Patient satisfaction with the information provided at a psychiatric emergency unit.

OBJECTIVE: Evaluation of patient satisfaction with information at a psychiatric emergency unit. DESIGN: Patient survey. SETTING: Psychiatric patients assessed information provided by staff on illness, symptoms, treatment alternatives, treatment design, medication, time schedule for treatment and the expected therapeutic response. PARTICIPANTS: The sample included 100 subjects (63% response rate). OUTCOME MEASURE: Patient satisfaction. RESULTS: 59% were women. Mean age was 43 years. 87% were Swedish. 30% had psychotic, 35% bipolar and 35% anxiety disorders. 87% were admitted voluntarily. Almost 80% were satisfied with the patient-staff relationship. Questions on information, except medication, scored low. Patients with non-psychotic disorder were more satisfied with information on symptoms, treatment alternatives and treatment design, and voluntary patients with information about medication. Patients born in Sweden and voluntary patients awarded influence on treatment planning higher scores. CONCLUSIONS: Psychiatric patients requiring emergency care did understand information. The staff provided satisfactory information only when knowledgeable.

Involuntarily detained HIV-infected patients in Sweden: reasons for referral and psychiatric diagnoses.

The Swedish Communicable Diseases Act permits the isolation of an HIV-infected person if there is risk of disease transmission. The purpose is for the patient to receive the support needed to alter his or her attitude and behaviour so that the isolation can be terminated. This study describes the reasons for referral and the psychiatric diagnoses of 34 isolated HIV-infected patients. All patients who were isolated in Stockholm from 1986 to 1993 were included. Psychiatric data were collected from their psychiatric records. The most frequent reason for referral was unprotected sex with a partner who was not informed about the infection. The most common psychiatric diagnosis was amphetamine or opiate abuse. Drug users without delusions and immigrants with adjustment disorders or post-traumatic stress disorder had the shortest treatment periods. All patients belonged to underprivileged groups, were drug users or refugees. More effort is needed to teach these groups about HIV.

Adaptation of heterosexually infected HIV-positive women: a Swedish pilot study.

The experiences and adaptation of 8 women who were heterosexually infected with the HIV were examined. An interview schedule consisting of open-ended questions was used to elicit a full range of responses. Roy's (1984) adaptation model, focusing on physiological needs, self-concept, role-function, and interdependence provided the structure for analysis of each transcript. The interviews indicated that the women who had strong social and family support were coping better with their situation than were women who had little support. The interview responses also showed a lack of professional comportment among health care professionals in their contact with women who are HIV positive, indicating a need for further investigation of health care workers' knowledge and understanding of the needs of HIV-positive women. To plan effective programs, health care professionals need to identify the specific needs of each woman from a holistic perspective.

Quantitative detection of brain aberrations in human immunodeficiency virus type 1-infected individuals by magnetic resonance imaging.

The brains of 65 individuals with antibodies to human immunodeficiency virus type 1 (HIV-1), 20 HIV-1 seronegative homosexual men, and 75 heterosexual controls were examined by a quantitative magnetic resonance imaging technique. A white matter aberration was detected most frequently in patients with AIDS-related complex (ARC) or AIDS, but also in asymptomatic HIV-1 seropositive persons and in HIV-1 seronegative homosexual men, of whom two of three tested were reactive for HIV-1 DNA by polymerase chain reaction. The aberration was not found in the control group. Brain atrophy was mainly confined to patients with ARC or AIDS. The brain lesions correlated with the presence of HIV-1 in cerebrospinal fluid and with elevated levels of beta 2-microglobulin and neopterin. The most pronounced brain aberrations were in patients with AIDS-dementia complex. These findings indicate that brain aberrations may occur in persons in the early stages of HIV-1 infection, although to no greater extent than in HIV-1 seronegative homosexual men. The occurrence of pronounced brain lesions seems to be associated with the presence of an advanced immunodeficiency.

[A magnetic tomography study: 3 out of 4 HIV-I infected men suffer subcortical pathologic changes]. / Magnettomografiundersökning: Tre av fyra HIV-1-infekterade män hade subkortikala patologiska förändringar.

Forty HIV-1-sero-positive and 15 HIV-1 antibody negative homosexual or bisexual men were examined by means of magnetic resonance imaging (MRI) and 20 neuropsychological tests. Subcortical, mainly frontal cerebral pathological aberrations were detected in 75 per cent of the patients on examination with ultra low field MRI computer assisted classification. No such changes were found among controls. The extent of the subcortical aberrations detected correlated with severity of immune deficiency, stage of infection (CDC classification), duration of infection, and reported neuropsychological symptoms. Neuropsychological testing showed impairment in memory function, concentration capacity, and fine motor control in the patients but not in the controls.