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Dalum HS, Hem E, Ekeberg Ø, Reneflot A, Stene-Larsen K, Hauge LJ. Suicide rates among health-care professionals in Norway 1980-2021. J Affect Disord 2024; 355:399-405. [PMID: 38537752 DOI: 10.1016/j.jad.2024.03.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/28/2024] [Accepted: 03/23/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Suicide rates have been high in several health-care professions. Suicide rates were described in physicians, dentists, veterinarians, psychologists, pharmacists, nurses, as well as theologians, other graduates and the general population in Norway. METHODS Data on educational attainment were linked to data on suicide and all-cause mortality from 1980 to 2021. Suicide rates were reported per 100,000 person-years. The total number of person-years included in the study was 66.4 and 67.2 million for males and females, respectively. RESULTS Between 1980 and 2021, male veterinarians (35.9, 95 % CI 19.3-52.4), physicians (25.7, 21.3-30.2) and nurses (22.2, 16.6-27.7) had higher suicide rates compared others with higher education (11.7, 10.7-12.7). For females, this was the case for psychologists (15.0, 8.2-21.7) and nurses (9.3, 8.3-10.3), vs. others with higher education (5.1, 4.2-6.0). Suicide rates declined over the four decades for most groups. For physicians, suicide rates declined and approached the suicide rate of others with higher education. Suicide rates among physicians increased with age, with physicians over 60 years having twice as high suicide rates compared to others with higher education. LIMITATIONS The study included only educational status, not current occupation or employment status. This is a descriptive study, with some known risk factors for suicide not accounted for. CONCLUSIONS Suicide rates for physicians declined over time, but not for nurses. From 2010 to 2021, nurses of both genders was the only group with higher suicide rates compared to other graduates. The increased suicide rates among veterinarians, nurses, female psychologists and elderly physicians are concerning.
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Affiliation(s)
- Helene Seljenes Dalum
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway; Institute for Studies of the Medical Profession, Oslo, Norway.
| | - Erlend Hem
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway; Institute for Studies of the Medical Profession, Oslo, Norway
| | - Øivind Ekeberg
- Psychosomatic and CL Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Kim Stene-Larsen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Lars Johan Hauge
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
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Grimholt TK, Bonsaksen T, Heir T, Schou Bredal I, Skogstad L, Ekeberg Ø. Prevalence of suicide attempt and associations with deliberate self-harm, mental health problems, drug misuse and traumatic experiences - a cross sectional survey of the Norwegian population. BMC Psychiatry 2024; 24:164. [PMID: 38408936 PMCID: PMC10895832 DOI: 10.1186/s12888-024-05610-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/14/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Monitoring self-reported suicide attempts (SA) with nationally representative surveys is important to initiate suicide prevention strategies. The aim of the study was to assess the prevalence of SA and compare deliberate self-harm, (DSH), mental health, drug misuse and traumas between SA and non-suicide attempters (NSA). METHODS In this cross-sectional survey of a representative sample (N=1757) of the Norwegian population, we compared people with self-reported SA (n=54) to NSA (n=1703) regarding sociodemographic data, mental health problems, drug misuse and exposure to trauma. RESULTS The prevalence of SA was 3.1 %. There was a higher proportion of welfare recipients and more deliberate self-harm, mental health problems, drug misuse and traumas in the SA group compared to NSA. CONCLUSION This national study confirms the association between suicide attempt and deliberate self-harm, mental health problems, drug misuse and traumas.
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Affiliation(s)
- T K Grimholt
- Faculty of Health, VID Specialized University, Oslo, Norway.
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.
| | - T Bonsaksen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Health, Faculty of Health Sciences, VID Specialized University, Stavanger, Norway
| | - T Heir
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - I Schou Bredal
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - L Skogstad
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Ø Ekeberg
- Psychosomatic and Consultation-Liaison psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Persett PS, Bjornaas MA, Jacobsen D, Ekeberg Ø, Myhren H. Health-related quality of life in patients discharged from hospital after suicide attempt with violent methods compared to self-poisonings. Nord J Psychiatry 2024; 78:37-45. [PMID: 37712668 DOI: 10.1080/08039488.2023.2257686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 08/21/2023] [Accepted: 09/06/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Suicide attempts by violent methods (VM) can leave the patient with physical and mental trauma affecting health-related quality of life (HRQOL). There is limited knowledge about the impact and HRQOL after a suicide attempt by VM. AIMS To compare HRQOL in patients after a suicide attempt by VM, both to self-poisonings (SP) and the general population, and the association of hospital anxiety and depression to the HRQOL in the two groups. METHODS Patients admitted to hospital after a suicide attempt were included in this prospective cohort-study from 2010 to 2015. For HRQOL, Short Form Health Survey (SF-36), and Hospital anxiety and depression scale scores (HADS-A and HADS-D) were assessed during study follow-up. RESULTS The VM-group scored lower HRQOL for the physical dimensions at 3 months (p<.05), compared to the SP group, and only role limitation physical at 12 months (p<.05). Both groups scored lower HRQOL than the general population (p < .05).At baseline, the VM group scored lower for HADS-A than the SP group (p < .05). Both groups had lower HADS scores one year after (p < .05). In multiple regression analyses, the HADS scores were associated with HRQOL in the VM-group (p < .05). SP group HADS scores were negatively associated with general health, vitality, social functioning, and mental health (p < .05). CONCLUSION Both groups scored lower for HRQOL than the general population, and the VM group had worse score than the SP group in physical dimensions. Both groups had less symptoms of anxiety and depression over time, but it`s association to HRQOL was strong.
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Affiliation(s)
- Per Sverre Persett
- Department of Acute Medicine, Oslo University Hospital, Ullevaal, Oslo, Norway
- Institute of Clinical Sciences, University of Oslo, Oslo, Norway
| | | | - Dag Jacobsen
- Department of Acute Medicine, Oslo University Hospital, Ullevaal, Oslo, Norway
- Institute of Clinical Sciences, University of Oslo, Oslo, Norway
| | - Øivind Ekeberg
- Psychosomatic and CL psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Hilde Myhren
- Department of Acute Medicine, Oslo University Hospital, Ullevaal, Oslo, Norway
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Hovland IS, Skogstad L, Stafseth S, Hem E, Diep LM, Ræder J, Ekeberg Ø, Lie I. Prevalence of psychological distress in nurses, physicians and leaders working in intensive care units during the COVID-19 pandemic: a national one-year follow-up study. BMJ Open 2023; 13:e075190. [PMID: 38135308 PMCID: PMC10897841 DOI: 10.1136/bmjopen-2023-075190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE To report and compare psychological distress as symptoms of anxiety, depression and post-traumatic stress among intensive care units' (ICU) nurses, physicians and leaders at 12 months after the baseline survey (spring 2020), during the COVID-19 pandemic in Norway. Furthermore, to analyse which baseline demographic and COVID ICU-related factors have a significant impact on psychological distress at 12 months. DESIGN Prospective, longitudinal, observational cohort study. SETTING Nationwide, 27 of 28 hospitals with COVID ICUs in Norway. PARTICIPANTS Nurses, physicians and their leaders. At 12 month follow-up 287 (59.3%) of 484 baseline participants responded. PRIMARY AND SECONDARY OUTCOME MEASURES Symptoms of anxiety and depression using the Hopkins Symptoms Checklist-10 (HSCL-10). Symptoms of post-traumatic stress using the post-traumatic stress disease checklist for the Diagnostic and Statistical Manual of Mental Disorders 5 (PCL-5).Demographics (included previous symptoms of anxiety and depression) and COVID ICU-related factors (professional preparations, emotional experience and support) impacting distress at 12 months. RESULTS Psychological distress, defined as caseness on either or both HSCL-10 and PCL-5, did not change significantly and was present for 13.6% of the participants at baseline and 13.2% at 12 month follow-up. Nurses reported significantly higher levels of psychological distress than physicians and leaders. Adjusted for demographics and the COVID ICU-related factors at baseline, previous symptoms of depression and fear of infection were significantly associated with higher levels of anxiety and depression at 12 months. Previous symptoms of depression, fear of infection and feeling of loneliness was significantly associated with more symptoms of post-traumatic stress. CONCLUSION One year into the COVID-19 pandemic 13.2% of the ICUs professionals reported psychological distress, more frequently among the nurses. Fear of infection, loneliness and previous symptoms of depression reported at baseline were associated with higher levels of distress. Protective equipment and peer support are recommended to mitigate distress. TRIAL REGISTRATION NUMBER ClinicalTrials.gov. Identifier: NCT04372056.
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Affiliation(s)
- Ingvild Strand Hovland
- Department of Acute Medicine, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Department of the Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- Centre for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - Laila Skogstad
- Centre for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromso, Norway
| | - Siv Stafseth
- Centre for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
- Department of MEVU, Lovisenberg Diaconal University College, Oslo, Norway
| | - Erlend Hem
- Department of the Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- Institue of Studies of the Medical Profession, Oslo, Norway
| | - Lien M Diep
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Johan Ræder
- Department of Anesthesiology, Intitute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway
| | - Øivind Ekeberg
- Psychosomatic and CL psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Irene Lie
- Centre for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
- Department of Health Sciences in Gjøvik, Norwegian University of Science and Technology, Gjøvik, Norway
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Schou-Bredal I, Grimholt TK, Bonsaksen T, Skogstad L, Heir T, Ekeberg Ø. Psychological responses and associated factors during the initial lockdown due to the corona disease epidemic (COVID-19) among Norwegian citizens. J Ment Health 2023; 32:1057-1064. [PMID: 34309479 DOI: 10.1080/09638237.2021.1952949] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/14/2021] [Accepted: 06/01/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Ongoing COVID-19 studies pay little attention to the risk or protective factors related to psychological stress. AIMS This study aims to estimate the prevalence of anxiety, depression and insomnia during the initial phase of the COVID-19 outbreak, and explore factors that might be associated with these outcomes. METHODS A population-based cross-sectional survey was conducted using snowball-sampling strategy. Participants from 18 years or older filled out an anonymous online questionnaire. RESULTS A total of 4527 citizens filled out the questionnaire. Prevalence rates were; insomnia 31.8%, anxiety 17.1% and depression 12.5%. Risk factors associated with anxiety, depression and insomnia were being single (OR = 0.75, OR = 0.57, OR = 0.59), unemployed (OR = 0.47, OR = 0.53, OR = 0.73), financial concerns (OR = 1.66, OR = 2.09, OR = 1.80) at risk for complication from COVID-19 (OR = 1.63, OR = 1.68, OR = 1.60), and being generally worried due to the COVID-19 (OR 0 3.06, OR = 1.41, OR = 1.74). CONCLUSION Being single, unemployed, at risk of health complications, or having concerns because of financial or other consequences of the pandemic are associated with mental health adversities such as anxiety, depression and insomnia during a pandemic lockdown.
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Affiliation(s)
- Inger Schou-Bredal
- Institute for Health and Science, Faculty of Medicine, University in Oslo, Oslo, Norway
| | - Tine K Grimholt
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Tore Bonsaksen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Elverum, Norway
- Faculty of Health Studies, VID Specialized University, Sandnes, Norway
| | - Laila Skogstad
- Department of Research, Sunnaas Rehabilitation Hospital HF, Nesodden, Norway
- Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Trond Heir
- Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Norway
| | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Lerdal A, Gay C, Bonsaksen T, Ekeberg Ø, Grimholt T, Heir T, Kottorp A, Lee KA, Skogstad L, Schou-Bredal I. Validation of a short version of the Lee fatigue scale in adults living in Norway: a cross-sectional population survey. BMC Public Health 2023; 23:2132. [PMID: 37904144 PMCID: PMC10617107 DOI: 10.1186/s12889-023-17036-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 10/20/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Due to the nature of fatigue, a brief reliable measure of fatigue severity is needed. Thus, the aim of our study was to evaluate a short version of the Lee Fatigue Scale (LFS) in the Norwegian general population. METHODS This cross-sectional survey consists of a representative sample from the Norwegian population drawn by The National Population Register in Norway. The study is part of a larger study (NORPOP) aimed at collecting normative data from several questionnaires focused on health in adults living in Norway. Registered citizens between 18 and 94 years of age were randomly selected stratified by age, sex and geographic region. Of the 4971 respondents eligible for the study, 1792 (36%) responded to the survey. In addition to age and sex, we collected responses on a 5-item version of the LFS measuring current fatige severity. The psychometric properties focusing on internal structure and precision of the LFS items were analyzed by a Rasch rating scale model. RESULTS Complete LFS scores for analyses were available for 1767 adults. Women had higher LFS-scores than men, and adults < 55 years old had higher scores than older respondents. Our analysis of the LFS showed that the average category on each item advanced monotonically. Two of the five items demonstrated misfit, while the three other items demonstrated goodness-of-fit to the model and uni-dimensionality. Items #1 and #4 (tired and fatigue respectively) showed differential item functioning (DIF) by sex, but no items showed DIFs in relation to age. The separation index of the LFS 3-item scale showed that the sample could be separated into three different groups according to the respondents' fatigue levels. The LFS-3 raw scores correlated strongly with the Rasch measure from the three items. The core dimensions in these individual items were very similarly expressed in the Norwegian language version and this may be a threat to the cultural-related or language validity of a short version of the LFS using these particular items. CONCLUSIONS The study provides validation of a short LFS 3-item version for estimating fatigue in the general population.
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Affiliation(s)
- Anners Lerdal
- Research Department, Lovisenberg Diaconal Hospital, Oslo, Norway.
- Department of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Caryl Gay
- Department of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Family Health Care Nursing, University of California, San Francisco, USA
| | - Tore Bonsaksen
- Department of Health and Nursing, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Health, Faculty of Health Studies, VID Specialized University, Stavanger, Norway
| | - Øivind Ekeberg
- Psychosomatic and CL Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Trine Grimholt
- Department of Health, Faculty of Health Studies, VID Specialized University, Oslo, Norway
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Trond Heir
- Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anders Kottorp
- Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Kathryn A Lee
- Department of Family Health Care Nursing, University of California, San Francisco, USA
| | - Laila Skogstad
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Inger Schou-Bredal
- Department of Public Health Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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Stafseth SK, Skogstad L, Ræder J, Hovland IS, Hovde H, Ekeberg Ø, Lie I. Correction: Stafseth et al. Symptoms of Anxiety, Depression, and Post-Traumatic Stress Disorder in Health Care Personnel in Norwegian ICUs during the First Wave of the COVID-19 Pandemic, a Prospective, Observational Cross-Sectional Study. Int. J. Environ. Res. Public Health 2022, 19, 7010. Int J Environ Res Public Health 2022; 19:15424. [PMID: 36498448 PMCID: PMC9681019 DOI: 10.3390/ijerph192315424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 06/17/2023]
Abstract
In the original publication [...].
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Affiliation(s)
- Siv Karlsson Stafseth
- Department of Postoperative and Intensive Care, Division of Emergencies and Critical Care, Oslo University Hospital, 0424 Oslo, Norway
- MEVU, Lovisenberg Diaconal University College, 0456 Oslo, Norway
| | - Laila Skogstad
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, 9019 Tromsø, Norway
| | - Johan Ræder
- Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, 0424 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, 0313 Oslo, Norway
| | - Ingvild Strand Hovland
- Department of Acute Medicine, Division of Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Haakon Hovde
- The Norwegian Association for Critical Care Nurses, 0152 Oslo, Norway
| | - Øivind Ekeberg
- Psychosomatic and Consultation-Liaison Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway
| | - Irene Lie
- Centre for Patient-Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, 0424 Oslo, Norway
- Department of Health Sciences in Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 2815 Gjøvik, Norway
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Stafseth SK, Skogstad L, Ræder J, Hovland IS, Hovde H, Ekeberg Ø, Lie I. Symptoms of Anxiety, Depression, and Post-Traumatic Stress Disorder in Health Care Personnel in Norwegian ICUs during the First Wave of the COVID-19 Pandemic, a Prospective, Observational Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:7010. [PMID: 35742259 PMCID: PMC9222786 DOI: 10.3390/ijerph19127010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/03/2022] [Accepted: 06/05/2022] [Indexed: 11/25/2022]
Abstract
Background: The COVID-19 pandemic has induced demanding work situations in intensive care units (ICU). The objective of our study was to survey psychological reactions, the disturbance of social life, work effort, and support in ICU nurses, physicians, and leaders. Methods: From May to July 2020, this cross-sectional study included 484 ICU professionals from 27 hospitals throughout Norway. Symptoms of anxiety and depression were measured on Hopkins Symptom Checklist-10 (HSCL-10). Symptoms of post-traumatic stress disorder (PTSD) were measured on the PCL-5. Results: The study population were highly educated and experienced professionals, well prepared for working with COVID-ICU patients. However, 53% felt socially isolated and 67% reported a fear of infecting others. Probable cases of anxiety and depression were found in 12.5% of the registered nurses, 11.6% of the physicians, and 4.1% of the leaders. Younger age and <5 years previous work experiences were predictors for high HSCL-10 scores. Reported symptom-defined PTSD for nurses 7.1%; the leaders, 4.1%; and 2.3% of physicians. Conclusions: ICU health care professionals experienced talking with colleagues as the most helpful source of support. The COVID-ICU leaders reported a significantly higher mean score than physicians and nurses in terms of pushing themselves toward producing high work effort.
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Affiliation(s)
- Siv Karlsson Stafseth
- Department of Postoperative and Intensive Care, Division of Emergencies and Critical Care, Oslo University Hospital, 0424 Oslo, Norway
- MEVU, Lovisenberg Diaconal University College, 0456 Oslo, Norway
| | - Laila Skogstad
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, 9019 Tromsø, Norway;
| | - Johan Ræder
- Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, 0424 Oslo, Norway;
- Institute of Clinical Medicine, University of Oslo, 0313 Oslo, Norway
| | - Ingvild Strand Hovland
- Department of Acute Medicine, Division of Medicine, Oslo University Hospital, 0424 Oslo, Norway;
| | - Haakon Hovde
- The Norwegian Association for Critical Care Nurses, 0152 Oslo, Norway;
| | - Øivind Ekeberg
- Psychosomatic and Consultation-Liaison Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway;
| | - Irene Lie
- Centre for Patient-Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, 0424 Oslo, Norway;
- Department of Health Sciences in Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 2815 Gjøvik, Norway
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Schou-Bredal I, Bonsaksen T, Ekeberg Ø, Skogstad L, Grimholtg TK, Heir T. A comparison between healthcare workers and non-healthcare workers’ anxiety, depression and PTSD during the initial COVID -19 lockdown. Public Health in Practice 2022; 3:100267. [PMID: 35535328 PMCID: PMC9068258 DOI: 10.1016/j.puhip.2022.100267] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/31/2022] [Accepted: 04/29/2022] [Indexed: 11/26/2022] Open
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10
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Schou-Bredal I, Bonsaksen T, Ekeberg Ø, Skogstad L, Grimholt TK, Lerdal A, Heir T. Sexual Assault and the Association With Health, Quality of Life, and Self-Efficacy in the General Norwegian Population. J Interpers Violence 2022; 37:1878-1901. [PMID: 32515259 PMCID: PMC8793317 DOI: 10.1177/0886260520926307] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The lifetime prevalence of sexual assault was examined in a representative sample of the general Norwegian adult population (n = 1,792), in addition to the association between sexual assault and health, quality of life, and general self-efficacy. Respondents completed questionnaires assessing these factors. Overall, 6.7% (n = 120) of the respondents (10.9% of women and 1.9% of men) reported an experience of sexual assault. Respondents in the sexual assault group reported significantly worse mental and physical health as well as poorer quality of life and lower self-efficacy, compared with those without sexual assault experience. The most prevalent mental problems in the sexual assault group were depression (61.7%), sleep problems (58.3%), eating disorders (26.7%), and posttraumatic stress disorder symptoms at a clinical level (25.0%). The most prevalent physical problems were chronic pain (47.5%) and musculoskeletal disease (30.8%). The proportions of physical and mental health problems were not significantly different between male and female victims. Results indicated that having experienced sexual assault during one's life appears to be associated with lifetime occurrence of multiple health problems for both genders and reduces a person's perceived general self-efficacy and quality of life.
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Affiliation(s)
| | - Tore Bonsaksen
- Oslo Metropolitan University, Akershus, Norway
- VID Specialized University, Sandnes, Norway
| | - Øivind Ekeberg
- University of Oslo, Norway
- Oslo University Hospital, Norway
| | | | | | - Anners Lerdal
- University of Oslo, Norway
- Lovisenberg Diakonale Hospital, Oslo, Norway
| | - Trond Heir
- University of Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
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Lie I, Stafseth S, Skogstad L, Hovland IS, Hovde H, Ekeberg Ø, Ræder J. Healthcare professionals in COVID-19-intensive care units in Norway: preparedness and working conditions: a cohort study. BMJ Open 2021; 11:e049135. [PMID: 34635518 PMCID: PMC8506047 DOI: 10.1136/bmjopen-2021-049135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 09/15/2021] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE To survey the healthcare professionals' background and experiences from work with patients with COVID-19 in intensive care units (ICUs) during the first wave of the COVID-19 pandemic in Norway. DESIGN Observational cohort study. SETTING COVID-ICUs in 27 hospitals across Norway. PARTICIPANTS Healthcare professionals (n=484): nurses (81%), medical doctors (9%) and leaders (10%), who responded to a secured, web-based questionnaire from 6 May 2020 to 15 July 2020. PRIMARY AND SECONDARY MEASURES Healthcare professionals': (1) professional and psychological preparedness to start working in COVID-ICUs, (2) factors associated with high degree of preparedness and (3) experience of working conditions. RESULTS The age of the respondents was 44.8±10 year (mean±SD), 78% were females, 92% had previous ICU working experience. A majority of the respondents reported professional (81%) and psychological (74%) preparedness for working in COVID-ICU. Factors significantly associated with high professional preparedness for working in COVID-19-ICU in a multivariate logistic model were previous ICU work experience (p<0.001) and participation in COVID-ICU simulation team training (p<0.001). High psychological preparedness was associated with higher age (p=0.003), living with spouse or partner (p=0.013), previous ICU work experience (p=0.042) and participation in COVID-ICU simulation team training (p=0.001). Working with new colleagues and new professional challenges were perceived as positive in a majority of the respondents, whereas 84% felt communication with coworkers to be challenging, 46% were afraid of being infected and 82% felt discomfort in denying access for patient relatives to the unit. Symptoms of sweating, tiredness, dehydration, headache, hunger, insecurity, mask irritation and delayed toilet visits were each reported by more than 50%. CONCLUSIONS Healthcare professionals working during the first wave of COVID-ICU patients in Norway were qualified and prepared, but challenges and potential targets for future improvements were present. TRIAL REGISTRATION NUMBER NCT04372056.
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Affiliation(s)
- Irene Lie
- Centre for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - Siv Stafseth
- Department of Postoperative and Intensive Care, Administrative Section, Oslo University Hospital, Oslo, Norway
- Department of MEVU, Lovisenberg Diaconal University College, Oslo, Norway
| | - Laila Skogstad
- Department of Research, Sunnaas Sykehus HF, Nesoddtangen, Norway
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Haakon Hovde
- Critical Care Nurses, Norwegian Nurses Association, Oslo, Norway
| | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Johan Ræder
- Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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12
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Vibeto JH, Vallersnes OM, Dobloug A, Brekke M, Jacobsen D, Ekeberg Ø, Wangen KR. Treating patients with opioid overdose at a primary care emergency outpatient clinic: a cost-minimization analysis. Cost Eff Resour Alloc 2021; 19:48. [PMID: 34348747 PMCID: PMC8335998 DOI: 10.1186/s12962-021-00303-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Treating patients with acute poisoning by substances of abuse in a primary care emergency clinic has previously been shown to be a safe strategy. We conducted an economic evaluation of this strategy compared to hospital treatment, which is the usual strategy. METHODS Assuming equal health outcomes, we conducted a cost-minimization analysis. We constructed a representative opioid overdose patient based on a cohort of 359 patients treated for opioid overdose at the Oslo Accident and Emergency Outpatient Clinic (OAEOC) from 1.10.2011 to 30.9.2012. Using a health care system perspective, we estimated the expected resources used on the representative patient in primary care based on data from the observed OAEOC cohort and on information from key informants at the OAEOC. A likely course of treatment of the same patient in a hospital setting was established from information from key informants on provider procedures at Drammen Hospital, as were estimates of hospital use of resources. We calculated expected costs for both settings. Given that the treatments usually last for less than one day, we used undiscounted cost values. RESULTS The estimated per patient cost in primary care was 121 EUR (2018 EUR 1.00 = NOK 9.5962), comprising 97 EUR on personnel costs and 24 EUR on treatment costs. In the hospital setting, the corresponding cost was 612 EUR, comprising 186 EUR on personnel costs, 183 EUR on treatment costs, and 243 EUR associated with intensive care unit admission. The point estimate of the cost difference per patient was 491 EUR, with a low-difference scenario estimated at 264 EUR and a high-difference scenario at 771 EUR. CONCLUSIONS Compared to hospital treatment, treating patients with opioid overdose in a primary care setting costs substantially less. Our findings are probably generalizable to poisoning with other substances of abuse. Implementing elements of the OAEOC procedure in primary care emergency clinics and in hospital emergency departments could improve the use of health care resources.
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Affiliation(s)
| | - Odd Martin Vallersnes
- Department of General Practice, University of Oslo, Oslo, Norway. .,Oslo Accident and Emergency Outpatient Clinic, City of Oslo Health Agency, Oslo, Norway.
| | - Andrea Dobloug
- Department of Medicine, Drammen Hospital, Vestre Viken Trust, Drammen, Norway
| | - Mette Brekke
- General Practice Research Unit, University of Oslo, Oslo, Norway
| | - Dag Jacobsen
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Øivind Ekeberg
- Psychosomatic and Consultation-Liaison Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Knut Reidar Wangen
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
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13
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Bonsaksen T, Ekeberg Ø, Schou-Bredal I, Skogstad L, Heir T, Grimholt TK. Use of Alcohol and Addictive Drugs During the COVID-19 Outbreak in Norway: Associations With Mental Health and Pandemic-Related Problems. Front Public Health 2021; 9:667729. [PMID: 34195169 PMCID: PMC8236640 DOI: 10.3389/fpubh.2021.667729] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 03/29/2021] [Indexed: 01/16/2023] Open
Abstract
Background: The outbreak of COVID-19 has had a major impact on people's daily life. This study aimed to examine use of alcohol and addictive drugs during the COVID-19 outbreak in Norway and examine their association with mental health problems and problems related to the pandemic. Methods: A sample of 4,527 persons responded to the survey. Use of alcohol and addictive drugs were cross-tabulated with sociodemographic variables, mental health problems, and problems related to COVID-19. Logistic regression analyses were used to examine the strength of the associations. Results: Daily use of alcohol was associated with depression and expecting financial loss in relation to the COVID-19 outbreak. Use of cannabis was associated with expecting financial loss in relation to COVID-19. Use of sedatives was associated with anxiety, depression, and insomnia. Use of painkillers was associated with insomnia and self-reported risk of complications if contracting the coronavirus. Conclusion: The occurrence of mental health problems is more important for an understanding of the use of alcohol and addictive drugs during the COVID-19 outbreak in Norway, compared to specific pandemic-related worries.
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Affiliation(s)
- Tore Bonsaksen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Faculty of Health Studies, VID Specialized University, Sandnes, Norway
| | - Øivind Ekeberg
- Psychosomatic and Consultation-Liaison Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Inger Schou-Bredal
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Department for Cancer, Oslo University Hospital, Oslo, Norway
| | - Laila Skogstad
- Department of Research, Sunnaas Rehabilitation Hospital HF, Bjørnemyr, Norway
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Trond Heir
- Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tine K. Grimholt
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
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14
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Schou-Bredal I, Skogstad L, Grimholt TK, Bonsaksen T, Ekeberg Ø, Heir T. Concerns in the Norwegian Population during the Initial Lockdown Due to the COVID-19 Pandemic. Int J Environ Res Public Health 2021; 18:ijerph18116119. [PMID: 34204043 PMCID: PMC8201037 DOI: 10.3390/ijerph18116119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 01/07/2023]
Abstract
Although concern affects one’s welfare or happiness, few studies to date have focused on peoples’ concerns during the initial COVID-19 lockdown. The aim of the study was to explore concerns in the Norwegian populations according to gender and age, and identify which concerns were most prominent during the lockdown. A population-based cross-sectional online survey using snowball-sampling strategies was conducted, to which 4527 adults (≥18 years) responded. Questions related to concerns had response alternatives yes or no. In addition, they were asked which concern was most prominent. Nearly all the 4527 respondents (92%) reported that they were concerned: 60.9% were generally concerned about the pandemic, 83.9% were concerned about family and friends, 21.8% had financial concerns, and 25.3% expected financial loss. More women were concerned about family and friends than males, (85.2% vs. 76.2%, p < 0.001), whereas more men expected financial loss (30.4% vs. 24.4%y, p = 0.001). Younger adults (<50 years) had more financial concerns than older adults (25.9% vs. 10.5%, p < 0.001). Being concerned about family and friends was the most prominent concern and was associated with; lower age (OR 0.79), female gender (OR 1.59), and being next of kin (2.42). The most prominent concern for adults 70 years or older was being infected by COVID-19. In conclusion, women and younger individuals were most concerned. While adults under 70 years of age were most concerned about family and friends and adults 70 years or older were most concerned about being infected by COVID-19.
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Affiliation(s)
- Inger Schou-Bredal
- Faculty of Medicine, Institute for Health and Science, University in Oslo, 0130 Oslo, Norway
- Correspondence:
| | - Laila Skogstad
- Department of Research, Sunnaas Rehabilitation Hospital HF, 1453 Bjørnemyr, Norway;
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Metropolitan University, 0130 Oslo, Norway
| | - Tine K. Grimholt
- Faculty of Health Studies, VID Specialized University, 0319 Oslo, Norway;
- Department of Acute Medicine, University Hospital, 0424 Oslo, Norway
| | - Tore Bonsaksen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, 2418 Elverum, Norway;
- Faculty of Health Studies, VID Specialized University, 4306 Sandnes, Norway
| | - Øivind Ekeberg
- Psychosomatic and CI Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway;
| | - Trond Heir
- Norwegian Center for Violence and Traumatic Stress Studies, 0409 Oslo, Norway;
- Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway
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15
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Persett PS, Ekeberg Ø, Jacobsen D, Bjornaas MA, Myhren H. Higher Suicide Intent in Patients Attempting Suicide With Violent Methods Versus Self-Poisoning. Crisis 2021; 43:220-227. [PMID: 33890826 PMCID: PMC9102881 DOI: 10.1027/0227-5910/a000773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Suicidal intent for patients attempting suicide using violent methods (VMs) is assumed to be higher than for those using self-poisoning (SP), which may explain the higher mortality observed in follow-up studies. However, this has not been studied prospectively. Aims: We aimed to compare patients attempting suicide using VMs with those using SP regarding suicidal intent, suicidal ideation, depression, and hopelessness during hospital stay and after 1 year. Methods: Patients hospitalized after suicide attempt by VMs (n = 80) or SP (n = 81) completed the Beck scales for Suicide Intent, Suicide Ideation, Depression Inventory, and Hopelessness on admission and at the 12-month follow-up. Results: On admission, those using VMs had higher suicidal intent than those using SP (M = 16.2 vs. 13.3, p < .001), but lower depression scores (M = 22.2 vs. 26.8, p < .05). No significant differences were found in suicidal ideation (M = 20.1 vs. 23.1) or hopelessness (M = 10.1 vs. 11.9). At 12-month follow-up, depression scores decreased significantly for both groups, while hopelessness decreased only for the SP group. Limitations: The statistical power achieved was lower than intended. Conclusion: The higher levels of suicidal intent, but lower levels of depression, may indicate more impulsivity among people attempting suicide using VMs. Suicidal ideation was relatively stable.
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Affiliation(s)
| | - Øivind Ekeberg
- Divisions of Mental Health and Addiction, Oslo University Hospital, Norway.,Department of Behavioral Sciences in Medicine, University of Oslo, Norway
| | - Dag Jacobsen
- Department of Acute Medicine, Oslo University Hospital, Norway.,Institute of Clinical Sciences, University of Oslo, Norway
| | | | - Hilde Myhren
- Department of Acute Medicine, Oslo University Hospital, Norway
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16
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Skogstad L, Schou-Bredal I, Bonsaksen T, Heir T, Ekeberg Ø, Grimholt T. Concerns Related to the COVID-19 in Adult Norwegians during the First Outbreak in 2020: A Qualitative Approach. Int J Environ Res Public Health 2021; 18:4312. [PMID: 33921705 PMCID: PMC8073491 DOI: 10.3390/ijerph18084312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 12/27/2022]
Abstract
Concerns related to the first outbreak of the COVID-19 pandemic in the Norwegian population are studied in a cross-sectional web-survey conducted between 8 April and 20 May 2020. The qualitative thematic analysis of the open-ended question "Do you have other concerns related to the pandemic?", followed a six-step process. Concerns from 1491 informants were analyzed, 34% of women and 30% of men (p = 0.05) provided concerns. Respondents with higher educational level reported concerns more often (86% vs. 83%, p = 0.022). The qualitative analysis revealed five themes-society, health, social activities, personal economy and duration-and 13 sub-themes, mostly related to the themes "society" and "health" (724 and 704, respectively). Empathy for others was prominent, for society (nationally and globally), but also concerns related to infecting others and family members at risk for developing serious illness if infected. The responses to the open-ended question yielded additional information, beyond the information obtained from questions with pre-categorized response options, especially related to concerns about society and health. Themes arising from the qualitative analysis shed light on what are important concerns for people during the pandemic and this may serve as targeted measures for the authorities.
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Affiliation(s)
- Laila Skogstad
- Department of Research, Sunnaas Rehabilitation Hospital HF, 1453 Bjørnemyr, Norway
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
| | | | - Tore Bonsaksen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, 2418 Elverum, Norway;
- Faculty of Health Studies, VID Specialized University, 4306 Sandnes, Norway
| | - Trond Heir
- Norwegian Center for Violence and Traumatic Stress Studies, 0409 Oslo, Norway;
- Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway
| | - Øivind Ekeberg
- Psychosomatic and CI Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway;
| | - Tine Grimholt
- Faculty of Health Studies, VID Specialized University, 0370 Oslo, Norway;
- Department of Acute Medicine, Oslo University Hospital, 0424 Oslo, Norway
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17
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Bonsaksen T, Skogstad L, Heir T, Ekeberg Ø, Schou-Bredal I, Grimholt TK. Suicide Thoughts and Attempts in the Norwegian General Population during the Early Stage of the COVID-19 Outbreak. Int J Environ Res Public Health 2021; 18:4102. [PMID: 33924558 PMCID: PMC8069206 DOI: 10.3390/ijerph18084102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/30/2022]
Abstract
The aim of the study was to examine the prevalence of suicide thoughts and attempts during the early stage of the COVID-19 outbreak and examine pandemic-related factors associated with suicide thoughts in the general Norwegian population. A sample of 4527 adults living in Norway were recruited via social media. Data related to suicide thoughts and attempts, alcohol use, pandemic-related concerns, and sociodemographic variables were collected. Associations with suicide thoughts were analyzed with logistic regression analysis. In the sample, 3.6% reported suicide thoughts during the last month, while 0.2% had attempted suicide during the same period. Previous suicide attempts (OR: 11.93, p < 0.001), lower age (OR: 0.69, p < 0.001), daily alcohol use (OR: 3.31, p < 0.001), being in the risk group for COVID-19 complications (OR: 2.15, p < 0.001), and having economic concerns related to the pandemic (OR: 2.28, p < 0.001) were associated with having current suicide thoughts. In addition to known risk factors, the study suggests that aspects specific to COVID-19 may be important for suicidal behaviors during the pandemic.
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Affiliation(s)
- Tore Bonsaksen
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, 2418 Elverum, Norway
- Faculty of Health Studies, VID Specialized University, 4306 Sandnes, Norway
| | - Laila Skogstad
- Department of Research, Sunnaas Rehabilitation Hospital HF, 1453 Bjørnemyr, Norway;
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Trond Heir
- Norwegian Center for Violence and Traumatic Stress Studies, 0484 Oslo, Norway;
- Institute of Clinical Medicine, University of Oslo, 0450 Oslo, Norway
| | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway;
| | | | - Tine K. Grimholt
- Faculty of Health Studies, VID Specialized University, 0370 Oslo, Norway;
- Department of Acute Medicine, Oslo University Hospital, 0424 Oslo, Norway
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18
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Bonsaksen T, Skogstad L, Grimholt TK, Heir T, Ekeberg Ø, Lerdal A, Schou-Bredal I. Substance use in the Norwegian general population: prevalence and associations with disease. Journal of Substance Use 2021. [DOI: 10.1080/14659891.2020.1784303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Tore Bonsaksen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Sandnes, Norway
| | - Laila Skogstad
- Department of Research, Sunnaas Rehabilitation Hospital HF, and Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Tine K. Grimholt
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, Oslo, Norway
| | - Trond Heir
- Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anners Lerdal
- Department for Patient Safety and Research, Lovisenberg Diakonale Hospital, Oslo, Norway
- Department of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Inger Schou-Bredal
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department for Cancer, Oslo University Hospital, Oslo, Norway
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Bonsaksen T, Heir T, Schou-Bredal I, Ekeberg Ø, Skogstad L, Grimholt TK. Post-Traumatic Stress Disorder and Associated Factors during the Early Stage of the COVID-19 Pandemic in Norway. Int J Environ Res Public Health 2020; 17:ijerph17249210. [PMID: 33317135 PMCID: PMC7764050 DOI: 10.3390/ijerph17249210] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/06/2020] [Accepted: 12/07/2020] [Indexed: 12/21/2022]
Abstract
The COVID-19 outbreak and the sudden lockdown of society in March 2020 had a large impact on people’s daily life and gave rise to concerns for the mental health in the general population. The aim of the study was to examine post-traumatic stress reactions related to the COVID-19 pandemic, the prevalence of symptom-defined post-traumatic stress disorder (PTSD), and factors associated with post-traumatic stress in the Norwegian population during the early stages of the COVID-19 outbreak. A survey was administered via social media channels, to which a sample of 4527 adults (≥18 years) responded. Symptom-defined PTSD was measured with the PTSD Checklist for the DSM-5. The items were specifically linked to the COVID-19 pandemic. We used the DSM-5 diagnostic guidelines to categorize participants as fulfilling the PTSD symptom criteria or not. Associations with PTSD were examined with single and multiple logistic regression analyses. The prevalence of symptom-defined PTSD was 12.5% for men and 19.5% for women. PTSD was associated with lower age, female gender, lack of social support, and a range of pandemic-related variables such as economic concerns, expecting economic loss, having been in quarantine or isolation, being at high risk for complications from COVID-19 infection, and having concern for family and close friends. In conclusion, post-traumatic stress reactions appear to be common in the Norwegian population in the early stages of the COVID-19 outbreak. Concerns about finances, health, and family and friends seem to matter.
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Affiliation(s)
- Tore Bonsaksen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, 2418 Elverum, Norway
- Faculty of Health Studies, VID Specialized University, 4306 Sandnes, Norway
| | - Trond Heir
- Norwegian Center for Violence and Traumatic Stress Studies, 0484 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, 0450 Oslo, Norway
| | | | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway
| | - Laila Skogstad
- Department of Research, Sunnaas Rehabilitation Hospital HF, 1453 Bjørnemyr, Norway
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0167 Oslo, Norway
| | - Tine K Grimholt
- Faculty of Health Studies, VID Specialized University, 0370 Oslo, Norway
- Department of Acute Medicine, Oslo University Hospital, 0424 Oslo, Norway
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20
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Schou-Bredal I, Ekeberg Ø, Kåresen R. Variability and stability of coping styles among breast cancer survivors: A prospective study. Psychooncology 2020; 30:369-377. [PMID: 33167066 DOI: 10.1002/pon.5587] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES We aimed to examine: (1) the long-term association between coping styles and psychological distress, (2) if women diagnosed with breast cancer have a predominant coping style, (3) stability of coping styles, (4) predictors of changes in coping styles, (5) if maladaptive coping adversely impacts disease-free survival (DFS). METHODS This prospective study included women diagnosed with primary breast cancer during 2006-2009. Patients completed questionnaires for the Norwegian Mini-Mental Adjustment to Cancer scale, which includes positive attitude (PA), helplessness/hopelessness (HH), anxious preoccupation (AP), and avoidance (AV), and the Hospital Anxiety and Depression Scale at diagnosis and 1, 3, and 5 years postdiagnosis. RESULTS Two hundred and ninety-three of 367 women (79.8%) completed the questionnaires at all time points. Anxiety and depression were moderately to strongly correlated with HH and AP coping styles (r = 0.31 to r = 0.69) at all time points. The predominant coping style was PA (23.4-29.9%). Stability for PA and cognitive AV styles was found at the group level, but not at an individual level. Chemotherapy and comorbidity were predictors for HH, AP, and AV 5 years postdiagnosis (p < 0.05). Maladaptive coping was not associated with DFS. CONCLUSIONS HH and AP were associated with higher psychological distress at all times. Group level coping remained stable over time for PA and AV. Coping style stability at an individual level was not observed. Having received chemotherapy and experienced adverse events affected coping at 5 years postdiagnosis. Maladaptive coping was not associated with DFS.
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Affiliation(s)
- Inger Schou-Bredal
- Institute of Health Science and Society, University of Oslo, Oslo, Norway.,Department for Cancer, Oslo University Hospital, Oslo, Norway
| | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Behavioral Sciences in Medicine, University of Oslo, Oslo, Norway
| | - Rolf Kåresen
- Administration, Oslo University Hospital, Oslo, Norway
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21
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Ekeberg Ø. Ø. Ekeberg svarer. Tidsskriftet 2020; 140:19-0798. [DOI: 10.4045/tidsskr.19.0798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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22
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Bonsaksen T, Ekeberg Ø, Skogstad L, Heir T, Grimholt TK, Lerdal A, Schou-Bredal I. Self-rated global health in the Norwegian general population. Health Qual Life Outcomes 2019; 17:188. [PMID: 31870385 PMCID: PMC6929488 DOI: 10.1186/s12955-019-1258-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 12/09/2019] [Indexed: 11/23/2022] Open
Abstract
Background Prevalence studies are needed to assess the distribution of diseases. However, in a contrasting health promotion perspective, self-rated health is in itself an important field of study. This study investigated self-rated global health in the general population in Norway. Methods As part of a national survey, a two-item measure of global health (score range 0–100) was administered to a general population sample, and 1776 of 4961 eligible participants (response rate 36%) responded. Group comparisons were conducted using independent t-tests and one-way analyses of variance, whereas factors associated with global health was investigated with linear regression analysis. Results In the adjusted analyses, better global health was associated with higher age (β = 0.13, p < 0.001), having higher education (β = 0.10, p < 0.001), being employed (β = 0.21, p < 0.001), and living with a spouse or partner (β = 0.05, p < 0.05). Conclusions While global health was similar for men and women in the Norwegian general population, other sociodemographic variables were linked with global health. In particular, the link between employment and self-rated global health was strong. The findings are considered representative for the Norwegian population.
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Affiliation(s)
- Tore Bonsaksen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Box 4 St. Olavs Plass, 0130, Oslo, PO, Norway. .,Faculty of Health Studies, VID Specialized University, Sandnes, Norway.
| | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
| | - Laila Skogstad
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.,Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Trond Heir
- Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tine K Grimholt
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Anners Lerdal
- Department for Patient Safety and Research, Lovisenberg Diakonale Hospital, Oslo, Norway.,Department of Interdisciplinary Health Sciences, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Inger Schou-Bredal
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department for Cancer, Oslo University Hospital, Oslo, Norway
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Abstract
BACKGROUND It has been suggested that countries with more resources and better healthcare have populations with a higher risk of post-traumatic stress disorder (PTSD). Norway is a high-income country with good public healthcare. AIMS To examine lifetime trauma exposure and the point prevalence of PTSD in the general Norwegian population. METHOD A survey was administered to a national probability sample of 5500 adults (aged ≥18 years). Of 4961 eligible individuals, 1792 responded (36%). Responders and non-responders did not differ significantly in age, gender or urban versus rural residence. Trauma exposure was measured using the Life Events Checklist for the DSM-5. PTSD was measured with the PTSD Checklist for the DSM-5. We used the DSM-5 diagnostic guidelines to categorise participants as fulfilling the PTSD symptom criteria or not. RESULTS At least one serious lifetime event was reported by 85% of men and 86% of women. The most common event categories were transportation accident and life-threatening illness or injury. The point prevalence of PTSD was 3.8% for men and 8.5% for women. The most common events causing PTSD were sexual and physical assaults, life-threatening illness or injury, and sudden violent deaths. Risk of PTSD increased proportionally with the number of event categories experienced. CONCLUSIONS High estimates of serious life events and correspondingly high rates of PTSD in the Norwegian population support the paradox that countries with more resources and better healthcare have higher risk of PTSD. Possible explanations are high expectations for a risk-free life and high attention to potential harmful mental health effects of serious life events. DECLARATION OF INTEREST None.
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Affiliation(s)
- Trond Heir
- Professor, Section for Trauma, Norwegian Center for Violence and Traumatic Stress Studies; and Institute of Clinical Medicine, University of Oslo, Norway
| | - Tore Bonsaksen
- Professor, Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University; and Faculty of Health Studies, VID Specialized University, Norway
| | - Tine Grimholt
- Associate Professor, Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Norway
| | - Øivind Ekeberg
- Professor, Division of Mental Health and Addiction, Oslo University Hospital; and Department of Behavioral Sciences in Medicine, University of Oslo, Norway
| | - Laila Skogstad
- Associate Professor, Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Norway
| | - Anners Lerdal
- Professor, Department for Patient Safety and Research, Lovisenberg Diakonale Hospital; and Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway
| | - Inger Schou-Bredal
- Associate Professor, Institute of Health and Society, University of Oslo; and Department for Cancer, Oslo University Hospital, Norway
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Ekeberg Ø, Hem E. Ø. Ekeberg and E. Hem respond. Tidsskr Nor Laegeforen 2019; 139:19-0520. [PMID: 31502792 DOI: 10.4045/tidsskr.19.0520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Valsø Å, Rustøen T, Skogstad L, Schou-Bredal I, Ekeberg Ø, Småstuen MC, Myhren H, Sunde K, Tøien K. Post-traumatic stress symptoms and sense of coherence in proximity to intensive care unit discharge. Nurs Crit Care 2019; 25:117-125. [PMID: 31418993 DOI: 10.1111/nicc.12466] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Post-traumatic stress (PTS) symptoms following intensive care unit (ICU) treatment can lead to post-traumatic stress disorder and represent a severe health burden. In trauma patients, a strong sense of coherence (SOC) is associated with fewer PTS symptoms. However, this association has not been investigated in a general ICU sample. AIMS AND OBJECTIVES To examine the occurrence of PTS symptoms in general ICU patients early after ICU discharge and to assess possible associations between PTS symptoms and SOC, ICU memory, pain, and demographic and clinical characteristics. DESIGN This was a cross-sectional study. METHODS Adult patients aged ≥18 years admitted for ≥24 hours to five ICUs between 2014 and 2016 were recruited. PTS symptoms and SOC were measured at the ward within the first week after discharge from the ICU using the Posttraumatic Stress Scale-10 and Sense of Coherence Scale-13. Multiple linear regression analysis was used to identify associations between PTS symptoms and SOC and the selected independent variables. RESULTS A total of 523 patients were included (17.8% trauma patients; median age 57 years [range 18-94]; 53.3% male). The prevalence of clinically significant PTS symptoms was 32%. After adjustments for gender and age, lower SOC (P < 0.001), more ICU delusional memories (P < 0.001), greater pain interference (P < 0.001), not being a trauma patient (P = 0.02), and younger age (P = 0.03) were significantly associated with more PTS symptoms. CONCLUSIONS One third of patients experienced clinically relevant PTS symptoms early after discharge from the ICU. In the present study, SOC, delusional memory, pain interference, younger age, and not being a trauma patient were factors associated with more PTS symptoms. RELEVANCE TO CLINICAL PRACTICE Early individual follow up after ICU discharge focusing on pain relief and delusional memory may reduce PTS symptoms, with a potential of improving rehabilitation.
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Affiliation(s)
- Åse Valsø
- Department of Postoperative and Intensive Care, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Tone Rustøen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Laila Skogstad
- Department of Nursing and Health Promotion, Prehospital Trauma Care - Bachelor paramedics, OsloMet - Oslo Metropolitan University of Oslo, Oslo, Norway
| | - Ingerl Schou-Bredal
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,Unit for Breast- and Endocrine Surgery, Division of Cancer, Oslo University Hospital, Oslo, Norway
| | - Øivind Ekeberg
- Department of Behavioral Sciences in Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Milada C Småstuen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Department of Public Health, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Hilde Myhren
- Department of Acute medicine, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Kjetil Sunde
- Department of Anesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kirsti Tøien
- Department of Postoperative and Intensive Care, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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Wisløff‐Aase K, Ræder J, Månum G, Løvstad M, Schanke A, Dyb G, Ekeberg Ø, Stanghelle JK. Chronic pain among the hospitalized patients after the 22 July 2011 terror attacks in Oslo and at Utøya Island. Acta Anaesthesiol Scand 2019; 63:913-922. [PMID: 30968401 DOI: 10.1111/aas.13373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 01/16/2019] [Accepted: 03/13/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND On 22 July 2011, 48 people were hospitalized due to physical injuries from gun shots or explosion, following 2 terror attacks in the Oslo area, Norway. In this study, we have investigated the occurrence of chronic pain, the severity and consequences of chronic pain in these patients, 3 to 4 years after the incidents. METHODS Totally 43 eligible terror trauma patients were invited to participate in the study, 30 patients were included. They underwent a consultation with a psychologist and a physician; containing psychological assessment, neuropsychological screening, a standardized clinical interview, medical examination, and a pain protocol. RESULTS In 18 (60%) the injury was severe, as defined by New Injury Severity Score > 15. Twenty-four patients (80%) reported injury-related chronic pain after the trauma, in 22 with consequences on daily life. Analgesics were used by 20 patients, including 5 in need of opioids. Ten patients had unmet needs of further specialist pain care. In 12 patients, the average pain score last week was above three on a 0-10 Numeric Rating Scale. In these patients, clinical signs of neuropathic pain were evident in 10, as tested by the Douleur Neuropathique score. There were significant correlations (P < 0.05) between severity of chronic pain and presence of post-traumatic stress symptoms, reduced quality of life, reduced psychosocial and physical function; but no correlation with pre-injury patient characteristics or the degree of physical injury. CONCLUSION Chronic pain was frequent and significant, irrespective of injury severity, in these patients who obtained their physical injuries under extreme psychological conditions.
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Affiliation(s)
- Kristin Wisløff‐Aase
- Department of Anaesthesiology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine, Faculty of Medicine University of Oslo Oslo Norway
| | - Johan Ræder
- Department of Anaesthesiology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine, Faculty of Medicine University of Oslo Oslo Norway
| | - Grethe Månum
- Institute of Clinical Medicine, Faculty of Medicine University of Oslo Oslo Norway
- Sunnaas Rehabilitation Hospital Nesodden Norway
| | - Marianne Løvstad
- Sunnaas Rehabilitation Hospital Nesodden Norway
- Department of Psychology University of Oslo Oslo Norway
| | - Anne‐Kristine Schanke
- Sunnaas Rehabilitation Hospital Nesodden Norway
- Department of Psychology University of Oslo Oslo Norway
| | - Grete Dyb
- Institute of Clinical Medicine, Faculty of Medicine University of Oslo Oslo Norway
- Norwegian Center for Violence and Traumatic Stress Studies Oslo Norway
| | - Øivind Ekeberg
- Division of Mental Health and Addiction Oslo University Hospital Oslo Norway
- Department of Behavioral Sciences in Medicine, Faculty of Medicine University of Oslo Oslo Norway
| | - Johan Kvalvik Stanghelle
- Institute of Clinical Medicine, Faculty of Medicine University of Oslo Oslo Norway
- Sunnaas Rehabilitation Hospital Nesodden Norway
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Grimholt TK, Bonsaksen T, Schou-Bredal I, Heir T, Lerdal A, Skogstad L, Ekeberg Ø. Flight Anxiety Reported from 1986 to 2015. Aerosp Med Hum Perform 2019; 90:384-388. [PMID: 30922426 DOI: 10.3357/amhp.5125.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: Fear of flying is one of the most common phobias. It hinders people in performing their work and hampers family relations. Even though flight traffic has increased, there are new fears. Valid studies are needed to answer whether there have been changes in the prevalence of flight anxiety, are there sex differences in relation to fear of flying, use of alcohol, and tranquilizers, which situations cause the most flight anxiety, and whether the above factors have changed compared to a similar study from 1986.METHODS: A questionnaire was distributed to a representative random sample of the Norwegian population (N = 5500), where 36% answered. To assess flight anxiety across the time period, we used similar instruments to those we used in 1986.RESULTS: The prevalence of an assumed flight phobia decreased from 8% in 1986 to 3% in 2015. The percentage of those reported to never fly had decreased from 5% in 1986 to 0.5% in 2015. There were 11.0% who always used alcohol in 1986 and 7.5% in 2015 and 3% and 2%, respectively, always used tranquillizers. More women reported being afraid of both flying and other situations compared to men. Turbulence, unknown sounds, and fear of terror attacks caused the most anxiety.DISCUSSION: Flight anxiety still affects a considerable proportion of the Norwegian population and more women than men report that they are afraid of flying. However, in spite of methodology, people are significantly less afraid of flying than in 1986.Grimholt TK, Bonsaksen T, Schou-Bredal I, Heir T, Lerdal A, Skogstad L, Ekeberg Ø. Flight anxiety reported from 1986 to 2015. Aerosp Med Hum Perform. 2019; 90(4):384-388.
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Bonsaksen T, Heir T, Ekeberg Ø, Grimholt TK, Lerdal A, Skogstad L, Schou-Bredal I. Self-evaluated anxiety in the Norwegian population: prevalence and associated factors. ACTA ACUST UNITED AC 2019; 77:10. [PMID: 30923612 PMCID: PMC6421651 DOI: 10.1186/s13690-019-0338-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 02/18/2019] [Indexed: 11/10/2022]
Abstract
Background Self-evaluations of mental health problems may be a useful complement to diagnostic assessment, but are less frequently used. This study investigated the prevalence of self-evaluated current and lifetime anxiety in the general Norwegian population, and sociodemographic and psychological factors associated with current anxiety. Methods A cross-sectional population survey was conducted, using anxiety stated by self-evaluation as outcome. Single and multivariate logistic regression analyses were conducted to examine associations between sociodemographic and psychological variables and anxiety. Results One thousand six hundred eighty-four valid responses (34% of the eligible participants) were analysed in this study. One hundred and eleven participants (6.6%) reported current anxiety, while 365 (21.7%) reported lifetime anxiety. Adjusting for sociodemographic and psychological variables, higher age reduced the odds of current anxiety (OR = 0.87, 95% CI = 0.75-0.99), whereas higher levels of neuroticism increased the odds (OR = 2.04, 95% CI = 1.77-2.36). Conclusions The study concludes that higher age appears to protect against anxiety, whereas neuroticism appears to increase the odds of experiencing anxiety.
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Affiliation(s)
- Tore Bonsaksen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet, Oslo Metropolitan University, PO Box 4, St. Olavs Plass, 0130 Oslo, Norway.,2Faculty of Health Studies, VID Specialized University, Sandnes, Norway
| | - Trond Heir
- 3Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway.,4Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Øivind Ekeberg
- 5Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,6Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
| | - Tine K Grimholt
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet, Oslo Metropolitan University, Oslo, Norway.,Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anners Lerdal
- 9Department for Patient Safety and Research, Lovisenberg Diakonale Hospital, Oslo, Norway.,Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Laila Skogstad
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet, Oslo Metropolitan University, Oslo, Norway
| | - Inger Schou-Bredal
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,11Department for Cancer, Oslo University Hospital, Oslo, Norway
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Månum G, Løvstad M, Wisløff-Aase K, Ræder J, Schanke AK, Larsen I, Dyb G, Ekeberg Ø, Stanghelle JK. Clinical characteristics and physical functioning in persons hospitalized following the Norwegian terror attacks in July 2011: A follow up study. J Rehabil Med 2019; 51:225-233. [PMID: 30816422 DOI: 10.2340/16501977-2521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To describe the clinical characteristics and physical functioning in persons hospitalized after 2 terror attacks in Norway in 2011. DESIGN Cross-sectional study with retrospective acute medical data. SUBJECTS Surviving persons hospitalized with physical injuries. METHODS Medical and psychological assessments 3-4 years after injury, with data on injury type and severity collected from medical records. RESULTS A total of 30 out of 43 potential subjects participated (19 women, 11 men; age range 17-71 years (median 23 years)). Eighteen participants had suffered a severe injury, with New Injury Severity Scale (NISS) scores > 15. All body parts were affected. The number of surgical procedures ranged from 0 to 22 (median 3), and days in intensive care ranged from 0 to 59 (median 2.5), of which 16 had more than 24 h intensive care. Three to 4 years later, a majority of the participants had a broad spectrum of somatic and psychological problems and reduced physical functioning. Two-thirds of the participants reported their physical health to be unsatisfactory, and continuous need for healthcare and unmet needs were identified for all except 4 of the participants. CONCLUSION Persons hospitalized following a terror attack experience a broad spectrum of somatic and psychological problems and need long-term physical and psychological follow-up. This study indicates specific needs for rehabilitation after injuries acquired under psychological traumatic circumstances.
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Affiliation(s)
- Grethe Månum
- Department of Research, Sunnaas Rehabilitation Hospital, NO-14555 Nesoddtangen, Norway.
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Gravensteen IK, Ekeberg Ø, Thiblin I, Helweg-Larsen K, Hem E, Rogde S, Tøllefsen IM. Psychoactive substances in natural and unnatural deaths in Norway and Sweden - a study on victims of suicide and accidents compared with natural deaths in psychiatric patients. BMC Psychiatry 2019; 19:33. [PMID: 30658618 PMCID: PMC6339417 DOI: 10.1186/s12888-019-2015-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 01/04/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The extent of post-mortem detection of specific psychoactive drugs may differ between countries, and may greatly influence the national death register's classification of manner and cause of death. The main objective of the present study was to analyse the magnitude and pattern of post-mortem detection of various psychoactive substances by the manner of death (suicide, accidental, undetermined and natural death with a psychiatric diagnosis) in Norway and Sweden. METHODS The Cause of Death Registers in Norway and Sweden provided data on 600 deaths in 2008 from each country, of which 200 were registered as suicides, 200 as accidents or undetermined manner of death and 200 as natural deaths in individuals with a diagnosis of mental disorder as the underlying cause of death. We examined death certificates and forensic reports including toxicological analyses. RESULTS The detection of psychoactive substances was commonly reported in suicides (66 and 74% in Norway and Sweden respectively), accidents (85 and 66%), undetermined manner of deaths (80% in the Swedish dataset) and in natural deaths with a psychiatric diagnosis (50 and 53%). Ethanol was the most commonly reported substance in the three manners of death, except from opioids being more common in accidental deaths in the Norwegian dataset. In cases of suicide by poisoning, benzodiazepines and z-drugs were the most common substances in both countries. Heroin or morphine was the most commonly reported substance in cases of accidental death by poisoning in the Norwegian dataset, while other opioids dominated the Swedish dataset. Anti-depressants were found in 22% of the suicide cases in the Norwegian dataset and in 29% of suicide cases in the Swedish dataset. CONCLUSIONS Psychoactive substances were detected in 66 and 74% of suicides and in 85 and 66% of accidental deaths in the Norwegian and Swedish datasets, respectively. Apart from a higher detection rate of heroin in deaths by accident in Norway than in Sweden, the pattern of detected psychoactive substances was similar in the two countries. Assessment of a suicidal motive may be hampered by the common use of psychoactive substances in suicide victims.
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Affiliation(s)
- Ida Kathrine Gravensteen
- 0000 0004 0389 8485grid.55325.34Department of Forensic Sciences, Oslo University Hospital, Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Øivind Ekeberg
- 0000 0004 1936 8921grid.5510.1Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Box 1111 Blindern, N-0317 Oslo, Norway ,0000 0004 0389 8485grid.55325.34Division of Mental Health and Addiction, Oslo University Hospital Ullevaal, Box 4956 Nydalen, N-0424 Oslo, Norway
| | - Ingemar Thiblin
- 0000 0004 1936 9457grid.8993.bDepartment of Surgical Sciences, Uppsala University, Box 256, 751 05 Uppsala, Sweden
| | - Karin Helweg-Larsen
- 0000 0001 0674 042Xgrid.5254.6Department of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Erlend Hem
- 0000 0004 1936 8921grid.5510.1Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Box 1111 Blindern, N-0317 Oslo, Norway ,0000 0004 0389 8485grid.55325.34Division of Mental Health and Addiction, Oslo University Hospital Ullevaal, Box 4956 Nydalen, N-0424 Oslo, Norway
| | - Sidsel Rogde
- 0000 0004 0389 8485grid.55325.34Department of Forensic Sciences, Oslo University Hospital, Box 4950 Nydalen, N-0424 Oslo, Norway ,0000 0004 1936 8921grid.5510.1Institute of Clinical Medicine, University of Oslo, Box 1072 Blindern, N- 0316 Oslo, Norway
| | - Ingvild Maria Tøllefsen
- Division of Medicine, Department of Acute Medicine, Oslo University Hospital Ullevaal, Box 4950 Nydalen, N-0424, Oslo, Norway.
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Vallersnes OM, Jacobsen D, Ekeberg Ø, Brekke M. Mortality and repeated poisoning after self-discharge during treatment for acute poisoning by substances of abuse: a prospective observational cohort study. BMC Emerg Med 2019; 19:5. [PMID: 30634924 PMCID: PMC6329053 DOI: 10.1186/s12873-018-0219-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 12/20/2018] [Indexed: 11/21/2022] Open
Abstract
Background Though substance use is a known risk factor for self-discharge, patients self-discharging during treatment for acute poisoning have not previously been described. We charted characteristics of patients self-discharging during treatment for acute poisoning by substances of abuse looking for associations between self-discharge, repeated poisoning, and death. Methods All patients 12 years and older treated for acute poisoning by substances of abuse at an emergency outpatient clinic in Oslo, Norway, were included consecutively from October 2011 through September 2012. We collected data on gender, age, main toxic agent, suicidal intention, homelessness, history of severe mental illness, and self-discharge. Information on deaths was retrieved from the National Cause of Death Register. We did a multiple logistic regression analysis to look for associations between self-discharge and repeated poisoning and a Cox regression analysis for associations between self-discharge and death. Results During one year, 1731 patients were treated for 2343 episodes of acute poisoning by substances of abuse. Two-hundred-and-sixty-six (15%) patients self-discharged during at least one poisoning episode. Self-discharging patients were older, median age 39 years vs 32 years (p < 0.001), more frequently homeless, 20/266 (8%) vs 63/1465 (4%) (p = 0.035), and the main toxic agent more frequently was an opioid, 82/266 (31%) vs 282/1465 (19%) (p < 0.001). Self-discharge was an independent risk factor for repeated poisoning. The adjusted odds ratio for two or more poisoning episodes during one year among self-dischargers was 3.0 (95% CI 2.2–4.1). The association was even stronger for three or more poisoning episodes, adjusted odds ratio 5.0 (3.3–7.5). In total, there were 34 deaths, 9/266 (3.4%) among self-discharging patients and 25/1465 (1.7%) among patients not self-discharging (p = 0.12). The adjusted hazard ratio for death among self-discharging patients was 1.6 (0.75–3.6). Conclusions Self-discharge was associated with frequent poisonings by substances of abuse. Short-term mortality was doubled among self-discharging patients, though this increase was not statistically significant. Still, the increased risk of repeated poisoning marks self-discharging patients as a vulnerable group who might benefit from targeted post-discharge follow-up measures.
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Affiliation(s)
- Odd Martin Vallersnes
- Department of General Practice, University of Oslo, Oslo, Norway. .,Department of Emergency General Practice, City of Oslo Health Agency, Oslo Accident and Emergency Outpatient Clinic, Oslo, Norway.
| | - Dag Jacobsen
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
| | - Mette Brekke
- General Practice Research Unit (AFE), University of Oslo, Oslo, Norway
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Abstract
AIM Patients admitted to somatic departments may face psychiatric challenges, such as suicidal behavior, substance abuse, crisis reactions, or somatoform disorders. Mental disorders can complicate the diagnosis and treatment of a somatic disorder. The Consultation-Liaison Psychiatry Service (CLP) can provide advice and guidance to attending staff in somatic departments. CLP in Norwegian hospitals was last reviewed in 1997. There is insufficient awareness of the service as it currently stands. This specialist field is expanding, and there is a need to examine how the service is organized at present and how it works. MATERIALS AND METHODS A study of the scope, quality, availability, content, and organization of the psychiatric consultative service was conducted in February-March 2016. The study also examined whether service users and providers were satisfied with the service, the content of the service, and whether they considered the service to be adequate. RESULTS AND CONCLUSIONS Although CLP has expanded over the last three years, somatic and psychiatric departments wish for its further expansion. The service provision is at an acceptable level during the daytime, but not during weekends and holidays. We found that 20% of all referrals are rejected and that 80-90% of all physicians wanted outpatient services for short-term follow-up and for help with undiagnosed, unclear, unexplained, (indeterminate) conditions. DISCUSSION The service works satisfactorily during ordinary working hours. There is a need to establish outpatient services and to strengthen the services outside these hours. Collaborative research should be further developed.
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Affiliation(s)
| | - Trond H Diseth
- b Department of Child and Adolescent Mental Health in Hospitals, Division of Paediatric and Adolescent Medicine , Oslo University Hospital , Oslo , Norway.,c Institute of Clinical Medicine, Faculty of Medicine , University of Oslo , Oslo , Norway
| | - Birgitte Boye
- d Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine , University of Oslo , Oslo , Norway.,e Section of Psychosocial Oncology , Norwegian Radium Hospital , Oslo , Norway
| | - Ann Faerden
- f Acute psychiatric ward, Division of Mental Health and Addiction , Oslo University Hospital , Oslo , Norway
| | - Øivind Ekeberg
- g Division of Mental Health and Addiction , Oslo University Hospital , Oslo , Norway.,h Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences , University of Oslo , Oslo , Norway
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Ekeberg Ø. Selvmordsatferd blant alvorlig syke pasienter. Tidsskriftet 2019; 139:19-0542. [DOI: 10.4045/tidsskr.19.0542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Ekeberg Ø, Urnes Ø, Kvarstein EH, Eikenæs IUM, Hem E. Rettelse: Pasienter med emosjonelt ustabil personlighetsforstyrrelse trenger tilpasset akuttbehandling. Tidsskriftet 2019; 139:19-0661. [DOI: 10.4045/tidsskr.19.0661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Ekeberg Ø, Kvarstein EH, Urnes Ø, Eikenæs IUM, Hem E. Pasienter med emosjonelt ustabil personlighetsforstyrrelse trenger tilpasset akuttbehandling. Tidsskriftet 2019; 139:19-0492. [DOI: 10.4045/tidsskr.19.0492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Bugge I, Jensen TK, Nilsen LG, Ekeberg Ø, Dyb G, Diseth TH. Psychosocial care for hospitalized young survivors after the terror attack on Utøya Island: A qualitative study of the survivors' experiences. Injury 2019; 50:197-204. [PMID: 30366828 DOI: 10.1016/j.injury.2018.10.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/04/2018] [Accepted: 10/20/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of the study was to explore hospitalized youths' experiences with psychosocial care in the hospital after the shooting on Utøya Island, Norway, in 2011. METHODS 17 hospitalized youths were interviewed face-to-face 30-31 months after the attack. The interviews were analysed using interpretative phenomenological analysis (IPA). The initial reading and coding of the interviews was carried out inductively. To explore the emphasis placed on everyday conversation and ordinary interaction detected during the initial reading, the text was re-read while bearing in mind concepts from the research field of sociology concerning the therapeutic potential in commonplace conversations and situations. RESULTS The youths highlighted the need for health care workers to embrace essential aspects of their past, present and future. Therefore, three overarching categories emerged related to 1) Remembering the past, 2) Dealing with the present and 3) Preparing for the future. For each temporal category, two related subcategories were identified: Past:Engaging in the trauma narrative; Understanding the trauma reminders; Present: Bringing back normalcy; Being there; Future: Supporting confidence; Instilling trust. CONCLUSIONS For the youths in the current study, talking with the hospital staff about their traumatic experiences was mostly perceived as positive and linked to various helpful outcomes. In addition to engaging in the trauma narrative, the staff needed to comprehend and address how the traumatic experiences and the hospitalization resulted in the survivors' extended fear and changed appraisals about the world and themselves. Having the time to stay physically and mentally close to the youths and engage in everyday interaction was crucial in rebuilding their sense of safety and bringing back normalcy. The hospital staff played a significant role in strengthening the survivors' confidence in own capabilities and trust in others. The different professionals in the hospital contributed to various aspects of psychosocial care, and both trauma-focused interventions and commonplace conversations and actions were emphasized as important and meaningful approaches.
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Affiliation(s)
- Ingrid Bugge
- Department of Child and Adolescent Psychiatry, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Norway; Department of Paediatric and Adolescent Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway.
| | - Tine K Jensen
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway; Norwegian Centre for Violence and Traumatic stress Studies, Norway
| | | | - Øivind Ekeberg
- Department of Research and Development, Division of Mental Health and Addiction, Oslo University Hospital, Norway; Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Grete Dyb
- Norwegian Centre for Violence and Traumatic stress Studies, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
| | - Trond H Diseth
- Department of Child and Adolescent Psychiatry, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Norway; Department of Paediatric and Adolescent Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
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Vallersnes OM, Jacobsen D, Ekeberg Ø, Brekke M. Factors associated with rapidly repeated acute poisoning by substances of abuse: a prospective observational cohort study. BMC Res Notes 2018; 11:724. [PMID: 30314502 PMCID: PMC6186040 DOI: 10.1186/s13104-018-3834-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 10/09/2018] [Indexed: 11/18/2022] Open
Abstract
Objective We have previously found that 9% of patients treated for acute poisoning by substances of abuse in a primary care emergency outpatient setting presented with a new poisoning within a week. We now identify factors associated with rapidly repeated acute poisoning by substances of abuse. Results In 169/1952 (9%) cases of acute poisoning by substances of abuse included consecutively from October 2011 through September 2012 at a primary care emergency outpatient clinic in Oslo, Norway, the patient re-presented within a week with a new poisoning. Homeless patients were more likely to re-present, adjusted odds ratio (AOR) 2.0 (95% confidence interval (CI) 1.3–3.2, p = 0.003), as were self-discharging patients, AOR 1.7 (95% CI 1.2–2.4, p = 0.007), and patients with an opioid as main toxic agent, AOR 1.5 (95% CI 1.0–2.3, p = 0.028). There was no statistically significant association between rapid re-presentation and severe mental illness or suicidal intention.
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Affiliation(s)
- Odd Martin Vallersnes
- Department of General Practice, University of Oslo, Oslo, Norway. .,Oslo Accident and Emergency Outpatient Clinic, City of Oslo Health Agency, Oslo, Norway.
| | - Dag Jacobsen
- Department of Acute Medicine, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
| | - Mette Brekke
- General Practice Research Unit (AFE), University of Oslo, Oslo, Norway
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Bonsaksen T, Grimholt TK, Skogstad L, Lerdal A, Ekeberg Ø, Heir T, Schou-Bredal I. Self-diagnosed depression in the Norwegian general population - associations with neuroticism, extraversion, optimism, and general self-efficacy. BMC Public Health 2018; 18:1076. [PMID: 30157827 PMCID: PMC6116443 DOI: 10.1186/s12889-018-5990-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 08/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multi-item rating scales for depression informs about the level of depression, but does not allow individuals to state by self-evaluation whether they feel depressed or not. The insider perspective on depression is rarely assessed. This study investigated the prevalence of self-diagnosed depression in the Norwegian general population, and associations with sociodemographic and psychological factors. METHODS As part of a national survey, the General Self-Efficacy Scale, the Life Orientation Test-Revised, a short version of the Eysenck Personality Questionnaire and a one-item measure of self-diagnosed depression was administered to 5.500 persons in the general Norwegian population. Of the 4961 eligible participants ≥ 18 years of age, 1.787 (response rate 36%) participated in the survey, and 1.684 of these had valid scores on the relevant scales. The associations between sociodemographic factors and self-diagnosed depression were examined using univariate and multivariate logistic regression analyses. RESULTS One hundred and thirty-six participants (8.1%) reported depression during the preceding month. When adjusting for sociodemographic and psychological variables, higher age (OR = 0.82), being in work (OR = 0.57), and higher levels of general self-efficacy (OR = 0.67) and optimism (OR = 0.52) were associated with lower risk of self-diagnosed depression, whereas higher levels of neuroticism (OR = 1.97) was associated with higher risk. CONCLUSIONS The prevalence of self-diagnosed depression in the adult Norwegian population was higher for women than for men. Higher age, being in work and having higher levels of psychological resources appear to reduce the risk of self-diagnosed depression, whereas neuroticism increases the risk.
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Affiliation(s)
- Tore Bonsaksen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs Plass, 0130 Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Sandnes, Norway
| | - Tine K. Grimholt
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Laila Skogstad
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Anners Lerdal
- Department for Patient Safety and Research, Lovisenberg Diakonale Hospital, Oslo, Norway
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
| | - Trond Heir
- Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Inger Schou-Bredal
- Institute of Health and Society, University of Oslo, Oslo, Norway
- Department for Cancer, Oslo University Hospital, Oslo, Norway
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Grimholt TK, Skogstad L, Hafstad GS, Vallersnes OM, Ekeberg Ø. [July 22, 2011 – psychological reactions in patients at the accident and emergency department in Oslo]. Tidsskr Nor Laegeforen 2018; 138:17-0132. [PMID: 29947209 DOI: 10.4045/tidsskr.17.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Following the bomb attack on the government quarter on 22 July 2011, many of the injured were treated at the accident and emergency department in Oslo. MATERIAL AND METHOD The patients (n=79) were sent a questionnaire ten months after their treatment and again after three years. A total of 42 patients responded on one or both occasions. Post-traumatic stress reactions were measured using PTSD-RI (University of California at Los Angeles PTSD Reaction Index). Symptoms of anxiety and depression were measured with the aid of HSCL-8 (Hopkins Symptom Checklist). Physical symptoms were surveyed using twelve questions. Satisfaction with follow-up was measured with eight questions on a five-point scale. RESULTS After ten months, the average score for PTSD-RI was 1.4 (95 % CI 1.0-1.7), and 31 % of the responses were at a clinical PTSD level. After three years, the average score was 1.3 (95 % CI 0.9-1.7), and 25 % were at a clinical PTSD level. Symptom score for anxiety and depression after ten months was 0.9 (95 % CI 0.6-1.2) and after three years 0.8 (95 % CI 0.5-1.2). The most frequent physical symptom was headache. The satisfaction with follow-up varied somewhat but was generally good. INTERPRETATION Several patients who received treatment for injuries at the accident and emergency department in Oslo had mental symptoms for a long period following the terror attack. The patients were satisfied with the follow-up, which was mainly provided by the primary healthcare service.
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Vallersnes OM, Jacobsen D, Ekeberg Ø, Brekke M. Mortality, morbidity and follow-up after acute poisoning by substances of abuse: A prospective observational cohort study. Scand J Public Health 2018; 47:452-461. [PMID: 29886813 DOI: 10.1177/1403494818779955] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS Despite the excess mortality and morbidity associated with acute poisoning by substances of abuse, follow-up is frequently not organised. We assessed morbidity, including repeated poisoning, and follow-up after acute poisoning by substances of abuse through charting contacts with health services. We also charted short-term mortality. METHODS Patients 12 years and older treated for acute poisoning by substances of abuse at a primary care emergency outpatient clinic in Oslo, Norway, were included consecutively from October 2011 through September 2012. We retrieved information from national registers on fatalities, hospital admissions, and contacts at outpatient specialist health services and with general practitioners (GPs), during the 90 days following a poisoning episode. RESULTS We included 1731 patients treated for 2343 poisoning episodes. During the 90 days following the poisoning, 31% of the patients were treated at somatic hospitals, 9% admitted to psychiatric hospitals, 37% in treatment at outpatient psychiatric/addiction specialist health services, 55% saw their GP, while 34% had no follow-up. The short-term mortality rate was 2.0%, eight times higher than expected. Increasing age, suicidal intention, opioid poisoning, and severe mental illness were associated with increased risk of death. Increasing age, male gender, opioid poisoning, and severe mental illness were associated with repeated poisoning. Patients with increased risk of repeated poisoning were more likely to be in follow-up at outpatient specialist psychiatric/addiction services and in contact with their GP. CONCLUSIONS Follow-up measures seem targeted to those most in need, though one out of three had none. The mortality rate calls for concern.
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Affiliation(s)
- Odd Martin Vallersnes
- 1 Department of General Practice, University of Oslo, Norway
- 2 Oslo Accident and Emergency Outpatient Clinic, Department of Emergency General Practice, City of Oslo Health Agency, Norway
| | - Dag Jacobsen
- 3 Department of Acute Medicine, Oslo University Hospital, Norway
| | - Øivind Ekeberg
- 4 Division of Mental Health and Addiction, Oslo University Hospital, Norway
- 5 Department of Behavioural Sciences in Medicine, University of Oslo, Norway
| | - Mette Brekke
- 1 Department of General Practice, University of Oslo, Norway
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Bonsaksen T, Lerdal A, Heir T, Ekeberg Ø, Skogstad L, Grimholt TK, Schou-Bredal I. General self-efficacy in the Norwegian population: Differences and similarities between sociodemographic groups. Scand J Public Health 2018; 47:695-704. [PMID: 29417880 DOI: 10.1177/1403494818756701] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: General self-efficacy (GSE) refers to optimistic self-beliefs of being able to perform and control behaviors, and is linked with various physical and mental health outcomes. Measures of self-efficacy are commonly used in health research with clinical populations, but are less explored in relationship to sociodemographic characteristics in general populations. This study investigated GSE in relation to sociodemographic characteristics in the general population in Norway. Methods: As part of a larger national survey, the GSE scale was administered to a general population sample, and 1787 out of 4961 eligible participants (response rate 36%) completed the scale. Group comparisons were conducted using independent t-tests and one-way analyses of variance. Linear regression analysis was used to examine factors independently associated with GSE. Results: GSE was lower for older compared to younger participants (p < 0.001). It was higher for men compared to women (p < 0.001), higher for those with higher levels of education compared to those with lower levels (p < 0.001) and higher for those in work compared to their counterparts (p < 0.001). Controlling for all variables, male gender and employment were independently associated with higher GSE. Age moderated the associations between gender and employment on one hand, and GSE on the other. The association between being male and having higher GSE was more pronounced in younger age, as was the association between being employed and having higher GSE. Conclusions: Male gender and being employed were related to higher GSE among persons in the general population in Norway, and these associations were stronger among persons of younger age. The findings are considered fairly representative for the Norwegian population.
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Affiliation(s)
- Tore Bonsaksen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.,Faculty of Health Studies, VID Specialized University, Sandnes, Norway
| | - Anners Lerdal
- Department for Patient Safety and Research, Lovisenberg Diakonale Hospital, Oslo, Norway.,Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Trond Heir
- Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
| | - Laila Skogstad
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Tine K Grimholt
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Inger Schou-Bredal
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department for Cancer, Oslo University Hospital, Oslo, Norway
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Gravensteen IK, Jacobsen EM, Sandset PM, Helgadottir LB, Rådestad I, Sandvik L, Ekeberg Ø. Anxiety, depression and relationship satisfaction in the pregnancy following stillbirth and after the birth of a live-born baby: a prospective study. BMC Pregnancy Childbirth 2018; 18:41. [PMID: 29361916 PMCID: PMC5781321 DOI: 10.1186/s12884-018-1666-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 01/11/2018] [Indexed: 11/30/2022] Open
Abstract
Background Experiencing a stillbirth can be a potent stressor for psychological distress in the subsequent pregnancy and possibly after the subsequent birth. The impact on women’s relationship with her partner in the subsequent pregnancy and postpartum remains uncertain. The objectives of the study were 1) To investigate the prevalence of anxiety and depression in the pregnancy following stillbirth and assess gestational age at stillbirth and inter-pregnancy interval as individual risk factors. 2) To assess the course of anxiety, depression and satisfaction with partner relationship up to 3 years after the birth of a live-born baby following stillbirth. Methods This study is based on data from the Norwegian Mother and Child Cohort Study, a population-based pregnancy cohort. The sample included 901 pregnant women: 174 pregnant after a stillbirth, 362 pregnant after a live birth and 365 previously nulliparous. Anxiety and depression were assessed by short-form subscales of the Hopkins Symptoms Checklist, and relationship satisfaction was assessed by the Relationship Satisfaction Scale. These outcomes were measured in the third trimester of pregnancy and 6, 18 and 36 months postpartum. Logistic regression models were applied to study the impact of previous stillbirth on depression and anxiety in the third trimester of the subsequent pregnancy and to investigate gestational age and inter-pregnancy interval as potential risk factors. Results Women pregnant after stillbirth had a higher prevalence of anxiety (22.5%) and depression (19.7%) compared with women with a previous live birth (adjusted odds ratio (aOR) 5.47, 95% confidence interval (CI) 2.90–10.32 and aOR 1.91, 95% CI 1.11–3.27) and previously nulliparous women (aOR 4.97, 95% CI 2.68–9.24 and aOR 1.91, 95% CI 1.08–3.36). Gestational age at stillbirth (> 30 weeks) and inter-pregnancy interval < 12 months were not associated with depression and/or anxiety. Anxiety and depression decreased six to 18 months after the birth of a live-born baby, but increased again 36 months postpartum. Relationship satisfaction did not differ between groups. Conclusion Women who have experienced stillbirth face a significantly greater risk of anxiety and depression in the subsequent pregnancy compared with women with a previous live birth and previously nulliparous women.
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Affiliation(s)
- Ida Kathrine Gravensteen
- Institute of Clinical Medicine, University of Oslo, P.O box 1171, Blindern, 0318, Oslo, Norway. .,Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway. .,Department of Haematology, Oslo University Hospital, Oslo, Norway.
| | | | - Per Morten Sandset
- Institute of Clinical Medicine, University of Oslo, P.O box 1171, Blindern, 0318, Oslo, Norway.,Department of Haematology, Oslo University Hospital, Oslo, Norway
| | | | | | - Leiv Sandvik
- Oslo Centre for Biostatistics and Epidemiology, Research support services, Oslo University Hospital, Oslo, Norway
| | - Øivind Ekeberg
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Rø KI, Djerv L, Boye TB, Ekeberg Ø. Gruppeveiledning – et udekket behov hos leger i spesialisering. Tidsskriftet 2018; 138:18-0569. [DOI: 10.4045/tidsskr.18.0569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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46
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Ekeberg Ø, Hem E. Ø. Ekeberg & E. Hem svarer. Tidsskriftet 2018; 138:18-0006. [DOI: 10.4045/tidsskr.18.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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47
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48
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Affiliation(s)
| | - Linnea Shumba
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øivind Ekeberg
- Division of Mental Health and Addiction, Oslo University Hospital Ullevaal, Nydalen, Oslo, Norway
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Blindern, Oslo, Norway
| | - Stig Tore Bogstrand
- Department of Drug Abuse Research, Norwegian Institute of Public Health, Nydalen, Oslo, Norway
- Lovisenberg University College, Oslo, Norway
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Schou-Bredal I, Heir T, Skogstad L, Bonsaksen T, Lerdal A, Grimholt T, Ekeberg Ø. Population-based norms of the Life Orientation Test-Revised (LOT-R). Int J Clin Health Psychol 2017; 17:216-224. [PMID: 30487897 PMCID: PMC6220921 DOI: 10.1016/j.ijchp.2017.07.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 07/25/2017] [Indexed: 01/10/2023] Open
Abstract
Background/Objective: The most common used instrument to measure optimism, both in psychological and medical research, is the Life Orientation Test- Revised (LOT-R). A multi-countries study using the future item from the LOT-R, found that level of optimism varied between countries. The provision of population-based norms is necessary, since norms enable the application of the LOT-R in individual diagnosis to compare individuals or special patient groups' scores with reference data. Method: A representative population based survey was conducted in 2014-2015. Norwegian aged 18-94 years (N = 1,792) completed questionnaires assessing sociodemographic, optimism and health and quality of life. Results: The mean age was 53.2 (SD = 16.6) and 53% were women. Mean LOT-R score was 17.2 (SD 3.0). There were marginal age and no gender differences. Although optimism was associated with sociodemographic variables, these were considered negligible due to small effect size. Norm data are given for the entire population. Optimism was associated with better health and quality of life. Conclusions: This study provides age and gender specific norm values from a representative sample of the Norwegian population. The normative data may be used in comparisons of optimism between individuals or between different samples of patients or sub-groups of people.
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Affiliation(s)
| | | | - Laila Skogstad
- Oslo and Akershus University College of Applied Sciences, Norway
| | - Tore Bonsaksen
- Oslo and Akershus University College of Applied Science, Norway
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50
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Gravensteen IK, Jacobsen EM, Sandset PM, Helgadottir LB, Rådestad I, Sandvik L, Ekeberg Ø. Healthcare utilisation, induced labour and caesarean section in the pregnancy after stillbirth: a prospective study. BJOG 2017; 125:202-210. [PMID: 28516500 DOI: 10.1111/1471-0528.14750] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate healthcare utilisation, induced labour and caesarean section (CS) in the pregnancy after stillbirth and assess anxiety and dread of childbirth as mediators for these outcomes. DESIGN Population-based pregnancy cohort study. SETTING The Norwegian Mother and Child Cohort Study. SAMPLE A total of 901 pregnant women; 174 pregnant after stillbirth, 362 pregnant after live birth and 365 previously nulliparous. METHODS Data from questionnaires answered in the second and third trimesters of pregnancy and information from the Medical Birth Registry of Norway. MAIN OUTCOME MEASURES Self-reported assessment of antenatal care, register-based assessment of onset and mode of delivery. RESULTS Women with a previous stillbirth had more frequent antenatal visits (mean 10.0; 95% CI 9.4-10.7) compared with women with a previous live birth (mean 6.0; 95% CI 5.8-6.2) and previously nulliparous women (mean 6.3; 95% CI 6.1-6.6). Induced labour and CS, elective and emergency, were also more prevalent in the stillbirth group. The adjusted odds ratio for elective CS was 2.5 (95% CI 1.3-5.0) compared with women with previous live birth and 3.7 (1.8-7.6) compared with previously nulliparous women. Anxiety was a minor mediator for the association between stillbirth and frequency of antenatal visits, whereas dread of childbirth was not a significant mediator for elective CS. CONCLUSIONS Women pregnant after stillbirth were more ample users of healthcare services and more often had induced labour and CS. The higher frequency of antenatal visits and elective CS could not be accounted for by anxiety or dread of childbirth. TWEETABLE ABSTRACT Women pregnant after stillbirth are ample users of healthcare services and interventions during childbirth.
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Affiliation(s)
- I K Gravensteen
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Department of Haematology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - E-M Jacobsen
- Department of Haematology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - P M Sandset
- Department of Haematology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - L B Helgadottir
- Department of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - I Rådestad
- Sophiahemmet University, Stockholm, Sweden
| | - L Sandvik
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Ø Ekeberg
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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