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OBJECTIVE: The major aims of this study were to examine (1) the association between fear of hypoglycemia (FOH) in adults with type 1 diabetes with demographic, psychological (anxiety and depression), and disease-specific clinical factors (hypoglycemia history and unawareness, A1c), including severe hypoglycemia (SH), and (2) differences in patient subgroups categorized by level of FOH and risk of SH. RESEARCH DESIGN AND METHODS: Questionnaires were mailed to 764 patients with type 1 diabetes including the Swedish translation of the Hypoglycemia Fear Survey (HFS) and other psychological measures including the Perceived Stress Scale, Hospital Anxiety and Depression Scale, Anxiety Sensitivity Index, Social Phobia Scale, and Fear of Complications Scale. A questionnaire to assess hypoglycemia history was also included and A1c measures were obtained from medical records. Statistical analyses included univariate approaches, multiple stepwise linear regressions, Chi-square t tests, and ANOVAs. RESULTS: Regressions showed that several clinical factors (SH history, frequency of nocturnal hypoglycemia, self-monitoring) were significantly associated with FOH but R (2) increased from 16.25 to 39.2 % when anxiety measures were added to the model. When patients were categorized by level of FOH (low, high) and SH risk (low, high), subgroups showed significant differences in non-diabetes-related anxiety, hypoglycemia history, self-monitoring, and glycemic control. CONCLUSION: There is a strong link between FOH and non-diabetes-related anxiety, as well as hypoglycemia history. Comparison of patient subgroups categorized according to level of FOH and SH risk demonstrated the complexity of FOH and identified important differences in psychological and clinical variables, which have implications for clinical interventions.
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Diabetes Mellitus Tipo 1/psicología , Hipoglucemia/psicología , Adulto , Ansiedad , Glucemia/metabolismo , Diabetes Mellitus Tipo 1/metabolismo , Miedo , Femenino , Humanos , Hipoglucemia/metabolismo , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
BACKGROUND: It is important to identify factors that influence the risk of relapses in inflammatory bowel disease. Few studies have been conducted and with limited methodology. This prospective case-crossover study, aims to examine whether perceived stress has a short-term acute effect, namely whether it acts as a trigger, on the risk of relapse in inflammatory bowel disease. METHODS: Sixty patients with inflammatory bowel disease and in remission were included. The case-crossover design was employed, which is an epidemiological design developed to study triggers for acute events and diseases. To collect information regarding symptoms and potential trigger factors, such as perceived stress, a structured diary was constructed. The participants were instructed to fill in the diary daily during six months. Fifty patients completed the study. RESULTS: The analysis showed an effect for high level of perceived stress. Being exposed to "quite a lot" of stress, yield an increase in risk for relapse during the forthcoming day (OR = 4.8, 95% CI 1.09 - 21.10). No statistically increased risk for lower levels of perceived stress was found, although elevated effect estimates were found for "some" stress. CONCLUSION: This study supports earlier findings regarding perceived stress as an important factor in triggering relapses in IBD. However, this is the first case-crossover study performed to explore the trigger risk of stress in this population. Further investigations with larger patient samples are needed to confirm the findings.
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OBJECTIVES: to describe the grief of mothers and fathers and its influence on their relationships after the loss of a stillborn baby. DESIGN: a postal questionnaire at three months, one year and two years after stillbirth. SETTING: a study of mothers and fathers of babies stillborn during a one-year period in the Stockholm region of Sweden. PARTICIPANTS: 55 parents, 33 mothers and 22 fathers. FINDINGS: mothers and fathers stated that they became closer after the loss, and that the feeling deepened over the course of the following year. The parents said that they began grieving immediately as a gradual process, both as individuals, and together as a couple. During this grieving process their expectations, expressions and personal and joint needs might have threatened their relationship as a couple, in that they individually felt alone at this time of withdrawal. While some mothers and fathers had similar grieving styles, the intensity and expression of grief varied, and the effects were profound and unique for each individual. KEY CONCLUSIONS: experiences following a loss are complex, with each partner attempting to come to terms with the loss and the resultant effect on the relationship with their partner. IMPLICATIONS FOR PRACTICE: anticipating and being able to acknowledge the different aspects of grief will enable professionals to implement more effective intervention in helping couples grieve both individually and together.
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Adaptación Psicológica , Relaciones Familiares , Pesar , Padres/psicología , Mortinato/psicología , Adulto , Actitud Frente a la Muerte , Femenino , Humanos , Masculino , Apoyo Social , Encuestas y Cuestionarios , SueciaRESUMEN
AIM: This paper is a report of a study comparing eating difficulties among patients 3 months after stroke in relation to the acute phase. BACKGROUND: There is limited knowledge of patients with eating problems early after stroke, hence the progress of eating abilities needs to be further explored. METHOD: From March 2007 to June 2008 36 stroke patients with 2-7 eating difficulties or problems with reduced alertness or swallowing in the acute phase were included. Eating difficulties were detected using a structured protocol of observation of meals. In addition, stroke severity (National Institute of Health Stroke Scale), functional status (Barthel Index), unilateral neglect (Line Bisection test and Letter Cancellation test), psychological well-being (The Well-being Questionnaire-12), nutritional status (Mini Nutritional Assessment) and oral status (Revised Oral Assessment Guide) were assessed. RESULTS: There were 36 participants (58% female) with a median age of 74·5 years. The proportion of eating difficulties decreased significantly from the acute phase to the 3-month follow-up in 'sitting position', 'managing food on the plate' and 'manipulating food in the mouth' and increased regarding inadequate food consumption. Improvements were shown at 3 months in stroke severity, functional status, nutritional status and neglect. Oral status and psychological well-being remained unchanged. CONCLUSION: The majority of eating problems persisted 3 months after stroke despite a marked improvement in most of the physical functions. The unchanged psychological well-being and sustained problems with food consumption indicate that factors other than physical function should be taken into account regarding eating difficulties poststroke.
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Trastornos de Deglución/fisiopatología , Trastornos de Alimentación y de la Ingestión de Alimentos/fisiopatología , Calidad de Vida , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular/fisiopatología , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Nivel de Alerta , Investigación en Enfermería Clínica , Ingestión de Alimentos/fisiología , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Evaluación Nutricional , Estado Nutricional , Trastornos de la Percepción/diagnóstico , Trastornos de la Percepción/fisiopatología , Índice de Severidad de la Enfermedad , Perfil de Impacto de Enfermedad , Accidente Cerebrovascular/psicología , Factores de TiempoRESUMEN
In this study the authors describe parents' experiences of support over a 2-year period after a stillbirth and its effect on parental grief. Data was collected by questionnaire from 33 mothers and 22 fathers at 3 months, 1 year, and 2 years after a stillbirth. Midwives, physicians, counselors, and priests--at the hospital where the stillbirth occurred--are those on the front line providing professional support. The support from family and friends was seen to be important 2 years after the stillbirth. The need for professional support after stillbirth can differ, depending on the support provided by family, friends, and social networks. They may not fully realize the value of their support and how to be supportive. Printed educational materials given to individuals in the social network or family might therefore be helpful.
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Pesar , Padres/psicología , Apoyo Social , Mortinato/psicología , Adulto , Consejo , Femenino , Humanos , Estudios Longitudinales , Masculino , Satisfacción del Paciente , Personal de Hospital , Religión , Factores de TiempoRESUMEN
AIMS AND OBJECTIVES: To examine eating difficulties among stroke patients - a comparison between women and men. BACKGROUND: Gender differences have been reported in studies of stroke, but the findings are inconclusive and few of these studies have specifically focused on gender differences in eating difficulties. DESIGN: This study was a descriptive, cross-sectional, comparative study. METHOD: Patients with stroke were recruited at a general hospital in Sweden. To detect eating difficulties, individual observations of the patients were made during one meal using a structured observation protocol. Assessment also included measurements of nutritional and oral status, degree of independence, stroke severity, neglect and well-being. RESULTS: One hundred and four patients (53·8% women) were included in the study. The proportion of stroke patients with one or more eating difficulties was 81·7%. The most common eating difficulties were 'managing food on the plate' (66·3%), 'food consumption' (54·8%) and 'sitting position' (45·2%). Women had lower 'food consumption', more severe stroke (p = 0·003), worse functional status (p = 0·001) and lower quality of life (QoL) (p=0·038) than men. More women than men were malnourished and living alone. After adjustment for functional status and motor arm, the odds ratio of having difficulties with food consumption was four times higher among women than men (1·7-9·4, confidence interval 95%). CONCLUSIONS: More women than men with stroke suffered from inadequate food consumption. The women had more severe strokes, experienced poorer QoL and showed lower functional status than the men. In the rehabilitation process of women with stroke, these factors should be taken into consideration. RELEVANCE TO CLINICAL PRACTICE: Structured observation of meals, including assessment of food consumption, might be necessary in acute stroke care to detect patients, especially women, who might need closer supervision and nutritional intervention.
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Trastornos de Alimentación y de la Ingestión de Alimentos/etiología , Accidente Cerebrovascular/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación Nutricional , Calidad de Vida , Accidente Cerebrovascular/fisiopatología , SueciaRESUMEN
AIM: To identify predictors of low health-related quality of life among patients with inflammatory bowel disease and make a comparison between Crohn's disease and ulcerative colitis with disease duration. BACKGROUND: Studies have shown that patients with inflammatory bowel disease rate their health-related quality of life lower, as compared with a general population. DESIGN: Survey. METHODS: In this study, 197 patients in remission were included and divided into a Crohn's disease group and an ulcerative colitis group. Each group was also divided into separate groups whether the patients had short disease duration or long disease duration. Generic instruments, combined with disease-specific questionnaires, were used for measuring health-related quality of life. RESULTS: The analysis showed a non-significant effect for diagnosis, but a significant effect for disease duration showing that the patients with short disease duration had lower scores of health-related quality of life compared with patients with long disease duration. A significant interaction between diagnosis and disease duration was also revealed. CONCLUSION: Patients with longer disease duration experienced a better health-related quality of life than patients with short disease duration. Patients with Crohn's disease and short disease duration have the lowest health-related quality of life and are in greatest need of education and support. RELEVANCE TO CLINICAL PRACTICE: It is important to identify which patients' are in the greatest need of education and support.
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Colitis Ulcerosa/fisiopatología , Enfermedad de Crohn/fisiopatología , Calidad de Vida , HumanosRESUMEN
THE STUDY'S RATIONALE: Eating difficulties are common after stroke. However, to better meet individuals' needs, in terms of care, support and rehabilitation after stroke, it was considered important to know more about how patients with stroke experience their eating difficulties while in process of regaining their ability. AIMS AND OBJECTIVES: The aim of this study was to explore the experience of eating difficulties among patients with stroke 3 months after stroke onset. METHODOLOGICAL DESIGN AND JUSTIFICATION: A qualitative interpretive descriptive approach was used. The analysis was based on constant comparative approach, using the principles of grounded theory. RESEARCH METHODS: The study included 14 participants with stroke and eating difficulties. A semi-structured interview guide with open-ended questions and probes was used. The interview guide was gradually modified during the data collection process. The interviews were digital audio recorded and fully transcribed. Memos were documented simultaneously with the analysis. INSTRUMENTS: A structured observation of a meal verified eating difficulties, and semi-structured interviews were conducted. RESULTS: 'Striving for control' emerged as a tentative core category. The participants related their striving for control to 'eating safely', and 'eating properly'; they also had to analyse the consequences of their eating difficulties, being careful when eating, and/or avoiding activities. Some also felt a need of help from others. Those others could remind and provide advice in this matter. CONCLUSION: This study highlights the complexity of having eating difficulties after stroke. Aspects related to the participants' striving for control are based on different strategies to eat safely and properly. Nurses can use this knowledge to support patients in their strive for control by observing them in eating situations. In addition, nurses can also ask them to describe and make explicit the experience of eating situations after stroke.
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Ingestión de Alimentos , Accidente Cerebrovascular/fisiopatología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , SueciaRESUMEN
We studied the advice mothers with stillbirths were given concerning a suitable time to become pregnant. A questionnaire was sent in 2001 to mothers with a stillbirth at one of five hospitals in the Stockholm region in Sweden. At three months follow-up, 33 mothers participated and at 12 months 31. The advices varied from waiting one to 12 months. Eleven mothers were advised to trust their own feelings of readiness and six were advised to wait until they had dealt with their grief before becoming pregnant. At one year post-loss, most of the mothers felt that a suitable time for a subsequent pregnancy was as soon as the mother herself wanted. Mothers whose baby had died in utero were given radically different kinds of advice concerning a suitable time for a subsequent pregnancy. The best advice seems to be that the mother should wait until she, herself, feels ready.
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Madres/psicología , Relaciones Profesional-Paciente , Mortinato/psicología , Adaptación Psicológica , Adulto , Femenino , Muerte Fetal , Pesar , Humanos , Embarazo , Encuestas y CuestionariosRESUMEN
This study aims to capture parental descriptions of how siblings take leave of and mourn a stillborn brother or sister and how their parents support them. Data were collected by questionnaires from 16 parents of siblings to a stillborn child one year after the stillbirth. Data were analysed numerically for the multiple-choice questions and content analysis was used for parental comments and descriptions. The results describe siblings' farewell to a stillborn brother or sister and how their parents in the midst of their own grief were involved in supporting siblings' wellbeing, and observed their mourning reactions. Although the findings need to be interpreted with caution, they may provide insight that enables staff to become more sensitive to the whole family experience in the practice of their profession. Further research into siblings' grief and parental support after stillbirth is crucial so that further light may be shed on their situation.
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Pesar , Relaciones Padres-Hijo , Psicología Infantil , Hermanos/psicología , Mortinato/psicología , Adaptación Psicológica , Aflicción , Niño , Preescolar , Salud de la Familia , Femenino , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
PURPOSE: To explore the experience and management of eating situations among persons affected by stroke, 6 months after stroke onset. METHOD: A qualitative constant comparative approach, influenced by principles of grounded theory, was used to analyse the interviews. Thirteen participants were interviewed in the home setting 6 months after the stroke. RESULTS: Experiences and desire to master eating situations varied, and was related to values and previous habits. Eating difficulties were experienced as disgusting, uncomfortable, strenuous, or unproblematic and not implying shame. Getting help from others could be experienced as embarrassing and undesirable. In particular, eating could be more difficult when eating in company of unfamiliar people. The participants found new ways of mastering eating situations. Some had regained former routines. CONCLUSIONS: Old values and habits and/or involvement of other people were the basis of mastering eating situations. New ways of mastering were found, some accepted, and got used to the new situation. Some regained former routines. This knowledge could contribute to health care personnel's awareness of each patient's individual values and previous habits during the rehabilitation process. A dialogue is needed with the person suffering from eating difficulties after stroke, to help create the best possible individual conditions for mastering eating situations.
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Ingestión de Alimentos/fisiología , Accidente Cerebrovascular/fisiopatología , Adaptación Fisiológica , Anciano , Anciano de 80 o más Años , Culinaria , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Ajuste SocialRESUMEN
BACKGROUND: Worries and concerns of patients with IBD comprise an important negative factor in their HRQOL. The Rating Form of Inflammatory Bowel Disease Patient Concerns (RFIPC) was developed to describe the nature and degree of the worries and concerns of IBD patients. In the original version, the specific issues of worries are divided into four separate factors. These factors provide useful information about HRQOL and the kind of worries and concerns which are most important to the patient. However, the Swedish version of the RFIPC is often scored using a single sum score, implying that all the specific issues of worries stem from a single general worry factor. The aim of this study was to validate the factor structure of the Swedish version of the RFIPC. METHODS: A sample consisting of 195 patients with IBD filled out the RFIPC. Confirmatory factor analysis was performed to examine fit of three hypothesized models of factor structure. Spearman's correlation and Mann-Whitney analysis were used to follow up the results. RESULTS: The single-factor model displayed poor fit indices. The four-factor model marked substantive improvement, but still remains inadequate. The final four-factor model permitting correlated error terms between some items displayed the most adequate fit. CONCLUSIONS: The factorial structure of the RFIPC, as suggested in the original version, was able to be replicated with a slight modification in the Swedish version. The separate factors identified in this structure provide more detailed information about the worries and concerns of IBD patients as these components of worries are different related to HRQOL and general health.
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OBJECTIVE: To examine the impact of a Cognitive Behavior Therapy (CBT)-based intervention on HbA(1c), self-care behaviors and psychosocial factors among poorly controlled adult type 1 diabetes patients. METHODS: Ninety-four type 1 diabetes patients were randomly assigned to either an intervention group or a control group. The intervention was based on CBT and was mainly delivered in group format, but individual sessions were also included. All subjects were provided with a continuous glucose monitoring system (CGMS) during two 3-day periods. HbA(1c), self-care behaviors and psychosocial factors were measured up to 48 weeks. RESULTS: Significant differences were observed with respect to HbA(1c) (P<0.05), well-being (P<0.05), diabetes-related distress (P<0.01), frequency of blood glucose testing (P<0.05), avoidance of hypoglycemia (P<0.01), perceived stress (P<0.05), anxiety (P<0.05) and depression (P<0.05), all of which showed greater improvement in the intervention group compared with the control group. A significant difference (P<0.05) was registered with respect to non-severe hypoglycemia, which yielded a higher score in the intervention group. CONCLUSION: This CBT-based intervention appears to be a promising approach to diabetes self-management. PRACTICE IMPLICATIONS: Diabetes care may benefit from applying tools commonly used in CBT. For further scientific evaluation in clinical practice, there is a need for specially educated diabetes care teams, trained in the current approach, as well as cooperation between diabetes care teams and psychologists trained in CBT.
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Terapia Cognitivo-Conductual , Diabetes Mellitus Tipo 1/terapia , Hemoglobina Glucada , Adulto , Anciano , Análisis de Varianza , Automonitorización de la Glucosa Sanguínea , Intervalos de Confianza , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , AutocuidadoRESUMEN
AIM: To describe experience from a behavioural medicine intervention among poorly controlled adult type 1 diabetes patients, in terms of feasibility, predictors and associations of improved glycaemic control. METHODS: Data were collected on 94 poorly controlled adult type 1 diabetes patients who were randomised to a study evaluating the effects of a behavioural medicine intervention. Statistics covered descriptive and comparison analysis. Backward stepwise regression models were used for predictive and agreement analyses involving socio-demographic and medical factors, as well as measures of diabetes self-efficacy (DES), diabetes locus of control (DLOC), self-care activities (SDSCA), diabetes-related distress (Swe-PAID-20), fear of hypoglycaemia (HFS), well-being (WBQ), depression (HAD) and perceived stress (PSS). RESULTS: The participation rate in the study was 41% and attrition was 24%. Of those patients actually participating in the behavioural medicine intervention, 13% withdrew. From the regression models no predictors or associations of improvement in HbA(1c) were found. CONCLUSIONS: The programme proved to be feasible in terms of design and methods. However, no clear pattern was found regarding predictors or associations of improved metabolic control as the response to the intervention. Further research in this area is called for.
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Medicina de la Conducta/métodos , Diabetes Mellitus Tipo 1/psicología , Diabetes Mellitus Tipo 1/terapia , Adolescente , Adulto , Anciano , Terapia Cognitivo-Conductual , Diabetes Mellitus Tipo 1/metabolismo , Humanos , Persona de Mediana Edad , Educación del Paciente como Asunto , Autocuidado/psicología , Resultado del Tratamiento , Adulto JovenRESUMEN
The purpose of the present study was to describe HIV-infected patients' self-reported health-related quality of life (HRQOL) in relation to sense of coherence over a 24-month period. A total of 104 HIV-infected patients (71% males) answered questionnaires at three times at 12-month intervals. At the same time, clinical characteristics were collected from the patients' medical records. HRQOL was measured by the HIV-symptom scale, the Health Index, and the Well-Being Scale. Coping ability was measured with the 29-item sense of coherence (SOC) scale. The patients were divided into three groups depending on SOC scores (low, moderate, high). The results indicate that the group with low SOC scores rate their HRQOL worse than the other groups at all three measurements (p values from <0.05 to <0.001). Over the 2-year period, the patients' CD4 cell count=mm3 increased significantly (p values <0.001), indicating good response to antiretroviral treatment. However, their HRQOL did not improve during these 2 years. Patients with higher SOC rate their HRQOL better than those with a lower SOC, during these years. Future studies should investigate the predictive value of the SOC scale of HRQOL in HIV-infected patients.
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Actitud Frente a la Salud , Infecciones por VIH/psicología , Estado de Salud , Personalidad , Calidad de Vida/psicología , Autoeficacia , Adaptación Psicológica , Análisis de Varianza , Recuento de Linfocito CD4 , Estudios Transversales , Femenino , Estudios de Seguimiento , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/inmunología , Infecciones por VIH/virología , VIH-1/genética , Humanos , Control Interno-Externo , Masculino , Valor Predictivo de las Pruebas , ARN Viral/análisis , ARN Viral/genética , Factores de Riesgo , Encuestas y Cuestionarios , Suecia , Resultado del TratamientoRESUMEN
AIM: The aim of this study was to examine predictors of the life situation of the significant other of depressed or aphasic stroke patients. BACKGROUND: Depression and aphasia are common consequences of stroke, and both may put pressure on the significant other who have to deal not only with a possible physical handicap but also with communication and/or serious psychiatric difficulties. DESIGN: Descriptive, cross-sectional study. METHODS: The participants were significant others of 71 depressed and 77 aphasic stroke patients. Depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorder, and degree of aphasia was diagnosed with the Amsterdam Nijmegen Everyday Language Test. Assessments of the life situation, state of depression and aggression, personality change and need of assistance were made through questionnaires issued to the significant others. RESULTS: Perceived need of assistance was the only common predictor of life situation of the significant other in both groups (p < 0.001). With respect to the aphasic patients, perceived personality change (p < 0.001) and living with the patient (p = 0.004) were factors that had a negative effect on the life situation of the significant other. CONCLUSIONS: This study highlights that the perception of the patient's need of assistance is an important factor in predicting the life situation among spouses of depressed as well as aphasic stroke patients. A comparison of the two groups to explain the life situation of the significant others revealed greater explanatory power for the aphasic group. RELEVANCE TO CLINICAL PRACTICE: Assessments of the spouses' perception as well as of the patients' factual situation may identify those significant others at risk. With this new approach, necessary steps may be taken to alleviate pressure on the significant other.
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Adaptación Psicológica , Afasia/enfermería , Actitud Frente a la Salud , Depresión/enfermería , Esposos/psicología , Accidente Cerebrovascular/complicaciones , Actividades Cotidianas , Anciano , Afasia/etiología , Cuidadores/psicología , Costo de Enfermedad , Estudios Transversales , Depresión/diagnóstico , Depresión/etiología , Femenino , Evaluación Geriátrica , Humanos , Acontecimientos que Cambian la Vida , Masculino , Evaluación de Necesidades , Evaluación en Enfermería , Investigación Metodológica en Enfermería , Personalidad , Calidad de Vida/psicología , Análisis de Regresión , Factores de Riesgo , Encuestas y Cuestionarios , SueciaRESUMEN
OBJECTIVE: The objective of this study was to evaluate the psychometric properties of the Swedish version of the Hypoglycaemia Fear Survey (Swe-HFS) for use among Swedish-speaking patients with type 1 diabetes. METHODS: The HFS was translated using the forward-backward translation method and was thereafter answered by 325 type 1 patients. The psychometric properties were investigated using exploratory factor analysis, Cronbach's alpha, content and convergent validity. RESULTS: The factor analysis showed that a three-factor solution was reasonable with the subscales Behaviour/Avoidance (10 items), Worry (6 items) and Aloneness (4 items). Cronbach's alpha coefficient for the total score was 0.85. The result also supports the instrument's content validity and convergent validity. CONCLUSION: The Swedish version of the HFS appears to be a reliable and valid instrument for measuring fear of hypoglycaemia (FoH) in type 1 patients. PRACTICE IMPLICATIONS: The results from this study suggest that the Swe-HFS, an instrument that is brief and easy to administer, may be valuable in clinically assessing FoH among patients with type 1 diabetes.
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Automonitorización de la Glucosa Sanguínea/psicología , Diabetes Mellitus Tipo 1/psicología , Miedo , Hipoglucemia/psicología , Encuestas y Cuestionarios , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Psicológicos , Psicometría , Reproducibilidad de los Resultados , SueciaRESUMEN
BACKGROUND: Considering the importance of psychological aspects in the management of diabetes, there is a need of validated measurements in this area. Such tools make it possible to screen patients for specific conditions as well as they serve as reliable measures when evaluating medical, psychological and educational interventions. OBJECTIVES: The current study was conducted to adapt the Problem Areas in Diabetes Scale for use among Swedish-speaking patients with type 1 diabetes and to evaluate the psychometric properties. DESIGN: Methodological research design was used in this study. SETTING AND PARTICIPANTS: A convenience sample of 325 type 1 diabetes patients was systematically selected from the local diabetes registry of a university hospital in Stockholm, Sweden. METHODS: Following the linguistic adaptation using the forward-backward translation method, the 20-item PAID was answered by the selected patients. Statistics covered exploratory factor analysis, Cronbach's alpha, convergent validity and content validity. RESULTS: In the factor analysis a three-factor solution was found to be reasonable with the sub-dimensions diabetes-related emotional problems (15 items), treatment-related problems (2 items) and support-related problems (3 items). Cronbach's alpha coefficient for the total score was 0.94 and varied between 0.61 and 0.94 in the three subscales. The findings also gave support for the convergent and content validity. CONCLUSIONS: The Swedish version of the Problem Areas in Diabetes Scale (Swe-PAID-20) seems to be a reliable and valid outcome for measuring diabetes-related emotional distress in type 1 diabetes patients.
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Diabetes Mellitus Tipo 1/diagnóstico , Psicometría , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , SueciaRESUMEN
BACKGROUND: The informal caregivers perceive lack of choice to take on the role of caregiving, receiving little or no preparation for the caregiving role at home. The typical informal caregiver is female, either a spouse or adult child of the care recipient, and seldom shares the responsibilities of caregiving with other family members. The spouses worry about the ill relative, but also about what consequences the disease might have for their own life. The worries seem to vary with gender and disease. There are, to our knowledge, few previous longitudinal studies that have focused on gender differences among spouses of stroke patients. OBJECTIVES: To explore gender differences among spouses in perceived psychological well-being and general life situation, during the first year after the patients' stroke event. DESIGN: Longitudinal study with three assessments regarding psychological well-being and general life situation during 1 year. SETTINGS: The study took place at a stroke ward, Stockholm, Sweden. PARTICIPANTS: Consecutively 80 female and 20 male spouses of stroke patients admitted to a stroke unit participated. METHODS: Data were analysed using analyses of variance. RESULTS: Female spouses have a negative impact on psychological well-being, while male spouses have a lower occurrence of emotional contacts in their social network. Consistently, the female spouses reported lower quality of life and well-being than the male spouses. CONCLUSIONS: This study generates the hypotheses that there are gender differences among spousal caregivers of stroke patients; female spouses are more negatively affected in their life situation due to the patients' stroke event than the male spouses. It is important to take the individual differences under consideration when designing a nursing intervention, to meet the different needs and demands of male and female caregivers. The interventions should focus on individual support, so that the caregivers can adapt to their new role and be comfortable and effective as informal caregivers.
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Factores Sexuales , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/psicología , Femenino , Humanos , Estudios Longitudinales , MasculinoRESUMEN
OBJECTIVE: Health-related quality of life is impaired in patients with inflammatory bowel disease and improved disease-related information can improve this situation. The aims of this study were to create an education programme that could be readily applicable at the clinic and would be suitable for newly diagnosed patients with inflammatory bowel disease, and to investigate whether the programme could improve their health-related quality of life. MATERIAL AND METHODS: Ninety-three patients with inflammatory bowel disease in remission were included and randomized to an intervention group or a control group. The intervention group attended a multiprofessional education programme while the control group received regular information. Four questionnaires were used for measuring health-related quality of life. Both groups completed the questionnaires at baseline and after 6 months. The intervention group also completed the questionnaires after 1 month. RESULTS: No significant differences were found when comparing the two groups at 6 months. However, the multi-professional education programme was highly appreciated by the patients. CONCLUSIONS: In the present study no improvement could be seen in health-related quality of life in patients with inflammatory bowel disease after participating in an education programme in comparison with the control group. This might be due to the fact that the questionnaires were not sensitive enough or that some patients were not in clinical remission. The patients' enthusiasm for the multiprofessional education programme has led to its being part of the regular care at the clinic.