Scandinavian journal of social medicine最新文献

This study aimed to examine two indices of need, the underprivileged area (UPA) score and a Swedish Care Need Index (CNI, in Swedish vårdbehovsindex) with weightings from British and Swedish GPs respectively, and an index of material deprivation, Townsend score at SAMS (Small Area Market Statistics) level and at municipality level for the whole of Sweden. One third of primary health care physicians from the whole of Sweden received a questionnaire about their workload. CNI, UPA and Townsend scores were calculated using information from the Swedish census of 1990 and the registers of unemployment and migration for 1992. The Swedish GPs weighted some of the variables quite differently from the GPs in the UK. This may be important, especially at the SAMS level. The GPs in both countries considered that older people living alone contributed most to their workload. However, in Sweden the physicians ranked foreign-born people high compared with the English doctors, and in England the GPs ranked children under five years much higher than the doctors in Sweden. The correlation between the scores was high.

Disadvantage in school age affects health during the remaining part of life. Health promotion might alleviate this situation. It is reasonable to focus on mental health, since this is the leading cause of disability adjusted life years lost in this age group and to focus on the school, since this is the most important setting. Co-operation between the public health and the educational sector is rational, yet complicated by different perspectives on knowledge and technology used in these two sectors. It is, however, possible to carry through a dialogue. Then, the public health representatives have to clarify current scientific knowledge on health promotive characteristics of the school. Such characteristics are, enhanced health control at school, aged mixed ability grouping, class sizes of 15-20 students, a task oriented school culture and employment of skills training programmes, e.g. for tobacco deterrence.

The purpose of this study was to assess the effect of social support variables, personality, clinical variables (New York Heart Associations classification), and social disability upon depression. The sample consisted of 119 clinically stable patients (34 females, 85 males) with symptomatic heart failure, recruited from an outpatient hospital practice. The patients underwent a brief physical examination and completed a set of questionnaires. Descriptive statistics were used to characterise the patients' informal functional network. The analysis revealed that the intimate social network support (spouses) and primary social network support (close family) were rated as most supportive. Results from the path analysis showed that social disability was explained by the two personality factors, neuroticism and extraversion, and by the severity of disease (NYHA). No significant effects of the social support variables upon social disability were detected. Moreover, path-analyses showed that poor intimate network support, social disability and neuroticism were significantly positively associated with depression.

Objective: To assess similarities and differences in the Nordic countries regarding ETS (environmental tobacco smoke) exposure in young children.

Design: A population-based cross-sectional study comprising a randomly selected sample of 5,500 households which included a child born in 1992. Data were collected using a mailed anonymous questionnaire.

Results: While the prevalence of household smoking was similar in all countries, there was a great difference between the countries with regard to child ETS exposure. Finnish parents were more likely than all other Nordic parents to protect their children from ETS and the situation was worst in Denmark and Iceland, where almost half of all households, and nine out of ten households containing daily smokers, exposed their children. Approximately eight out of ten current and former smokers in all countries stated that they had made efforts to change their smoking habits because of their children.

Psychosocial problems are often ignored among patients in general practice. By identifying high risk groups this situation could possibly be altered. This study aimed to explore if patients in general practice perceiving themselves as work-disabled by at least 50% more often have health-affecting psychosocial problems than those not work-disabled. In a geographically defined population, 1,058 consecutive adult patients consulting 89 general practitioners were approached during one regular working day in March 1995. They completed a questionnaire at home, returning it directly to the department of general practice. Male patients considered themselves work-disabled more often than female patients. All psychosocial problems except having a demanding caregiving task were more common among the work-disabled. The doctors should bear in mind that work-disabled patients more often than other patients have concomitant health-affecting psychosocial problems. Granting long-term sick leave or a disability pension may not be the only management needed.

Objective: To examine different sick-leave measures used in sickness absence research, and to suggest a systematic way of assessing sickness absence.

Methods: A review and analysis of five major studies on sick-leave performed 1983-1988 with an epidemiological approach.

Results: Terminology and measures used varied in the different studies reviewed. The choice of a certain measure was seldom discussed in relation to the aim of the study. Based on the review five measures are suggested: frequency, length, incidence rate, cumulative incidence and duration. The definition of incidence rate is new and is a measure useful in studies of recurrent events within epidemiology.

Conclusions: We have reviewed sick-leave measures previously used in the literature and suggested five basic measures for assessing sick-leave.

A prevalence study of psychiatric symptoms was performed in parts of a hospital catchment area in Mid-Sweden. In total 717 patients, aged 75 years and above, who were receiving care in an emergency hospital, three nursing homes, five old people's homes and two home medical care districts were included. All patients were examined using the OBS-scale (Organic Brain Syndrome Scale). Anxiety (51%), psychomotor slowing (45%), delirium (44%), depressed mood (41%), irritability (40%) and dementia (33%) were the most prevalent psychiatric symptoms or diagnoses in the sample but there were wide differences between the four care settings. The present study shows that the prevalence of dementia, delirium and psychiatric symptoms is high in all types of care settings for the elderly. It also demonstrates the need for psychiatric medical and nursing competence in all types of care for the elderly.

To study the magnitude of agreement between a short self-administered food frequency questionnaire and a 7-day weighed dietary record regarding the consumption of fibre and fat, we collected information from 92 randomly selected middle-aged Swedish men. The participants first recorded all foods and drinks consumed over seven consecutive days by means of a digital scale. One month after the 7-day weighed record had been completed, a self-administered food frequency questionnaire on habitual consumption of foods containing fibre or fat during the preceding month was sent to the subjects. The 20 largest contributors of fibre and fat in the diet accounted for 71% and 52% of the total intake, respectively, based on the 7-day weighed record. The estimated mean consumption of fibre was 19.0 grams per day based on the 7-day weighed record and 18.3 grams per day based on the food frequency questionnaire. Corresponding estimated mean consumption of fat was 88.6 grams per day versus 46.9 grams per day. Men with high physical activity and low BMI, respectively, had higher intake of fibre and fat. These differences were seen for both dietary measurement methods but were more marked using the 7-day weighed record. The agreement between methods for each individual was also assessed. Based on five categories of fibre consumption, 61% of the respondents in the highest quintile according to the 7-day weighed record were classified in one of the two highest quintiles according to the food frequency questionnaire. The corresponding figure for fat intake was 56%. We conclude that the short self-administered food frequency questionnaire used in the present study can assess the absolute intake of fibre, but not of fat, with good precision. Also, the ranking of individuals in broad categories of consumption of fibre and fat was not largely misclassified based on this short questionnaire.