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Biomedical subjects

B Arnetz

Publications and source records attributed to B Arnetz.

28 records · Page 2Linked to original sources
PubMed1993

Physiological effects on patients following temporary closing of a geriatric day care unit.

Geriatric day care is an essential part of modern geriatric care providing rehabilitation and social support. During a 5 week summer closure of a geriatric day care unit, 24 long attenders (defined as patients having day care > 26 weeks), were non-electively discharged and included in this study. Blood samples were drawn one week before the closure (0 week), at the reopening (7 weeks) and 7 weeks after the reopening (14 weeks). The results show a longitudinal tendency of rising plasma prolactin levels during the whole study period. There was non-significant increase in cortisol during the closure followed by a significant decrease 7 weeks after the reopening. All other measures were unaffected. The study indicates that geriatric patients submitted to longterm day care have a measurable psychophysiological response as a result of a non-controllable closure of a day care unit. The changes in plasma prolactin and cortisol levels are part of a general adaptation pattern. The study shows that elderly have a functional physiological response and chronically sick patients react selectively with regard to the hormone response. Thus, the results indicate that the support during minor life events induced by the closure of the day care ward should be improved.

Adaptation, Psychological↗
PubMed1993

[Computer screen allergy--a Swedish problem?].

Since autumn 1985 many Swedish employees with skin problems have attributed them to their work with visual display units (VDUs). However, studies have shown the prevalence of skin signs and skin diseases among people exposed to VDUs to be comparable with that among controls; and provocation studies of subjects exposed to electromagnetic fields have failed to show any relationship to exist between the occurrence of such symptoms and work with VDUs. On the other hand, there are studies showing that the symptoms might be due to work-related stress. Occasional cases of symptoms among people working with VDUs have been reported from other countries, but not with the same order of epidemiological prevalence. Outside Sweden the occurrence of the same types of skin symptoms is attributed to other causes than exposure to VDUs or other electromagnetic sources.

Data Display↗
PubMed1991

Mortality and morbidity rates of discharged elderly day care patients. A one-year follow-up of an experimental day care programme.

The purpose of this study was to assess possible long-term effects of a focused psychosocial complementary programme added to a 3-month day care rehabilitation programme for elderly patients. Sixty-five referred elderly patients of a day care unit were randomly allocated to an experimental or control group. The experimental group was offered the chance to participate in the psychosocial addition aimed at enhancing personal control. Perceived health, autonomy, life satisfaction and psychophysiological state were shown to benefit from the psychosocial programme during the intervention period. A one-year follow-up of the patients showed no differences in mortality rates between the experimental (2/33) and control (2/32) groups. However, significantly fewer patients were readmitted to hospital from the experimental group (13/33, compared with 21/32, p = 0.02). Length of stay in hospital was significantly shorter in the experimental group (22.1 days, compared with 61.9 days in the control group, p = 0.03). The results indicate that patients benefit not only psychologically from the psychosocial intervention programme during the treatment period, but also in a longer time perspective. This programme also resulted in a reduction in in-patient health care costs.

Aftercare↗
PubMed1991

Physiological concomitants of an "autonomous day programme" in geriatric day care.

Sixty-five geriatric patients with a mean age of 74 years (range 61-90) who were referred to the day care unit of a geriatric hospital were randomly allocated to an experimental and a control group in groups of 5-8 patients, respectively. Controls were cared for according to usual routines. Patients in the experimental groups were subject to a new organizational routine. These patient groups constituted a forum for discussion and definition of individual treatment goals. Patients in the experimental and control conditions were observed before as well as 6, 12 and 24 weeks after the start of the treatment, which lasted for twelve weeks. Patients in the intervention programme had significantly lower plasma prolactin levels following the initiation of the programme than patients in the control group. According to literature, an absence of a plasma prolactin elevation during a crisis period may indicate active coping. Such a conclusion was supported by other observations in the study which indicated a progressively more internalized locus of control in the experimental group.

Aged↗
PubMedDate not supplied

Effects of performance-based reimbursement on the professional autonomy and power of physicians and the quality of care.

The key question addressed in this study is whether performance-based reimbursement in health care affects the professional power and autonomy of physicians, and if so, whether this has any consequences for the quality of care. This cohort study examines the period 1994-98 in 11 Swedish county councils. Four hundred and eighteen physicians were studied in Stockholm County Council, which has a performance-based reimbursement system, and in ten councils without such a system. The results show that professional power and autonomy are considered to be very limited in all councils, and that they have decreased during the period studied. Professional autonomy is, however, more limited in Stockholm. The limitations in Stockholm are more related to financial considerations, whereas the limitations in the other councils are more due to guidelines and lists of recommended drugs. Professional autonomy and power were found to be important determinants for quality of care, and the physicians in Stockholm estimated the quality of care lower than their colleagues in the ten other councils. Thus, our study suggests that the performance-based reimbursement system might fail to reach the desired results due to its negative impact on professional power and autonomy.

Adult↗
PubMedDate not supplied

Employee effects of an educational program for managers at an insurance company.

BACKGROUND: Possible health effects for employees of efforts to improve the psychosocial competence of managers have not been studied scientifically in the past. OBJECTIVE: To explore how efforts to improve management will change the work environment and health of the employees. METHODS: Managers of the experimental department in a large insurance corporation underwent 2-hour biweekly training sessions for 1 year-altogether, 60 hours. A control group of employees in other departments in the corporation not affected by the modification was followed with the same assessments. Morning blood samples for the assessment of serum cortisol were collected both at baseline and after 1 year in 155 participants in the experimental group and in 147 subjects in the control group. Liver enzymes and lipids were also assessed. In the questionnaire part of the 1-year follow-up study, there were 119 participants in the experimental group and 132 in the control group. RESULTS: When repeated-measures ANOVA was used, a significant interaction effect was found for the level of serum cortisol; serum cortisol levels were decreased in the intervention group and were unchanged in the control group (ANOVA two-way interaction, p =.02; after exclusion of the managers, p =.005). A significant interaction effect was also observed for decision authority, with increased decision authority in the intervention group and, conversely, a decreased level in the control group (p =.001; after exclusion of managers, p =.02). CONCLUSIONS: The study indicates that a moderately intensive psychosocial manager program lasting for 1 year can be beneficial for the employees with regard to both lowered serum cortisol and improved authority over decisions.

Administrative Personnel↗