Subjective well-being in Swedish active seniors or seniors with cognitive complaints and its relation to commonly available biomarkers.

Well-being (WB) is a complex variable in its relation to physical health and other personal and social characteristics. The aim was to study subjective well-being (SWB) and its possible associations with traditional biomarkers of cardiovascular risk or dementia, in Swedish seniors. SWB was estimated by the Psychological General Well-Being (PGWB) index in two study groups. The active seniors (AS) group consisted of community-dwelling elderly Swedes leading an active life (n=389). The DGM cohort (n=300) consisted of subjects referred to the Memory Unit at the Department of Geriatrics, the cognitive problems had to be subjective, mild or moderate (MMSE≥10). There were differences in all six subdimensions of SWB or distress, and in the sum of PGWB scores, between the two study groups (p<0.001 for all), and adjustment for differences in biomarkers of somatic health (age, sex, blood pressure, BMI, HDL cholesterol, ApoB/ApoA1 ratio, creatinine, and homocysteine) did not attenuate these differences. In addition, cognition as assessed by the Clock-Drawing Test (CDT) showed independent associations with four of the PGWB subdimensions and with the PGWB sum. Among the subjects in the DGM cohort, SWB was equally low among subjects with an MCI (minor cognitive impairment) diagnosis or without a dementia diagnosis as among subjects diagnosed with dementia disorder. We conclude that the nosological grouping variable (AS vs. DGM cohort) and a cognitive factor were the main independent predictors of SWB in this sample of elderly Swedes, whereas biomarkers of somatic health played a subordinated role.

Humour seen from a public health perspective.

Humour is to be regarded as a salutogenic factor. As with other such factors there are reasons to believe that humour is a part of the individual's personality with the possibility of being strengthened by influences from the family, school, and workplace. The use of humour in population-based health promotive intervention strategies is a field lacking evidence-based knowledge.

Palliative care in a coronary care unit: a qualitative study of physicians' and nurses' perceptions.

BACKGROUND: Earlier research has shown that physicians and nurses are motivated to provide good palliative care, but several factors prevail that prevent the best care for dying patients. To provide good palliative care it is vital that the relationship between nurses and physicians is one based on trust, respect and sound communication. However, in settings such as a coronary care unit, disagreement sometimes occurs between different professional groups regarding care of dying patients. AIM AND OBJECTIVES: The aim of this study was to describe and understand physicians' and nurses' perceptions on their working relationship with one another and on palliative care in a coronary care unit setting. DESIGN: Using a convenience sample, professional caregivers were interviewed at their work in a coronary care unit in Sweden. METHODS: Data collection and analysis were done concurrently using a qualitative approach. RESULTS: From the interviews, a specific pattern of concepts was identified. The concepts were associated with a dignified death, prerequisites for providing good palliative care and obstacles that prevented such care. CONCLUSIONS: Caregivers who work in a coronary care unit are highly motivated to provide the best possible care and to ensure a dignified death for their patients. Nevertheless, they sometimes fail in their intentions because of several obstacles that prevent good quality care from being fully realized. RELEVANCE TO CLINICAL PRACTICE: To improve practice, more attention should be paid to increasing dying patients' well-being and participation in care, improving strategic decision-making processes, offering support to patients and their relatives, and improving communication and interaction among caregivers working in a coronary care unit. Caregivers will be able to support patients and relatives better if there are good working relations in the work team and through better communication among the various professional caregivers.

The essence of humour and its effects and functions: a qualitative study.

Humour is one of the innate abilities that an individual develops whilst growing up and which is affected by his/her experiences in life. The purpose of this study was to describe which categories can be included in the term 'humour' and to describe the effects and functions that humour has on people. The study was exploratory. The data were based on 20 interviews, nine of which were made with women and 11 with men who had no formal connection to health services or nursing. Ages ranged from 17 to 75 years and all the interviewees were from Sweden. The research question was: 'what does humour mean to you?'. The answers given were labelled as: laughter, happiness, unforeseen events/situations, real humour/art form, jokes, plays on words/puns, situation comedy and political satire. The categories were: possibilities/obstacles and weapon/protection. We conclude that the essence of humour can be categorized as possibilities/obstacles and weapon/protection. Humour has effects and functions on individuals. Empathy is a prerequisite for the use of humour in the context of health services and nursing.