Uncovering health and social care needs among myotonic dystrophy patients: Utility of the Needs and Provisions Complexity Scale.

OBJECTIVES: Myotonic dystrophy type 1 (DM1) is a slowly progressive multisystem disorder. Guidelines recommend multidisciplinary follow-up. We aimed to investigate the presence of unmet health and social care needs among patients with DM1 and whether unmet needs correlated with motor function, cognitive impairments, or quality of life. MATERIAL AND METHODS: Patients were 22 adults with DM1. "Needs and Provisions Complexity Scale" (NPCS) was applied to evaluate the individual's needs and provision of health and social services. The Muscular Impairment Rating Scale (MIRS) was used to measure motor function and disease stage. All patients underwent neuropsychological testing. The EQ-5D-3L questionnaire was used to evaluate the patients' health-related quality of life (HRQoL). RESULTS: Median time from diagnosis was 11 years (range: 1-40). Twenty patients had developed needs related to social care, personal care, and rehabilitation that had not been met, whereas need for medical follow-up was largely met. The more pronounced the muscular impairment, the more unmet needs were experienced by DM1 patients (r = 0.50, P = 0.019). Degree of unmet needs did not correlate with full-scale IQ (r = -0.27, P = 0.23) or HRQoL (r = -0.14, P = 0.55). CONCLUSION: Using NPCS, we discovered that patients with DM1 had unmet needs with respect to social care, personal care, and rehabilitation although their need for medical follow-up was met. Thus, the use of NPCS helped bring our practice in better accordance with guidelines. A higher MIRS grade should alert the clinician to the likelihood of unmet needs.

[Did Henrik Wergeland have AD/HD?]. / Ville Henrik Wergeland i dag ha fått diagnosen ADHD?

Henrik Wergeland (1808 - 45) is one of Norwegian cultural history's most notable figures. He is honoured as a national symbol during this year's 200-year jubilee for his birth. Biographies and numerous academic publications have been written about him for more than 100 years. His life was short and diverse; on one hand he continuously worked to give people general education, he was an author and a poet and on the other hand he was always in a dispute with someone and involved in endless court cases and scandals. After his death it was said that Wergeland was one who <>. As I see it, his life is so full of events that indicate hyperactivity and impulsivity that I think it is legitimate to ask whether he would have received the diagnosis AD/HD (attention-deficit/ hyperactivity disorder) today.