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Biomedical subjects

A Finset

Publications and source records attributed to A Finset.

36 records · Page 2Linked to original sources
PubMed1997

Physician-patient interaction and coping with cancer: the doctor as informer or supporter?

BACKGROUND: The physician-patient relationship may be important in helping cancer patients to cope with their disease, but little research has focused on the role of the physician in the process of coping with cancer. The objective of this study was to investigate the patients' experience of the informational and emotional aspects of physician-patient interactions, and the relevance of these two aspects of such interactions for the coping process. METHODS: In three focus group sessions, patients were interviewed about their relationships with their physicians. Statements about physician-patient interactions were subjected to quantitative and qualitative analysis. RESULTS: How physicians helped the patients to cope with their illness was seldom spontaneously mentioned in any of the three focus group sessions. The patients frequently described specific encounters with doctors, often with an emotional content. When asked, they indicated that these encounters had been important in their adaptation to their illness. CONCLUSIONS: The findings indicate that coping strategies tend to remain an implicit topic in physician-patient interactions. Some patients consider emotional components of physician behavior to be significant for their coping. Physicians should consider more explicitly therapeutic strategies to enhance patient coping behaviors.

Adaptation, Psychological↗
PubMed1997

Long-term prevalence of impairments and disabilities after multiple trauma.

The prevalence of impairments and disabilities in activities of daily living (ADL), nonwork activities, and work were registered in a consecutive series (n = 69) of subjects with severe injuries. At follow-up 3 years after trauma, residual impairments prevailed in 80%. Only a few (6%) were ADL-dependent. Seventy-six percent had lost at least one nonwork activity, while vocational disability caused by the trauma occurred in 19%. Cognitive impairment was significantly associated with vocational disability, while physical impairment and pain were significantly associated with nonwork disability. Other parameters that influenced vocational disability negatively were age and blue-collar employment status. Although overall changes in social network quantity and quality were small, significantly more subjects with cognitive impairment or vocational disability experienced a decline in the quality and quantity of their social network after trauma. Furthermore, 25% of the subjects reported an increase in feelings of loneliness after trauma. We recommend the design of individualized, multidisciplinary rehabilitation plans before discharge from departments of surgery.

Abbreviated Injury Scale↗
PubMed1996

A new measure of patient satisfaction with mammography. Validation by factor analytic technique.

BACKGROUND AND OBJECTIVES: The success of national breast screening programmes hinges on women's adherence. By monitoring patients' perceptions, potential barriers to attendance may be detected, measured and possibly alleviated. Consequently a new questionnaire MGQ, measuring patients' experience of and satisfaction with mammography, has been developed. As discomfort is a predictor of non-attendance, a dimension measuring physical and psychological discomfort was included. METHODS: The internal structure of observed variables was tested using factor analysis as part of the validation process. The study was conducted in six radiological departments in Norway including 550 patients presenting for mammography. The analysis suggested eight factors explaining 56.7% of the variance. RESULTS: Construct validity was supported since the factor scales covered all hypothesized dimensions and all but one subdimension. The factors were internally consistent and externally independent, indicating that distinct aspects of patients' experience with mammography may be assessed and thus possibly improved. CONCLUSIONS: A relationship between pain and re-attendance was suggested as pain and worries about the next mammography belonged to the same factor. This underlines the importance of including a discomfort dimension when monitoring patient satisfaction with mammography.

Adult↗
PubMed1995

[Does social support have an impact on the prognosis in cancer?].

Social support is a compound concept. It is being used about different aspects of social integration and about the support provided by people in a social network. Increasing research has been done on the effect of social support on malignant diseases. However, weaknesses in the methodology make it difficult to evaluate the results. For example, the concept of social support may not be adequately defined and the aspects of social support that are studied may be somewhat arbitrary. Both epidemiological research and studies on certain groups of patients support the idea that social support influences our health and our life expectancy. We have reviewed the existing literature on the impact of social support on malignant disease to find out if social support has proven to be of any prognostic value in the case of cancer.

Humans↗
PubMed1995

[Regaining of function following severe head injury. From primary rehabilitation to 2 years after the injury].

72 patients with sequelae after severe traumatic brain injury were studied during primary rehabilitation and two years post-injury. The patients were grouped into two main categories, one dependent as regards activities of daily living (ADL) and one mainly independent group. Most of the dependent patients, except seven low level patients close to a vegetative state, showed marked functional recovery. Among the independent patients, those who were admitted to primary rehabilitation relatively early (< 60 days post-injury) and those who were allowed a longer stay upon first admission to hospital showed better progress in functional level scores than those who were admitted later and were allowed a shorter stay during primary inpatient rehabilitation.

Activities of Daily Living↗
PubMed1995

Team development and memory training in traumatic brain injury rehabilitation: two birds with one stone.

The need for developing team cooperation procedures when treating patients with traumatic brain injury (TBI) is stated. One approach in promoting team cooperation is to combine team development with a specific training programme. A memory training programme used in a subacute TBI rehabilitation unit is described. A combination of a team development procedure and memory training programme was performed in the unit. A questionnaire to assess team members' attitudes to team cooperation was administered before and after team development, and memory training procedures were implemented. The post-training questionnaire administration indicated a more positive perception among team members of how the team functioned. The efficacy of memory training showed variable results. The programme described may illustrate the advantages of combining a specific treatment programme with efforts to promote team development.

Adult↗
PubMed1994

[A new teaching program in behavioral sciences in Oslo].

The Department of Behavioural Sciences in Medicine at the University of Oslo was established in 1977. The teaching programme followed the same main principles until 1992, and took place in the third and fourth terms. Since 1992, however, several changes have taken place. The teaching is now given together with medical history during ten weeks at the end of the preclinical term. Teaching practical skills in doctor-patient communication is introduced in this term, and is continued in the first clinical year. The students work together in plenary seminars on the main topics presented in the lectures. The teaching is still concentrated on four main topics: Psychobiology, medical psychology, medical sociology and the doctor-patient relationship and communication. We conclude that the changes have improved the teaching. Written evaluation by the students strongly supports this conclusion.

Behavioral Sciences↗
PubMed1992

[Amantadine in cognitive failure in patients with traumatic head injuries].

In patients with severe cerebral injuries, attentional dysfunction may cause greater difficulties for rehabilitation than neurological deficits. These functions seem to be controlled by catecholaminergic neural systems in the central nervous system. Dopamine agonists have therefore been recently introduced in the treatment of these patients. We describe two patients treated with amantadine in daily doses of 200-400 mg. We observed improvement of cognitive functions such as visual attention, speed of information processing, attentional span, learning capacity and alertness. We stress the value of amantadine as a treatment adjuvant in patients with severe attentional deficits following injury of the brain.

Adult↗
PubMed1992

Subacute brain injury rehabilitation: a program description and a study of staff program evaluation.

The concept of continuity of care is introduced and briefly discussed. Three aspects of subacute rehabilitation of patients with Traumatic Brain Injury (TBI) are discussed: the need for differentiated treatment programs, for team integration and emphasis on environmental or milieu factors to accomplish treatment success. The so called Wing Team Model at the TBI Unit at Sunnaas Rehabilitation Hospital is described. In our program the patients are divided in three groups: the North Wing Program, for slow to recover patients, the East Wing program for patients with severe sequelae after TBI and the South Wing Program for ambulatory patients mainly with cognitive sequelae. A questionnaire study of how staff members evaluate certain aspects of the program is presented. The study indicates that the staff members have in general a positive attitude towards the treatment model, but they wish an improved team coordination of the individual programs.

Attitude of Health Personnel↗
PubMed1989

Depressed mood and intra-hemispheric location of lesion in right hemisphere stroke patients.

42 stroke patients with verified right hemisphere lesions were studied. Depressed mood was measured by means of a global rating scale, and an inventory administered as a structured interview. As measured by the global ratings and one of the inventory subscales, patients with deep, retrorolandic lesions showed significantly more depressed mood than other patients. The findings are discussed in the light of current relevant research, and implications for management of depressed mood in stroke patients are suggested.

Adult↗
PubMed1988

Neuropsychological predictors in stroke rehabilitation.

A mailed questionnaire, sent routinely to discharged stroke patients, divided left-hemisphere (n = 68) and right-hemisphere (n = 77) patients into three groups of general help dependency in basic activities-of-daily-life skills. A subsample of 29 patients was visited at home and asked to reanswer the questionnaire under guidance of a trained occupational therapist. The reliability of the questionnaire was considered satisfactory. Both neurological deficits and neuropsychological syndromes correlated significantly with the level of help needed for managing alone at home. Multiple regression analysis revealed a major gain in explained variance in help dependency when neuropsychological test results were added to information on degree of hemiplegia and hemianopia. Keeping in mind the subject characteristics of the study sample, apraxia and pathological emotional reactions were the more important variables in the left-hemisphere and right-hemisphere groups respectively. The challenge from rehabilitation psychology is discussed and the need for developing more sophisticated methods for assessing rehabilitation potential is stressed.

Activities of Daily Living↗
PubMedDate not supplied

Work disability in rheumatoid arthritis is predicted by physical and psychological health status: a 7-year study from the Oslo RA register.

OBJECTIVE: To explore the prevalence of work disability (WD) and to identify bio-psychological factors that predicts future WD in rheumatoid arthritis (RA) over a 7-year period. METHODS: Patients were selected from the Oslo RA register. The prevalence of WD was studied cross-sectionally among respondents <67 years (n = 526) in a postal survey. Mean age (SD) was 51.1 (11.9) years, mean disease duration 11.3 (9.4) years, and 49% of patients were RF-positive. The patients studied for predictive factors for WD were respondents in postal surveys both at baseline and at the 7-year follow-up, in work at baseline and still in working age (<67 years) at follow-up (n = 159). Mean age at baseline (SD) was 44.5 (9.7) years, mean disease duration 8.4 (6.6) years, mean years of formal education 12.7 (3.1) years, 48% were RF-positive. Assessments included socio-demographic variables and health status measures (MHAQ, AIMS2, SF-36, fatigue and pain on VAS 0-100 mm, self efficacy, and RAI as a measure for helplessness). RESULTS: Among the 526 respondents at baseline <67 years, the prevalence of WD was 40%. A high level of education was a predictor of reduced risk of work disability [odds ratio (OR) = 0.4, 95% confidence interval (CI) 0.1; 0.9], while female gender (OR 3.0, 95% CI 1.1; 8.0), physical disability (MHAQ-score) (OR = 3.9, 95% CI 1.2; 12.5) and helplessness over median RAI-score (OR = 3.0, 95% CI 1.4; 6.7) were independent predictors of increased risk for new work disability over 7 years. CONCLUSION: Physical disability, increased helplessness, low formal education, and female gender were found to be independent risk factors for new work disability over the 7-year study period.

Adult↗
PubMedDate not supplied

Cognitive performance in multiple trauma patients 3 years after injury.

OBJECTIVES: Patients with sequelae from multiple trauma commonly display cognitive disturbances, specifically in the areas of attention and memory. This study was designed to assess cognitive functioning 3 years after severe multiple trauma and to investigate how cognitive performance is related to head injury severity and psychological distress respectively. METHODS: Sixty-eight multiple trauma patients were tested with a screening battery consisting of six neuropsychological tasks 3 years after injury. A measure of psychological distress (20-item General Health Questionnaire, or GHQ-20) was also administered. RESULTS: Patients who neither showed signs of reduced consciousness on admission to the hospital nor reported significant psychological distress at follow-up tended to have normal test performance. In five of the six tasks, cognitive impairment was related to the severity of the traumatic brain injury as measured by the Glasgow Coma Scale (GCS). In both attention span tasks, patients designated as cases by the GHQ had significantly lower scores than noncase patients. These bivariate relationships were upheld in multiple regression analyses, in which age, sex, and GCS and GHQ scores were entered as independent variables. When patients with severe head injuries were excluded from the analyses, GCS scores still contributed to the variance in tests of verbal attention span and delayed recall, but performance on attentional tasks was more strongly related to psychological distress than to GCS scores. CONCLUSIONS: Cognitive deficits in multiple trauma patients were related both to the severity of the traumatic brain injury and to the degree of psychological distress. The strength of the association between brain injury as indicated by GCS scores and cognitive performance differed between different tasks. Neuropsychological testing may assist in differentiating primary organic from secondary psychogenic impairments.

Adolescent↗
PubMedDate not supplied

Trait anxiety and reactions to patient-centered and doctor-centered styles of communication: an experimental study.

OBJECTIVE: A patient-centered model of communication has often been advocated in preference to a doctor-centered model. The aim of the present study was to assess in an experimental setting how subjects' general level of anxiety affects their reactions to these two communication styles as measured by emotional reactions and satisfaction immediately after consultation. METHODS: Twenty students with low trait anxiety and 21 students with high trait anxiety each had a single consultation with a physician who performed the consultation using either a patient-centered or doctor-centered style of communication. Questionnaires about emotional state were completed by the students before and after the consultation, and a questionnaire about satisfaction was completed after the consultation. RESULTS: Students with low trait anxiety were significantly more satisfied with a patient-centered than a doctor-centered style of communication. There were no significant differences in emotional response to the two styles of communication. Students with high trait anxiety reacted emotionally more positively to a doctor-centered communication style, with significant and nearly significant change scores for the emotions of tension/anxiety and vigor/activity, respectively. No significant difference was found between satisfaction scores. CONCLUSIONS: Data indicate that differences between subjects' emotional traits may be of importance for a differentiated response to patient-centered and doctor-centered communication styles. Subjects' trait anxiety seems to be a significant factor that should be taken into account when assessing the effects of different communication styles.

Adult↗
PubMedDate not supplied

Self-reported social networks and interpersonal support 2 years after severe traumatic brain injury.

Fifty-four patients with traumatic brain injury (TBI) consecutively admitted to a rehabilitation hospital were examined 2 years post-injury. Social interaction and support, subjective complaints, and functional status were assessed. A large variability in social interaction and support patterns was found. Most patients had more interaction and received more support from family members than from friends and neighbours. Thirty-one patients (57.4%) reported that their social networks had markedly declined subsequent to injury. Relatively short duration of coma (< 1 week) and severe sequelae in terms of low functional status and poor emotional adjustment at follow-up, especially in terms of deficits in initiating behaviour, were found to be related to little interaction and support. The importance of both provider and patient initiative in order to establish and preserve a social support network is suggested, and clinical implications briefly discussed.

Activities of Daily Living↗