Randi Andenæs

Psychological distress in hospitalized patients with chronic obstructive pulmonary disease

Objectives: To investigate the prevalence of psychological distress in hospitalized patients with chronic obstructive pulmonary disease (COPD), and to examine possible associations between psychological distress and several sociodemographic variables. Methods: NThe Hopkins Symptom Checklist was used to gather data from 92 hospitalized COPD patients. These data were compared with 3,319 respondents aged 45 or over drawn from the 1998 Norwegian Statistics Health Survey. The latter were divided into four groups: respondents with COPD, respondents with other respiratory diseases, respondents with mixed chronic diseases, and a healthy group. Results: The prevalence of psychological distress was found to be 58.7% in the hospitalized COPD patients and 42.9% in the community-based COPD sample. After controlling for sociodemographic variables and current smoking, the results showed a higher risk of psychological distress among hospitalized COPD patients (OR = 23.69; 95% CI: 13.37–41.98) and the community-based COPD sample (OR = 18.16; 95% CI: 8.31–39.68), and with sub-samples with other respiratory diseases (OR = 5.87; 95% CI: 3.82–9.02), and mixed chronic diseases (OR = 3.51; 95% CI: 2.39–5.18). Conclusions: COPD is associated with a high prevalence of psychological distress in both hospital and community settings. Furthermore, it appears that age, gender, education, marital status, and current smoking status do not substantially mediate the association between the severity of psychological distress and COPD status. The results provide additional evidence of the importance of screening for psychological distress symptoms in both hospitalized and community-based patients with COPD.

The relationships of self-efficacy, physical activity, and paid work to health-related quality of life among patients with chronic obstructive pulmonary disease (COPD)

Purpose Although chronic obstructive pulmonary disease (COPD) primarily affects the lungs, it is regarded as a systemic disorder associated with comorbidity and physical deterioration, which often results in reduced levels of health-related quality of life (HRQoL). Self-efficacy is an important concept in self-management, which is vital for improving HRQoL in patients with COPD. The purpose of this study was to examine how general self-efficacy, leisure time physical activity, and sociodemographic variables such as employment status are related to the physical and mental health components of HRQoL in patients with COPD. Patients and methods In this cross-sectional study, 97 COPD patients (54.6% male, mean age 64.6 years, standard deviation [SD] 9.5) beginning a pulmonary rehabilitation program completed three self-report questionnaires: the short form (SF)-12v2 Health Survey as a measure of HRQoL; the General Self-Efficacy Scale; and a standardized instrument measuring regular leisure time physical activity. Results The physical health component median score was 31.3 (interquartile range [IQR] 16.3) and the mental health component median score was 45.9 (IQR 21.5). Two sets of linear regression analyses were performed, one predicting physical health and the other predicting mental health. The first analysis showed that better physical health was directly related to being in paid work (P-value <0.001), but was not significantly related to age, sex, marital status, education, work status, physical activity, or self-efficacy. In the second analysis, better mental health was directly related to living with a partner, being physically active, and having higher self-efficacy (P-value <0.001). Conclusion The findings suggest that general self-efficacy has differential relationships to the two dimensions of HRQoL. Our results indicate that general self-efficacy, physical activity, and paid work might be important factors for improving HRQoL of persons with COPD, and should be taken into consideration in pulmonary rehabilitation.

Changes in health-related quality of life in people with morbid obesity attending a learning and mastery course. A longitudinal study with 12-months follow-up.

BackgroundSevere obesity is a complex condition that is associated with a wide range of serious health complications and reduced health-related quality of life (HRQoL). In addition to physiological factors, activity and participation, environmental factors, and personal factors are related to an individual’s overall quality of life HRQoL. In Norway, a course based on cognitive behavioral principles is offered to people seeking medical treatment for weight management. The aim is to assist participants to achieve a healthier lifestyle and thereby improve their HRQoL. We therefore investigated changes in HRQoL in participants after they attended this learning and mastery course, and explored how well sociodemographic variables, paid work, social support, personal factors, and surgery predicted HRQoL at 12-month follow-up.MethodsA single-group longitudinal study was conducted. Data were collected by self-reported questionnaires. This article reports on those who had completed the questionnaire at the 12-month (n = 69) follow-up. HRQoL was assessed with the EQ-5D. Other standardized instruments measured employment, social support, self-efficacy, and surgery.ResultsAt the 12-month follow-up, participants scored higher on all dimensions of the EQ-5D and on the EQ-VAS. Generalized linear model showed that having paid work, and social support were statistically significant predictors of HRQoL at the 12-month follow-up. Sex, self-efficacy, and surgery were not statistically significant associated with HRQoL.ConclusionsParticipation in paid work, and receiving social support from persons with whom they had a close relationship were strongly related to HRQoL in obese people 12 months after participating in a learning and mastery course.Trial registrationThe study is registered in Clinical Trials: NCT01336725.

Mental health problems among individuals with persistent health challenges from adolescence to young adulthood: a population-based longitudinal study in Norway

BackgroundPersistent health challenges are increasing throughout the world. It has been shown that adolescents with persistent health challenges are at greater risk of having mental health problems than their healthy peers. However, these studies are mainly cross-sectional, and little is known about the transition to adulthood. Thus, the aim of this study was to examine how mental health problems in adolescents and young adults with persistent health challenges vary during adolescence and in the transition to young adulthood.MethodsThe study used longitudinal and time-series data from the “Young in Norway” study. A sample of adolescents was prospectively followed from adolescence to young adulthood with measures at four different time points (n = 3,087; T1–T4): 2921 adolescents (12–19 years) participated at T1 and T2, while 2448 young adults participated at T3 and T4. Persistent health challenges, age, gender, mental health problems and parental socio-economic status were measured in the longitudinal survey. Regression models were applied to estimate associations between persistent health challenges (understood as having a chronic health condition or disability) and mental health problems during adolescence and young adulthood. Different models were tested for chronic health conditions and disability.ResultsAdolescents with disability had higher scores for depressive and anxiety symptoms, loneliness and self-concept instability, and lower scores for self-worth, appearance satisfaction, scholastic competence and social acceptance compared with adolescents without disability. In young adulthood, there were also significant associations between disability and most mental health problems. The longitudinal associations between chronic health conditions and mental health problems during adolescence and young adulthood showed that significant associations between chronic health conditions and mental health problems were only found during adolescence.ConclusionsThis longitudinal survey revealed that on average, adolescents with disability had more mental health problems than those with a chronic health condition. In addition, the problems followed into adulthood for adolescents with disability. Thus, disability seems to be a much higher risk factor for developing and maintaining mental health problems than having a chronic health condition. These findings need to be followed up in further studies.

Socio-Economic Gradients and Disability During The Transition to Young Adulthood: A Longitudinal Survey and Register Study in Norway

ABSTRACT The study aimed to investigate trends and explanatory factors for socio-economic inequalities associated with disability during the transition to young adulthood. A sample of 2606 participants (56% females and 44% males) was prospectively followed from adolescence to young adulthood. Disability status, age, gender, mental health problems, scholastic competence and social acceptance were measured from the longitudinal survey Young in Norway, while socio-economic indicators such as participants’ and their parents’ levels of education, annual income, unemployment and welfare benefits were extracted from the National Population Register in Norway. Regression models were applied to estimate associations between disability and socio-economic outcomes. The findings show that disabled adolescents have a significantly greater risk of achieving lower levels of education and are unemployed and over-represented in welfare benefits during the transition to young adulthood. Most of these associations between disability and socio-economic outcomes were explained by mental wellbeing and self-perceptions. The study suggests that interventions addressing mental wellbeing and social competence might reduce the development of socio-economic inequalities among young people with disability.

Reporting of pain by people with chronic obstructive pulmonary disease (COPD): comparative results from the HUNT3 population-based survey

BackgroundChronic obstructive pulmonary disease (COPD) is often associated with chronic pain, but pain in COPD remains poorly understood, particularly in comparison to pain in other groups. We compared the pain reported by people with COPD with that reported by arthritis, heart disease, diabetes, and those not reporting any disease, while adjusting for the effects of selected sociodemographic and lifestyle factors, comorbidities, anxiety, and depression.MethodsUsing cross-sectional data from a population-based health survey in Norway (HUNT3; n = 50,807), we included participants with COPD (n = 1199), participants without COPD, but with arthritis (n = 8582), heart disease (n = 4109), or diabetes (n = 1254), and participants without any disease (n = 18,811). Logistic and linear regression analyses were performed to estimate the probability of reporting chronic pain and the level of pain intensity in the different groups adjusting for other relevant factors.ResultsApproximately half (51.8%) of people with COPD reported chronic pain, which was a significantly higher rate than in the diabetes and non-disease groups, and similar to the heart disease group. People with arthritis had a chronic pain rate of 75.4%, which was higher than all other groups, including COPD. Analyses of pain intensity yielded similar findings, with the COPD group having higher pain intensity than the diabetes and non-disease groups, similar pain intensity as the heart disease group, and less pain intensity than the arthritis group. The likelihood of chronic pain and the intensity of pain were generally higher among women, people employed in occupations with low educational requirements, smokers, and those with comorbidity. Chronic pain rates and pain intensity increased with age and higher anxiety and depression scores, and were inversely related to physical activity.ConclusionsPeople with COPD are at increased risk for chronic pain and higher pain intensity, second only to those with arthritis among the disease groups included in this study. The findings indicate a close relationship between pain and anxiety and depression. The relationships between pain and socioeconomic and lifestyle factors (e.g., smoking and exercise) suggest the need for efforts at the societal level to reduce inequality in health.

Jobbtilfredshet og livskvalitet blant norske hjemmesykepleiere

Job Satisfaction and Quality of Life among Norwegian Homecare Nurses: a cross-sectional study The aim of this cross-sectional study was to investigate job satisfaction and quality of life among homecare nurses. A questionnaire including socio demographic variables, the Job Satisfaction Scale and the World Health Organization Quality of Life measurement was used to assess data (N = 126, mean age 39 years, 78 percent were women). The study showed moderate overall job satisfaction among homecare nurses. Satisfaction with colleagues had the highest item score in job satisfaction. Moderate satisfaction was displayed for the following items; responsibility you are given, variation on work, your opportunities to use your skills, freedom to choose your own methods of working, your physical working conditions, your work hours, and recognition you get for good achievements. Overall quality of life as well as the domains; physical, psychological, social relations and environment, showed high scores. Job satisfaction was significantly associated with both physical and environment domain of quality of life.

Anxiety mediates the effect of smoking on insomnia in people with asthma: evidence from the HUNT3 study

Objective The aim of this study was to investigate factors related to insomnia in a cohort of people with asthma. Design This secondary analysis utilized cross-sectional data from the Norwegian Nord-Trøndelag Health Study, a population-based health survey (n=50,807). Participants We used self-reported data from 1,342 men and women with a physician-confirmed asthma diagnosis ranging in age from 19.5 to 91 years. Measurements Data on sleep, lifestyle variables (smoking and exercise), anxiety, and depression were included. An insomnia scale and asthma impact scale were constructed using factor analysis. Hierarchical series of multiple regression models were used to investigate direct and mediational relationships between the study variables and insomnia. Results The hierarchical models revealed significant independent contributions of female sex, higher age, not exercising, asthma impact, anxiety, and depression on insomnia (R2=25.2%). Further, these models suggested that the impact of smoking on insomnia was mediated by anxiety, and that the beneficial impact of exercise was mitigated by depression symptoms. Conclusion Smokers with asthma have more insomnia, and this relationship may be mediated by anxiety. Further, people with asthma who experience depression symptoms are less likely to benefit from physical exercise as a method to enhance sleep quality. Our findings would suggest that helping smokers to manage their anxiety and depression through behavioral methods may reduce their insomnia symptoms, and enable them to engage in other health-enhancing pursuits, such as physical exercise.

Psychosocial factors are strongly associated with insomnia in users and nonusers of prescribed sleep medication: evidence from the HUNT3 study

Objective The aim of this study was to examine how neuroticism, stressful life events, self-rated health, life satisfaction, and selected lifestyle factors were related to insomnia both by sex and among users and nonusers of prescribed sleep medication (PSM). Design Cross-sectional data from the Norwegian Nord-Trøndelag Health Study (HUNT3, 2006–2008), a population-based health survey, were linked to individual data from the Norwegian Prescription Database. Methods Logistic regression analyses were used to investigate the associations between the selected variables and insomnia in both males and females and among subjects using and not using PSM. Individuals were considered to have a presumptive diagnosis of insomnia disorder if they reported difficulty with sleep initiation, sleep maintenance, or early morning awakening several days per week for the last 3 months. PSMs were categorized as anxiolytics or hypnotics; the dose was estimated according to defined daily dose (DDD). Results Of the total 50,805 participants, 6,701 (13.2%) used PSM. The proportions of PSM users were larger among elderly participants. Increased risk of insomnia was strongly associated with poor self-rated health and higher level of neuroticism. These associations were evident for both sexes and were similar among both users and nonusers of PSM. Low satisfaction with life was strongly related to insomnia, but only among nonusers of PSM. Increased doses of PSM were not associated with reduced likelihood of insomnia. Conclusion Insomnia is a problem among both users and nonusers of PSM and is associated with psychosocial factors. Our findings suggest that successful treatment for sleep problems should take individual variation into account, such as age, sex, personality traits, satisfaction with life, and health perception.