Fysioterapeuten 3-2022

FYSIOTERAPEUTEN 3/22 35 barnehageansatt, eller de kunne få tilbud om arbeid med så store krav til norskkunnskaper at de ikke hadde mulighet til å lykkes. Vår studie viser at innvandrere med følgetilstand etter polio ofte har sammensatte medisinske og psykososiale utfordringer, som krever en bred tverrfaglig vurdering på spesialistnivå, hvor kompetanse om kultursensitivitet, flerspråklighet og tilpasning av helseinformasjon både skriftlig og muntlig, er viktig. Noen har behov for lengre vurderingsopphold, eventuelt flere kortere opphold med avtalt oppfølging. Innvandrergruppen med polio er fortsatt relativt ung og vil ha behov for et godt og tilrettelagt vurde- rings- og rehabiliteringstilbud i lang tid framover. Denne studien er basert på et relativt lite utvalg av 74 polioskadde personer fra et bredt spekter av land og med varierende botid i Norge. Innvandrere er ikke en kulturelt homogen gruppe, selv om det var et kriterium for inklu- sjon i denne studien at de kom fra et ikke-vestlig land. Vår studie synes imidlertid å underbygge funn i tilsvarende, tidligere studier blant innvandrere i Norge og Sverige, spe- sielt med hensyn til utfordringer knyttet til fysisk kapasitet, yrkesytelse og psykososiale forhold [9, 10]. Konklusjon og kliniske implikasjoner Innvandrere med følgetilstand etter poliomyelitt er vesent- lig yngre enn nålevende vestlige polioskadde, og de får ofte alvorlige helse- og sosiale problemer i yngre alder enn norske polioskadde. Polioskadde innvandrere har gjerne sammensatte medisinske og psykososiale utfordringer, som krever en bred tverrfaglig vurdering på spesialist- nivå. Gruppen synes å ha behov for ekstra oppmerksom- het, og helsepersonell i Norge må få oppdatert kunnskap, hvor kompetanse om kultursensitivitet, flerspråklighet og tilpasning av helseinformasjon inngår, i tillegg til generell poliokompetanse. Referanser 1. Nathanson N, KewOM. From emergence to eradication: the epidemiology of poliomyelitis deconstructed. Am J Epidemiol, 2010; 172(11): 1213-29. 2.Ward NA, Milstien JB, Hull HF et al.TheWHO-EPI initiative for the global eradica- tion of poliomyelitis. Biologicals 1993; 21: 327–333 3. GlobaleWPV1 & cVDPV Cases1, Jan 2020 – Polio, Global Eradication Initiative. European Polio Union, [cited March 2018 and February 2021]. 4. Performance of Acute Flaccid Paralysis (AFP) Surveillance and Incidence of Poliomyelitis. Global Polio Eradication Initiative – AFP/Polio case count summary [cited March 2018, 19 February 2021]. 5. Baj A, Colombo M, Headley JL et.al. Post-poliomyelitis syndrome as a possible viral disease. International Journal of Infectious Diseases 2015; 35: 107-116 . https://doi.org/10.1016/j.ijid.2015.04.018 6.Wekre LL, Stanghelle JK, Lobben S, et al.The Norwegian Polio Study 1994: a nation-wide survey of problems in long-standing poliomyelitis. Spinal Cord 1998; 36 (4): 280-4. DOI :10.1038/sj.sc.3100557 7. Halstead L, Grimby G. Post-polio syndrome. Red. 1995, Philadelphia: Hanley- Belfus, INC. 8. Center for Disease Control,Worldwide, 2015–2016, in MMWR Morb MortalWkly Rep. 2017. p. 359-65. 9. Festvag LV, Stanghelle JK, Gilhus NE, et.al. Polio and post-polio syndrome in non-Western immigrants: A new challenge for the healthcare system in Norway. J Rehabil Med, 2019;51(11):861-8. DOI: 10.2340/16501977-2624 10.Werhagen L, Borg K. Survey of young patients with polio and a foreign back- ground at a Swedish post-polio outpatient clinic. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2016;37(10):159-601. 11.Vreede KS, Sunnerhagen K. Characteristics of patients at first visit to a polio clinic in Sweden. PLoS One 2016 (journals.plos.org ) . https://doi.org/10.1371/ journal.pone.0150286 12. https://helseforskning.etikkom.no/reglerogrutiner/soknadsplikt/ sokerikkerek?p_dim=34999 . 13. Farbu E, Gilhus NE, Barnes MP et al. EFNS guideline on diagnosis andmana- gement of post-polio syndrome. Report of an EFNS task force. Eur J Neurol, 2006. 13(8): p. 795-801. DOI: 10.1111/j.1468-1331.2006.01385.x 14. Festvag LV, Schanke AK, Stanghelle JK, et al. Health and social conditions in Norwegian polio survivors: A 20-year follow-up study. J Rehabil Med, 2016; 48(8): 688-695. DOI :10.2340/16501977-2118 15. Koopman FS, Beelen A, Gilhus NE et.al.Treatment for postpolio syndrome. Cochrane database of systematic reviews. 2015(5): Cd007818. https://doi. org/10.1002/14651858.CD007818.pub3 16. SolumGM. Hvem er jeg nå? Beretninger fra møter med den norske velferden. Sykehuset Innlandet HF, Avdeling for Fysikalsk medisin og rehabilitering, Ottestad 2009. 17. Levin N. Gjennommarg og bein: Den norske hverdagen til innvandrerkvinner med senskader etter polio: Unversitetet i Oslo, Norge; 2011. 18. SantosTavares Silva I,Thoren-Jonsson AL. Struggling to be part of Swedish society: Strategies used by immigrants with late effects of polio. Scandinavian journal of occupational therapy. 2015; 22(6): 450-61 . https://doi.org/10.3109/11 038128.2015.1057222 Abstract Title: A study of Medical and Psychosocial Challenges in Immigrants with Poliomyelitis Objective : To explore the health and psychosocial situa- tion among non-Western immigrants to Norway with polio sequelae. Method : A retrospective study was performed in 74 persons, 34 men and 40 women, with the diagnosis poliomyelitis or post-polio syndrome (ICD-10 codes B91 or G14), with immi- grant background from non-Western countries, registered in DIPS (digital patient record system) at Sunnaas Rehabilitation Hospital HF, Norway, in the period 2014–2020. Demographic data such as sex, age, country of birth, place of residence, education and occupational status were recorded, in addition to physical, psychosocial function and suggested therapeutic interventions. Results : The selection came from 23 different countries and had a mean age of 44 years. Mean age at acute polio was 2.6 years and post-polio symptoms were reported at mean age of 34 years. Decreased motor function was the predominant cause of referral (45%). Pain, increasing fatigue, anxiety and depression were reported by 40 % as contributing factors to the referral. There was an under-consumption of relevant technical aids and treatment facilities in the group, and more than 80 % were referred for follow-up by orthopedic engineer or physical– and occupational therapists for adaptation of orthoses and technical aids. Conclusion : Immigrants to Norway with polio sequelae repor- ted extensive health and social problems, including fatigue and pain. They were younger thanWestern polio patients, and they also seemed to have more health and social problems from a younger age. They reported complex medical and psychosocial challenges, which require interdisciplinary assessment and treatment. Health professionals in Norway should have up-to-date knowledge about polio, in addition to having cultural sensitivity and experience in immigrant- specific health issues when dealing with this group. Keywords : C05–Musculoskeletal disease, C02–virus diseases, A08–nervous system, Polio, poliomyelitis, post-polio syn- drome, immigrants, non-Western, health, social conditions, psycho-social health.