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Brumunddal, Norway

Jelsness-Jorgensen L.-P.,Ostfold University College | Bernklev T.,Telemark Hospital | Henriksen M.,Ostfold Hospital Trust | Torp R.,Innlandet Hospital Trust Hamar | Moum B.,University of Oslo
Journal of Crohn's and Colitis

Objective: Specialist nurses have become increasingly involved in the management of Inflammatory Bowel Disease (IBD). The objectives of this study were to investigate the impact of nurse-led versus conventional follow-up on patient outcomes, such as quality of life, worries and time from relapse to start of treatment. Methods: Patients completed the Short Form 36 (SF-36), Inflammatory Bowel Disease Questionnaire (N-IBDQ) and the Rating Form of IBD Patient Concerns (RFIPC) at baseline and after 1. year. Socio-demographic and clinical variables were obtained at V1 and V2. In addition the amount of e.g., relapses, hospitalisations, time from relapse to start of treatment, sick-leave, unscheduled visits or telephone calls was recorded during the follow-up period. Results: A total of 140 patients were included; ulcerative colitis (UC) n. =. 92, Crohn's disease (CD) n. =. 48, mean age 46.9 and 40.0. years old, respectively. One hundred and thirty three patients attended the follow-up after 1. year. After 1. year there were no differences between the groups in relation to quality of life, worries, amount of relapse, sick-leave, hospitalisations or surgery. Participants in nurse-led follow-up had a significantly (. p<. 0.05) shorter interval from the start of a relapse to the start of treatment. Conclusions: Nurse-led follow-up of IBD patients produces PRO results comparable to that of gastroenterologists and may shorten the interval from the beginning of a relapse to the start of treatment. © 2012 European Crohn's and Colitis Organisation. Source

Kristjansson S.R.,University of Oslo | Ronning B.,University of Oslo | Hurria A.,City of Hope | Skovlund E.,University of Oslo | And 4 more authors.
Journal of Geriatric Oncology

Background: Measuring frailty in older adults with cancer may identify patients with an increased risk of treatment complications. As it remains controversial how to identify frailty, the aim of this study was to compare a pre-operative multi-domain frailty measure based on a comprehensive geriatric assessment (CGA) to a modified version of the physical phenotype of frailty (PF) in a cohort of older adults with colorectal cancer, and to analyze the ability of the two classifications to predict post-operative complications and survival. Methods: A prospective longitudinal study including 176 patients aged 70-94. years electively operated for colorectal cancer in three Norwegian hospitals. A pre-operative CGA, self-reported quality of life, and measurements of grip strength and gait speed were performed. CGA-frailty was defined as fulfilling one or more of the following criteria: dependency in activities of daily living, severe comorbidity, cognitive dysfunction, depression, malnutrition, or > seven daily medications. PF was defined with three or more of the following criteria: unintentional weight loss, exhaustion, low physical activity, impaired grip strength, or slow gait speed. Outcome measures were post-operative complications and survival. Results: The agreement between the classifications was poor. CGA-frailty was identified in 75 (43%) patients, while PF was identified in 22 (13%) patients. Only CGA-frailty predicted post-operative complications [P. =0.001]. Both measures predicted survival. Conclusions: A multi-domain frailty measure based on a CGA was more useful than frailty identified from a modified version of the PF criteria in predicting post-operative complications. For overall survival, both frailty measures were predictive. © 2011 Elsevier Inc. Source

Jelsness-Jorgensen L.-P.,Ostfold Hospital Trust | Jelsness-Jorgensen L.-P.,University of Oslo | Bernklev T.,University of Oslo | Henriksen M.,Ostfold Hospital Trust | And 2 more authors.
Alimentary Pharmacology and Therapeutics

Background: Fatigue is reported to reduce health-related quality of life (HRQOL) in chronic diseases. Studies on the importance of fatigue and its implications for the patient's HRQOL in inflammatory bowel disease (IBD) remain scarce and need to be explored. Aim: To investigate the influence of chronic fatigue on both generic and disease-specific HRQOL in IBD. Methods: Patients in remission, with mild and moderate IBD completed the Fatigue Questionnaire, the Short-Form 36 (SF-36) and the Norwegian version of the Inflammatory Bowel Disease Questionnaire (N-IBDQ). In addition, demographic and clinical variables were obtained. Results: In total, 140 patients were included; the mean age of patients with chronic fatigue was 44.2 years (s.d. = 15.8), that of nonfatigued was 44.7 years (s.d. = 16.0). Ulcerative colitis (UC)/Crohn's disease (CD) = 92/48. Chronic fatigue was associated, after controlling for covariates, with a reduction of HRQOL scores in 6/8 SF-36 dimensions in UC and 5/8 dimensions in CD. In N-IBDQ, chronic fatigue was associated with a reduction of HRQOL in four subdimensions and total score in CD and all dimensions in UC. Conclusions Fatigue is associated with reduction of HRQOL scores in IBD. The physical HRQOL domains are particularly affected. The impact of fatigue on disability, sick leave, school and work attendance has to be studied further. © 2010 Blackwell Publishing Ltd. Source

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