Jan Stubberud

Stemmeanalyse kan supplere vanlig klinisk praksis i utredning og løpende vurderinger av depresjon.

Survivors of childhood acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), and non-Hodgkin lymphoma (NHL) are at risk of developing long-term adverse effects after survival. This study examined observed proportions of perceived mental distress, fatigue, and executive function (EF) impairment in adult childhood cancer survivors (CCSs) of ALL, AML, and NHL. Secondly, it examined the association between perceived EF impairment and mental distress or fatigue. Participants (n = 132; 57% female) were recruited from two major Norwegian hospitals. Self-report questionnaires included the Behavior Rating Inventory of Executive Function, Adult Version, the Hopkins Symptom Checklist-25, and the Fatigue Severity Scale. Proportions exceeding established clinical thresholds were calculated, and groups were compared using Pearson’s chi-squared test and Newcombe confidence intervals. Overall, 49% and 41% of participants met the clinical thresholds for depression and anxiety; 43% for fatigue; and 28% for EF impairment. Perceived EF impairment was significantly associated with mental distress and fatigue. Mental distress, fatigue, and EF impairment are commonly reported and distressing late effects among CCSs of ALL, AML, and NHL. Follow-up care focusing on neurocognitive and psychological outcomes is important for the long-term functioning and well-being of this survivor group. Targeted neurocognitive rehabilitation may represent a key component of follow-up care.

Post-stroke fatigue affects rehabilitation, daily activities, and quality of life. Its relationship with sleep remains unclear. We aimed in the acute stroke phase to (a) describe fatigue and sleep using self-reported and objective sleep measures, (b) describe sleep apnoea and (c) explore the associations between sleep measures and post-stroke fatigue. This cross-sectional study examined Norwegian adults within 14 days of first ischaemic stroke. Fatigue was assessed with the Fatigue Severity Scale. Self-reported sleep factors (Pittsburgh Sleep Quality Index [PSQI], Epworth Sleepiness Scale) and objective WatchPAT measures (apnoea-hypopnea, sleep time, efficiency, REM/deep sleep) served as exposure variables. Multivariable regression models, adjusted for age, sex, mRS, and depression or anxiety symptoms, were used to examine associations between sleep and fatigue. Participants (n = 107, mean age 65 (SD14) years, n = 65(61%) male) had a mean NIHSS score of 2.5 [SD3.3], Fatigue Severity Scale score of 3.11 [SD1.82], and n = 71 (66%) scored as having disturbed sleep (PSQI). Mean total sleep time (n = 81) was 7.04 [SD1.46] hours and 54 (71%) had sleep apnoea. In the final multivariable model, only poor sleep quality (b = 0.45, p = 0.010) was associated with post-stroke fatigue. Addressing sleep quality in the acute stroke phase may benefit post-stroke fatigue.

Background: Digital health technologies play a pivotal role in stroke prevention and rehabilitation. However, variations in digital health literacy (DHL) among stroke survivors may impede effective use of these tools. Understanding DHL-profiles and their influencing factors is essential for tailoring interventions. Aim: This study aimed to identify DHL-profiles among stroke survivors and possible associations with sociodemographic and clinical characteristics. Methods: We conducted a cross-sectional study with 177 first-time stroke patients (2021–2022) from the Norwegian stroke registry. DHL was measured using the eHealth Literacy Questionnaire. Cluster analysis identified DHL profiles, and multinomial regression explored associations with sociodemographic and clinical variables. Results: Three distinct DHL-profiles emerged: Novices (26%), Cautious users (57%), and Navigators (17%). Novices exhibited notable DHL limitations, cautious users demonstrated moderate proficiency, and navigators displayed a high level of proficiency. Participants aged ≥67 years were five times more likely to be Novices compared to Cautious users. Lower education and cognitive functioning increased novice likelihood, whereas living alone decreased the chance of being a Navigator. Conclusions: Diverse DHL-profiles among stroke survivors highlight the need for personalized digital health services. Tailored interventions, developed through co-design and addressing specific DHL challenges, may improve equitable access and enhance usability, ultimately promoting health equity.

Objective: There is limited research on neurocognitive outcome and associated risk factors in long-term, adult survivors of childhood acute lymphoblastic leukemia (ALL), without treatment of cranial radiation therapy. Moreover, the impact of fatigue severity and pain interference on neurocognition has received little attention. In this cross-sectional study, we examined neurocognitive outcome and associated factors in this population.Method: Intellectual abilities, verbal learning/memory, processing speed, attention, and executive functions were compared to normative means/medians with one sample t tests or Wilcoxon signed-rank tests. Associations with risk factors, fatigue severity, and pain interference were analyzed with linear regressions.Results: Long-term, adult survivors of childhood ALL (N = 53, 51% females, mean age = 24.4 years, SD = 4.4, mean = 14.7 years post-diagnosis, SD = 3.4) demonstrated above average intellectual abilities, but performed below average in attention, inhibition, processing speed, and shifting (p < 0.001). Executive functioning complaints were significantly higher than normative means, and positively associated with fatigue (p < 0.001). There was no interaction between sex and fatigue and no neurocognitive impairments were associated with pain interference, risk group, age at diagnosis, or sex.Conclusions: Long-term, adult survivors of ALL treated without cranial radiation therapy, demonstrate domain-specific performance-based neurocognitive impairments. However, continued research on the neurocognitive outcome in this population as they age will be important in the coming years. Executive functioning complaints were frequently in the clinical range, and often accompanied by fatigue. This suggests a need for cognitive rehabilitation programs.