Identified and unidentified mental illness in primary health care - social characteristics, medical measures and total care utilization during one year

A definition of community nursing was given, and the following roles of the community nurse was briefly described: - A provider for primary health care. - A provider of personal health care to non-hospital patients. - A n advisor. - A n observer. The special skills that a community nurse must have was also briefly discussed. The role of the community nurse in the handling and prevention of mental illness at the three levels of prevention was discussed, and criteria for the measurement of mental health was highlighted.

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Pain drawings, interpreter support and clinical findings among immigrant patients on sick leave in Swedish primary health care

Primary Health Care Research & Development ◽

10.1017/s1463423619000628 ◽

2019 ◽

Vol 20 ◽

Author(s):

Monica Löfvander

Keyword(s):

Health Care ◽

Primary Health Care ◽

Sick Leave ◽

Formal Education ◽

Clinical Findings ◽

Psychosocial Stressors ◽

Foreign Born ◽

Pain Drawing ◽

Primary Health ◽

One Year

Abstract Aim: To evaluate the spread of pain and its correlates among immigrant patients on sick leave. Background: Backache, outspread pain and sick-leave questions are problematic to handle primary health care, especially in multicultural settings. Methods: Two hundred and thirty-five patients 20–45 years on paid sick leave (59% women, 93% foreign-born, mostly non-Europeans). Many had little formal education. One-third had professional interpreter support. The patients pointed out on their bodies where they felt pain. This information was transferred on a pain drawing [pain drawing fields (PDFs) 0–18] by a doctor. Major depression and psychosocial stressors were assessed using Diagnostic and Statistical Manual of Mental Disorders. Nociceptive locations for pain were established (pain-sites 0–18). Dependent variable was the number of PDFs. Independent variables were social data, sick leave, interpreter, depression, stress levels and number of pain sites. Calculations were done using descriptive methods and multi-variable linear regression in full models, by gender. Findings: Many patients had depression (51% women versus 32% men). A majority were exposed to psychosocial stressors. Women had more PDFs, in median 5 [inter-quartile ranges (IQR) 4–8] versus men 3 (IQR 2–5), and also more pain sites, in median 3 (IQR 2–5) versus men in median 2 (IQR 1–3). For men, the regression calculations revealed that numbers of PDFs associated only with increasing numbers of pain sites (B 0.871 P < 0.001). For women, this association was weaker (B 0.364, P < 0.001), with significant values also for age (B 0.103) and sick leave > one year (B 0.767, P = 0.010), and a negative predicting value for interpreter support (B −1.198, P < 0.043). To conclude, PDFs associated often with somatic findings but varied much among the women. This implies potential problems regarding cause, function and sick leave questions. However, support by professional interpreters may facilitate a shared understanding with immigrant women having long-standing pain.

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