uu.seUppsala University Publications
Change search
Link to record
Permanent link

Direct link
BETA
Hedlund, Mathilde
Publications (3 of 3) Show all publications
Hedlund, M., Zetterling, M., Ronne-Engström, E., Carlsson, M. & Ekselius, L. (2011). Depression and posttraumatic stress disorder after aneurysmal subarachnoid hemorrhage in relation to lifetime psychiatric morbidity. British Journal of Neurosurgery, 25(6), 693-700
Open this publication in new window or tab >>Depression and posttraumatic stress disorder after aneurysmal subarachnoid hemorrhage in relation to lifetime psychiatric morbidity
Show others...
2011 (English)In: British Journal of Neurosurgery, ISSN 0268-8697, E-ISSN 1360-046X, Vol. 25, no 6, p. 693-700Article in journal (Refereed) Published
Abstract [en]

Introduction. Little is known about the roles that lifetime psychiatric disorders play in psychiatric and vocational outcomes of aneurysmal subarachnoid haemorrhage (SAH). Materials and methods. Eighty-three SAH patients without apparent cognitive dysfunction were assessed using the Structured Clinical Interview for DSM-IV axis I disorders (SCID-I) after their SAH. Diagnoses were assessed for three time periods, 'lifetime before SAH', '12 months before SAH' and '7 months after SAH'. Results. Forty-five percentage of patients with SAH reported at least one lifetime psychiatric disorder. After SAH, symptoms of depression and/or post-traumatic stress disorder (PTSD) were seen in 41%, more often in those with a psychiatric history prior to SAH (p = 0.001). In logistic regressions, depression after SAH was associated with a lifetime history of major depression, or of anxiety or substance use disorder, as well as with lifetime psychiatric comorbidity. Subsyndromal or full PTSD was predicted by a lifetime history of major depression. After the SAH, 18 patients (22%) had received psychotropic medication and/or psychological treatment, 13 of whom had a disorder. Those with a lifetime history of major depression or treatment with antidepressants before SAH had lower return to work rates than others (p = 0.019 and p = 0.031, respectively). This was also true for those with symptoms of depression and/or PTSD, or with antidepressant treatment after SAH (p = 0.001 and p = 0.031, respectively). Conclusions. Depression and PTSD are present in a substantial proportion of patients 7 months after SAH. Those with a history of psychiatric morbidity, any time before the SAH, are more at risk and also constitute a risk group for difficulties in returning to work.

Keywords
Subarachnoid haemorrhage, mental disorders, depression, stress disorders, post-traumatic
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-109759 (URN)10.3109/02688697.2011.578769 (DOI)000297337800007 ()
Available from: 2009-10-26 Created: 2009-10-26 Last updated: 2017-12-12Bibliographically approved
Hedlund, M., Ronne-Engström, E., Ekselius, L. & Carlsson, M. (2008). From monitoring physiological functions to using psychological strategies: Nurses' view of caring for the aneurysmal subarachnoid haemorrhage patient. Journal of Clinical Nursing, 17(3), 403-411
Open this publication in new window or tab >>From monitoring physiological functions to using psychological strategies: Nurses' view of caring for the aneurysmal subarachnoid haemorrhage patient
2008 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 3, p. 403-411Article in journal (Refereed) Published
Abstract [en]

AIMS: The aims of this study were: (1) to describe nurses' views of the physical and supportive needs of patients who have suffered a subarachnoid haemorrhage (SAH), (2) to describe nurses' views of changes in social circumstances and (3) changes in the mental condition of patients after SAH. BACKGROUND: As patients with SAH are generally younger and predominantly female compared with other stroke groups they may have different needs of nursing support to facilitate adaptation. Caring for persons surviving stroke involves advanced nursing skills such as monitoring neurological functions in neurointensive care and providing physical care during rehabilitation. DESIGN: Explorative descriptive design. METHOD: Semi-structured interviews were performed with 18 nurses in neurointensive and rehabilitation care. A qualitative latent content analysis was conducted. RESULTS: Nurses viewed patients' need for support as a process ranging from highly advanced technological care to 'softer' more emotional care. However, shortages in the communication between neurointesive and rehabilitation nurses regarding this support were acknowledged. Changes in social circumstances and mental conditions were viewed both as obstacles and advantages regarding return to everyday life. Nurses also viewed that the characteristics of the group with SAH was not particularly different from the group with other types of stroke. CONCLUSIONS: Support to patients with SAH is viewed as a process carried out by nurses at neurointensive care units and rehabilitation units. Shortages in communication, regarding this support, were acknowledged. Obstacles and advantages with respect to returning to everyday life could apply to any stroke group, which could make it more difficult for nurses to detect the specific needs of patients with SAH. RELEVANCE TO CLINICAL PRACTICE: The communication between neurointensive nurses and rehabilitation nurses regarding support to patients with SAH is not satisfactory. Occasionally the specific needs of patients with SAH are not recognized.

Keywords
Care, Neurosurgery, Nurse roles, Nurses, Nursing, Subarachnoid haemorrhage
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-17712 (URN)10.1111/j.1365-2702.2006.01878.x (DOI)000252397000015 ()17419788 (PubMedID)
Available from: 2008-08-18 Created: 2008-08-18 Last updated: 2017-12-08Bibliographically approved
Hedlund, M., Stålenheim, G., Ekselius, L. & Carlsson, M. (2005). Diagnostic agreement between a doctor and a nurse for psychiatric disorders: A pilot study. Nord J Psychiatry, 59, 339-342
Open this publication in new window or tab >>Diagnostic agreement between a doctor and a nurse for psychiatric disorders: A pilot study
2005 (English)In: Nord J Psychiatry, Vol. 59, p. 339-342Article in journal (Refereed) Published
Abstract [en]

The aim with the present paper is to illustrate the use of multivariate strategies (i.e. integration of different multivariate methods) with five examples, four from the pharmaceutical industry and one from environmental research.

In the first part, two examples wherein hierarchical models are applied to quality control (QC) and process control are discussed. In the second part a more complex problem and a strategy for material discovery/development are presented wherein a combination of multivariate calibration, multivariate analysis and multivariate design is needed. In the third part, a process analytical/optimization problem is illustrated with a two-step process, demanding that different multivariate tools are combined in a sequential way so that a useful model can be established and the process can be understood. In the final part the usefulness of principal component analysis followed by soft independent modelling of class analogy is illustrated with an example from environmental process monitoring. The five examples from quite different areas show that the chemometric tools are even more powerful if used integrated. However, different strategies and combinations of the tools have to be applied, depending on the problem and the aim.

Keywords
Adult, Albuminuria/*complications, Blood Pressure, Body Mass Index, Cross-Sectional Studies, Diabetes Mellitus; Type 1/epidemiology/*urine, Diabetes Mellitus; Type 2/epidemiology/*urine, Diabetic Nephropathies/*epidemiology, Female, Hemoglobin A; Glycosylated/analysis, Humans, Hypertension/epidemiology, Male, Middle Aged, Registries, Regression Analysis, Research Support; Non-U.S. Gov't, Risk Factors, Smoking/epidemiology, Sweden/epidemiology
Identifiers
urn:nbn:se:uu:diva-76265 (URN)doi:10.1080/08039480500319654 (DOI)
Available from: 2007-03-07 Created: 2007-03-07 Last updated: 2011-01-11
Organisations

Search in DiVA

Show all publications