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Biomedical subjects

G Nordström

Publications and source records attributed to G Nordström.

At least 19 recordsLinked to original sources
PubMed2001

Persons with insulin-dependent diabetes mellitus: acceptance and coping ability.

AIMS: The purposes of this study were to describe how persons with insulin-dependent diabetes mellitus (IDDM) accept their disease and what sense of coherence they have, in order to determine whether a person's acceptance of the disease is related to his or her sense of coherence. Whether acceptance of the disease and sense of coherence are related to the disease duration, complications of the disease, metabolic control and demographic data would also be determined. DESIGN: One hundred and seven, randomly selected, insulin-dependent, diabetic subjects (47 men and 60 women) participated in the study. The Acceptance of Disability Scale Modified (ADM scale), the Sense of Coherence Scale (SOC scale), a study-specific questionnaire and the patients records were used to collect the data. BACKGROUND: IDDM implies a major change in way of life. Ingrained procedures and patterns of behaviour must be adapted to the disease and its treatment. RESULTS: The results of the present study show that educational level seems to be an important factor for how well a person accepts the disease and the sense of coherence. Persons with higher scores on the ADM and the SOC scales had higher levels of education. Moreover, they also had a better metabolic control. Individuals with a poor metabolic control had more disease-related complications. A significant correlation between the ADM and the SOC scores was found, indicating that persons with a high degree of acceptance of the IDDM also had a high coping capability. CONCLUSIONS: It is important to individualize the care of subjects with IDDM and to identify the persons with low acceptance of their disease and a low sense of coherence.

Adaptation, Psychological↗
PubMed2001

Nurses' experiences of research utilization within the framework of an educational programme.

This paper explores nurses' reflections on their experiences of disseminating and implementing research findings in clinical practice within the framework of an educational programme. Ten registered nurses, all in clinical practice, participated in a research-orientated educational programme with the aim of facilitating the dissemination and implementation of research findings in clinical practice. Thus, the programme contained different activities designed to disseminate and implement research findings in the participants' wards. Focus groups were used to collect data and a qualitative content analysis was performed. The main themes that were developed were: organizational and leadership issues; acquiring a new role; responses and reactions by others; and orientation to research. Organizational and leadership issues, nurses' interest in research, nurses' reading habits, and support and feedback from their head nurses and other managers and from their nursing colleagues and physicians were seen as important. This study confirms that research utilization and the change to research-based nursing practice are complex issues which require both organizational and educational efforts.

Attitude of Health Personnel↗
PubMed2001

Nutritional status, symptoms experienced and general state of health in HIV-infected patients.

The aim of the study was to describe HIV-infected patients with respect to nutritional status, symptoms experienced, general state of health, and relevant medical and laboratory data. An additional aim was to study the relationships between some of these variables. On admission to an acute care hospital in Sweden, 25 HIV-positive men were consecutively included in the study. Medical data, anthropometric variables such as weight, height, body mass index (BMI) and percentage weight loss were studied. The following instruments were used: the subjective global assessment (SGA) was used to determine nutritional status; the oral assessment guide (OAG) was used for subjective assessment of the oral cavity; and the numeric rating scale (NRS) was used to assess the symptoms experienced. The Health Index (HI) was used to evaluate general state of health. The results showed that more than half of the patients had suspected/severe malnutrition; between 48% and 72% complained of moderate to severe symptoms of various kinds. Two thirds felt their general state of health was rather poor or very poor. Correlations showed that the lower the BMI, the worse the nutritional status (SGA); the greater the weight loss in percent, the worse the nutritional status (SGA); and the worse the general state of health (HI), the worse the nutritional status (SGA). In conclusion, it is important that nurses have good knowledge concerning nutritional problems in order to be able to detect these conditions at an early stage and/or to endeavour to prevent them.

Activities of Daily Living↗
PubMed2001

Early discharge of preterm infants followed by domiciliary nursing care: parents' anxiety, assessment of infant health and breastfeeding.

UNLABELLED: The aim of this study was to evaluate the effect of early discharge of preterm infants, followed by domiciliary nursing care, on the parents' anxiety, their assessment of infant health and breastfeeding. Seventy-five families including 88 preterm infants who were physiologically stable but in need of further special care, such as gavage feeding, were allocated to an early discharge group (EDG) that was offered home visits (n = 40), or to a control group offered standard neonatal care (CG) (n = 35). Seventy families (37 in the EDG and 33 in the CG) completed the study to the 1-y follow-up. Data were collected by means of questionnaires on three occasions: in the EDG, at hospital discharge, on completion of the domiciliary care programme and after 1 y, and in the CG at the corresponding points in time, which were during hospitalization, at hospital discharge and after 1 y. No statistical differences were observed between the groups in emotional well-being, except that mothers in the EDG had a lower level of situational anxiety at the time of hospital discharge compared with CG mothers whose infants remained in hospital. One year after the birth, the EDG mothers said they had felt better prepared to take responsibility for the care of their babies after completion of the domiciliary care programme, in contrast to CG mothers. However, no statistical differences were observed in the recollection of anxiety, confidence in handling the baby and periods of mental imbalance. No statistical difference was observed in breastfeeding rates between the groups. Fathers in the EDG group tended to perceive their babies as being healthier, compared with CG fathers. CONCLUSION: Early discharge of preterm infants followed by domiciliary nursing care did not seem to have any major effect on the parents' anxiety and their assessment of infant health.

Anxiety↗
PubMed2000

Reducing blood exposures during orthopedic surgical procedures.

Surgical team members constantly are exposed to blood during procedures. Inadvertent injuries (e.g., needle sticks, cuts) and contaminations expose team members and patients to the risk of transmission of bloodborne pathogens. Injuries and contaminations can be decreased significantly for scrub people and first assistants, however, by introducing new working methods (i.e., no-touch instrument passing technique, instrument neutral zone).

Blood-Borne Pathogens↗
PubMed2000

Living a restricted life with Ehlers-Danlos syndrome (EDS).

Ehlers-Danlos syndrome (EDS) is an inherited connective tissue disorder, primarily affecting the skin, ligaments, joints and blood vessels. The symptoms can vary from undiagnosed cases with mild symptoms to more severe forms. A qualitative study was conducted with the purpose of exploring how individuals with different symptoms of EDS describe their symptoms and perceive their daily life. Eleven interviewees were recruited via a support group in Sweden. The main strategies of the grounded theory method were used in collection and analysis of data. The identified main theme, "Living a restricted life", seemed to explain the way in which fears, pain, stigmatisation and experiences of non-affirmation in health-care limited the possibility of self-actualisation in daily living and social life. This study provides a conceptual framework for future research and an understanding of the type of professional support individuals with EDS require.

Adaptation, Psychological↗
PubMed2000

Treatment decision-making and its relation to the sense of coherence and the meaning of the disease in a group of patients with colorectal cancer.

UNLABELLED: The aims of the present study were to describe the preferred and the actual participating roles in treatment decision-making in relation to patients with newly diagnosed, colorectal cancer and to relate this result to the sociodemographic data, the Sense of Coherence Scale (SOC) and the patients' meaning of the disease. Eighty-six patients were studied. The following instruments were used: the Control Preferences Scale (CPS); the eight Lipowski categories of the meaning of the disease (LCMD); and the SOC. The results showed that 62% of the patients preferred a collaborative role and 28% a passive role in treatment decision-making. Agreement between the preferred and the actual participating roles was achieved by 44% of the patients. Seventy-one per cent of the patients showed an optimistic understanding of their disease. The mean SOC score was 150. There was no statistically significant difference between the CPS groups as regarded the sociodemographic data, the SOC and the LCMD. CONCLUSION: Sociodemographic data, the perceived meaning of the disease as well as the patients' sense of coherence were not related to the decision-making preferences in the investigated group of patients. Therefore, further investigations are needed to get an understanding of influencing factors of the decision-making preferences.

Adult↗
PubMed2000

Perceptions of research utilization: comparisons between health care professionals, nursing students and a reference group of nurse clinicians.

The study reported in this paper was carried out to investigate a group of nursing teachers' (n=37), nursing students' (n=166), nursing administrators' (n=33) and physicians' (n=127) perceptions of barriers to and facilitators of nurses' use of research findings in clinical practice. The results were compared with the corresponding figures for a reference group of nurse clinicians (n=237). The Barriers Scale and a questionnaire for the demographic issues were used for data collection. The organization and the communication of research were seen as barriers to research utilization by the nursing teachers, students and administrators in agreement with the nurse clinicians. The nurses' research-related competence and awareness were seen as barriers by the nursing teachers, students and administrators to a greater extent than by the nurse clinicians themselves. The physicians perceived barriers to a lesser extent than the other groups did. The students' perceptions were closest to the nurse clinicians, while the physicians' perceptions differed most. Education to increase the nurses' knowledge of research and to develop their competence to evaluate research results, increased resources for education, more staff, support from the administration and research presented in a user-friendly way were the most frequently suggested facilitators. The nurses' isolation from knowledgeable colleagues with whom to discuss the research was seen as a barrier by the majority of the participants. This indicates a need for positions in clinical practice for nursing researchers, in order to promote a research-based, nursing practice.

Adult↗
PubMed2000

The health-related quality of life in a Swedish sample of HIV-infected persons.

The purposes of the present study are (1) to assess the health-related quality of life (HRQOL) and the subjective health status in a sample of human immunodeficiency virus (HIV)-infected persons (2) to relate the results to different population groups and (3) to investigate the relationship of medical and demographic variables with HRQOL. A total of 72 HIV-infected men were included. They answered the Swedish health-related quality of life questionnaire and the health index. Demographic and medical data were obtained from the medical records. The data collection took place before entering a therapeutic HIV vaccine trial. The results showed a more negative impact on the HRQOL and subjective health status in the HIV-positive subjects, compared with male population groups. The dimensions of emotional well-being were most affected. When comparisons were made according to the medical and demographic variables for different subgroups within the HIV sample, differences in the physical-dimension scales were most prominent. Symptomatic HIV infection or acquired immunodeficiency syndrome (AIDS), anti-retroviral treatment, sick leave or disability pension, low income and basic education were associated with worse HRQOL and health status. In conclusion, it is of utmost importance to take into account, aspects of the patients' emotional well-being in nursing, as well as in medical care and interventions. Moreover, individualized caring programs are needed because the disruptions in HRQOL fluctuated within the HIV sample.

Adult↗
PubMed2000

Oral health status of psychiatric patients.

Many patients suffering from long-term psychiatric illness are on medication for long periods. These medications frequently cause xerostomia leading to an increased risk of caries, gingivitis, periodontitis and stomatitis. Oral hygiene is therefore of the utmost importance for these patients. Nurses interact with patients on a daily basis, and therefore they are the psychiatric caregivers of choice to support these patients. The main aim of this study was to describe the oral health status of patients in short-term and long-term psychiatric care by means of oral assessment. A second aim was to discover whether the assessment guide used could distinguish any differences between these two groups. A modified version of the Oral Assessment Guide (OAG) developed by Eilers et al. (1988) was used. In addition, new items/categories were developed, forming the Oral Assessment Guide for Psychiatric Care (OAG-PC). A total of 57 patients in psychiatric care, short-term (n = 32) and long-term (n = 25), were assessed by the OAG-PC. Patients in long-term psychiatric care had significantly higher scores on the total OAG-PC compared with those in short-term psychiatric care, indicating a worse oral health status. Statistically significant differences were also found in relation to the following OAG-PC categories: odour from the mouth, mucous membranes, gums, teeth or dentures, calculus on teeth and appearance of teeth. Further research should be focused on the difficulties for nurses in approaching their patients in order to perform oral care and on evaluating the effect of teaching and training psychiatric nurses in oral care, preferably with the assistance of the OAG-PC. This assessment guide may thereby also be valuable for nurses' documentation in estimating, planning, implementing and evaluating their psychiatric patients' oral care needs.

Antipsychotic Agents↗
PubMed2000

Moral sensitivity: some differences between nurses and physicians.

We report the results of an investigation of nurses' and physicians' sensitivity to ethical dimensions of clinical practice. The sample consisted of 113 physicians working in general medical settings, 665 psychiatrists, 150 nurses working in general medical settings, and 145 nurses working in psychiatry. The instrument used was the Moral Sensitivity Questionnaire (MSQ), a self-reporting Likert-type questionnaire consisting of 30 assumptions related to moral sensitivity in health care practice. Each of these assumptions was categorized into a theoretical dimension of moral sensitivity: relational orientation, structuring moral meaning, expressing benevolence, modifying autonomy, experiencing moral conflict, and following the rules. Significant differences in responses were found between health care professionals from general medical settings and those working in psychiatry. The former agreed to a greater extent with the assumptions in the categories 'meaning' and 'autonomy' and to a lesser degree with the categories 'benevolence' and 'conflict'. Moreover, those from the psychiatric sector agreed to a greater extent to the use of coercion if necessary. Significant differences were also found for some of the MSQ categories, between physicians and nurses, and between males and females.

Ethics, Medical↗
PubMed1999

Evaluation of a nurse-run asthma school.

Important aims of the study were to investigate whether an educational program (the 'Asthma School') directed by a nurse led to improved knowledge of the disease, to improved self-medication and self-management and to improved, self-rated, functional status. A total of 32 patients (6 males, 26 females, mean age 43 years) was included. The following methods were used to collect the data before and one year after the Asthma School was completed; two study-specific questionnaires for collecting demographic data and measuring different aspects of the patients' knowledge of the disease and its treatment, monthly diary cards, lung-function tests (FEV1) and the Sickness Impact Profile (SIP) questionnaire. The main results of the study were an improved knowledge of the disease and its treatment, better self-management, i.e. more frequent use of the peak expiratory flow meter (PEF-meter) and use of inhaled bronchodilators on an as-required basis, fewer patients on sick-leave and a better, self-rated, physical health status. However, in spite of these encouraging results, the lungfunction was found to be unaffected, no pronounced changes in the use of asthma drugs could be found and the patients' need for medical care remained the same.

Adolescent↗
PubMed1999

Exposure to polycyclic aromatic hydrocarbons and genotoxic effects on nonsmoking Swedish road pavement workers.

OBJECTIVES: The objective of this study was to investigate exposure to polycyclic aromatic hydrocarbons (PAH) from asphalt fumes among Swedish road pavement workers and determine whether any effects could be detected with genotoxic tests. METHODS: The study included 28 nonsmoking road pavers and 30 nonsmoking referents. The concentration of PAH was determined in the breathing zone of the road pavers. 1-Hydroxypyrene was analyzed before and after shifts of asphalt work and during the afternoon for referents. Sister chromatid exchanges (SCE) and micronuclei (MN) were determined in peripheral lymphocytes. RESULTS: Several 3- or 4-ring PAH were found, and the analysis indicated that they occurred in bitumen fumes rather than in traffic fumes. The average total concentration of PAH was 2.3 (range 0.2-23.8) microg/m3. The concentration of 1-hydroxypyrene in urine was higher for the road pavers than for the referents, but there was no significant difference between the pre- and postshift values of the road pavers. The road pavers had no significant increase in SCE or MN. CONCLUSIONS: The study showed that Swedish road pavers have an increased exposure to PAH from bitumen fumes, but no genotoxic effects could be detected by SCE or MN tests.

Adult↗
PubMed1998

Barriers to and facilitators of research utilization, as perceived by a group of registered nurses in Sweden.

A survey was conducted to describe registered nurses' (n = 237), perceptions of the barriers to and the facilitators of research utilization at two hospitals in Sweden. A questionnaire, Barriers and Facilitators to Using Research in Practice developed by Funk et al., was used to collect the data. The major barriers to research utilization were that the research is not readily available along with inadequate facilities for implementation of research findings, lack of competent colleagues with whom to discuss research, lack of time for reading and implementing research findings and the nurses lack of authority in the organization. The nurses who had studied research methods in their basic nursing education, seemed to perceive fewer barriers than those who had not. The facilitating factors most frequently suggested by the nurses were diverse models of education to increase their knowledge of research methods and to develop skills in evaluating research findings. The allocation of resources for education and implementation of research findings in clinical practice, in addition to special positions in clinical practice for nurses with scientific qualifications, were also suggested.

Adult↗
PubMed1998

A 9-year longitudinal study of reported oral problems and dental and periodontal status in 70- and 79-year-old city cohorts in northern Sweden.

Before 1981 no representative studies of oral health in an elderly population in northern Sweden had been presented, and longitudinal studies of oral health in the aging person were in general rare. Thus the aim of this study was to investigate longitudinal changes in oral health in a representative sample of an elderly city population in northern Sweden. Reported oral problems and treatment needs were noted, and dental and periodontal status was registered in clinical examinations. The frequency of reported annual dental visits and of being called by the dentist increased in the younger but not in the older cohort during the 9-year period. In 1990 all the 79- and 88-year-olds with annual visits reported that they were recalled by the dentist. The clinical investigation showed an increasing amount of tooth loss, root caries, and periodontal disease with increasing age. Among dentulous persons 1.7 teeth per subject were lost from 1981 to 1990 in the younger cohort, compared with 2.6 teeth per subject in the older cohort. The number of sound teeth decreased very little in the younger cohort (from 3.44 to 3.34) but more evidently in the older cohort (from 3.47 to 2.65) during the 9-year period. The frequency of surfaces with attachment level > 3 mm increased statistically significantly from 1981 to 1990 in the older cohort. Subjects with annual visits had in general fewer oral problems.

Aged↗
PubMed1997

Correlation of bone density to strength and physical activity in young men with a low or moderate level of physical activity.

The objective of this study was to evaluate the relationship among bone mineral density (BMD), physical activity, muscle strength, and body constitution, in young men with a low or moderate level of physical exercise. Another aim was to investigate whether the head is unaffected by physical activity. The subjects consisted of 33 Caucasian healthy men, mean age 24.8 +/- 2.3 years. BMDs of the total body, lumbar spine (L2-L4), femoral neck, Ward's triangle and trochanter, humerus, and head were measured using dual-energy-X-ray absorptiometry (DXA). Bivariate correlations were measured among the different BMD sites and age, weight, height, body mass index (BMI), fat mass, lean body mass, amount of physical activity (hours/week), hamstrings strength, and quadriceps strength. Significant predictors were found for all BMD sites except the head. Using all these variables, only 6% of the variation in BMD of the head could be explained, whereas 46% (total body), 31% (humerus), 17% (lumbar spine), 38% (femoral neck, Ward's), and 41% could be explained for the trochanter. Physical activity and muscle strength were found to be independent significant predictors of BMD of the total body and the sites at the proximal femur. These results suggest that at the time of peak bone mass attainment, physical activity is an important predictor of the clinically relevant proximal femur in young men with a low or moderate level of physical activity. Furthermore, since head BMD was not related to the level of physical activity, we suggest that head BMD may be used as an internal standard, to control for selection bias, in studies investigating the effect of physical activity on bone mass.

Absorptiometry, Photon↗
PubMed1997

Psychiatric morbidity in primary public health care: a multicentre investigation. Part II. Hidden morbidity and choice of treatment.

A total of 1,281 patients were examined during consultation with their GP in a Nordic multicentre study focusing on the prevalence of psychiatric illness, hidden psychiatric morbidity, treatment and pathways to specialized care. The methodology and prevalence were reported in an accompanying paper. The present paper presents results concerning the variables hidden psychiatric morbidity, treatment and pathways to specialized care. The GPs detected 44% of the psychiatric cases compared with the result of a diagnostic interview (PSE). The distinction between psychosis and non-psychosis did not influence the GPs' ability to detect a mental illness. According to the GPs' assessment the majority of patients suffering from a mental disorder consulted their GP about physical complaints. The GPs treated the patients themselves, and only a limited number of cases were referred to psychiatrists or psychologists.

Adolescent↗