Biomedical subjects

T Theorell

Publications and source records attributed to T Theorell.

At least 91 records · Page 5Linked to original sources

PubMed1993

Pain thresholds during standardized psychological stress in relation to perceived psychosocial work situation. Stockholm Music I Study Group.

The hypothesis that perceived psychosocial work situation is associated with pain threshold was tested on a sample of 103 men and women aged 19-65 yr in Stockholm. Half of the studied sample was a random sample of men (N = 26) and women (N = 31), while the remaining subjects were medical secretaries (women, N = 28) and furniture movers (N = 31). Pain thresholds were measured by means of an algometer before, during and after a standardized colour word test. The measurements were made on six different points in the neck and shoulder region. Before psychological stress in the laboratory, perceived psychological demands were significantly associated with pain threshold--the higher the demands the higher the pain threshold. During stress those who reported low decision latitude and high degree of sleep disturbance were shown to have a low pain threshold. The findings are consistent with the hypothesis that subjects with high demand levels have an elevated pain threshold when they are not under excessive psychological stress. During psychological stress, on the other hand, those with low decision latitude are more pain sensitive than others, and this is aggravated in those who also report a high degree of sleep disturbance.

Adaptation, Psychological↗

PubMed1993

On physiological effects of positive and negative life changes--a longitudinal study.

A sample of working men and women were followed longitudinally on four occasions during a year with regard to serum triglycerides, plasma prolactin and systolic and diastolic blood pressure at rest. Participants were asked about life changes that they had gone through during the examination year. They were also asked to rate the importance and the direction (positive and negative, respectively) of the changes. On the basis of this information participants were divided into a no event group (N = 20), a positive event group (N = 11) and a negative event group (N = 11). Statistical analyses revealed that prolactin levels tended to increase in the negative event group whereas blood pressure as well as serum triglycerides increased in the negative event group and decreased in the positive event group.

Adult↗

PubMed1993

Stressful life events and the risk of colorectal cancer.

We examined the relation of stressful life events to the risk of colorectal cancer in a population-based case-control study conducted in Stockholm from 1986 to 1988. Completed questionnaires were available for 569 incident cases ascertained through hospital records and the regional cancer registry. Controls were randomly selected from a population register and were frequency matched to the age and sex distribution of the cases; 510 controls completed the study questionnaire. A history of serious work-related problems in the prior 10 years was strongly associated with the occurrence of colorectal cancer. Compared with those with no such problems, the age- and sex-adjusted odds ratio (OR) was 5.5 [95% confidence interval (CI) = 2.3-23.5]. Change of residence was also associated with increased risk: relative to those who had not moved, the OR was 2.8 (95% CI = 1.1-7.1). Similar analyses revealed that increased odds of colorectal cancer were associated with death of a spouse: OR = 1.5 (95% CI = 1.0-2.3). After multivariate adjustment for dietary risk factors and physical activity, these ORs were not substantially altered. Because most of the events were relatively uncommon in this population, the estimates of effect were not precise.

Adult↗

PubMed1993

Medical health and emotional effects of art stimulation in old age. A controlled intervention study concerning the effects of visual stimulation provided in the form of pictures.

The present article reports on a controlled intervention study of the effects of a nondirected use of pictures as a possible modality for improving well-being in elderly women. Works of art were chosen for the individual taste pattern on the basis of psychological and art scientific research on aesthetic reactions to and perception of art. Participants were randomly allocated either to the intervention (n = 20) or to the control (n = 20) group. Participants in both groups had the same amount of social contact with and attention from the experimenter. The difference between the groups indicated improved well-being in the intervention group, an improvement not seen in the control group. The quantitative analyses of the results reveal a significant improvement of the positive mood parameters happiness, peacefulness, satisfaction and calmness and the negative parameters low-spirited, unhappy and sad. Systolic blood pressure decreased and an improvement was seen in the subjects' medical health status with regard to reported dizziness, fatigue, pain and use of laxatives.

Activities of Daily Living↗

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

Influence of job strain and emotion on blood pressure in female hospital personnel during workhours.

A homogeneous sample of 56 women who were between the ages of 20 and 59 years and worked in acute emergency care, child psychiatry, or a pediatric outpatient clinic comprised the subjects of this study to determine the relationship between job strain and blood pressure. Job strain was measured with a standardized questionnaire, and blood pressure during workhours with self-triggered equipment. Endocrine factors (morning concentration of plasma prolactin, cortisol, and dehydroepiandrosterone) and emotional states recorded in diaries were also studied. Significant interrelationships occurred among perceived job strain, plasma prolactin, and diastolic blood pressure during workhours even when body mass index, age, family history of hypertension, level of education, and mood state were adjusted for in a multiple regression analysis. Thus job strain of female care givers was associated with systolic and diastolic blood pressure during workhours and also with diastolic blood pressure at rest, but not with blood pressure during leisure time.

Adult↗

PubMed1993

[Modifying the environment in psychosomatic projects].

Experiences from five different evaluated psychosocial interventions, namely 1. increased support to relatives of cancer patients during the period of care, 2. worksite interventions in six different occupations, 3. controlled evaluation of a psychosocial exploration and feedback programme in worksites, 4. a psychosocial stimulation programme for elderly and finally 5. a psychosocial daycare programme in a longterm ward, are described. In most of these studies the programmes have been evaluated by means of standardized follow-up of the experimental conditions and the control group. The experiences point at the enormous importance of preparing and organizing the intervention and to allow longterm follow-up. Results indicate that simple changes in the psychosocial framework of these situations may result in measurable beneficial changes in the physiological and psychological state of the participants. The points is made that some psychosomatic mechanisms can be understood only in intervention projects in which the time perspective is taken into account.

Adaptation, Psychological↗

PubMed1992

Minimum heart rate and coronary atherosclerosis: independent relations to global severity and rate of progression of angiographic lesions in men with myocardial infarction at a young age.

The relations of hemodynamic factors, plasma fibrinogen concentration, serum lipoprotein levels, and clinical risk indicators to coronary atherosclerosis were studied in 56 men who had survived a first myocardial infarction before the age of 45 years and who subsequently underwent two coronary angiographies with an intervening time interval of 4 to 7 years. Presence, severity, and rate of progression of both diffuse lesions and distinct stenoses were determined by means of separate classification systems in 15 proximal coronary arterial segments. High minimum heart rate measured during a 24-hour period in connection with the reangiography was associated with progression of both diffuse lesions and distinct stenoses. High minimum heart rate also correlated positively with angiographic scores of global severity of diffuse atherosclerosis and stenoses. Progression of disease was predicted independently by minimum heart rate and low-density lipoprotein/high-density lipoprotein ratio, whereas lipoprotein A, fibrinogen levels, hypertension, smoking, and beta-adrenergic receptor blockade treatment did not discriminate between patients with and without progression.

Adult↗

PubMed1992

The psychological and social condition of hypertensives resistant to pharmacological treatment.

To characterize patients with therapy-resistant essential hypertension (TR) from a psychosocial point of view, 29 hypertensives, filling specified criteria for TR in a hypertension clinic were selected out of 800 patients screened. A control group of patients with established, but well controlled hypertension, pair-wise matching study patients for age and gender was also selected. TR patients were predominantly of working-class origin (68 vs 19% P less than 0.001). They tended to be more obese (BMI 28.7 +/- 5.5 vs 26.9 +/- 3.9 ns). TR tended to report fewer important life events, and reported significantly fewer positive events from the last 10 year period P less than 0.05. According to the EAI, their ability to channel emotions, especially anger, was impaired (P less than 0.01). So was their instrumental handling of emotions such as anger and sorrow (P less than 0.05). They experienced less of joy, and even had a more negative attitude towards that emotion (P less than 0.05). When adjusted for social class this latter difference was not statistically significant. Their degree of global emotional differentiation was lower (P less than 0.05). In the ISSI interview they had low scores for availability of emotional attachment (P less than 0.01), and friendship (P less than 0.05), but not for social integration. To conclude, when compared to well controlled hypertensives, TR exhibited the pattern, which has been shown to characterize young, asymptomatic, hypertensives in comparison to healthy subjects. These results must not be overinterpreted due to the limited sample.(ABSTRACT TRUNCATED AT 250 WORDS)

Affective Symptoms↗

PubMed1992

Psychosocial adjustment and general state of health in patients with ileal conduit urinary diversion.

The psychosocial adjustment and general state of health were investigated in 66 patients (40 males, 26 females) who had been subjected to an ileal conduit urinary diversion on account of bladder cancer (44 patients) or incontinence or bladder dysfunction (22 patients). Seventy per cent of the patients reported unchanged, overall, social activity (OSA) after the operation. Twenty per cent reported less and 10% more activity. Bladder-cancer patients were more likely to curtail their social activities compared with the patients with incontinence or bladder dysfunction. Appliance-related problems were mentioned by half of the patients who reported decreased OSA. One-third of the patients considered accidental leakage or fear of such leakage as the most negative aspect of surgery. Factors related to an altered body image were the most common negative aspect reported by females. Despite psychosocial problems, the majority of the patients (80%) considered their health to be good. Males, individuals working full-time and patients with unchanged OSA scored higher on a Health Index, i.e. considered themselves healthier than the rest of the patients.

Adaptation, Psychological↗

PubMed1992

Do physicians care about patients with dysphagia? A study on confirming communication.

Thirty-nine patients with longstanding oesophageal dysphagia took part in an interview and a questionnaire study to investigate whether they considered themselves met with interest, respect, understanding and knowledge (felt confirmed) when consulting their physician for the first time (mostly general practitioner), whether non-confirmed patients have any distinguishing attributes, and whether confirmation affects the patient's impression of being helped. Twenty-five of these considered themselves as non-confirmed. There was no difference between the groups as regards sex, age, education, degree of swallowing difficulties and incidence of chest symptoms other than dysphagia. There was a greater fear of cancer (P less than 0.05) and a stronger indirect aggression (P less than 0.05) among the non-confirmed patients. Patients who felt confirmed reported more often that a correct oesophageal diagnosis had been given (P less than 0.05), felt they had received adequate help (P less than 0.001) and experienced improvement in swallowing difficulties (P less than 0.05). It is concluded that patient attributes seem to slightly influence the patients' possibilities of being confirmed, and that confirmation is of great importance for the patient's feeling of being helped and improved.

Adolescent↗

PubMed1992

Time trends in survival from myocardial infarction in Stockholm County 1976-1984.

In Stockholm county, a rapid decline in mortality from acute myocardial infarction (AMI) was observed among middle-aged men in the early 1980s. In the present study survival among AMI patients from 1976 to 1984 was investigated in order to explore whether improvements in survival may have contributed to this decline. AMI patients aged 30-74 years (n = 16,108) were identified through a hospital discharge register. Deaths within one year of hospital admission were ascertained by means of linkage to the national cause of death register. Survival 1 year after hospital admission increased in both genders during the period 1981-1984, but among women there was no uniform trend over the whole study period. The estimated age-adjusted relative risk of death within one year after hospital admission for patients with a first infarction admitted to hospital in 1983-1984 as compared to in 1981-1982 was 0.88 for men and 0.79 for women. The causes of the observed increase in survival could not be determined from this study, but changes in medical intervention as well as diagnostic improvements may have been important. Improved survival may have contributed to about 30% of the decline in mortality from AMI among middle-aged men in Stockholm county during the early 1980s.

Adult↗

PubMed1992

Geographical differences in myocardial infarction incidence in eight Swedish counties, 1976-1981.

Considerable regional variation in coronary heart disease mortality has been observed in Sweden. This variation is of public health concern and is also a point of departure for etiologic studies. The central aim of the present study was to investigate whether there are also regional differences in myocardial infarction incidence and to evaluate whether these are likely to be explained by regional differences in smoking, blood pressure, and serum cholesterol. The study base consisted of subjects age 30-64 living in eight Swedish counties during 1976-1981. Cases of myocardial infarction were identified using both hospital discharge and death records. A 30-40% increased incidence of myocardial infarction was found in the two northernmost counties compared with Stockholm county. The regional differences in myocardial infarction incidence were not related to differences in smoking but might be due in part to differences in serum cholesterol and blood pressure, and to socioeconomic factors as well.

Adult↗

PubMed1992

Five-year follow-up of young adults visiting an emergency unit because of atypical chest pain.

A five-year follow-up, by means of a personal interview, was performed on patients below the age of 40 years with acute chest pain without obvious organic cause (n = 64). They had been consecutively admitted to the emergency unit over a period of 8 weeks, and had all been subjected to a thorough medical and psychosocial investigation with feedback soon after the initial consultation (investigation patient group, IP). For comparison, a non-investigation patient (NIP) group (n = 51) was recruited over a period of 8 separate weeks. Half of the patients in each group reported at the follow-up that they continued to suffer from chest pain. Compared to normal subjects, they reported more depression. This means that the initial research programme performed in the investigation group had no sustained therapeutic effect compared to routine care at the emergency unit. Tension, anxiety and number of consultations with a physician, as reported in the initial investigation, were negatively correlated with the outcome at follow-up. We conclude that acute chest pain without obvious organic cause in young adults is a condition with an excellent prognosis in strictly physical terms. However, a high proportion of the patients continue to suffer from chest pain for several years, and many of them continue to be consumers of medical resources. We therefore suggest that therapeutic programmes should be developed, particularly for those who report psychological symptoms and those with a history of many consultations with physicians.

Acute Disease↗

PubMed1992

Critical life changes. A review of research.

This review of ideas presented in life event research presents a psychological and a sociological research tradition. Physiological recordings of endocrine factors have been utilized in studies of life events both in the study of natural course (bereavement and accidents, for instance) and in the laboratory during talk about critical life events. Recently, several programmes have been started for improving people's life event tolerance. However, 'eventlessness' has also been observed to be a possible disease-provoking factor.

Accidents↗

PubMed1992

Employer control and the work environment: a study of the Swedish Public Dental Service.

The Public Dental Service in Sweden has a system of surveillance and supervision based on time studies, piecework wages for dentists, and detailed time reporting. This control system and its development are described in this article. The focus is on the effects of the system on the staff. A representative group of Swedish dentists (n = 896) and dental nurses (n = 600) was asked to participate in a questionnaire study exploring the work environment in the Public Dental Service. The response rate was 87 percent. The dentists reported that they felt constantly supervised and evaluated. Their work tempo was related to surveillance, competition, and demands of the employer. There was no correlation between work tempo and piecework results. A high percentage of the staff mentioned weaknesses in the charging and piecework system that they thought could result in an undesirable influence on dentists' work. A majority would have preferred fixed salaries. The results are discussed in terms of gender, motivation, proletarianization, and management style.

Dental Assistants↗

PubMed1992

Psychosocial work environment in relation to changes in selected biochemical parameters in district nurses.

Sixty-four female district nurses between the ages of 25 and 60 in the greater Stockholm area were subjects in a longitudinal study of psychosocial work environment and biochemical serum parameters. Each participant filled out questionnaires and had blood drawn on four different occasions at three-month intervals during one year. The rating on the fourth occasion showed psychosocial work environment to have deteriorated--social climate and authority over decisions were significantly inferior to those on previous occasions. These changes were accompanied by small but significant elevations of serum cholesterol, calcium and triglycerides. Another pattern was also observed which was probably due to increased health habit awareness--a progressive decrease in glycated haemoglobin and gamma glutamyl transferase. No significant interactions were observed with age or smoking habits--old and young subjects did not differ in their change patterns over time, nor did smokers in respect to non-smokers.

Adult↗

PubMed1992

Psychophysiological effects of stimulation with pictures of works of art in old age.

The present article reports on a controlled intervention study concerning the effects of non-directed use of pictures of works of art as a way of stimulating institutionalized elderly women. After the stimulation period differences in ratings between the groups indicated improved well-being in the intervention group. Such improvement was not seen in the C-group. The quantitative analyses of the results reveal a significant change of the parameters happiness, peacefulness, creativeness, social activities and systolic blood pressure. The qualitative analysis shows that the conversations about pictures of works of art in the intervention group give the person free rein to her own imagination and are merely characterized by happiness. In the control group the conversations are to a great extent characterized by downheartedness, despair and complaining.

Aged↗