Biomedical subjects

Bente Thommessen

Publications and source records attributed to Bente Thommessen.

6 recordsLinked to original sources

PubMed2006

Emotional symptoms in acute ischemic stroke.

BACKGROUND: Anxiety and depressive symptoms encountered in acute stroke influence the patients' neurological outcome and the psychosocial burden of family members. These emotional changes may be caused by the patients' brain damage per se or by psychological reactions. The aims of the present study were to assess the prevalence of anxiety and depressive symptoms in the acute stage of ischemic stroke, and to identify the factors associated with such problems. METHODS: Anxiety and depressive symptoms were evaluated in 178 patients with acute ischemic stroke using the Hospital Anxiety and Depression Scale (HADS) between day 3 and 7 after admittance to the stroke unit. Factors associated with anxiety and depressive symptoms were identified using logistic regression analyses. RESULTS: 26.4% of the patients suffered from anxiety symptoms, 14.0% from depressive symptoms and 7.9% from both. Anxiety symptoms were associated with single marital state (OR 2.53, 95% CI 1.18-5.41) and a low Mini Mental State Examination (MMSE) score (< 26 points) (OR 0.53, 95% CI 0.31-0.87) whereas depressive symptoms were related to a low Barthel Activities of Daily Living index (BI) (score < 90 points) (OR 0.37, 95% CI 0.15-0.88). CONCLUSION: The present study indicates that anxiety symptoms are more frequent than depressive symptoms in the acute stage of ischemic stroke. It is important to focus on both anxiety and depressive symptoms throughout the rehabilitation phase in order to ease the patients' personal anguish and improve neurological outcome after stroke.

Adult↗

PubMed2005

[Stroke: when the diagnosis is wrong].

BACKGROUND: There is a lack of knowledge of stroke symptoms in the population and among health professionals. Many non-cerebrovascular diseases present with a strokelike clinical picture. The present study focuses on non-cerebrovascular conditions that were referred to a neurological acute stroke unit as strokes. METHODS: In an observational study, 354 consecutive patients who presented to the stroke unit with a diagnosis of stroke were evaluated. Patients were assessed by neurologists and classified as non-stroke patients or true stroke patients. RESULTS: Eighty-eight were non-stroke patients (25%), who were younger than the true strokes (65.5 vs 71.5). Clinical features were falls (23%), sensory impairment (19%), vertigo (13%), loss of consciousness (11%) and confusion (9%). Half of the non-stroke diagnoses were either migraine, infection, postural vertigo or sequelae after a previous stroke. In 25% another neurological disease was present, such as epilepsy, cranial nerve disorder, neuropathy, transient global amnesia or demyelinating disease. There were 6 patients with previous stroke among the 11 non-stroke patients who had a final diagnosis of infection. DISCUSSION: Misdiagnosis of stroke is common among non-neurologists. Non-stroke patients often have another neurological disease. All stroke patients should be seen by a neurologist in the early phase.

Adult↗

PubMed2004

Well-being and instrumental activities of daily living after stroke.

OBJECTIVE: To explore the relationship between subjective well-being and competence in instrumental activities of daily living after stroke. DESIGN: Cross-sectional with evaluation at six months post stroke. SUBJECTS: Eighty-two patients admitted to an acute stroke unit, of whom 64 were seen at six months. The mean age was 77.5 years, 55% were females and 55% were living alone. MAIN OUTCOME MEASURES: The General Health Questionnaire (GHQ-20 version), a well-being scale, was factor analysed and yielded three dimensions, named 'coping', 'anxiety' and 'satisfaction' that served as main outcomes. RESULTS: Explanatory variables were the four subscales of the Nottingham IADL scale, the Ullevaal Aphasia Screening test, urinary continence and demographics. Structural equation modelling showed that the GHQ dimension 'satisfaction' related significantly to the Nottingham subscale 'leisure activities' (beta = -0.38, p = 0.01), whereas 'coping' was indirectly associated with 'leisure activities' by its correlation with 'satisfaction' (R = 0.26, p = 0.01). None of the outcomes were statistically associated with aphasia, continence or the background variables. CONCLUSION: 'Leisure activities' demonstrated the strongest association to subjective well-being as expressed by the 'satisfaction' dimension. In stroke rehabilitation leisure activities should be addressed when assessing function and planning intervention.

Activities of Daily Living↗

PubMed2003

Emotional well-being of close relatives to stroke survivors.

OBJECTIVE: To compare the well-being of stroke patients' relatives with that of a reference group, and to identify variables related to the well-being of the relatives. DESIGN: Cross-sectional study. SETTING: Outpatient hospital department and patients' and relatives' own homes. SUBJECTS: Fifty-four patients one year after a stroke and their closest relatives. A reference population consisted of 419 elderly people drawn at random from the census files. OUTCOME MEASURES: Emotional well-being was assessed with the General Health Questionnaire (GHQ-20), and the perceived burden attributed to the care of the patient with the Caregiver Strain Index (CSI). The personal and instrumental activities of daily life (PADL and IADL), motor and cognitive functions of the patients were assessed with standardized tests. RESULTS: The relatives rated their well-being lower than the reference group rated theirs, the odds ratio (OR) being 5.6 (95% confidence interval (CI) 3.1-10) adjusted for age and gender. No association was found between the relatives' well-being and the motor, cognitive, PADL, IADL or other characteristics of the patients. Strong relationships were found between the CSI and the GHQ scores of the relatives, the OR (95% CI) for a poor GHQ score being 2.4 (1.6-3.7) for each unit increase in CSI, adjusted for gender. CONCLUSIONS: Emotional well-being is influenced when a close relative gets a stroke. This seems to relate more strongly to the perceived burden of care than to objective characteristics of the patient.

Activities of Daily Living↗

PubMed2002

The psychosocial burden on spouses of the elderly with stroke, dementia and Parkinson's disease.

OBJECTIVE: To characterize the psychosocial burden on spouses living with the elderly suffering from mild dementia, stroke and Parkinson's disease, and to identify patient characteristics associated with it. Materials and methods Data on patient-spouse couples came from three studies of patients with stroke (36 couples), mild dementia (92 couples) and Parkinson's disease (58 couples). The psychosocial burden was recorded by the 15-item Relatives' Stress Scale (RSS). A factor analysis of this instrument produced a one-factor solution (CFI = 0.98) consisting of eight items with good face validity and acceptable reliability within each diagnostic group (Cronbach's alpha range 0.66-0.69). Covariates of this factor were identified using structural equation modeling (SEM) by regression on patient's age, gender, cognitive function (MMSE), activities of daily living (ADL) and depressive symptoms (MADRS). RESULTS: Disorganization of household routines, difficulties with going away for holidays, restrictions on social life, and the disturbances of sleep were the most frequently reported problems in all three groups. According to the mean sumscore on the RSS, the perceived psychosocial burden was similar across the diagnostic groups. In the final SEM model, a lower cognitive function of the patient was associated with a higher psychosocial burden on the spouses of patients with stroke (beta = -1.3, p = 0.01) and Parkinson's disease (beta = -0.89, p < 0.01), while in the dementia group, only an insignificant trend was demonstrated. In the dementia group, a significantly higher burden was identified on female spouses (beta = -0.56, p = 0.04). A heavier burden of care was also associated with depressive symptoms in the patients with Parkinson's disease. In neither group did the final model disclose any effect of ADL function on the spouse's psychosocial burden. CONCLUSION: Spouses caring for patients with dementia, stroke and Parkinson's disease perceive a similar type and level of psychosocial burden, independent of the disease. The cognitive functioning of the patient is a particularly important factor in this, especially when caring for patients with stroke or Parkinson's disease.

Activities of Daily Living↗

PubMed2002

Validity of the aphasia item from the Scandinavian Stroke Scale.

We studied the validity of the aphasia item of a widely used stroke scale - the Scandinavian Stroke Scale (SSS) - in discriminating between aphasia and normal language function in 33 stroke patients of an acute stroke unit. They were assessed by a nurse using the aphasia item from the SSS and by a speech and language therapist carrying out a full evaluation of the language function. The latter served as the 'gold standard'. The agreement between the nurses' and the speech and language therapist's scoring was good (weighted kappa = 0.74, 95% CI 0.51-0.97), and the sensitivity and specificity of the SSS aphasia item were also satisfactory. However, the predictive value of a positive test was as low as 0.55 (95% CI 0.23-0.83), indicating nearly every second of the positives being false positive. Using the aphasia score of the SSS as a diagnostic aid for aphasia after stroke results in a high rate of false positives and inflates the prevalence figures for aphasia in epidemiological studies of stroke.

Aged↗