Search PubMed⌕ Search

Biomedical subjects

M Nylenna

Publications and source records attributed to M Nylenna.

At least 127 records · Page 7Linked to original sources
PubMed1987

How do patients evaluate cancer related symptoms and signs? A study from general practice.

Descriptions of twenty different clinical situations, most of which included cancer related symptoms and signs, were assessed by 329 patients. The patients showed a satisfactory level of alertness in response to the clinical situations. Lumps and bumps and visible bleeding gave the quickest response. An inverse relationship was found between how frequent a situation was experienced among the patients and how serious it was interpreted to be. A comparison between the patients' assessment and the advice given by a random sample of 90 general practitioners revealed a quicker response rate recommended by the doctors than found among the patients for most of the symptoms and signs. The gap between doctors' and patients' understanding and interpretation of symptoms and signs is at least partly due to different levels of medical knowledge. This gap should be narrowed by public information and health education. In planning this education, knowledge of patients' evaluation of symptoms, as shown in this study, is of importance.

Adult↗
PubMed1987

Symptomatic and non-symptomatic reasons for encounter in general practice.

A total of 10,278 consecutive doctor-patient contacts in general practice were classified as either caused by a symptom or complaint (symptomatic) or caused by other reasons (non-symptomatic) according to the Reason for Encounter Classification system (RFEC). Of all consultations and of all house-calls 61.5% and 91.7% respectively were classified as "symptomatic". Significant differences according to sex and type of problem were found between "symptomatic" and "non-symptomatic" consultations. Patients seeking advice for non-symptomatic reasons have other expectations and represent other challenges to the doctor than patients with symptoms and complaints. Knowledge of the distribution of "symptomatic" and "non-symptomatic" consultations is important for the understanding of the workload and utilization of general practice.

Family Practice↗
PubMed1986

Diagnosing cancer in general practice: from suspicion to certainty.

Three hundred and eighty two patients who were suspected of having cancer by general practitioners were followed up for up to two years until the suspicion was either confirmed or rejected; 7014 patients who were not suspected of having a malignancy served as the control group. Less than every tenth suspicion proved correct. The general practitioner's assessment of the strength of suspicion of cancer was the best predictor of outcome in the suspected patients. The incidence of cancer among the unsuspected patients did not differ from the total incidence of cancer in the study area. The patient's fear of cancer was an important predictor of a malignancy. A higher proportion of patients who consulted for non-symptomatic reasons than for symptomatic reasons was reported to have a malignancy. No single symptom had a strong predictive value for cancer. The predictive value of a palpable lump or tumour was 2.5%.

Family Practice↗
PubMed1986

Diagnosing cancer in general practice: when is cancer suspected?

Of 10,278 encounters with patients recorded by 33 general practitioners in a defined Norwegian population during a two month period, 429 (4.2%) were classified as resulting in a follow up for suspected cancer. The patient's fear of cancer was the most important indicator of suspicion of cancer among the doctors. Patients who consulted for digestive and gynaecological problems were most frequently suspected of having cancer. Comparing the pattern of suspicion of cancer with the incidence of cancer in the area showed a relative oversuspicion in young patients and women.

Adult↗
PubMed1986

A survey of cancer patients in general practice.

A study of cancer patients in general practice was carried out in a defined and limited population of 29,420 inhabitants with a known occurrence of malignancy. A cancer patient was defined as a person who had ever been diagnosed as having a malignancy. Out of 553 cancer patients living in the study area 257 (46.5%) were seen by the general practitioner during a two-month period. Cancer patients accounted for 3.9% of all encounters and the calculated yearly contact rate for these patients was more than twice that for other patients (4.3 contacts per year against 2.1). One-third of the cancer patients were not recognized as having a malignancy by the doctor, and only 1.3% of all encounters were caused by or partly caused by cancer. The diagnostic distribution of cancers among these patients correlated with the prevalence in the population, with two exceptions: gastrointestinal cancer was over-represented and skin cancer was under-represented.

Adolescent↗
PubMed1986

Open prospective recording: how is the doctor influenced?

In open prospective recording the participating doctors may be influenced by the study itself. There are two factors contributing to this influence: the doctor's status as an observer and as an observed subject. A model for analysing this influence is presented. In a Norwegian general practice study of the recording of conditions suspected of being cancer the changes owing to the recording itself have been studied by three different means: indicator comparison, time-trend analysis and post-registration enquiry. The study showed that the effect of the recording was small, and this was perhaps a result of prophylactic efforts by the doctors to minimize the influence. An influence on the doctors' actions and thinking during a period of registration should always be expected, and control methods to give a semi-quantitative expression of the consequences of this influence should therefore be carried out.

Data Collection↗
PubMed1985

Why do our patients see us? A study of reasons for encounter in general practice.

The patients' reasons for encounter were recorded in 10 278 personal doctor-patient contacts in nine Norwegian municipalities over a two-month period, and were classified according to a simplified version of the WHO "Reason for Encounter Classification". A two-dimensional classification system was used where each reason was classified according to the location and type of problem. Symptoms and complaints made up 64.9% of all encounters. Most of the encounters were related to the musculo-skeletal, circulatory and female genital systems. The most frequent single reason for encounter was pain in the musculo-skeletal system (15.5% of all encounters). Psychological and social reasons were rather infrequent 3.1% and 0.3%. Compared with the frequencies of psychiatric and social diagnoses recorded in general practice, this indicates a discrepancy between the patient's own opinion of problems and the doctor's interpretations. Females had a significantly higher contact rate than males, mainly due to problems related to the genital system, inclusive of the breast.

Adult↗
PubMed1985

The general practitioner and information to cancer patients.

Information to cancer patients is a continuous process, and a considerable personal undertaking is usually needed. The general practitioner is in an unique position because of his contact with the cancer patient and his family during all stages of the disease. This gives him both opportunities and the responsibility for this information. The basis for cancer patient information can briefly be given in the "three c's": Communication, Coordination and Cooperation--communication both to patient and family and coordination and cooperation between the multitude of professionals, who often taken care of the cancer patient right through his illness.

Aged↗
PubMed1984

Fear of cancer among patients in general practice.

The general practitioners dealing with cancer has other parameters than statistics of incidence and prevalence. In 400 consecutive interviews with patients in general practice when asked if the consultation was brought about because of fear or thoughts of cancer, eight % answered "yes" and 11% "partly". When asked if they thought about or feared cancer, a total of 47% answered "yes" or "sometimes". Many more women than men expressed fear of cancer. The fear did not increase with age in contrast to the increasing incidence of the disease. For every new case of diagnosed cancer there are many patients in whom malignancy has been suspected but not verified. Almost every tenth patient in this study was investigated further due to possible cancer.

Adult↗