Elin Olaug Rosvold

Physicians who do not take sick leave: hazardous heroes?

Background: Physicians seem to have problems in accepting their own illness, and they tend to avoid taking sick leave. This study reports the diseases that physicians bring to work, and discusses selected factors associated with the behaviour of working when ill. Methods: Of a random sample of 1,476 Norwegian physicians, 70% answered a mailed, anonymous questionnaire as a part of The Norwegian Medical Associations health survey. Results: During one year, 80% of the physicians had worked during an illness for which they would have sick-listed their patients. More than half of the physicians in the study had worked whilst having an infectious disease. Factors independently associated with the behaviour of working when ill include being in the age group 30-39 years, working as a clinician outside hospital, having received medical treatment during the last three years, and having low job satisfaction . Conclusion : A large number of physicians work whilst having infections and other diseases. This behaviour might be harmful to the physicians themselves as well as to their patients and staff members.

Undertreatment and overtreatment with statins: the Oslo Health Study 2000-2001.

Objective.  We examined the prevalence and factors associated with use of cholesterol‐lowering statins in the population.

Symptom prevalence during menopause and factors associated with symptoms and menopausal age. Results from the Norwegian Hordaland Women's Cohort study

OBJECTIVES To describe symptoms during the menopausal transition and age at menopause in a representative Norwegian female cohort over a ten year period, to analyze factors associated with frequency and burden of symptoms and influence on self-rated health. STUDY DESIGN 2229 women aged 40-44 years at inclusion, randomly selected from a national health survey in Hordaland County, Norway, and followed with seven postal questionnaires from 1997 throughout 2009. Data for 2002 women (90%) were eligible for analyses. RESULTS In a longitudinal analysis, 36% of the women reported daily hot flushes in one or more questionnaires, whereas 29% did not experience hot flushes at all. The prevalence of daily hot flushes increased from 2% at age 41-42 to 22% at age 53-54, decreasing to 20% at age 55-57. The odds ratio for reporting daily hot flushes vs. never/seldom for daily smokers was 1.6 (1.24-2.10). Women in the lowest education group had an OR=1.8 (1.21-2.56) for reporting daily hot flushes compared to women with a university degree. There was no relation between the symptom burden and degree of physical exercise, overall feeling of health, BMI, family income, parity or menarche age as recorded at baseline. The mean age for final menstruation period (FMP) in the cohort was 51.1 (50.9-51.3) years. Smokers had a mean age of FMP 0.9 years earlier compared to the non-smokers. CONCLUSIONS Daily smoking and educational level were independent risk factors for experiencing daily menopausal symptoms. Degree of physical exercise, BMI, parity or menarche age did not have significant influence.

Breast self-examination and cervical cancer testing among Norwegian female physicians: A nation-wide comparative study

Practice of breast self-examination (BSE) and cervical cancer testing (Pap smear tests) was studied in a nation-wide Norwegian representative sample of 284 female physicians aged 24-67. BSE was performed at least once a month in 30.6% of the cases, and 54.6% had a Pap smear test once every third year at least. BSE was never practised among 19.2% of the physicians, the main reasons being that they forgot it, or that they stated that they were in a low risk group or had no symptoms of disease. 16.2% had never had routine Pap smears, and these physicians claimed that they were in a low risk group or had no symptoms of disease, that they had a problem in finding a physician to attend, or that they forgot to take the test. A subgroup of 135 physicians aged 35-49 years was compared with 738 women with higher university education included from a nation-wide representative sample of the general population of Norway. A significantly higher percentage of physicians practised BSE monthly or more often compared with other university educated women. However, a significantly lower percentage of the physicians had Pap smear tests every third year or more frequently. The positive association between being a physician and practising BSE, and the negative association between being a physician and having Pap smear tests, remained after controlling for potential confounders in multivariate analyses.

Hypnosis as a treatment of chronic widespread pain in general practice: A randomized controlled pilot trial

BackgroundHypnosis treatment in general practice is a rather new concept. This pilot study was performed to evaluate the effect of a standardized hypnosis treatment used in general practice for patients with chronic widespread pain (CWP).MethodsThe study was designed as a randomized control group-controlled study. Sixteen patients were randomized into a treatment group or a control group, each constituting eight patients. Seven patients in the treatment group completed the schedule. After the control period, five of the patients in the control group also received treatment, making a total of 12 patients having completed the treatment sessions. The intervention group went through a standardized hypnosis treatment with ten consecutive therapeutic sessions once a week, each lasting for about 30 minutes, focusing on ego-strengthening, relaxation, releasing muscular tension and increasing self-efficacy. A questionnaire was developed in order to calibrate the symptoms before and after the 10 weeks period, and the results were interpolated into a scale from 0 to 100, increasing numbers representing increasing suffering. Data were analyzed by means of T-tests.ResultsThe treatment group improved from their symptoms, (change from 62.5 to 55.4), while the control group deteriorated, (change from 37.2 to 45.1), (p = 0,045). The 12 patients who completed the treatment showed a mean improvement from 51.5 to 41.6. (p = 0,046). One year later the corresponding result was 41.3, indicating a persisting improvement.ConclusionThe study indicates that hypnosis treatment may have a positive effect on pain and quality of life for patients with chronic muscular pain. Considering the limited number of patients, more studies should be conducted to confirm the results.Trial RegistrationThe study was registered in ClinicalTrials.gov and released 27.08.07 Reg nr NCT00521807 Approval Number: 05032001.

Use of minor tranquilizers among Norwegian physicians. A nation-wide comparative study

The use of minor tranquilizers (hypnotics and anxiolytics) during the last month before a questionnaire was answered was studied in a postal survey of a nation-wide representative sample of Norwegian physicians (n = 1467), aged 25 to 69 years. The response rate was 73%. A total of 12.2% of the physicians had used minor tranquilizers in the past month, one third of these on a daily or weekly basis. There was no gender difference. High age, high mental distress, and working outside the hospital was identified as risk factors for drug use. Compared to a representative sample of subjects from the general population with the same age and education level, (The Nord-Trøndelag Health Survey), more male physicians than males in the comparison sample had used minor tranquilizers in the past month, also when controlled for subjective well-being. However, the physicians had used the drugs more sporadic. When self-prescription of minor tranquilizers was studied in a different sample of 1024 Norwegian physicians, it was found that 72.6% of the physicians had self-prescribed the drugs. There was no gender difference in self-prescribing.

Psychotropic drug use among persons with mental distress symptoms: a population-based study in Norway.

Aims: To explore psychotropic drug use in the general population and in particular among non-institutionalized persons with mental distress symptoms. Methods: A total of 14,139 women and 11,665 men participating in the Oslo Health Study or the Oppland/Hedmark Study 2000—2001 submitted a self-administered questionnaire on health status and drug use, lifestyle, and socioeconomic factors. Respondents using antidepressants, hypnotics, and/or anxiolytics during the last four weeks were defined as users. A high Hopkins Symptoms Checklist-10 score indicated mental distress. The 15% with the highest score in each gender and age group (adults: 30/40/45 years; elderly: 60 years) were studied. Results: The prevalence of antidepressant use among those with mental distress was, for women: adults 21%; elderly 30%; and for men, adults 15%; elderly 15%. These figures were nearly four times higher than in the general population. Not participating in the labour market was the main factor associated with use of antidepressants for subjects with mental distress: adult women (odds ratio (OR) 3.5; 95% confidence interval (CI) 2.5—5.0); elderly women (OR 5.2; CI 2.7—10.2); adult men (OR 4.7; CI 3.0—7.3); and elderly men (OR 2.9; CI 1.4—6.0). Use of analgesics was the main factor associated with use of anxiolytics/hypnotics: adult women (OR 2.4; CI 1.7—3.4); elderly women (OR 2.3; CI 1.4—3.8); adult men (OR 2.1; CI 1.3—3.3); and elderly men (OR 3.4; CI 1.9—6.0). Conclusions: Among individuals with mental distress, not participating in the labour market and regular use of analgesics were the main factors associated with use of psychotropics in both genders regardless of age.

Substance abuse in pregnant women. Experiences from a special child welfare clinic in Norway

BackgroundSubstance abuse during pregnancy may harm the foetus and can cause neonatal abstinence syndrome. Exposure to alcohol and other substances can influence the child for the rest of its life. A special child welfare clinic was set up in 1994 in Kristiansand, Norway, targeting pregnant women with substance abuse problems in the county of Vest-Agder. Pregnancy is not an indication for opioid replacement therapy in Norway, and one of the clinics aims was to support the drug dependent women through their pregnancy without any replacements. The object of this paper is to describe concurrent health and social problems, as well as the predictors for stopping drug abuse, in the clinics user group.MethodsRetrospective cohort study. Data was gathered from the medical records of all 102 women seen in the clinic in the period between 1992 and 2002. The study includes 59 out of 60 women that were followed until their children were two years old or placed in alternative care, and a comparison group of twice the size. Both groups were presented with a questionnaire concerning both the pregnancy and health and socio-economic issues.ResultsFour (4.5 percent) of the women that completed their pregnancies did not manage to reduce their substance abuse. All the others reduced their substance abuse considerably. The odds ratio for stopping substance abuse within the first trimester was significantly associated with stopping smoking (O.R. 9.7) or being victims of rape (O.R. 5.3).ConclusionA low cost and low threshold initiative organised as a child welfare clinic may support women with substance abuse problems in their efforts to stop or reduce their substance abuse during pregnancy.

Self-medication with OTC analgesics among 15 - 16 year-old teenagers

BACKGROUND OTC analgesics were released for sale outside pharmacies in Norway in 2003. This study assesses indications and frequency of use of these drugs among 15-16 year-old teenagers in Norway after 2003. MATERIAL AND METHOD We developed a questionnaire, which contained 65 questions with one or more response options. This was given to all pupils in the final grade at six junior high schools in a town with 60,000 inhabitants (Drammen). RESULTS 367 of 626 (58.6 %) pupils participated. 50 % of the boys and 71 % of the girls had used OTC analgesics during the last four weeks; 26 % of them on a daily or weekly basis. Girls experienced episodes of pain more frequently than boys, but the proportion of episodes treated with analgesics did not differ between the sexes. Headache and muscle pain were common. Half of those with severe headache/migraine used OTC analgesics on a daily or weekly basis. The teenagers reported several reasons for experiencing pain and discomfort, such as long time spent in front of various screens, tight time schedules with physical exercise and friends, drinking too little and much noise in the classroom. INTERPRETATION Use of OTC analgesics has increased considerably among Norwegian teenagers. Drug-induced headache may occur as an adverse event. If more effort is made to improve life situations that adolescents perceive as painful and a cause of discomfort, the need for OTC analgesics may be reduced.

Determinants of Control of High Blood Pressure. The Oslo Health Study 2000-2001

Objective: To examine determinants of control of high blood pressure in Oslo, Norway. Methods: The Oslo Health Study 2000–2001, a population‐based survey, included 6301 men and 7645 women born in 1924/25, 1940/41, 1955 and 1960 that were screened for high blood pressure and other cardiovascular risk factors. Uncontrolled high blood pressure was defined as systolic >140 mmHg or diastolic >90 mmHg or both. Results: Use of antihypertensive drugs was 4.1% at age 40–45 years, 19.1% at age 60 years and 35.8% at age 75 years. Among pharmacologically treated subjects with diabetes or cardiovascular disease (CVD), one‐third of subjects aged 40–45 years, over one‐half of those aged 60 years and nearly two‐thirds of those aged 75 years had uncontrolled high blood pressure. These proportions were 8–13 percentage points higher in subjects without diabetes or CVD. Among pharmacologically treated men, younger age, use of statins, body mass index below 25 kg/m 2 , and CVD or diabetes were associated with a lower risk of uncontrolled high blood pressure. Among treated women, younger age and cigarette smoking were associated with a lower risk (p < 0.05). Conclusion: The presence of CVD or diabetes and the prescription of cholesterol‐lowering statins were independently associated with better control of blood pressure. Non‐smoking women were more likely to have uncontrolled high blood pressure than their smoking counterparts.