Long-term follow-up after comprehensive rehabilitation of persons with epilepsy, with emphasis on participation in employment or education

The objective of this study was to describe the current situation of patients with epilepsy after rehabilitation with emphasis on employment and education and to investigate if clinical factors at admission were associated with increase in employment or education. All patients that participated in a comprehensive rehabilitation were eligible. Data were collected from medical records at admission, during rehabilitation, at discharge and from a structured telephone interview at follow-up 1-17 years after admission. In total, 124 patients participated in the follow-up. Participation in employment or education improved from admission to follow-up in 38 patients. In univariable analysis, active epilepsy with tonic-clonic seizures at admission was significantly associated with increased participation in employment or education at follow-up, so was decreased frequency of tonic-clonic seizures from admission to follow-up. The significance of the associations disappeared in adjusted multivariable analysis. Participation in employment or education was improved for many patients at follow-up.AFA InsuranceAccepte

Existential Loneliness and end-of-life care: A Systematic Review

Contains fulltext : 88662.pdf (publisher's version ) (Closed access)Patients with a life-threatening illness can be confronted with various types of loneliness, one of which is existential loneliness (EL). Since the experience of EL is extremely disruptive, the issue of EL is relevant for the practice of end-of-life care. Still, the literature on EL has generated little discussion and empirical substantiation and has never been systematically reviewed. In order to systematically review the literature, we (1) identified the existential loneliness literature; (2) established an organising framework for the review; (3) conducted a conceptual analysis of existential loneliness; and (4) discussed its relevance for end-of-life care. We found that the EL concept is profoundly unclear. Distinguishing between three dimensions of EL-as a condition, as an experience, and as a process of inner growth-leads to some conceptual clarification. Analysis of these dimensions on the basis of their respective key notions-everpresent, feeling, defence; death, awareness, difficult communication; and inner growth, giving meaning, authenticity-further clarifies the concept. Although none of the key notions are unambiguous, they may function as a starting point for the development of care strategies on EL at the end of life.1 april 201

Berättelser om ensamhetens vardag hos människor med psykiska funktionshinder

This dissertation deals with people with mental illness that currently live in their own accommodation in the community. Common to all mentally ill people is their serious difficulties in carrying out activities and meeting needs in important areas of life. Terms such as "normalisation" and "integration" into the community of this group were important words full of promise at the time the psychiatric reform was carried out. However, there is some strong evidence that the psychiatric reform has not been completely successful. Despite the knowledge that loneliness and social isolation commonly occur among people with mental illness, there is little research that describes how mentally ill people themselves experience their life situation. The overall aim of the dissertation was to gain deeper understanding of the life situation of peop with mental illness via their own narratives on how their day-to-day life appears to them, ar through this gain knowledge of the type of support needed for them to live a satisfactory life. Various data acquisition methods were applied. Study I involved in-depth interview of two men and two women on their daily life. Data acquisition in Study II was via participant observations, an activity unit for people with mental illness. Photographs were used for Studies III and IV Eight informants were issued with disposable cameras and asked to take approximately 10 pictures of objects, situations and/or individuals. These photographs were then used as a basis for follow-up interviews. Results from Study I showed that informants were aware both of their illness and their psychosocial disadvantages, and that they had insight into what was required of them to influence their situation, while simultaneously having insight into their poor ability to tak initiatives. Informants in Study II experienced themselves as unwelcome, vulnerable and marginalised individuals with little hope of a change in existence, resulting in anxiety over the future. They felt trust was lacking in relation to other people and experienced themselves as not accepted in the company of others or by society. Study III provided description of informants occupied with themselves and their existence. The informants tell of a form of spirituality giving them a sense of peace and tranquillity, but which only exists for them at the beginning and end ol life.  Animals are more loyal than people and make no demands, but are however, according to the informants, in a position of dependence on humans. Possessions are of significance to the informants, meaning they see their possessions as part of themselves. In Study IV informants related how they would like their future to appear. They also told what having an identity meant to them, how identity is formed in individuals, what having a mental illness and feeling good means. The informants showed a longing to be seen, but at the same time not wanting to be seen. Finding a meaning with life was important since it could end at any moment. In summary, the findings point to an existential loneliness that consists of a life pattern consisting of an interaction between the impact of the mental illness and the identity as a mentally ill person feelings of marginalisation and abandonment. Experiencing that life has a meaning, possibility o social exchange and a sense of control seem to be important for the persons with mental illness in this study. Consequently, it can be inferred that if the care of people with mental illness pays attention to the dimensions of existential loneliness persons with mental illness may be helped to experience that life has a meaning despite their disability