psoriasis after treatment in departments of dermatology.

The objective of this study was to assess the impact of chronic dermatological diseases on quality of life (QoL) of Norwegian patients following in-patient management. QoL was measured by the Norwegian version of the Dermatology Life Quality Index, a validated, self-administered questionnaire. Adult in-patients with psoriasis and eczema were selected for one year from the dermatological departments in Norway. A total of 212 patients were included, and 126 patients (50% men, 85 with psoriasis and 41 with eczema, mean age 46 years) completed the questionnaires at time of hospital admission and one week after discharge. The patients reported adverse impact on QoL, but no differences between the psoriasis and eczema groups could be demonstrated. Patients with psoriasis improved from 18.3 (7.6) (mean (SD)) to 12.1 (8.2) (p < 0.01), and those with eczema improved from 20.0 (6.0) to 14.4 (7.8) (p < 0.01). Seventy percent of the patients showed improvement, 20% remained unchanged and 10% worsened. The parameters for which the most improvement was seen were those that were of most concern to the patients, i.e. their symptoms and embarrassment. In conclusion, the results are consistent with previous international studies.

Administration, Cutaneous↗

PubMed2005

The course of mental health after miscarriage and induced abortion: a longitudinal, five-year follow-up study.

BACKGROUND: Miscarriage and induced abortion are life events that can potentially cause mental distress. The objective of this study was to determine whether there are differences in the patterns of normalization of mental health scores after these two pregnancy termination events. METHODS: Forty women who experienced miscarriages and 80 women who underwent abortions at the main hospital of Buskerud County in Norway were interviewed. All subjects completed the following questionnaires 10 days (T1), six months (T2), two years (T3) and five years (T4) after the pregnancy termination: Impact of Event Scale (IES), Quality of Life, Hospital Anxiety and Depression Scale (HADS), and another addressing their feelings about the pregnancy termination. Differential changes in mean scores were determined by analysis of covariance (ANCOVA) and inter-group differences were assessed by ordinary least squares methods. RESULTS: Women who had experienced a miscarriage had more mental distress at 10 days and six months after the pregnancy termination than women who had undergone an abortion. However, women who had had a miscarriage exhibited significantly quicker improvement on IES scores for avoidance, grief, loss, guilt and anger throughout the observation period. Women who experienced induced abortion had significantly greater IES scores for avoidance and for the feelings of guilt, shame and relief than the miscarriage group at two and five years after the pregnancy termination (IES avoidance means: 3.2 vs 9.3 at T3, respectively, p < 0.001; 1.5 vs 8.3 at T4, respectively, p < 0.001). Compared with the general population, women who had undergone induced abortion had significantly higher HADS anxiety scores at all four interviews (p < 0.01 to p < 0.001), while women who had had a miscarriage had significantly higher anxiety scores only at T1 (p < 0.01). CONCLUSION: The course of psychological responses to miscarriage and abortion differed during the five-year period after the event. Women who had undergone an abortion exhibited higher scores during the follow-up period for some outcomes. The difference in the courses of responses may partly result from the different characteristics of the two pregnancy termination events.

Abortion, Induced↗

PubMed2005

The influence of underweight and dietary support on well-being in lung transplant candidates.

BACKGROUND: Quality of life has been found to be a significant predictor of survival in lung transplantation candidates. The aim of this study was to investigate associations between underweight, dietary support and well-being. METHODS: A self-administered questionnaire for perceived well-being was administered to underweight (n=42) and normal-weight (n=29) candidates for lung transplantation before and after dietary intervention in which the underweight patients received dietary support for weight gain. RESULTS: Underweight compared with normal-weight, independent of lung function, was associated with low well-being in several of the measured dimensions. Improvements were observed after dietary intervention compared with baseline in the underweight patients, for scores in the dimension of tiredness 29.2 (4.2) vs. 26.2 (6.0), P<0.01; general satisfaction 4.7 (1.5) vs. 4.0 (1.4), P=0.01; social life 16.7 (3.9) vs. 15.0 (4.4), P=0.02) (mean (sd) before and after dietary intervention respectively), but not in the normal-weight patients. The underweight patients achieved the goal for energy intake and protein intake and experienced a significant weight gain. Regression analyses showed that none of the well-being improvements was associated with weight gain or change in body composition. However, an association between less tiredness and an increase in protein intake was indicated (b=-0.305, P=0.055). CONCLUSION: Underweight compared with normal-weight was associated with more impaired quality of life in candidates for lung transplantation and some benefit from dietary support in terms of well-being was indicated.

Adult↗

PubMed2005

Adolescents with a childhood experience of parental divorce: a longitudinal study of mental health and adjustment.

**This is a prospective Norwegian study of a group of adolescents with an experience of parental divorce or separation (n=413) and a comparison group without this experience (n=1758). Mean age at T1 was 14.4 years and mean age at T2 was 18.4 years. Parental divorce was prospectively associated with a relative change in anxiety and depression, subjective well-being, self-esteem, and school problems. Considering boys separately, parental divorce was prospectively associated only with school problems. Among the girls, divorce was prospectively associated with all variables. The effect of divorce on relative change was partially mediated by paternal absence.

Adaptation, Psychological↗

PubMed2005

Relationships between health domains and sense of coherence: a two-year cross-lagged study in patients with chronic illness.

The latent structure of Sense of Coherence (SOC) and its relationship with three domains of health (body function, activity and participation) were studied in a cohort of people with chronic illness (n = 771) over a period of 2 years. A structural equation approach with cross-lagged and synchronous models was applied to each combination of SOC and domain of health. Over the 2-year period SOC had enhanced body function and participation. Conversely, levels of activities as well as body function had contributed to SOC 2 years later. Significant synchronous effects were found that indicated the presence of reciprocal causation between SOC and all three domains of health. These findings challenge existing SOC theory and suggest that SOC can be considered a relevant outcome variable in chronic illness care.

Activities of Daily Living↗

PubMed2005

Predictors of quality of life in oncology outpatients with pain from bone metastasis.

The relationship between pain and quality of life (QOL) in cancer patients is complex due to the number and the diversity of factors that can influence pain and QOL. The aims of this study of oncology outpatients with pain from bone metastasis were: 1) to determine the extent to which pain characteristics (i.e., severity, duration, meaning of pain, and perceived availability and efficacy of pain relief), psychological distress (i.e., depression), physical functioning, social functioning and QOL are intercorrelated, and 2) to determine which of these variables are important predictors of QOL. A total of 157 oncology outpatients completed questionnaires that evaluated pain, QOL, depression, physical functioning, and social functioning at the time of enrollment into a randomized clinical trial that evaluated the effectiveness of a psychoeducational intervention to improve cancer pain management. Pearson product moment correlation coefficients were calculated to examine the relationships among the study variables. A blockwise, hierarchical multiple regression analysis was performed to determine which variables were the most important predictors of QOL. Meaning of pain was significantly correlated with all the other variables, in particular pain intensity and duration. The most important factors that predicted QOL were depression, social functioning, and physical functioning. Depression proved to be the most important predictor of QOL.

Adult↗

PubMed2005

Fatigue in the general population: a translation and test of the psychometric properties of the Norwegian version of the fatigue severity scale.

OBJECTIVE: A study was undertaken to test the psychometric properties of the Fatigue Severity Scale (FSS), and to explore the relationship between fatigue and sociodemographic variables in the general population. METHOD: A national representative sample of 1893 respondents was randomly selected from a pool of 4,000 Norwegians aged 19-81 years. A mailed questionnaire that included the FSS was used to measure fatigue severity. RESULTS: The FSS showed satisfactory internal consistency (Cronbach's alpha 0.88). The prevalence of high fatigue (FSS score > = 5) was 23.1% in the total sample. More women (26.2%) than men (19.8%) experienced high fatigue (p = 0.004). Respondents with chronic illness (more than six months) reported a higher mean (M = 4.69, SD = 1.35) than the rest of the sample (M = 3.67, SD = 1.17) (p<0.001). An inverse correlation was found between fatigue and level of formal education (r = 0.20, p<0.001). CONCLUSION: The psychometric properties of the Norwegian version of FSS were satisfactory. To avoid over-diagnosing people for high level of fatigue, the threshold for high fatigue probably should be 5 on the FSS scale instead of 4 as had been suggested originally, but further validation of the cut-off point is needed.

Adult↗

PubMed2005

Polymorphisms at codons 141 and 154 in the ovine prion protein gene are associated with scrapie Nor98 cases.

Until June 2004, thirty-eight scrapie cases with unusual features, designated Nor98, have been diagnosed in Norway. This study investigated the distribution of PrP genotypes among Nor98 cases, their flock-mates and a random sample of Norwegian slaughtered sheep. The PrP genotype distribution of Nor98 cases differed markedly from that of previous cases of classical scrapie. A leucine/phenylalanine polymorphism at codon 141 with hitherto unknown significance to scrapie was strongly associated with Nor98 cases. Twenty of 38 (52.6 %) cases were either homozygous or heterozygous for phenylalanine at codon 141. In contrast, this allele was present in only 10.5 % of the flock-mates and 4.5 % of the random sample of slaughtered sheep. Moreover, the H(154) allele was represented in 24 of 38 (63.2 %) of Nor98 cases, as opposed to 27.0 % of Nor98 flock-mates and 17.0 % of the slaughtered sheep.

Alleles↗

PubMed2005

Hope in patients hospitalized with heart failure.

BACKGROUND: Hope is seldom described in patients with heart failure, despite high morbidity and mortality for this population. OBJECTIVES: To describe hope in hospitalized patients with heart failure and to evaluate influences of demographic and health-related variables on hope. METHODS: Ninety-three patients with heart failure and 441 healthy control subjects completed questionnaires about sociodemographics, health indices, disease severity, and the Herth Hope Index. RESULTS: The patients with heart failure had a mean age of 75 years; 65% were men, and 47% lived alone. Lung diseases and diabetes were the most common comorbid diseases, with 58% classified as New York Heart Association class III. The mean global hope score among patients with heart failure was 37.69 (SD 5.3). Patients with skin (P = .01) and psychiatric (P = .02) disorders reported lower hope scores. Number of comorbid diseases was the only predictor of hope related to disease-specific variables (P = .01). Mean age of the control subjects was 60 years, and 66 (15%) lived alone. Once demographic variables were controlled for, patients with heart failure had significantly higher global hope scores than did control subjects. CONCLUSIONS: Adaptation to a life-threatening illness may induce a "response shift" that causes such patients to have more hope than the general population. Patients with heart failure may be more concerned with the past than the future. How patients judge their health and satisfaction with life influences their hope. Interventions supporting hope in patients with heart failure may influence treatment goals.

Adaptation, Psychological↗

PubMed2004

Is women's mental health more susceptible than men's to the influence of surrounding stress?

BACKGROUND: Most epidemiological population studies have demonstrated that women suffer more anxiety and depression than men. A higher level of stress, greater vulnerability to stress, and a non-additive effect of private/domestic and occupational obligations on women have been suggested as an explanation. OBJECTIVE: The objective of this study was to examine if women's mental health is more susceptible than men's to the influence of surrounding stress. MATERIAL AND METHOD: A cross-sectional, random sample of the population resulted in 651 men and 626 women, all of whom were employed, participating in the study. Participants were interviewed using face-to-face standardized questionnaires. RESULTS: Younger women experienced more stressful relationship events, illness events and network events than men of the same age. Relationship events were more important for men as they grew older, and interacted with other stress to increase anxiety and depression symptoms. Stressful illness events were more strongly related to anxiety/depression symptoms in women over 40 than in men of the same age, and interacted with work stress to increase symptom scores. CONCLUSION: Stress was more strongly related to symptoms in women, suggesting that they may have a greater susceptibility to surrounding stress, and to somatic illness stress. This might contribute to the sex difference in psychiatric illness.

Adult↗

PubMed2004

The Norwegian version of the Herth Hope Index (HHI-N): a psychometric study.

OBJECTIVE: The purpose of this study was to evaluate the psychometric properties of the Herth Hope Index (HHI) in a representative sample of the Norwegian population. METHODS: The HHI-N was administered to 4000 people randomly selected from the Norwegian population. 1893 questionnaires were usable, yielding a response rate of 48.5%. RESULTS: The internal consistency of the HHI-N, estimated by Cronbach's alpha, was 0.81. Factor analysis resulted in a two-factor solution, which explained 38% of the variance. The correlation between hope and overall quality of life was 0.48 (p < 0.001), and between hope and fatigue severity -0.30 (p < 0.001). SIGNIFICANCE OF RESULTS: Further testing, especially with regard to the dimensionality of the instrument, is recommended.

Adaptation, Psychological↗

PubMed2004

Quality of life in the general Norwegian population, measured by the Quality of Life Scale (QOLS-N).

The main aim of the present study was to derive norms or reference values from the general Norwegian population for the Norwegian version of the Quality of Life Scale (QOLS-N). In addition, associations between socio-demographic and health variables on the level of quality of life were examined. The sample consisted of 1893 subjects from a total of 4000 randomly selected Norwegian citizens representative of the entire Norwegian population, aged 19-81. The subjects received a mailed questionnaire containing the QOLS-N. Results show that the mean quality of life score was 84.1 (SD 12.5). Women reported a higher quality of life than men. People with higher levels of education reported a higher quality of life. Those who were married or cohabitating reported the highest quality of life and those who were unemployed reported a lower quality of life than those who worked. In addition, people reporting long-term diseases or health problems scored significantly lower on quality of life. These results could serve as reference values for the level of quality of life, as measured by the QOLS-N in the Norwegian population.

Adult↗

PubMed2003

The impact of demographic and disease-specific variables on pain in cancer patients.

The aim of this study was to examine to what extent demographic and disease-specific variables affected pain in cancer patients. Two to three weeks after their last hospitalization, 1,453 cancer patients completed questionnaires measuring demographic variables, quality of life, and pain (EORTC-QLQ C-30). Response rate was 72.1%. Data on type of cancer and the severity of the disease were also compiled. Sixty percent of the sample reported some pain. Type of cancer, presence of metastases, and time until death were significant predictors of experienced pain. The patients' experience of pain was mainly associated with disease-specific variables. Sex, age, level of education, and co-habitation were not related to pain, but employment status was. The patients on disability pensions had significantly more pain than the patients who were working or studying. Special attention should be given to patients with advanced prostate cancer with a short time to live, as they reported the most pain.

Adult↗