The association amongst visual, hearing, and dual sensory loss with depression and anxiety over 6 years: The Tromsø Study.

OBJECTIVE: To examine the longitudinal association of dual and single (vision and hearing) sensory loss on symptoms of depression and anxiety in older adults. METHODS: Two thousand eight hundred ninety adults aged 60 years or over who participated in the longitudinal population-based Tromsø Study, Norway, were included. The impact of objective vision loss, self-report hearing loss, or dual sensory loss on symptoms of depression and anxiety, as assessed by the Hopkins Symptom Checklist 10, was examined at baseline and 6-year follow-up using linear mixed models. RESULTS: Hearing loss had a cross-sectional relationship with increased depression (b = 0.1750, SE = 0.07, P = .02) and anxiety symptoms (b = 0.1765, SE = 0.08, P = .03); however, these relationships were not significant at the 6-year follow-up. Both vision loss only and dual sensory loss predicted increased depression scores at follow-up (b = 0.0220, SE = 0.01, P = .03; and b = 0.0413, SE = 0.02, P = .01, respectively). Adjustment for social isolation did not attenuate the main depression results. CONCLUSION: Dual sensory loss resulted in increased depression symptomatology over time and posed an additional long-term risk to depression severity beyond having a single sensory loss only. Only hearing loss is associated with anxiety symptoms. Older adults with vision, hearing, and dual sensory loss have different mental health profiles. Therefore, management and intervention should be tailored to the type of sensory loss.

[Cancer in primary care in Vestfold in the year of 2000]. / Kreftomsorg i allmennpraksis i Vestfold år 2000.

BACKGROUND: Developing high-quality patient-centred palliative care involving different professions in a local health care situation is a challenging task. It is difficult to establish co-operation on the allocation of resources to individual patients throughout the phases of disease. There are financial constraints, but also incongruities between the various levels of the health care system. Doctors' participation in cancer care is hidden in various tasks, and the contribution of GPs can be difficult to grasp. Patient-centred cancer care requires local co-operation; the intention in public health policy is to let the GP and the primary care nurse provide continuity of care, with the GP in the role of co-ordinator and organiser. MATERIAL AND METHODS: A postal questionnaire designed to survey GPs' own involvement in cancer care was sent to all 163 members of the Association of General Practitioners in Vestfold County, Norway. RESULTS: Out of 146 active members, 109 (75%) responded. GPs are regularly personally involved in the care of cancer patients; a majority of the GPs in Vestfold County have long experience. 72 respondents would take over controls as a shared responsibility and 80 are ready to follow up patients who want to live in their own homes until the end. Selv-evaluation of competence in pain control is good in a minority (13-40%). INTERPRETATION: There is a sizeable potential for quality improvement in local palliative cancer care and in the vertical and horizontal communication between the professional groups involved.

[Collegial support to improve prescription patterns for addictive preparations]. / Kollegial støtte for bedret forskrivning av A- og B-preparater.

Norwegian County Medical Officers monitor unsatisfactory prescription practices in relation to addictive drugs. In this context, our team has tried to reach out to colleagues with preventive guidance. Our aim was to build communications skills by promoting systematic reflection on the importance of our own attitudes and behaviour in our work as physicians. In collaboration with the Vestfold Branch of the Norwegian Medical Association and the Vestfold Addiction Clinic, the Vestfold County Medical Officer set up preventive guidance tutorials for a closed group. The County Medical Officer specifically invited 20 physicians; invitations were also sent to all other members of the Medical Association in the county. The tutorials were given in 1997-98, with a voluntary attendance of 15 physicians. An evaluation form was sent to participants two months after completion. The tutorials received a positive evaluation. The results suggest that the guidance on the whole was considered useful. Of those specifically invited, 10% (2) attended. The tutorials were meant as a practical step to helping doctors reflect more systematically on their own style of communication and understanding of pain behaviour. There is a common interest in expanding the conventional biomedical model of understanding of chronic non-malignant pain conditions, a model in which prescribing addictive drugs is quite controversial.