Non-western immigrants' satisfaction with the general practitioners' services in Oslo, Norway

<p>Abstract</p> <p>Background</p> <p>Over the last few years the number of immigrants from the non-western parts of the world living in Oslo, has increased considerably. We need to know if these immigrants are satisfied with the health services they are offered. The aim of this study was to assess whether the immigrants' level of satisfaction with visits to general practitioners was comparable with that for ethnic Norwegians.</p> <p>Methods</p> <p>Two population-based surveys, the Oslo Health Study and the Oslo Immigrant Health Study, were performed on selected groups of Oslo citizens in 2000 and 2002. The response rates were 46% and 33%, respectively. In all, 11936 Norwegians and 1102 non-western immigrants from the Oslo Health Study, and 1774 people from the Oslo Immigrant Health Study, were included in this analysis. Non-western immigrants' and ethnic Norwegians' level of satisfaction with visits to general practitioners were analysed with respect to age, gender, health, working status, and use of translators. Bivariate (Chi square) and multivariate analyses (logistic regression) were performed.</p> <p>Results</p> <p>Most participants were either moderately or very satisfied with their last visit to a general practitioner. Non-western immigrants were less satisfied than Norwegians. Dissatisfaction among the immigrants was associated with young age, a feeling of not having good health, and coming from Turkey, Iran, Pakistan, or Vietnam as compared to Sri Lanka. The attendance rates in the surveys were rather low and lowest among the non-western immigrants.</p> <p>Conclusion</p> <p>Although the degree of satisfaction with the primary health care was relatively high among the participants in these surveys, the non-western immigrants in this study were less satisfied than ethnic Norwegians with their last visit to a general practitioner. The rather low response rates opens for the possibility that the degree of satisfaction may not be representative for all immigrants.</p

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

<p>Abstract</p> <p>Background</p> <p>Hypnosis 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).</p> <p>Methods</p> <p>The 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.</p> <p>Results</p> <p>The 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.</p> <p>Conclusion</p> <p>The 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.</p> <p>Trial Registration</p> <p>The study was registered in ClinicalTrials.gov and released 27.08.07 Reg nr NCT00521807 Approval Number: 05032001.</p

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

Background Substance 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 clinic's 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 clinic's user group. Methods Retrospective 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. Results Four (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). Conclusion A 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

Can use of healthcare services among 15–16-year-olds predict an increased level of high school dropout? A longitudinal community study

Objectives To study associations between healthcare seeking in 15–16-year-olds and high school dropout 5 years later. Design Longitudinal community study. Setting Data from a comprehensive youth health survey conducted in 2000–2004, linked to data from national registries up to 2010. Participants 13 964 10th grade secondary school students in six Norwegian counties. Main outcome measure Logistic regression was used to compute ORs for high school dropout. Results The total proportion of students not completing high school 5 years after registering was 29% (girls 24%, boys 34%). Frequent attenders to school health services and youth health clinics at age 15–16 years had a higher dropout rate (37/48% and 45/71%), compared with those with no or moderate use. Adolescents referred to mental health services were also more likely to drop out (47/62%). Boys with moderate use of a general practitioner (GP) had a lower dropout rate (30%). A multiple logistic regression analysis, in which we adjusted for selected health indicators and sociodemographic background variables, revealed that seeking help from the youth health clinic and consulting mental health services, were associated with increased level of high school dropout 5 years later. Frequent attenders (=4 contacts) had the highest odds of dropping out. Yet, boys who saw a GP and girls attending the school health services regularly over the previous year were less likely than their peers to drop out from high school. Conclusions Adolescents who seek help at certain healthcare services can be at risk of dropping out of high school later. Health workers should pay particular attention to frequent attenders and offer follow-up when needed. However, boys who attended a GP regularly were more likely to continue to high school graduation, which may indicate a protective effect of having a regular and stable relationship with a GP

Neuropsychological screening of children of substance-abusing women attending a Special Child Welfare Clinic in Norway

Background Exposure to alcohol and illicit substances during pregnancy can have an impact on the child for the rest of his/her life. A Special Child Welfare Clinic (SCWC) in Norway provides care for pregnant women with substance abuse problems. Treatment and support are provided without replacement therapy. Methods We performed a neuropsychological screening of 40 children aged four to 11 years whose mothers had attended the SCWC during pregnancy, and of a comparison group of 80 children of women without substance abuse problems. The children were presented with tests chosen from Wechsler Intelligence Scale for Children, third version (WISC-III), Nepsy, Halstead-Reitan and Raven's Progressive Matrices, Coloured Version. The tests were grouped into five main domains; (1) learning and memory, (2) visual scanning, planning and attention, (3) executive function, (4) visuo-motor speed and dexterity and (5) general intellectual ability Results No children in the study had test results in the clinical range in any domain. Bivariate analyses revealed that children of short-term substance-abusing mothers (who stopped substance abuse within the first trimester) had significantly lower test scores than the comparison group in three out of five domains (domain 2,3,4). Children of long-term substance abusers (who maintained moderate substance abuse throughout pregnancy) had significantly lower test results than the comparison group in one domain of the test results (domain 1). All but one child in the long-term group were or had been in foster homes. Most children in the short-term group stayed with their mothers. Multivariate regression analyses revealed that foster care minimum 50% of life time was associated with better scores on domains (1) learning and memory, (2) visual scanning, planning and attention, and (3) executive functions, while no significant associations with test scores was found for substance abuse and birth before 38 weeks of gestation. Conclusion Children raised by former substance abusing mothers scored worse on the neuropsychological screening than children who had substance abusing mothers and mostly were raised in foster homes. This indicates that it is important to focus on the environment in cases where help and support are provided to presently or formerly addicted women raising children

Quality of life among mothers of preterm infants during the first year after birth : A longitudinal cohort study

Bakgrund För tidig födsel innebär ökade risker för barnets liv och hälsa. Att få ett mycket för tidigt fött barn och därmed behöva vårdas på neonatalavdelning kan vara traumatiskt, omvälvande och stressande för mammor och kan ha stor betydelse för deras livskvalitet. Syfte Att beskriva mammor till för tidigt födda barns livskvalitet och påverkande faktorer upp till 12 månader efter förlossningen. Metod Studien hade en kvantitativ design och var en longitudinell kohortstudie där mammor (n=493) till barn som vårdats på sex olika neonatalavdelningar i Sverige fick svara på enkäter om livskvalitet (SF-36) vid fyra olika tillfällen under det första året efter förlossningen. Data har analyserats för att se vilka faktorer som kan ha haft betydelse för mammans livskvalitet samt om det fanns några skillnader över tid. Resultat Lägst livskvalitet skattades vid utskrivning från neonatalavdelning med en signifikant och successiv förbättring de kommande 12 månaderna (p &lt;0,01). Inom grupperna med olika faktorer fanns vissa signifikanta skillnader i livskvalitet med liten eller medelhög effektstorlek i några dimensioner av livskvalitet. Slutsats Mammorna skattade lägre livskvalitet vid utskrivning än senare under det första året och det fanns skillnader i livskvalitet mellan olika grupper av mammor. Detta är viktig kunskap för hälso- och sjukvårdspersonal i mötet med mammor till för tidigt födda barn. Klinisk tillämpbarhet Resultatet kan hjälpa barnmorskor och även barnsjuksköterskor och distriktsjuksköterskor att få en bättre förståelse för mammor till för tidigt födda barn och därmed kunna förebygga ohälsa och stötta mammorna för att främja en god anknytning till barnet.Background Premature birth involves an increased risk for the child's life and health. Having a preterm infant and thus needing care at a neonatal unit may be traumatic and stressful for mothers and also have a great impact on their quality of life. Aim To describe the quality of life among mothers of preterm infants and influencing factors up to 12 months after birth. Method The study had a quantitative design and was a longitudinal cohort study. Mothers (n = 493) of preterm infants who were cared for at six neonatal units in Sweden answered questionnaires about quality of life (SF-36) on four different occasions during the first year after birth. Data has been analyzed to see which factors that may have had an impact on the mother's quality of life and whether there were any differences over time. Results The lowest quality of life was estimated at discharge from the neonatal unit with a significant and gradual improvement in the first year after delivery (p&lt;0,01). Within the different groups of mothers, there were significant differences in quality of life with a small or medium effect size in some dimensions of quality of life. Conclusion The mothers in this study rated their quality of life lowest at the time for discharge from the neonatal unit, and there were differences in quality of life between different groups of mothers. This is important knowledge for healthcare professionals. Clinical application The result of this study may help midwives and other healthcare professionals to gain a better understanding of mothers of preterm infants and their situation and thereby prevent mental illness and support the mothers to promote secure attachment with their children

Quality of life among mothers of preterm infants during the first year after birth : A longitudinal cohort study

Bakgrund För tidig födsel innebär ökade risker för barnets liv och hälsa. Att få ett mycket för tidigt fött barn och därmed behöva vårdas på neonatalavdelning kan vara traumatiskt, omvälvande och stressande för mammor och kan ha stor betydelse för deras livskvalitet. Syfte Att beskriva mammor till för tidigt födda barns livskvalitet och påverkande faktorer upp till 12 månader efter förlossningen. Metod Studien hade en kvantitativ design och var en longitudinell kohortstudie där mammor (n=493) till barn som vårdats på sex olika neonatalavdelningar i Sverige fick svara på enkäter om livskvalitet (SF-36) vid fyra olika tillfällen under det första året efter förlossningen. Data har analyserats för att se vilka faktorer som kan ha haft betydelse för mammans livskvalitet samt om det fanns några skillnader över tid. Resultat Lägst livskvalitet skattades vid utskrivning från neonatalavdelning med en signifikant och successiv förbättring de kommande 12 månaderna (p &lt;0,01). Inom grupperna med olika faktorer fanns vissa signifikanta skillnader i livskvalitet med liten eller medelhög effektstorlek i några dimensioner av livskvalitet. Slutsats Mammorna skattade lägre livskvalitet vid utskrivning än senare under det första året och det fanns skillnader i livskvalitet mellan olika grupper av mammor. Detta är viktig kunskap för hälso- och sjukvårdspersonal i mötet med mammor till för tidigt födda barn. Klinisk tillämpbarhet Resultatet kan hjälpa barnmorskor och även barnsjuksköterskor och distriktsjuksköterskor att få en bättre förståelse för mammor till för tidigt födda barn och därmed kunna förebygga ohälsa och stötta mammorna för att främja en god anknytning till barnet.Background Premature birth involves an increased risk for the child's life and health. Having a preterm infant and thus needing care at a neonatal unit may be traumatic and stressful for mothers and also have a great impact on their quality of life. Aim To describe the quality of life among mothers of preterm infants and influencing factors up to 12 months after birth. Method The study had a quantitative design and was a longitudinal cohort study. Mothers (n = 493) of preterm infants who were cared for at six neonatal units in Sweden answered questionnaires about quality of life (SF-36) on four different occasions during the first year after birth. Data has been analyzed to see which factors that may have had an impact on the mother's quality of life and whether there were any differences over time. Results The lowest quality of life was estimated at discharge from the neonatal unit with a significant and gradual improvement in the first year after delivery (p&lt;0,01). Within the different groups of mothers, there were significant differences in quality of life with a small or medium effect size in some dimensions of quality of life. Conclusion The mothers in this study rated their quality of life lowest at the time for discharge from the neonatal unit, and there were differences in quality of life between different groups of mothers. This is important knowledge for healthcare professionals. Clinical application The result of this study may help midwives and other healthcare professionals to gain a better understanding of mothers of preterm infants and their situation and thereby prevent mental illness and support the mothers to promote secure attachment with their children

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

Abstract Background Substance 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 clinic's 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 clinic's user group. Methods Retrospective 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. Results Four (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). Conclusion A 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.</p