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Tengsl bandvefs og verkja
Get PDFTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadÍ þessari grein er reynt að varpa ljósi á þátt bandvefs
(fascia) sem uppsprettu útlægrar skyntruflunar
(nociception) í langvinnum verkjavanda. Þessa
nálgun hefur verið stuðst við hjá Erasmus Medisch
Centrum í Rotterdam og út frá henni þróuð endurhæfingaraðferð
þar sem bandvefurinn er tekinn með inn í myndina
í meðferð langvinnra verkja. Þetta er heildræn nálgun. Hún
beinist að meðhöndlun útlægrar verkjauppsprettu
og endurheimt
jafnvægs í vöðva-bandvefskerfinu með sérhæfðum „manual“
meðferðaraðferðum og æfingum. Greinin fjallar um þessa nálgun
og útskýrir nánar þrjár mismunandi
útlægar uppsprettur skyntruflunar
sem geta valdið verkjum þ.e. kveikjupunkta (triggerpoints),
sjúkleika í bandvefshimnum (fasciapathology) og truflun á
hreyfanleika
taugavefs (neuropapathodynamics
Recent advances in the treatment of primary sclerosing cholangitis.
No full textTo access publisher's full text version of this article click on the hyperlink belowIntroduction: PSC is a rare liver disease that leads frequently to cirrhosis and need for liver transplantation. No medical treatment is of proven value. Liver transplantation is the only curative therapy available. There is a big medical need to find medical therapy that can alter the natural history of the disease. Areas covered: The authors highlight advances in PSC, based on recent literature retrieved from PubMed until September 2020 regarding both medical and endoscopic biliary therapy. Future possibilities for treatment of PSC are discussed. Expert opinion: Biliary endoscopy is the cornerstone in the treatment of dominant strictures. Single-user peroral cholangioscopy is an emerging modality. Balloon dilatation therapy is the treatment of choice of dominant strictures. The most promising medical therapies showing efficacy in phase II trials are nor-Ursodeoxycholic acid, obethicolic acid, the non-steroidal FXR agonist Cilofexor and Aldafermin, a synthetic analogue of FGF-19. Antibiotics, particularly vancomycin have shown potential benefits, particularly in children but phase III studies are lacking. In observational studies of effects of biological therapy in patients with IBD/PSC adalimumab was associated with reduction in ALP. Results of liver transplantation are favorable but recurrence can be of clinical relevance particularly in patients transplanted before the age of 40
WHODAS 2.0 — Translation into Icelandic and testing of its psychometric properties
No full textTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadInngangur
Í hugmyndafræði alþjóðlega flokkunarkerfisins um færni, fötlun og heilsu (ICF) er áhersla lögð á færni fólks við þær aðstæður sem það býr. WHODAS 2.0 spurningalistinn, WHO Disability Assessment Schedule 2.0, var saminn til að mæla færni og fötlun í takt við ICF, óháð mál- og menningarsvæðum eða þeim heilsufarsvanda sem að baki býr. Markmið rannsóknarinnar voru að þýða WHODAS 2.0 og staðfesta próffræðilega eiginleika íslensku þýðingarinnar.
Aðferð
WHODAS 2.0 var þýtt úr ensku. Þá var það lagt fyrir og rætt í rýnihópi fólks í endurhæfingu og leiddi það til minniháttar breytinga. Bakþýðing staðfesti samhljóm íslensku útgáfunnar við upprunalegu ensku útgáfuna. Þýðingin var þá lögð fyrir tvo hópa. Fyrri hópurinn (n = 81) var fólk sem var að hefja endurhæfingu en það svaraði WHODAS einu sinni auk þess að svara SF-36v2-spurningalistanum. Í síðari hópnum (n = 67) var fólk í viðhaldsþjálfun sem glímdi við hjarta- eða lungnasjúkdóma. Það svaraði WHODAS 2.0 tvisvar með 2 vikna millibili. Innri áreiðanleiki var prófaður með Cronbachs-alfa, áreiðanleiki endurtekinna mælinga með innanflokksfylgnistuðli og samtímaréttmæti við SF-36v2 var prófað með
fylgnistuðli Spearmans.
Niðurstöður
Innri áreiðanleiki var á bilinu 0,83–0,98 fyrir mælitækið í heild og alla undirkvarða þess. Áreiðanleiki endurtekinna mælinga reyndist 0,77–0,94. Fylgni milli WHODAS 2.0 og SF-36v2 var marktæk fyrir alla undirkvarða sem snúa að skyldum heilsutengdum þáttum (r = –0,25 til –0,7, p < 0,05) eða í 36 af 48 tilfellum.
Ályktanir
Próffræðilegir eiginleikar íslensku þýðingarinnar á WHODAS 2.0 eru góðir. Íslenska þýðingin er framlag til heilbrigðisþjónustu og rannsókna á Íslandi og auk þess opnast möguleikar á þátttöku Íslands í alþjóðlegum rannsóknum á færni og fötlun.
Lykilorð
WHODAS 2.0, íslenska, réttmæti, áreiðanleiki, SF-36v2Aim: The International Classification of Function, Disability and
Health (ICF) accentuates the functioning of the individual in his
ordinary surroundings. The WHODAS 2.0 questionnaire (WHO
Disability Assessment Schedule 2.0), was developed to assess
health status and disability across different cultures and settings
in accordance with the ICF. The aim of this study was to translate
WHODAS 2.0 into Icelandic and validate its psychometric properties.
Methods: WHODAS 2.0 was translated into Icelandic and then
tested and discussed in a focus group with patients in rehabilitation resulting in minor changes. Translation back into English
confirmed the accuracy of the Icelandic translation. The Icelandic
version was tested in two groups. One group (n = 81) consisted of
patients at admittance to rehabilitation, who answered WHODAS
2.0 once and filled in the SF-36 questionnaire. The second group
(n = 67) comprised chronic heart- and lung patients receiving
maintainance training. They answered WHODAS 2.0 twice with
rthe interval of two weeks. Internal reliability and test-retest reliability were tested using Cronbach’s alpha and intra class correlation (ICC) analysis, respectively. Concurrent validity with the
SF-36 was tested using the Spearman’s rho correlation.
Results: Cronbach’s alpha was 0.83–0.98 for the total score and the
subscales of WHODAS 2.0. Similarly, ICC was 0.77–0.94. Significant correlation emerged in 36 of 48 comparisons, i.e. between all
relevant subscales of the two instruments (r = –0.25 to –0.7; p <
0.05).
Conclusions: The Icelandic translation of WHODAS 2.0 is reliable
and valid. It can now be used in assessment of health and disability
status of people who speak Icelandic, both in clinical situations
and for research purposes.
Keywords: WHODAS 2.0, Icelandic translation, validity, reliability, SF-36v2Vísindasjóður Sjúkrahússins á Akureyr
What should I do — to whom should i refer? Daughters’ experience of caring for elderly parents: Multifaceted caregiver strain and uncertainty
No full textTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadTilgangur: Öldruðum fjölgar og óformlegir umönnunaraðilar, makar
eða dætur veita um þriðjungi eldri borgara á Íslandi aðstoð. Umönnunarálag getur gert vart við sig hjá aðstandendum og haft neikvæð
áhrif á andlega og líkamlega heilsu en rannsóknir hafa sýnt að draga
má úr því með stuðningi og fræðslu. Tilgangur rannsóknarinnar var
að lýsa reynslu dætra af því að vera aðstandendur aldraðra foreldra
með minnkaða færni og lýsa þörf þeirra fyrir fræðslu.
Aðferð: Rannsóknin var eigindleg. Þátttakendur voru 12 fullorðnar
dætur sem voru aðstandendur aldraðra foreldra sem misst höfðu
færni og bjuggu í heimahúsum. Gagna var aflað með hálfstöðluðum
einstaklingsviðtölum. Greining gagna fór fram með kerfisbundinni
textaþéttingu (e. systematic text condensation) samkvæmt aðferð
Malterud.
Niðurstöður: Greind voru tvö meginþemu. Fyrra þemað, margþætt
umönnunarálag, skiptist í þemun sálræn vanlíðan, svo sem kvíða; líkamleg vanlíðan, sem birtist meðal annars í orkuleysi, og skert félagsleg
þátttaka, en ein birtingarmynd þess var tilætlunarsemi foreldris.
Seinna meginþemað, óvissa, skiptist í þrjú þemu. Hið fyrsta var erfið
upplýsingaleit en í því kom fram flókið aðgengi að upplýsingum.
Annað þemað var þörf fyrir fræðslu, ráðgjöf og stuðning, þar sem því
var lýst að stuðningur frá fjölskyldu og vinum hjálpaði þátttakendum
mest. Þriðja þemað var þörf fyrir upplýsingaveitu, þar sem lýst var
þörf fyrir aðgengi að fagfólki og upplýsingum á einum stað sem hægt
væri að veita rafrænt að hluta til.
Ályktanir: Niðurstöðurnar benda sterklega til þess að dætur aldraðra
finni fyrir sálrænni, líkamlegri og félagslegri vanlíðan tengdri
umönnun foreldra sinna. Einnig höfðu dæturnar mikla þörf fyrir
fræðslu og ráðgjöf þar sem þær fundu til óvissu vegna vanþekkingar
á kerfinu og erfiðs aðgengis að upplýsingum.
Lykilorð: Aldraðir, dætur, umönnunaraðilar, fræðsla, líðan, umönnunarálag.Aim: The elderly population is growing in Iceland, and informal
caregivers, spouses or daughters assist about a third of them. In
this situation, the relatives can experience a burden, which can
negatively affect their physical and mental health. However, research has demonstrated benefits of education and support for relatives. The aim of the study was to explore daughters’ experience
of being caregivers of a parent with a functional decline and their
need for education.
Method: This was a qualitative phenomenological study. Participants were 12 adult daughters of parents who had a functional decline and lived at home. Data was collected with semi–structured
individual interviews and analyzed using the systematic text condensation method of Malterud.
Results: Two main themes emerged. The first theme, multifaceted
caregiver strain, was divided into psychological distress, such as anxiety, physical discomfort manifesting in energy deficiency, and
limited social participation manifesting in parents assuming assistance. The second main theme, uncertainty, included three themes,
the first one being difficult information search which showed that
it was difficult to access information. The next theme, need for education, counseling and support, revealed that support from family
and friends was most helpful. The last theme, navigated information source, described the need for access to health professionals
and information in one place. The daughters also expressed need
for education and counseling from professionals, which could
partly be provided online.
Conclusions: The results strongly suggest that the daughters experience psychological, physical, and social distress related to their
parents’ care. Furthermore, the daughters had much need for education and counseling as they experienced uncertainty related to
being unfamiliar with the formal care system and inaccessible information.
Keywords: Frail elderly, daughters, caregivers, education, wellbeing, burdenVísindasjóður Félags íslenskra hjúkrunarfræðinga, Atvinnumál kvenna, Uppbyggingarsjóður Vestfjarð
The homes of frail older persons who receive health care services: a review
No full textTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadInngangur: Tilgangur þessarar greinar er að endurskoða hugmyndir
um heimilið sem umhverfi sem mótar vellíðan og möguleika hrumra
eldri borgara til að líða vel. Greinin byggist á fjölfaglegri umfjöllun
um heimili þar sem hugmyndir, hugtök og skilningur sem mótað
hafa umfjöllun um heimili fólks, sérstaklega hrumra eldri borgara,
voru greindar og skýrðar. Gerð var leit í eftirtöldum gagnasöfnum:
Google Scholar, Scopus, PubMed, CINAHL og Leitir.is á árinu 2019
og að auki voru heimildalistar og tilvitnanir í lykilgreinar kannaðar.
Fram komu 1052 titlar sem voru skoðaðir nánar, en alls voru notuð
40 ritverk sem endurspegluðu lykilhugmyndir og hugtök sem tengdust tilgangi greinarinnar. Gögn voru greind með hliðsjón af hugtökum sem tengjast þessu fræðasviði, umhverfi, rými, stað, „að eiga
heima“ og verndun einkalífs.
Niðurstöður: Tvær meginhugmyndir voru greindar. Hin fyrri endurspeglar heimilið sem efnislegt og manngert umhverfi og hin síðari
fjallar um það hvernig fólk tengist og skynjar heimili sitt sem stað
með ríka merkingu. Rannsóknir um heimili fólks sem nýtur heilbrigðisþjónustu heima mótast annars vegar af skoðun rýmis, hönnunar og skipulags og því hve vel hið efnislega umhverfi fellur að
þörfum og óskum einstaklingsins. Hins vegar fjalla rannsóknir sem
beinast að tengslum fólks við heimilið og merkingu, um áhrif þess
að „eiga heima“ á sjálfsmynd og líðan.
Lokaorð: Þessi rannsókn samþættir fjölfaglegan skilning, kenningar
og rannsóknir um áhrif hönnunar heimila, og tilfinninga og reynslu
heimilismanna á möguleika fólks til að lifa góðu lífi heima. Niðurstöðurnar geta nýst til að skipuleggja og veita hjúkrun á einkaheimilum.
Lykilorð: umhverfi, heimili, rými, staður, „að eiga heima“, heimahjúkrunThe purpose of this article is to review ideas around the home as
an environment that shapes well-being and the ability to lead a
good life among frail older persons. This article draws on an interdisciplinary exploration of the home, focusing on ideas, concepts and understandings that influence discussions of the homes,
particularly of frail older people. A comprehensive search was conducted using five databases: Google Scholar, Scopus, PubMed,
CINAHL and Leitir.is (based in Iceland). In addition, reference
lists in articles and citing studies of key articles were reviewed.
This search yielded 1052 titles which were reviewed, and of these,
40 items were analysed in the synthesis presented here. The analysis was guided by key theoretical concepts in the field, i.e., space,
place, “at-home-ness” and protection of privacy.
Results: Two main ideas were identified. The first relates to the
home as a material and built space; the second conceptualises the
home as a place to which people feel connected, a place invested
with meaning. Studies focusing on frail older persons’ homes as a
material environment draw on understandings of space and how
design and organization meets the needs and wishes of people who
receive health care services at home. Studies addressing one’s relation to the home, and its meaning, have explored the impact of
“at-home-ness” on identity and well-being.
Conclusion: This is a synthesis of interdisciplinary concepts, theories and research findings related to how the design of homes, as
well as emotions and experiences, shape the possibilities of older
people to lead a good life in their homes. The synthesis has the
potential to benefit the organizing of nursing in private homes.
Keywords: environment, home, space, place, “at-homeness“, home care nursin
Hiatus hernia and interstitial lung abnormalities.
No full textTo access publisher's full text version of this article click on the hyperlink belowUnited States Department of Health & Human Services
National Institutes of Health (NIH) - USA
NIH National Heart Lung & Blood Institute (NHLBI
„Okkar viðkvæmustu konur“ - Veruleiki barnshafandi kvenna sem eru umsækjendur um alþjóðlega vernd
Get PDFTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Downloa
Diffuse idiopathic skeletal hyperostosis in elderly Icelanders and its association with the metabolic syndrome: the AGES-Reykjavik Study.
No full textTo access publisher's full text version of this article click on the hyperlink belowObjective: To describe the prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in a large population-based study of elderly Icelanders, with particular reference to weight-related factors and the metabolic syndrome.Method: The study population comprised 5321 participants aged 68-96 years (2276 males, mean ± sd age 76 ± 5 , and 3045 females, age 77 ± 6) from the AGES-Reykjavik Study. DISH diagnosis was based on computed tomography (CT) scans, and interpreted strictly by the Resnick criteria and additional suggestions for CT interpretation by Oudkerk et al. Radiology readings were taken by a radiology resident and sample readings by two experienced radiologists.Results: A diagnosis of DISH was made in 13.7% of males and 2.8% of females. There was no association with age, but a strong association was seen with the metabolic syndrome [odds ratio (OR) 2.12, 95% confidence interval (CI) 1.69-2.64, p = 3.9 × 10-11]. Among the components of the metabolic syndrome, the association with DISH was significant for the insulin resistance criterion (OR 1.66, 95% CI 1.32-2.01, p < 0.001) and the body mass index (BMI) criterion (OR 2.16, 95% CI 1.70-2.74, p < 0.001). Other weight-related variables (midlife BMI, weight, and abdominal circumference) showed similar associations.Conclusions: This study, which to our knowledge is the largest published study on the prevalence of DISH, shows an association with the metabolic syndrome, particularly with the insulin resistance and BMI criteria. This is analogous with previous reports linking DISH with metabolic causes. In this age category, we did not observe any increase in prevalence with age.United States Department of Health & Human Services
National Institutes of Health (NIH) - US
Long-Term Effect of Receiving a Family Strengths-Oriented Intervention on Family Cancer Caregiver Stress, Anxiety, and Depression Symptoms: A Longitudinal Quasi-Experimental Study.
No full textTo access publisher's full text version of this article click on the hyperlink belowThe aim of this longitudinal study was to evaluate the long-term effects of providing a therapeutic conversation intervention, based on Family Systems Nursing, to family caregivers of a close relative with advanced cancer over the period before and during bereavement. To prevent adverse outcomes, caregivers need ongoing support that begins pre-loss and extends into the post-loss period. This study employed a one-group pre-test, post-test quasi-experimental design. Twenty-four caregivers participated in two intervention trials conducted over a 42-month period, receiving two intervention sessions pre-loss (Trial 1) and one intervention session post-loss (Trial 2). Significant decreases in anxiety and stress were noted over the three post-loss assessments. The final post-loss stress outcome was significantly lower than the first pre-loss score. For the depression score, there was not a significant change over time within the pre- or post-loss period. The findings provide evidence of decreasing anxiety and stress following the implementation of an extended family nursing intervention for bereaved family caregivers.
Keywords: Family Systems Nursing; advanced cancer; bereavement; family caregiver; longitudinal research; palliative care.LUH Scientific fund
Scientific Fund of the Nurses Association in Iceland
Research Fund of Ingibjorg R. Magnusdotti
The application of exposure by psychologists in Iceland for the treatment of pediatric obsessive-compulsive disorder
No full textTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadÁráttu- og þráhyggjuröskun (ÁÞR) einkennist af áráttuhegðun og þráhyggjuhugsunum. Þráhyggja
lýsir sér í óþægilegum, uppáþrengjandi og óviðeigandi hugsunum sem valda vanlíðan og kvíða.
Árátta fylgir yfirleitt þráhyggju og einkennist af endurteknum athöfnum sem virka sem markviss
leið til þess að draga úr óþægindum sem þráhyggjuhugsanirnar valda. Hugræn atferlismeðferð
með berskjöldun og svarhömlun er fyrsti kostur sem meðferð við ÁÞR. Þessi rannsókn gengur
út á að kanna viðhorf sálfræðinga á Íslandi til berskjöldunar við ÁÞR og kanna hve mikið og
hvernig þeir beita berskjöldunarmeðferðinni þegar þeir vinna með börnum og unglingum með
ÁÞR. Stuðst var við erlendan spurningalista sem var þróaður til að athuga meðferðaraðferðir
sálfræðinga við kvíða og ÁÞR. Spurningalistinn var þýddur yfir á íslensku og sendur sálfræðingum
í Sálfræðingafélagi Íslands og einungis þeir sem höfðu meðhöndlað ÁÞR barns síðastliðið ár voru
þátttakendur, alls 26. Rannsóknin leiddi í ljós að almennt er viðhorf sálfræðinga á Íslandi jákvætt
til meðferðarinnar. Allir þátttakendur rannsóknarinnar sögðust nota berskjöldun í meðferð við
ÁÞR og eyddu 46,2% þátttakenda meira en 61% tíma meðferðar í berskjöldun. Í ljós kom þó að
ekki voru allir að nota bestu mögulegu aðferðir berskjöldunar í sinni meðferð en rúm 43% sögðust
ekki reyna að takmarka truflanir í æfingum, það er að segja truflanir í umhverfinu sem gætu komið
niður á árangri meðferðarinnar. Þetta gerir það að verkum að börnin eru ekki að fá bestu mögulegu
meðferðina vegna mögulegra truflana. Því þyrfti að auka kennslu og þjálfun í notkun berskjöldunar
svo að sálfræðingar beiti henni rétt til að börn með ÁÞR á Íslandi eigi mestan möguleika á bata.
Efnisorð: Þráhyggja, árátta, berskjöldun, svarhömlunObsessive-compulsive disorder (OCD) is characterized
by 1) obsessional thoughts, images or impulses which
appear as uncomfortable, intrusive and inappropriate and
lead to marked anxiety or distress, and 2) compulsion, a
goal-directed behavior or rituals to neutralize discomfort
or anxiety. Cognitive behavioral therapy with exposure
and response prevention is considered the first line therapy
for youth with OCD. The aim of this study is to examine
whether Icelandic psychologists use high quality exposure
therapy for youth with OCD, how it is used, and the overall
attitude towards exposure. We translated and adapted
a survey questionnaire used in a previous study on the
prevalence of exposure-based treatment in the US, the
questionnaire was sent through the Icelandic Psychological
Association and a total of 26 participants had treated at
least one child with OCD within the last year. All of the
participants reported using E/RP in OCD treatment, the
overall attitude towards E/RP was postitive and 46,2%
of participants spend more than 61% of the time using E/
RP. However, 43% did not try to limit distractions during
exposure which might prevent the most optimal results.
Therefore, it might be possible that some children with
OCD are simply not getting the most optimal treatment.
We suggest that E/RP instruction and training for Icelandic
psychologists should be increased in order to improve
recovery for youth with OCD in Iceland.
Keywords: Compulsion, obsession, exposure therapy,
response preventio