Increased self-awareness in the process of returning to work

Scand J Caring Sci; 2011; 25; 762–770
Increased self‐awareness in the process of returning to work Background: A group of employees on sick leave, living in the Oslo area, Norway, was offered participation in a counselling programme, based on Gestalt theory, mindfulness and phenomenological understanding of the body. Aims: To explore the participants’ processes of change related to their increased ability to work. Method design: This qualitative study is based on modified grounded theory. Method: A total of 12 female employees, all who had increased work ability 1 year after the programme, participated in open focus‐group interviews at the end of the programme. Findings: The participants’ experiences from processes of change are described through the following categories: becoming more aware of one’s own thoughts, emotions and bodily reactions; taking oneself seriously and accepting oneself; being secure enough to face being challenged; realizing new possibilities and choices and trying out new ways of acting. The participants further described what had been helpful in these processes. Experience of a secure setting and open‐minded listening seemed important for getting the courage to open up to all reactions. Then, they could explore new ways of thinking, communicating and behaving. Discussing existential issues such as their core values was important. This, together with being allowed to take their own emotions seriously and being challenged by the counsellors, had encouraged the processes of change. Conclusions: The women described how experiences of increased awareness contributed to reconstruction of their self‐understanding and opened up for new possibilities. This seemed to have provided them with new ways of communicating and acting, which enhanced participation in work. The context of the learning programme, the existential issues and counselling challenges appeared as essential in these processes of change. The findings give insights into aspects that may be important when designing rehabilitation programmes.     

Preliminary Evidence for a Classroom Based Psychosocial Intervention for Disaster Exposed Children with Posttraumatic Stress Symptomatology

Background

In 2004, a firework factory in a residential area of a large Danish city exploded. The children at the local school were screened for symptoms of posttraumatic stress disorder (PTSD) 16 months and 3½ years after the incident. A large proportion of the children still suffered from a substantial number of symptoms 3½ years after the incident. Thus, a treatment program designed to target PTSD symptoms in trauma-exposed children was established.

Objectives

The first aim of this study was to provide preliminary evidence that a classroom-based psychosocial intervention program for children with posttraumatic stress would be associated with reductions in symptoms. The second aim was to evaluate the usefulness of the Darryl, a cartoon-based PTSD screening instrument.

Methods

One hundred and eight children participated in the treatment program, all of whom fulfilled at least two out of the three DSM-IV PTSD symptom clusters. The children were screened for PTSD symptoms at baseline and 1 month after treatment using Darryl.

Results

There was a statistically significant reduction in PTSD symptoms from pre-treatment to post-treatment. Furthermore, a logistic regression analysis revealed that being female, being young, and having a high PTSD score at baseline predicted a probable PTSD diagnosis post-treatment.

Conclusion

The present study provides preliminary evidence of feasibility and that the treatment program described may help to alleviate PTSD symptoms children with chronic PTSD symptoms. Furthermore, the results indicated that the Darryl instrument is a useful screening tool for assessing PTSD symptoms in this sample of children.     

Breast cancer incidence trends in Norway—explained by hormone therapy or mammographic screening?

A decline in breast cancer incidence has been observed in several countries after 2002. Reduced use of menopausal hormonal therapy (HT), as a consequence of the publication of results from the Women's Health Initiative, has been argued to be the main reason. In Norway, the governmentally funded Norwegian Breast Cancer Screening Program (NBCSP) was implemented during the same time period as the increased use of HT. This study investigated trends in breast cancer incidence by use of HT and introduction of the screening program. We obtained rates of breast cancer from the Cancer Registry of Norway and sales data of HT preparations from the Norwegian Institute of Public Health. Mammography rates were estimated from published reports. Breast cancer incidence rates increased steadily from 1956 to the end of the 20th century, particularly in women aged 55-69 during 1996-2002 residing in the counties where the NBCSP was first introduced. The rates declined after 2002-2003. HT use increased in 1987-2001, peaking around year 2000. In particular, sales of combined estrogen and progestogen preparations declined after 2002. Among women aged 55-59, rates of hormone receptor positive breast cancers peaked in 2000-2003. No such trend was seen in other age groups. In conclusion, the interpretation of breast cancer incidence trends in Norway from 1987 to 2009 is complicated because the NBCSP was introduced during a period with increasing HT use. Both factors likely contributed to the observed trends, and the role of each may vary across age groups.     

Human bocavirus commonly involved in multiple viral airway infections.

BACKGROUND: Human bocavirus (HBoV) was recently discovered in children with acute respiratory tract infections. We have included a PCR for HBoV in a study on airway infections in children. OBJECTIVES: To study the occurrence of HBoV in Norwegian children, and to evaluate the results of a semiquantitative PCR. STUDY DESIGN: During a 4-month period in the winter season 2006/2007 we collected nasopharyngeal aspirations from children who were admitted to the Department of Pediatrics. All samples were examined for 17 agents with real-time PCR. RESULTS: HBoV was detected in 45 of 376 samples (12%). The occurrence of HBoV was stable during the study period. Multiple viral infections were present in 78% of the samples (42% double, 20% triple and 16% quadruple infections). RS-virus, enterovirus and human metapneumovirus were the most frequently codetected agents. In samples with a high load for HBoV, significantly fewer multiple infections were found than in the other samples. Eighty-eight percent of the 25 patients with HBoV recorded as either the only or the dominating virus, and 50% of the other patients, had lower respiratory tract infection. The difference was statistically significant. CONCLUSIONS: HBoV was frequently detected in nasopharyngeal aspirates from children with airway infections in Norway. Multiple viral infections were common among the HBoV-infected patients. Semiquantitative PCR results may be useful for interpretation of clinical relevance.