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Biomedical subjects

H Ursin

Publications and source records attributed to H Ursin.

At least 55 records · Page 3Linked to original sources
PubMed1995

The use of case histories to explore concepts of disease, illness and sickness certification.

A questionnaire with 12 case histories was constructed to investigate views on sickness certification and concepts of disease and illness among GPs and laymen. It was mailed to random samples of 436 Norwegian GPs and 600 Norwegians, stratified for gender, age and residence. Response rates were low, 44% for doctors, and 54% for laymen, probably indicating that the method was more suitable for smaller surveys. Case histories could be used to compare views of GPs and laymen on the concepts of disease and illness. They were also useful in examining views on sickness certification, but, in that case, they probably only reveal what respondents thought should be done. From this study it was not safe to conclude how often, and for what medical conditions doctors would issue sickness certificates in practice. ICPC was useful for coding diagnostic suggestions, set by GPs, but will be more useful after inclusion of criteria and more extensive synonym lists.

Abstracting and Indexing↗
PubMed1995

Modulatory effects of defense and coping on stress-induced changes in endocrine and immune parameters.

We examined whether habitual defense and coping affect the response of hormones (ACTH. cortisol, prolactin. endorphins, and noradrenaline) and immune parameters (numbers of T cells. B cells. natural killer [NK] cells, and proliferative responses to mitogens or antigens) to an acute laboratory stressor (i.e., solving a 3-dimensional puzzle and explaining it to a confederate) in 86 male high school teachers. Defense and coping were assessed by Kragh's tachistoscopic Defense Mechanism Test (a measure of perceptual defense) and by 4 questionnaire-based coping styles assessing instrumental mastery-oriented coping, emotion-focused coping, cognitive defense, and defensive hostility. The laboratory stressor per se caused a relative increase in immunological (in particular NK cells) and endocrine (cortisol, prolactin) parameters. Defense and coping, however, significantly codetermined the response to the stressor. In particular, instrumental mastery-oriented coping and perceptual defense were related to stress-induced changes in numbers of B cells and in the pituitary-adrenal hormones. The results indicate that the impact of a mild psychological stressor on the immune and endocrine system depends to a considerable extent on the specific ways people deal with stressors.

Journal Article↗
PubMed1995

Life events and stress in patients with functional dyspepsia compared with patients with duodenal ulcer and healthy controls.

BACKGROUND: Life events and stress may be important for functional dyspepsia and duodenal ulcer. METHODS: The perception of life events in the preceding 6 months was recorded in 100 patients with functional dyspepsia, 100 patients with duodenal ulcer, and 100 healthy controls. In addition, psychologic and social factors were assessed. RESULTS: Patients with functional dyspepsia experienced significantly more life events than patients with duodenal ulcer and healthy controls. The difference in life events between the groups was due to the difference in stressful life events. The patients with functional dyspepsia had higher levels of state-trait anxiety, general psychopathology, and depression than patients with duodenal ulcer and healthy controls. CONCLUSION: Patients with functional dyspepsia had higher scores on negative life events than patients with duodenal ulcer and healthy controls. This may be causally related to the higher levels of anxiety, depression, and general psychopathology in these patients.

Adult↗
PubMed1995

What are the real problems for patients with functional dyspepsia?

BACKGROUND: Patients with functional dyspepsia (FD) have more complaints than just the dyspepsia. METHOD: One hundred FD patients were assessed with regard to psychologic, medical, and social factors, before randomization, in a study of cognitive therapy. They were asked to list their main problem areas or 'target complaints'. RESULTS: Dyspepsia was the third most frequent target complaint (26 patients), and anxiety was the most frequent one (65 patients). Patients identifying dyspepsia as a target complaint differed from the other FD patients in several aspects. They had significantly more dyspeptic symptoms (p < 0.05) and scored significantly higher on multiple somatic complaints (p = 0.001), depression (p = 0.025), general psychopathology (p = 0.043), the global assessment scale (p = 0.001), and the General Health Questionnaire (p = 0.040). However, they did not have more somatic predisposing factors like consumption of alcohol and coffee or infection with Helicobacter pylori than the patients with other target complaints. CONCLUSIONS: Anxiety and not dyspepsia was the most frequent target complaint, and patients who identified dyspepsia as a target complaint did not have more somatic predisposing factors.

Adult↗
PubMed1995

Assessment of sickness certification and concepts of musculoskeletal disease and illness in the general population.

OBJECTIVE: To investigate how laymen assess the need for sickness certification and how they use the concepts "disease" and "illness" in relation to musculoskeletal disorders. DESIGN: Mail questionnaire with simulated case histories. SUBJECTS: A stratified, random sample of 600 Norwegians, aged 16-69 years. MAIN OUTCOME MEASURES: Scores that measured the respondents' use of the concept "illness", and their view on need for sickness certification were constructed and analysed. RESULTS: Response rate was 54%. The respondents perceived seven case histories describing musculoskeletal health problems more often as "illness" (61%) than as "disease" (46%). There was a close correlation between the use of "illness" and assessed need for sickness certification. However, sickness certification could be suggested for cases with neck pain, even if the patient was not perceived as ill. Women suggested sickness certification significantly more often than men. Age, length of education, and personal experience with serious musculoskeletal health problems influenced suggestions on certification among men. However, these variables could not explain any difference in use of the concept "illness".

Absenteeism↗
PubMed1995

Interpersonal relations during simulated space missions.

The present article derives from two isolation studies performed for the European Space Agency (ESA) as simulations of space travels, lasting for 4 and 9 weeks. The aim was to study how interpersonal relations were affected by time, and how individual characteristics related to conflicts and tension among crewmembers. A broad battery of methods was used, including video-recording, peer-ratings and self-reports. In both studies, group-functioning declined in the middle of the isolation and towards the end of the stay. Dominance and task motivation seemed to be important characteristics for compatibility between crewmembers, and negative relations established early in the isolation remained stable over time. These findings have implications for composition, training, and support of crews for extended spaceflights.

Adult↗
PubMed1994

Stress, distress, and immunity.

Since psychoimmunology is now 10 to 20 years of age, it seems appropriate to expect a certain maturity in the field. It seems reasonably well established that there really is neuroimmunomodulation. The biological and medical importance of this is the possible influence of psychological factors on immune competence. Inasmuch as it is reasonably well established that psychological factors do have such an influence, the field must now endeavor to establish how important this influence is. It no longer suffices to show that some sort of stressor has some sort of action on some part of the immune cascade of responses. "Stressors" do not act indiscriminately; they are filtered and interpreted by the brain following psychological principles that again are reasonably well known. The distinction between "stress" and "distress" is important for the health consequences of how and with what success an individual is handling a stressful situation. Concepts such as coping, control, helplessness, and hopelessness are required to understand how immune responses are influenced by the brain and to establish the extent to which these mechanisms have clinical validity in man and animals.

Humans↗
PubMed1994

[Health effects of physical activity and psychological training].

Skeletomuscular pain is a very frequent complaint. Most patients recover spontaneously, but in some this pain may become long-lasting or even chronic. This occurs only in a minority, but even so skeletomuscular pain is the most frequent reason for long-term sickness benefit and permanent disability in the present Norwegian population. This report reviews the results of a series of controlled studies in Norway demonstrating that such pain may be treated by several different methods. Positive effects have been demonstrated from aerobic physical training, stress management training, relaxation training, and combinations of these programmes. Interventions directed at the organisation of the work situation have also had positive effects. These effects include decrease of pain and of psychological and subjective health complaints. However, a comparison of the effects of the different types of treatment would have to be based on a large multicentre study.

Exercise↗
PubMed1994

Psychotherapy in functional dyspepsia.

Patients with functional dyspepsia were assigned at random to cognitive psychotherapy (10 sessions of 50 min duration, n = 50) or to a control group (no treatment, n = 50). Before treatment all patients were assessed on psychological, somatic and lifestyle factors. If allocated to the therapy group all patients were also asked to define the main problems they wanted to discuss in therapy ('target complaints'). The patients were evaluated at the end of therapy (after 4 months) and at 1 yr follow-up. Outcome measures were dyspeptic symptoms, scores on 'target complaints' and psychological parameters. Both groups showed improvement in dyspeptic and psychological parameters after 1 yr. The improvement in the control group was attributed to a non- specific effect of increased interest and attention. The therapy group showed greater reduction than the control group on dyspeptic symptoms [days of epigastric pain (p = 0.050), nausea (p = 0.024), heartburn (p = 0.021), diarrhoea (p = 0.002) and constipation (p = 0.047)]; and on scores on 'target complaints' (p = 0.001).

Adult↗
PubMed1994

Psychological factors and somatic symptoms in functional dyspepsia. A comparison with duodenal ulcer and healthy controls.

One hundred patients with functional dyspepsia, 100 patients with duodenal ulcer and 100 healthy controls were assessed on anamnestic factors, somatic symptoms and psychological measures. Patients with functional dyspepsia had significantly higher levels of state-trait anxiety, general psychopathology, depression, a lower general level of functioning and more somatic complaints from different organ systems, especially the musculo-skeletal system, compared to patients with duodenal ulcer and healthy controls. Patients with functional dyspepsia had more frequent dyspepsia symptoms and a longer disease history than duodenal ulcer patients. Discriminant analyses using a model of fifteen psychological and anamnestic variables, classified correctly 71.5% of the subjects due to diagnoses. The test for multiple somatic complaints (Giessener Beschwerdebogen) was the most important discriminating factor (Eigenvalue 0.78). Seventy-five per cent of the patients were correctly classified, 71% by diagnosis with respect to diagnoses of duodenal ulcer and functional dyspepsia using frequency of dyspeptic symptoms as discriminating factor (Eigenvalue 0.40). Functional dyspepsia seems to be a disease entity of its own, distinct from duodenal ulcer and strongly associated with psychological factors.

Adaptation, Psychological↗
PubMed1993

Psychobiology of coping and defence strategies.

The stress response should be regarded as an alarm system, occurring whenever there is something missing. Lack of information (uncertainty), and the absence or loss of control produce alarm, presence of information and control (coping), or cognitive defence mechanisms (distorted stimulus expectancies) reduce the alarm. Both immune and endocrine parameters of stress are dampened by defence and coping. Biologically, these two mechanisms have different time axes. While coping is related to the fast catecholamine response, defence is related to the slower pituitary-adrenal response. The role of cortisol seems to be to suppress and dampen the acute stress response in the later phase, once it has been elicited. The relation between stress and health depends on the stress-dampening mechanisms, on how the alarm is turned off, why it sometimes seems to be left on, and what the consequences really are of leaving the alarm on.

Adaptation, Psychological↗
PubMed1993

European isolation and confinement study. Group functioning and communication.

Six EMSInauts were isolated in the hyperbaric chambers at NUTEC for a period of 28 days at 5-msw overpressure. Based on previous studies of analogous conditions, the hypothesis was advanced that group and communication problems could possibly occur during the isolation period, and that this could be partly related to personality aspects. The scientific methods for the present study consisted of the following: (1) the team members were systematically observed through wide-angle cameras, and the activities in the working chamber were taped during the entire isolation period; (2) daily questionnaires regarding group functioning and communication were administered; and (3) post-isolation assessment interviews were given. Results were obtained by analysis of: (1) video tapes from the daily meetings; (2) questionnaires on group behavior and communication; (3) post-isolation interviews; and (4) personality inventories (DMT, Helmreich Test, MMPI). The following observations were made: 1. All team members were able to complete the 4-week isolation period while remaining functioning. 2. The commander became ever more central during the isolation period. Communications went more directly through him and less between the EMSInauts. At the same time he became evaluated less positively by the other EMSInauts. 3. There was a steady increase in emotional responses among all EMSInauts during the isolation period. In particular, there was an increase in negative emotional content. 4. Week 3 was evaluated by the EMSInauts as being the most positive period. They scored themselves then as being very task oriented. 5. The EMSInauts gave a low score to problems with the mission control room personnel, indicating few problems. There were indications of temporary increases during week 2 and at the end of the isolation period. In summary, it can be stated that all team members completed the 4-week isolation in good condition. The commander developed increasing control during the isolation period, which resulted in increasingly negative responses towards him from the other team members. During the isolation period there was an increase in emotional content. In particular, during the last week there was an increase of frustrations. There were few communication problems with mission control, though the scores were elevated in week 2 and on the final two days.

Communication↗
PubMed1993

European isolation and confinement study. Workload and stress: effects on psychosomatic and psychobiological reaction patterns.

Six healthy males, the EMSInauts, were isolated in hyperbaric chambers for a period of 28 days at 5-msw overpressure. During that period they had to carry out meaningful operational and research tasks in addition to monitoring their psychological and physiological reactions. The actual workload was evaluated and compared with the planned workload, and its effects on symptomatology and psychobiology. The perceived workload and its effects on psychosomatic symptomatology and on some biological indices were monitored. Thus it was possible to evaluate how the workload carried during 4 weeks of isolation affected the psychological and biological well-being of the six EMSInauts. The following three types of assessments were performed: 1. Workload assessment: The objective workload was calculated based on the schedule which was revised daily, and the actual load calculated by the commander. A workload questionnaire was administered daily after each working session. 2. Psychosomatic assessment: Morning and evening questionnaires were administered daily. The state of health and of anxiety were also evaluated. 3. Biological indices: Cortisol, testosterone, adrenalin, and noradrenaline were determined once a week. In addition, cardiac activity was monitored every day. The workload assessment showed that on the average the planned workload was accomplished in slightly less than the scheduled time. The workload was not perceived as severe in terms of cognitive, emotional, and physical load. The group rated the support received from each other and from the mission control personnel as average, with minor changes during the isolation period. They gave a high rating to the amount of control they had over their activities. Fatigue and tension were scored in the middle range. The psychosomatic assessment showed that there were few symptoms, and these were mostly of low severity. The most common symptom was general fatigue. Furthermore, minor dizziness, headache and light tremor was in some cases reported. The sleep quality was good, but complaints about poor sleep increased somewhat with the passing of time. Few and mostly minor health problems were experienced during isolation. Only one EMSInaut had to miss one day of work due to a bout of flu. The state of anxiety was below that of the general population throughout the isolation period. The biological indices used showed no evidence of stress from the workload handled during the isolation period. The level of the "stress hormone" cortisol actually decreased during isolation. The adrenalin excretion, which tends to go up during acute stress, remained unchanged during this period. Neither was there any evidence of changes in cardiac activity throughout the isolation period.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Psychological↗