The association of religious factors with mental health-service utilisation and satisfaction in a mixed Sámi and Norwegian adult population: Adopting the SAMINOR 2 Questionnaire Survey

The Indigenous Sámi have poorer mental health than the majority population and fairly equal access to professional mental healthcare. Despite this condition, certain studies indicate that this group is underrepresented among the users of such services. Religion or spirituality (R/S) often influences mental health-service utilisation and satisfaction among other Indigenous peoples and ethnic minorities. Thus, this study examines the situation in Sámi-Norwegian areas. We utilised cross-sectional data from the population-based SAMINOR 2 Questionnaire Survey (2012; subsample n = 2,364; 71% non-Sámi) in mixed Sámi-Norwegian regions of Northern and Central Norway. We analysed the associations between R/S factors and past-year mental health-service utilisation and satisfaction among individuals reporting mental health problems, substance use, or addictive behaviours. Multivariable-adjusted regression models considering sociodemographic factors, including Sámi ethnicity, were applied. Religious attendance was significantly associated with infrequent past-year use of mental health services (OR = 0.77) and fewer mental health problems, indicating that the R/S fellowship may buffer mental distress and represent an alternative psychological support to professional services. R/S was not significantly associated with lifetime mental health-service satisfaction. We found no ethnic differences in service utilisation or satisfaction

The effects of exceeding low-risk drinking thresholds on self-rated health and all-cause mortality in older adults: The Tromsø Study 1994-2020

Background Based on findings of increasing alcohol consumption in older adults, it is important to clarify the health consequences. Using data from the Tromsø study, we aimed to investigate the relationship between different levels of alcohol consumption in old adulthood and self-rated health trajectories and all-cause mortality. Methods This is an epidemiological study utilizing repeated measures from the Tromsø study cohort. It allows followup of participants from 1994 to 2020. A total of 24,590 observations of alcohol consumption were made in older adults aged 60–99 (53% women). Primary outcome measures: Self-rated health (SRH) and all-cause mortality. SRH was reported when attending the Tromsø study. Time of death was retrieved from the Norwegian Cause of Death Registry. The follow-up time extended from the age of study entry to the age of death or end of follow-up on November 25, 2020. Predictor: Average weekly alcohol consumption (non-drinker, Results We found that women who consumed ≥100g/week had better SRH than those who consumed Conclusions There was no clear evidence of an independent negative effect on either self-rated health trajectories or all-cause mortality for exceeding an average of 100g/week compared to lower drinking levels in this study with up to 25 years follow-up. However, some sex-specifc risk factors in combination with the highest level of alcohol consumption led to adverse efects on self-rated health. In men it was the use of sleeping pills or tranquilisers and≥20 years of smoking, in women it was physical illness and older age

Family members’ experiences of “wait and see” as a communication strategy in end-of-life decisions

The aim of this study is to examine family members’ experiences of end-of-life decision-making processes in Norwegian intensive care units (ICUs) to ascertain the degree to which they felt included in the decision-making process and whether they received necessary information. Were they asked about the patient’s preferences, and how did they view their role as family members in the decision-making process? A constructivist interpretive approach to the grounded theory method of qualitative research was employed with interviews of 27 bereaved family members of former ICU patients 3–12 months after the patient’s death. The core finding is that relatives want a more active role in end-of-life decision-making in order to communicate the patient’s wishes. However, many consider their role to be unclear, and few study participants experienced shared decision-making. The clinician’s expression “wait and see” hides and delays the communication of honest and clear information. When physicians finally address their decision, there is no time for family participation. Our results also indicate that nurses should be more involved in family–physician communication. Families are uncertain whether or how they can participate in the decision-making process. They need unambiguous communication and honest information to be able to take part in the decision-making process. We suggest that clinicians in Norwegian ICUs need more training in the knowledge and skills of effective communication with families of dying patients

Psykisk helse. Forståelse, kommunikasjon og samspill

Boka handler om å forstå mennesker med psykiske lidelser. Boka er skrevet for videreutdanningene inne psykisk helse, men er også nyttig for andre som arbeider med mennesker som enten har en psykisk lidelse eller nedsatt kognitiv evne.Boka drøfter følgende sentrale spørsmål: Hvordan forstå vrangforestillinger? Hva skjer når pasienter opplever at det de sier ansees som meningsløst eller irrelevant? Finnes et eget psykotisk språk? Hvordan etablere forstående relasjoner til en som sliter med psykisk lidelse? Hvordan bruke 'fortellinger' til å forstå pasientens erfaringer og opplevelser

“I Do Not Really Belong Out There Anymore”: Sense of Being and Belonging Among People With Medically Unexplained Long-Term Fatigue

In this article, we explore relations between health, being, belonging and place through an interpretive thematic analysis of autobiographic text and photographs about the everyday lives of 10 women and men living with medically unexplained long-term fatigue in Norway. While interpreting their place-related illness experiences, we ask: How do they experience their being in the world, where do they experience a sense of belonging/not belonging, and why do places become places of belonging/not belonging? The participants describe experiences of (a) being socially detached and alienated, (b) being imprisoned, (c) being spectators who observe the world, and (d) senses of belonging. They describe senses of being and belonging/not belonging as closely attached to physical and symbolic aspects of places in which they reside, and they wistfully reflect on the question of “why.” The study illustrates the influence of experienced place—material as well as immaterial—on health and illness

What is the impact of underweight on self-reported health trajectories and mortality rates: a cohort study

Background: Utilizing a cohort study design combining a survey approach with repeated physical examinations, we examined the independent effects of BMI on mortality and self-reported health (SRH) and whether these independent effects change as people grow older. Methods: The Tromsø Study consists of six surveys conducted in the municipality of Tromsø, Norway, with large representative samples of a general population. In total, 31,985 subjects participated in at least one of the four surveys administered between 1986 and 2008. Outcomes of interest were SRH and all-cause mortality. Results: Overweight and underweight subjects reported significantly lower levels of SRH, but age affected the thinnest subjects more than all others. The SRH trajectory of underweight subjects at age 25 was slightly above the other categories (0.08), but it fell to −.30 below the reference category at age 90. For obese subjects, the difference was −0.15 below the reference category at age 25 and −0.18 below at age 90. This implies that even though a low BMI was slightly beneficial at a young age, it represented an increasing risk with age that crossed the reference curve at age 38 and even crossed the obese trajectory at age 67 in the full fitted model. The proportional hazard ratio for those who were underweight was 1.69 (95% CI: 1.38-2.06) for all-cause death as compared to 1.12 (95% CI: 1.02-1.23) for obese subjects. Conclusion: BMI affected SRH and all-cause mortality independently from comorbidity, mental health, health-related behaviors and other biological risk factors. Being underweight was associated with excess mortality as compared to all others, and age affected the thinnest subjects more than all others. Weight increase was beneficial for mortality but not for SRH among the underweight. The rapid decline of SRH with increasing age suggests that particular attention should be paid to underweight after 38 years of age

Changes in self-reported health trajectories with focus on ageing in the Tromsø study

Aim: We aim to describe factors that affect self-reported health (SRH) and to describe differences in trajectories in an ageing cohort according to comorbid diseases, mental health, physical condition, education, and physical activity. Methods: Prospective cohort study of a general population in Norway utilizing repeated surveys and physical examinations (1986-2008). We included 16 745 men and women aged 20-74 at baseline, living in Tromsø municipality. Average followed-up time was 11 years. Results: The steepest decline of SRH was in midlife and when passing life expectancy. SRH decreased differently over time for men and women. The most important factors determining SRH was mental health symptoms (31.6%), specific medical conditions (17.5%) and age (17.6%), which combined explained 45.2% of the variance. Medical conditions affected SRH dependent on when in life it occurred - e.g. cardiovascular diseases affected more at younger age while asthma and diabetes affected the elderly more. BMI above 27kg/m2 (-0.086, CI: -0.170, -0.002) was detrimental for SRH at all ages. Very lean subjects had a significantly larger negative effect with increasing age than all others. BMI < 18.5 kg/m2 (0.282 CI: 0.004, 0.560) developed into a negative difference late in life because SRH deteriorated rapidly with age in the lowest BMI group (-0.078 CI: -0.127, -0.028). Exercise levels depended on age; intensive training was beneficial at younger ages, but unfavourable at older ages. Intermediate training was most beneficial from age 63 and above. Higher levels of education benefitted SRH. Conclusion: Ageing is an independent factor influencing SRH. Disease or mental illness symptoms are associated with lower SRH whenever in life they occur. Variations in SRH trajectories suggest that low BMI and exercise levels become increasingly important especially as the population ages