http://hdl.handle.net/1956/939 Search the Channel search http://bora.uib.no/simple-search http://hdl.handle.net/1956/2325 Title: Assessing medical students’ attitudes towards learning communication skills – which components of attitudes do we measure? <br/> <br/>Authors: Anvik, Tor; Gude, Tore; Grimstad, Hilde; Baerheim, Anders; Fasmer, Ole B.; Hjortdahl, Per; Holen, Are; Risberg, Terje; Vaglum, Per <br/> <br/>Abstract: Background. The Communication Skills Attitudes Scale (CSAS) created by Rees, Sheard and Davies and published in 2002 has been a widely used instrument for measuring medical students' attitudes towards learning communication skills. Earlier studies have shown that the CSAS mainly tests two dimensions of attitudes towards communication; positive attitudes (PAS) and negative attitudes (NAS). The objectives of our study are to explore the attitudes of Norwegian medical students towards learning communication skills, and to compare our findings with reports from other countries. Methods. The CSAS questionnaire was mailed simultaneously to all students (n = 3055) of the four medical schools in Norway in the spring of 2003. Response from 1833 students (60.0%) were analysed by use of SPSS ver.12. Results. A Principal component analysis yielded findings that differ in many respects from those of earlier papers. We found the CSAS to measure three factors. The first factor describes students' feelings about the way communication skills are taught, whereas the second factor describes more fundamental attitudes and values connected to the importance of having communication skills for doctors. The third factor explores whether students feel that good communication skills may help them respecting patients and colleagues. Conclusion. Our findings indicate that in this sample the CSAS measures broader aspects of attitudes towards learning communication skills than the formerly described two-factor model with PAS and NAS. This may turn out to be helpful for monitoring the effect of different teaching strategies on students' attitudes during medical school. Thu, 29 Mar 2007 22:58:59 GMT http://hdl.handle.net/1956/2211 Title: Cost-effectiveness of medical interventions to prevent cardiovascular disease in a sub-Saharan African country – the case of Tanzania <br/> <br/>Authors: Robberstad, Bjarne; Hemed, Yusuf; Norheim, Ole F. <br/> <br/>Abstract: Background: There is a high and rising prevalence of cardiovascular risk in sub-Saharan Africa, a development typical for countries in epidemiological transition. Contrary to recommendations in treatment guidelines, medical interventions to prevent cardiovascular disease are implemented only on a limited scale in these settings. There is a widespread concern that such treatment is not cost-effective compared to alternative health interventions. The main objectives of this article are therefore to calculate costs-, effects and cost-effectiveness of fourteen medical interventions of primary prevention of cardiovascular disease in Tanzania, including Acetylsalicylic acid, a diuretic drug (Hydrochlorothiazide), a β-blocker (Atenolol), a calcium channel blocker (Nifedepine), a statin (Lovastatin) and various combinations of these. Methods: Effect sizes were derived from systematic reviews or meta-analyses, and calculated as Disability Adjusted Life Years (DALYs). Data on drug costs were calibrated to a Tanzanian setting. Other recurrent and capital costs were derived from previous studies and reviewed by local experts. Expected lifetime costs and health outcomes were calculated using a life-cycle model. Probabilistic cost-effectiveness analysis was performed using Monte Carlo simulation, and results presented as cost-effectiveness acceptability curves and frontiers. The potential impacts of uncertainty in value laden single parameters were explored in one-way sensitivity analyses. Results: The incremental cost-effectiveness ratios for the fourteen interventions and four different levels of risk (totally 56 alternative interventions) ranged from about USD 85 per DALY to about USD 4589 per DALY saved. Hydrochlorothiazide as monotherapy is the drug yielding the most favorable cost-effectiveness ratio, although not significantly lower than when it is combined in duo-therapy with Aspirin or a β-blocker, in triple-therapy with Aspirin and a β-blocker, or than Aspirin given as mono-therapy. Conclusion: Preventive cardiology is not cost-effective for any patient group in this setting until willingness to pay exceeds USD 85 per DALY. At this level of willingness to pay, the optimal intervention is Hydrochlorothiazide to patients with very high cardiovascular risk. As willingness to pay for health increase further, it becomes optimal to provide this treatment also to patients with lower cardiovascular risk, and to substitute to more sophisticated interventions. Wed, 21 Feb 2007 22:58:59 GMT http://hdl.handle.net/1956/1732 Title: Mestring av virkninger etter seksuelle overgrep <br/> <br/>Authors: Vea, Hildur <br/> <br/>Abstract: Dette er en litteraturoppgave om mestring av virkninger etter seksuelle overgrep hos voksne kvinner. Oppgaven presenterer og drøfter hva som fremmer en positiv mestring hos de utsatte, og hvordan utøvelse av sykepleie kan bidra til en økt positiv mestring. Oppgaven bygger på kilder som forskningsartikler og tidskriftartikler, fagbøker, NOUèr og offentlige kilder. De to første kapitlene avklarer begreper og forhold som blir et bakteppe for å forstå hva mestring av virkninger etter seksuelle overgrep dreier seg om. Teori om virkninger etter seksuelt misbruk baserer seg på flere kilder; 1) Finkelhor og Browne`s teori om skadelige prosesser som oppstår hos barn som følge av seksuelt misbruk, 2) Ann Luise Kirkengen`s beskrivelse av 7 fenomen som er karakteristiske hos voksne utsatte, og 3) En oversikt som viser hvilke sykdommer, diagnoser og problemområder som forekommer hyppigere hos seksuelt misbrukte personer enn i en normalbefolkning. Begrepet mestring presenteres ut fra Lazarus & Folkman sin teori om mestring som prosess. De mest sentrale begrepene er mestringsressurser, mestringsstrategier og vurderinger. Det er laget en modell som viser hvordan disse begrepene virker i forhold til hverandre i en mestringsprosess. Drøftingen er inndelt i fire kapitler. Gjenerindringsprosess og forhold som virker på denne tas opp i kapittel 5. Hvilke mestringsressurser og hvordan de innvirker på utsattes mestring tas opp i kapittel 6. Hvilke mestringsstrategier som gir en positiv mestring tas opp i kapittel 7. Hvordan sykepleie kan utøves for å fremme en positiv mestring hos utsatte, tas opp i kapittel 8. Det gis i oppgaven eksempler på forsvarlig og uforsvarlig sykepleie i møte med utsatte kvinner i noen av de sammenhenger som sykepleiere møter utsatte kvinner, eksempelvis psykisk helsevern, gynekologiske avdelinger og fødeavdelinger, helsestasjoner og barneavdelinger, og somatisk helsetjeneste. Sun, 29 Oct 2000 22:58:59 GMT