Tone Rustøen

Prevalence and characteristics of chronic pain in the general Norwegian population

Background. Population‐based studies suggest that prevalence of chronic pain is increasing. The purpose of this study was to determine the prevalence of chronic pain in a sample drawn from the general Norwegian population. In addition, the characteristics of chronic pain, as well as differences in demographic characteristics and health‐related variables between persons with and without chronic pain were evaluated.

Fatigue in the general population: A translation and test of the psychometric properties of the Norwegian version of the fatigue severity scale:

Objective: A study was undertaken to test the psychometric properties of the Fatigue Severity Scale (FSS), and to explore the relationship between fatigue and sociodemographic variables in the general population. Method: A national representative sample of 1893 respondents was randomly selected from a pool of 4,000 Norwegians aged 19—81 years. A mailed questionnaire that included the FSS was used to measure fatigue severity. Results: The FSS showed satisfactory internal consistency (Cronbachs alpha 0.88). The prevalence of high fatigue (FSS score>=5) was 23.1% in the total sample. More women (26.2%) than men (19.8%) experienced high fatigue (p=0.004). Respondents with chronic illness (more than six months) reported a higher mean (M=4.69, SD=1.35) than the rest of the sample (M=3.67, SD=1.17) (p<0.001). An inverse correlation was found between fatigue and level of formal education (r=0.20, p<0.001). Conclusion: The psychometric properties of the Norwegian version of FSS were satisfactory. To avoid over-diagnosing people for high level of fatigue, the threshold for high fatigue probably should be 5 on the FSS scale instead of 4 as had been suggested originally, but further validation of the cut-off point is needed.

Age and the experience of chronic pain: differences in health and quality of life among younger, middle-aged, and older adults.

Objectives:To describe age differences in chronic pain and to evaluate for differences in demographic and health-related variables among younger (18-39 years), middle-aged (40-59 years), and older adults (60-81 years) who reported chronic pain. Methods:A total of 4000 Norwegian citizens were mailed a questionnaire that measured pain, quality of life, mood, and demographic and health-related variables. Results:Of the total sample (n = 1912), 19.2% of the younger age group, 27.5% of the middle-aged group, and 31.2% of the older group reported chronic pain (ie, >3 months duration). A total of 58.9% of the participants in chronic pain reported having a chronic disease, with the most common being musculoskeletal problems, chronic pain disorder, and osteoarthritis. Participants in the older age group reported pain of longer duration and more comorbidities and received pain treatment more often. They had higher total quality of life scores, were more satisfied with their material comforts and social life, and reported better mood. The middle-aged group reported the largest number of pain locations, reported having fibromyalgia more frequently, and reported that the cause of their pain was not known. They were less satisfied with their social life than the older age group. The younger age group reported the highest rates of injury and accidents as the cause of their pain, and almost 43% of this age group was not receiving any treatment of their chronic pain. Conclusion:This study found that the prevalence rates for chronic pain do vary with age and that the middle-aged group may be a high-risk group of patients with chronic pain.

Cutpoints for mild, moderate and severe pain in patients with osteoarthritis of the hip or knee ready for joint replacement surgery

BackgroundCutpoints (CPs) for mild, moderate and severe pain are established and used primarily in cancer pain. In this study, we wanted to determine the optimal CPs for mild, moderate, and severe pain in joint replacement surgery candidates with osteoarthritis (OA) of the hip or knee, and to validate the different CPs.MethodsPatients (n = 353) completed the Brief Pain Inventory (BPI), the WOMAC Arthritis Index, and the SF-36 health status measure. Optimal CPs for categorizing average pain with three severity levels were derived using multivariate analysis of variance, using different CP sets for average pain as the independent variable and seven interference items from the BPI as the dependent variable. To validate the CPs, we assessed if patients in the three pain severity groups differed in pain as assessed with WOMAC and SF-36, and if BPI average pain with the optimal CPs resulted in higher correlation with pain dimensions of the WOMAC and SF-36 than other CPs.ResultsThe optimal CPs on the 0–10 point BPI scale were CP (4,6) among hip patients and CP (4,7) among knee patients. The resulting pain severity groups differed in pain, as assessed with other scales than those used to derive the CPs. The optimal CPs had the highest association of average pain with WOMAC pain scores.ConclusionCPs for pain severity differed somewhat for patients with OA of the hip and knee. The association of BPI average pain scores categorized according to the optimal CPs with WOMAC pain scores supports the validity of the derived optimal CPs.

Self‐reported prevalence, etiology, and characteristics of pain in oncology outpatients

Purpose: To determine the self‐reported prevalence rates for cancer, non‐cancer, and both cancer and non‐cancer pain and to determine if there were differences in demographic, clinical, and pain characteristics among the three pain groups.

The Importance of Hope as a Mediator of Psychological Distress and Life Satisfaction in a Community Sample of Cancer Patients

Background:Although hope is an important resource for cancer patients, few studies include it as an independent or dependent variable in quality-of-life research. Objective:The purposes of this study, in a community-based sample of cancer patients, were to evaluate the relationships between demographic and clinical characteristics, health status, hope, psychological distress, and life satisfaction and evaluate whether hope mediated the relationship between psychological distress and life satisfaction. Methods:Participants (n = 194) completed a demographic and clinical questionnaire, a single item of self-assessed health, the Herth Hope Index, Impact of Event Scale, and a single-item rating of satisfaction with life. Structural regression models were examined to evaluate the interrelationships among these variables, with life satisfaction as the primary outcome. Results:Participants were primarily women with breast cancer. In the final structural regression model that explained 60% of the variance in life satisfaction, poorer health status, lower hope, and higher psychological distress were significantly related to lower satisfaction with life. Hope was found to mediate the relationship between psychological distress and health status, such that the direct association between distress and health status was no longer significant with hope in the model. Finally, hope partially mediated the association between psychological distress and life satisfaction. Conclusions:These data suggest that hope is an important resource for oncology patients that impacts their quality of life. Implications for Practice:Hope may be an important coping mechanism that clinicians need to consider when they try to help patients reduce the psychological distress associated with cancer and its treatment.

Quality of life in the general Norwegian population, measured by the Quality of Life Scale (QOLS-N)

The main aim of the present study was to derive norms or reference values from the general Norwegian population for the Norwegian version of the Quality of Life Scale (QOLS-N). In addition, associations between socio-demographic and health variables on the level of quality of life were examined. The sample consisted of 1893 subjects from a total of 4000 randomly selected Norwegian citizens representative of the entire Norwegian population, aged 19–81. The subjects received a mailed questionnaire containing the QOLS-N. Results show that the mean quality of life score was 84.1 (SD 12.5). Women reported a higher quality of life than men. People with higher levels of education reported a higher quality of life. Those who were married or cohabitating reported the highest quality of life and those who were unemployed reported a lower quality of life than those who worked. In addition, people reporting long-term diseases or health problems scored significantly lower on quality of life. These results could serve as reference values for the level of quality of life, as measured by the QOLS-N in the Norwegian population.

Hope in newly diagnosed patients with cancer.

In this study, 131 Norwegian patients with recently diagnosed cancer completed the Nowotny Hope Scale (NHS). The NHS is composed of six subscales, and both global and subscale scores were assessed. Most of the patients were found to be hopeful or moderately hopeful. The variable with the single most positive contribution to hope was whether the patient lived alone. Younger people, in particular, experienced less hope when living alone. Gender, the time elapsed since diagnosis, and treatments had no observable effect on the global hope score. However, age, education level, and type of cancer was associated with particular domains of hope.

Quality of life in women with breast cancer: a review of the literature and implications for nursing practice.

This article discusses the gap between an ever-increasing interest in research on the quality of life in patients with breast cancer and the lack of impact this research has had in the actual care of these women. A critical review of the literature is used to answer the question of how much can be accepted as established knowledge despite the often methodologically weak studies and contradictory results. Deficiency in research studies is no rationale for not improving nursing care in areas wherein there is an expressed need for support and assistance. Nurses are in contact with patients who have breast cancer at all stages of the disease and treatment, because they meet the women in the hospital, at the outpatient clinic, and in their homes. They play an important role in meeting the needs of these women. Ways of improving nursing practice at the different stages of the illness, from the pretreatment phase to posttreatment follow-up assessment, are discussed, and concrete suggestions made. This article addresses the women’s need both for adequate information and for social and emotional support.

Psychometric properties of the WHOQOL-BREF questionnaire for the Norwegian general population.

In 1994, the World Health Organization Quality of Life (WHOQOL) Group developed the procedure (the WHOQOL 100) to measure quality of life in healthy and ill persons from diverse cultures. The purpose of this study was to analyze the psychometric properties of a 26-item version of the WHOQOL 100, the WHOQOL-BREF, when applied to the Norwegian general population. The questionnaire was sent to 4,000 randomly selected Norwegian citizens aged 19 to 81 years. The response rate was 48.5%. Cronbachs alpha ranged from .60 in the social relationships domain to .84 in the physical health domain. Factor analysis resulted in a four-component solution partly supporting the established domain structure. Multiple regression analysis with sex, age, education, cohabitation and self-reported disease as independent variables explained 28%, 8%, 4%, and 15% of the variance for the physical health, psychological, social relationships and environmental domains, respectively. Self-reported disease was the strongest factor. The results appear to be promising regarding scaling qualities, discriminative power, and domain structure.