Biomedical subjects
Publications and source records attributed to A Norberg.
Two patients in the final stage of dementia of Alzheimer type were stimulated with music, touch and object presentation during 12 consecutive days (16 trials per patient). Evaluations were made by direct observations, analysis of video-taped recordings and registrations of pulse and rate of respiration. Both patients reacted differently to music than to touch and object presentation.
Five hospitalized patients in different stages of Alzheimer-type dementia were monitored by unstructured, direct observations during morning care. Orem's model of nursing as a compensation for the patient's lack of self-care capabilities was used as a frame of reference for an analysis of the behaviours of patients and nurses during morning care. A 12-step classification system was developed to be used as a guide to understand and determine abilities essential for performance of morning care for demented patients. The quantitative assessment showed that none of the patients was able to manage morning care independently, but there was a wide variation in their highest level of performance.
Using a training programme developed by Heimlich, we have attempted to train swallowing in a 78-year-old man who had been fed by a nasogastric tube for 3 years after a stroke. The training was successful and, during a follow-up of 1 year, the patient was eating normal food. The training process is analysed as a two-level communication between the patient and his trainer; the therapeutic relationship and the training programme. The development of the patient's attitudes during training is interpreted with reference to Erikson's theory of 'eight stages of man'.
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When patients with incurable dementia diseases no longer take food or fluid voluntarily, the care workers experience distress and anxiety. Thirty-nine care workers were interviewed about their thoughts, feelings and attitudes towards feeding severely demented patients. A phenomenological approach was used and the interviews were developed, attention paid to Bateson's double bind theory, Kohlberg's theory of moral development and ethical theories. Ethical theories, principles and rules, containing messages at different logical levels and the lack of empirical knowledge of the demented patients' inner world, led to the care worker's difficult double bind situations. To solve the conflicts the care workers need insight in all aspects of the problem. In order to understand all the components in a double bind situation it is important to redefine it from outside.
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The foul smell of urine around patients with urine incontinence is thought to be due mainly to the production of ammonia from urea by bacterial ureases. The production of ammonia was thus measured by infrared spectrophotometry in control diapers and in test diapers impregnated with copper acetate (CA), after use by urine-incontinent patients with persistent bacteriuria. The CA-impregnated diapers produced significantly less ammonia than the control diapers. The CA-impregnated diapers were not bactericidal, however. The results are consistent with the hypothesis that the smell reduction of the CA-impregnated diapers is due to a bacteriostatic action or an inhibition of bacterial ureases by CA.
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The spontaneous variation of catheter life, i.e. the time in days between catheter changes, was observed in 20 long-stay geriatric inpatients with initially short catheter lives. The study ran for 6 months. The catheter regimen was standardized throughout the study. The intra-individual and inter-individual catheter lives showed considerable variation. Each patient retained his individual pattern of catheter life. It is concluded that, despite the variation of isolated catheter lives, the median value of repeated observations of catheter life provides a reliable parameter of catheter function.
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Long-stay geriatric inpatients with an indwelling urinary catheter are harassed by foul-smelling urine, urine leakage, and frequent catheter blockages. It is reasonable to assume that catheter-induced bacteriuria plays an essential role in the catheter problems of these patients. An attempt to reduce the catheter-induced bacteriuria was made by the introduction of a latex catheter coated with a layer of copper metal. The antibacterial properties of the copper-coated catheters studied were, however, insufficient, probably due to too small amount of copper on the catheter. The copper layer was dissolved from the catheter in a few days. The effective time of copper treatment thus became too short.