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Psychological Distress and Health-Related Quality of Life in Public Sector Personnel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041865. [PMID: 33672946 PMCID: PMC7918692 DOI: 10.3390/ijerph18041865] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 11/17/2022]
Abstract
Background: This study has assessed health-related quality of life (HRQoL) and psychological distress between public sector professional groups. Methods: Short Form-36 Health Survey (SF-36) and Hospital Anxiety and Depression Scale (HADS) were administered to healthcare personnel, schoolteachers, and municipality and regional personnel in the region of Western Greece. Mean scores on all SF-36 dimensions and HADS were compared among these professional groups as well as with the Greek national norms to assess if there were significant differences between our study sample and the general population. Results: Healthcare personnel reported significantly lower SF-36 scores than teachers and municipality employees. Women reported poorer HRQoL than men on all SF-36 dimensions. This overall low score for health care workers masks the fact that male health care workers, primarily medical doctors, actually scored better than women, primarily nurses and auxiliary personnel. Average mean scores on all SF-36 dimensions reported by nurses and auxiliary personnel in healthcare were considerably lower than the ones from employees in all other occupational types. The impact on HRQoL observed mainly in vitality, social functioning and mental health was important. Many participants have shown psychological burden and depression. Conclusions: The health inequalities among healthcare employees are significant. This study is important to suggest taking measures for improving the HRQoL of health workers.
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Aili K, Arvidsson S, Nygren JM. Health related quality of life and buffering factors in adult survivors of acute pediatric lymphoblastic leukemia and their siblings. Health Qual Life Outcomes 2021; 19:55. [PMID: 33579311 PMCID: PMC7881557 DOI: 10.1186/s12955-021-01700-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 02/04/2021] [Indexed: 12/22/2022] Open
Abstract
Background The improvement in treatment of pediatric acute lymphatic leukemia (ALL) has introduced new challenges for pediatric oncology care in understanding and handling long-term treatment-related complications later in adult life. The aim of this study was to describe health related quality of life (HRQoL) and the relation to buffering factors among young adult (YA) pediatric ALL survivors and their siblings. Methods This cross-sectional study was performed among 227 adults, treated for pediatric ALL in Sweden between 1985 and 1997 and their siblings (n = 70). Group means of HRQoL (SF-36) were compared between YA ALL survivors and the siblings, as well as to normative values from the general population. Self-efficacy (GSES) and social support (SS-13 subscale AVSI) was considering potential buffering factors for HRQoL and mental health. Associations between HRQoL and mental health respectively and self-efficacy and social support was analyzed. Results The YA ALL survivors scored significantly lower on the HRQoL parameters general health (69.6 vs. 78.4, p = 0.004) and role emotional (77.1 vs. 88.1, p = 0.014), than the siblings. Further, they reported significantly lower general health (69.6 vs. 75.8), vitality (56.9 vs. 68.8), social functioning (84.5 vs. 88.6), role emotional (77.1 vs. 85.7) and mental health (71.3 vs. 80.9) compared with Swedish norms. Both YA ALL survivors and the siblings reported lower vitality and worse mental health than the general population. The HRQoL parameters, depression, stress and anxiety were all associated with both self-efficacy and social support among the YA ALL survivors. Among the siblings however, only general health, vitality, role emotional, mental health and depression were associated with social support, and only general health and mental health were associated with general self-efficacy. Conclusion The results from this study show that buffering factors, like social support and self-efficacy, may play an important role for psychosocial outcomes and HRQoL among YA ALL survivors later in life. The results suggest that this group could benefit from continuous support in adult life to handle consequences of their pediatric disease.
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Affiliation(s)
- Katarina Aili
- School of Health and Welfare, Halmstad University, Halmstad, Sweden. .,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Susann Arvidsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Jens M Nygren
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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103
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Gerdle B, Rivano Fischer M, Cervin M, Ringqvist Å. Spreading of Pain in Patients with Chronic Pain is Related to Pain Duration and Clinical Presentation and Weakly Associated with Outcomes of Interdisciplinary Pain Rehabilitation: A Cohort Study from the Swedish Quality Registry for Pain Rehabilitation (SQRP). J Pain Res 2021; 14:173-187. [PMID: 33542650 PMCID: PMC7850976 DOI: 10.2147/jpr.s288638] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/04/2020] [Indexed: 12/11/2022] Open
Abstract
Introduction The extent to which pain is distributed across the body (spreading of pain) differs largely among patients with chronic pain conditions and widespread pain has been linked to poor quality of life and work disability. A longer duration of pain is expected to be associated with more widespread pain, but studies are surprisingly scarce. Whether spreading of pain is associated with clinical presentation and treatment outcome in patients seen in interdisciplinary multimodal pain rehabilitation programs (IMMRPs) is unclear. The association between spreading of pain and (1) pain duration (2) clinical presentation (eg, pain intensity, pain-related cognitions, psychological distress, activity/participation aspects and quality of life) and (3) treatment outcome were examined. Methods Data from patients included in the Swedish Quality Registry for Pain Rehabilitation were used (n=39,916). A subset of patients that participated in IMMRPs (n=14,666) was used to examine whether spreading of pain at baseline predicted treatment outcome. Spreading of pain was registered using 36 predefined anatomical areas which were summarized and divided into four categories: 1–6 regions with pain (20.6% of patients), 7–12 regions (26.8%), 13–18 regions (22.0%) and 19–36 regions (30.6%). Results More widespread pain was associated with a longer pain duration and a more severe clinical picture at baseline with the strongest associations emerging in relation to health and pain aspects (pain intensity, pain interference and pain duration). Widespread pain was associated with a poorer overall treatment outcome following IMMRPs at both posttreatment and at a 12-month follow-up, but effect sizes were small. Discussion Spreading of pain is an indicator of the duration and severity of chronic pain and to a limited extent to outcomes of IMMRP. Longer pain duration in those with more widespread pain supports the concept of early intervention as clinically important and implies a need to develop and improve rehabilitation for patients with chronic widespread pain.
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Affiliation(s)
- Björn Gerdle
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping SE-58185, Sweden
| | - Marcelo Rivano Fischer
- Department of Neurosurgery and Pain Rehabilitation, Skåne University Hospital, Lund SE-22185, Sweden.,Research Group Rehabilitation Medicine,Dept of Health Sciences, Lund University, Lund, Sweden
| | - Matti Cervin
- Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund SE-22100, Sweden
| | - Åsa Ringqvist
- Department of Neurosurgery and Pain Rehabilitation, Skåne University Hospital, Lund SE-22185, Sweden
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Nilsson E, Garvin P, Festin K, Wenemark M, Kristenson M. Measuring psychosocial factors in health surveys using fewer items. Health Psychol Open 2021; 7:2055102920975983. [PMID: 33489301 PMCID: PMC7768575 DOI: 10.1177/2055102920975983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The present study investigated the possibility of reducing length of psychosocial scales, while maintaining validity, using easily manageable techniques. Data were collected 2003–2004 in a Swedish general population; n = 1007, ages 45–69, 50% women. Eight psychosocial scales were reduced from 6–20 to 3–7 items maintaining Cronbach’s alpha >0.7 and correlation coefficients between full and reduced scales > 0.85. Relationships to biomarkers for inflammation, self-rated health and 8-year incidence of coronary heart disease showed no difference between full and reduced scales. It was possible, using these easily manageable methods, to reduce scale length without threatening validity for use in population surveys.
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Psychometric properties of Short Form-36 Health Survey, EuroQol 5-dimensions, and Hospital Anxiety and Depression Scale in patients with chronic pain. Pain 2021; 161:83-95. [PMID: 31568237 PMCID: PMC6940032 DOI: 10.1097/j.pain.0000000000001700] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Supplemental Digital Content is Available in the Text. This large-sample item response theory-based evaluation assessed the measurement properties of SF-36, EQ-5D, and hospital anxiety and depression scale for chronic pain patients in clinical settings. Recent research has highlighted a need for the psychometric evaluation of instruments targeting core domains of the pain experience in chronic pain populations. In this study, the measurement properties of Short Form-36 Health Survey (SF-36),EuroQol 5-dimensions (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) were analyzed within the item response-theory framework based on data from 35,908 patients. To assess the structural validity of these instruments, the empirical representations of several conceptually substantiated latent structures were compared in a cross-validation procedure. The most structurally sound representations were selected from each questionnaire and their internal consistency reliability computed as a summary of their precision. Finally, questionnaire scores were correlated with each other to evaluate their convergent and discriminant validity. Our results supported that SF-36 is an acceptable measure of 2 independent constructs of physical and mental health. By contrast, although the approach to summarize the health-related quality of life construct of EQ-5D as a unidimensional score was valid, its low reliability rendered practical model implementation of doubtful utility. Finally, rather than being separated into 2 subscales of anxiety and depression, HADS was a valid and reliable measure of overall emotional distress. In support of convergent and discriminant validity, correlations between questionnaires showed that theoretically similar traits were highly associated, whereas unrelated traits were not. Our models can be applied to score SF-36 and HADS in chronic pain patients, but we recommend against using the EQ-5D model due to its low reliability. These results are useful for researchers and clinicians involved in chronic pain populations because questionnaires' properties determine their discriminating ability in patient status assessment.
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106
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Lingblom C, Albinsson S, Johansson L, Larsson H, Wennerås C. Patient-Reported Outcomes and Blood-Based Parameters Identify Response to Treatment in Eosinophilic Esophagitis. Dig Dis Sci 2021; 66:1556-1564. [PMID: 32495256 PMCID: PMC8053156 DOI: 10.1007/s10620-020-06368-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 05/23/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Noninvasive methods to assess treatment response in eosinophilic esophagitis are needed. AIMS Our aim was to determine whether a blood-based biomarker panel centered on immune parameters could identify histologic response to treatment in eosinophilic esophagitis patients. METHODS A pilot study involving adult patients with active eosinophilic esophagitis recruited at two Ear, Nose, Throat clinics in Sweden was designed. The patients (n = 20) donated blood and esophageal biopsies and filled in three questionnaires before and after a 2-month course of topical corticosteroids. Blood samples were analyzed for absolute levels of granulocytes and T cells and the fractions of eosinophils expressing 10 different surface markers by flow cytometry. All data were analyzed by multivariate methods of pattern recognition. RESULTS Multivariate modeling revealed that a combination of 13 immune parameters and 10 patient-reported outcome scores were required to create a model capable of separating responders (n = 15) from non-responders (n = 5). Questions regarding symptoms of esophageal dysfunction and capacity to eat certain foods from two of the questionnaires were discriminatory in the multivariate model, as were absolute counts of T cells, eosinophils, and eosinophil expression of activation markers and cell adhesion molecules. CONCLUSIONS A combination of blood-based immune parameters and directed questions may prove helpful to monitor response to treatment, perhaps reducing the need for repeat endoscopies in eosinophilic esophagitis patients in the future.
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Affiliation(s)
- Christine Lingblom
- grid.8761.80000 0000 9919 9582Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10A, 413 46 Göteborg, Sweden ,grid.1649.a000000009445082XDepartment of Clinical Microbiology, Sahlgrenska University Hospital, Göteborg, Region Västra Götaland Sweden
| | - Sofie Albinsson
- grid.8761.80000 0000 9919 9582Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10A, 413 46 Göteborg, Sweden
| | - Leif Johansson
- Department of ENT, Head and Neck Surgery, Skövde County Hospital, Skaraborgs Sjukhus, Lövängsvägen, 541 42 Skövde, Sweden
| | - Helen Larsson
- grid.459843.70000 0004 0624 0259Department of ENT, Head and Neck Surgery, NU Hospital Group, Lärketorpsvägen, 461 73 Trollhättan, Sweden
| | - Christine Wennerås
- grid.8761.80000 0000 9919 9582Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10A, 413 46 Göteborg, Sweden ,grid.1649.a000000009445082XDepartment of Clinical Microbiology, Sahlgrenska University Hospital, Göteborg, Region Västra Götaland Sweden
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107
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Pretorius M, Lundstam K, Hellström M, Fagerland MW, Godang K, Mollerup C, Fougner SL, Pernow Y, Aas T, Hessman O, Rosén T, Nordenström J, Jansson S, Heck A, Bollerslev J. Effects of Parathyroidectomy on Quality of Life: 10 Years of Data From a Prospective Randomized Controlled Trial on Primary Hyperparathyroidism (the SIPH-Study). J Bone Miner Res 2021; 36:3-11. [PMID: 33125769 DOI: 10.1002/jbmr.4199] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/28/2020] [Accepted: 10/07/2020] [Indexed: 12/21/2022]
Abstract
Primary hyperparathyroidism (PHPT) was previously considered a disease presenting with multiorgan involvement and a wide range of symptoms. Today, the disease presents with no symptoms or mild symptomatology in most patients. Data regarding nonspecific symptoms such as pain, fatigue, memory loss, depression, and other neuropsychiatric signs have been ambiguous, and results from prospective long-term randomized control trials are lacking. The Scandinavian Investigation on Primary Hyperparathyroidism (SIPH) is a prospective randomized controlled trial (RCT) with 10-year follow up, comparing parathyroidectomy (PTX) to observation without any treatment (OBS). From 1998 to 2005, 191 patients with mild PHPT were included from Sweden, Norway, and Denmark. A total of 95 patients were randomized to PTX and 96 to OBS. The generic Short Form-36 survey (SF-36) and the Comprehensive Psychopathological Rating Scale (CPRS) were studied at baseline, 2, 5, and 10 years after randomization. After 10 years, the PTX group scored significantly better on vitality (PTX 65.1 ± 20.2 versus OBS 57.4 ± 22.7; p = .017) compared to the OBS group in SF-36. We found no differences between the groups in the physical subscales. The OBS group had no significant change in any of the SF-36 scores throughout the study. The CPRS showed an improvement of symptoms in both groups for single items and sum scores after 10 years compared to baseline. There were, however, no significant differences between the two groups in the CPRS data. The results of this large and long-term RCT indicate improvement in some of the mental domains of SF-36 following PTX. However, the treatment effects between the groups were subtle with uncertain clinical significance. The observation group had stable SF-36 values and improvement in CPRS symptom-scores. Thus, in considering only quality of life (QoL) and in the absence of declines in renal and skeletal parameters, it may be safe to observe patients with mild PHPT for a decade. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Mikkel Pretorius
- Section of Specialized Endocrinology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Karolina Lundstam
- Department of Radiology, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mikael Hellström
- Department of Radiology, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Morten W Fagerland
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Kristin Godang
- Section of Specialized Endocrinology, Oslo University Hospital, Oslo, Norway
| | - Charlotte Mollerup
- Clinic of Breast and Endocrine Surgery, HovedOrtoCentret (HOC), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Stine L Fougner
- Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ylva Pernow
- Department of Molecular Medicine and Surgery, Department of Endocrinology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Turid Aas
- Department of Breast and Endocrine Surgery, Haukeland University Hospital, Bergen, Norway
| | - Ola Hessman
- Department of Surgery, Västmanland County Hospital, Västerås, Sweden
| | - Thord Rosén
- Department of Medicine, Section of Endocrinology, Diabetes, and Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jörgen Nordenström
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Svante Jansson
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ansgar Heck
- Section of Specialized Endocrinology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jens Bollerslev
- Section of Specialized Endocrinology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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Fernández-Abascal EG, Martín-Díaz MD. Longitudinal study on affect, psychological well-being, depression, mental and physical health, prior to and during the COVID-19 pandemic in Spain. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020; 172:110591. [PMID: 33518870 PMCID: PMC7831714 DOI: 10.1016/j.paid.2020.110591] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/03/2020] [Accepted: 12/06/2020] [Indexed: 01/15/2023]
Abstract
This longitudinal study, before and during the confinement of the COVID-19 pandemic, is to determine the evolution and effects on affect, psychological well-being, depression, and mental and physical health, during an ordinary week, from March 1 to March 7, in the week leading up to the establishment of confinement, from March 8 to March 14, and for several weeks of confinement, from March 15 to April 25. The most relevant results reveal significant differences between men and women in the confinement period, on almost all the scales of psychological well-being (SPWB), with the men obtaining a lower mean than the women. The analyses of the differences between the time periods show a significant difference in the Positive Affect scale (PANAS), the ordinary week group obtaining the highest score, and with this score decreasing in the pre-confinement week and the confinement period, and Negative Affect scale (PANAS) remained stable We found no significant differences in the participants' total depression score (BDI-II). S we obtained significant differences in the Role Physical and Physical Health Component scales (SF-36) between the pre-confinement week, with the highest mean, and the confinement.
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109
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Wahlström V, Olsson D, Öhberg F, Olsson T, Slunga Järvholm L. Underlying Factors Explaining Physical Behaviors among Office Workers-An Exploratory Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249158. [PMID: 33302452 PMCID: PMC7763999 DOI: 10.3390/ijerph17249158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/26/2020] [Accepted: 12/04/2020] [Indexed: 11/16/2022]
Abstract
Studies using technical measurements of physical behavior show wide interindividual variations. This study aimed to explore underlying factors related to sitting, standing and walking among office workers. Cross-sectional data for background characteristics, work-related variables, and device-based measures for sitting, standing and walking were collected among office workers in either a cell office or a flex office with activity-based work. Data were analyzed by Factor Analysis of Mixed Data (FAMD) and multiple robust linear regression. The FAMD resulted in the combination of underlying factors describing six character types. The (1) harmonic and healthy, (2) disabled with poor health, (3) manager that spend a lot of time in meetings and has very high workload, (4) engaged with high workload, (5) employee with creative and computer intense work, with high workload and, (6) employee with high BMI with creative and collaborative work. Regression analysis showed that the character type that was "engaged with high workload" sat more and stood less, while the character type with "high BMI and with creative and collaborative work" sat less. The results suggest that physical behavior among office workers is influenced by a complex combination of factors, which should be taken into account in the evaluation of future studies of larger cohorts.
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Affiliation(s)
- Viktoria Wahlström
- Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden; (D.O.); (T.O.); (L.S.J.)
- Correspondence:
| | - David Olsson
- Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden; (D.O.); (T.O.); (L.S.J.)
| | - Fredrik Öhberg
- Department of Radiation Sciences, Umeå University, 901 87 Umeå, Sweden;
| | - Tommy Olsson
- Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden; (D.O.); (T.O.); (L.S.J.)
| | - Lisbeth Slunga Järvholm
- Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden; (D.O.); (T.O.); (L.S.J.)
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110
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Kassymova G, Sydsjö G, Borendal Wodlin N, Nilsson L, Kjølhede P. The Effect of Follow-Up Contact on Recovery After Benign Hysterectomy: A Randomized, Single-Blinded, Four-Arm, Controlled Multicenter Trial. J Womens Health (Larchmt) 2020; 30:872-881. [PMID: 33232628 DOI: 10.1089/jwh.2020.8752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The objective of this trial was to analyze the effect of follow-up programs using standard follow-up protocol and structured coaching on recovery after hysterectomy in an enhanced recovery after surgery setting. Materials and Methods: A randomized, four-armed, single-blinded, controlled multicenter trial comprising 487 women was conducted at five hospitals in the southeast region of Sweden. The women were allocated (1:1:1:1) to Group A: no planned follow-up contact; Group B: a single, planned, structured, broadly kept, follow-up telephone contact with the research nurse the day after discharge; Group C: planned, structured, broadly kept follow-up telephone contact with the research nurse the day after discharge and then once weekly for 6 weeks; and Group D: as Group C, but with planned, structured, coaching telephone contact. Recovery was assessed by the health-related quality of life (HRQoL) questionnaires EuroQoL-5 Dimension with three levels (EQ-5D-3L) and Short-Form-Health Survey with 36 items (SF-36) and duration of sick leave. Results: Neither the recovery of HRQoL as measured by the EQ-5D-3L and the SF-36 nor the duration of sick leave (mean 26.8-28.1 days) differed significantly between the four intervention groups. Irrespective of mode of follow-up contact used, the women had recovered to their baseline EQ-5D-3L health index 4 weeks after surgery. The occurrence of unplanned telephone contact was significantly lower (by nearly 30%) in the women who had structured coaching. Conclusion: Follow-up contact, including coaching, did not seem to expedite the postoperative recovery in HRQoL or reduce the sick leave after hysterectomy, but the coaching seemed to reduce unplanned telephone contact with the health care services. ClinicalTrial.gov (NCT01526668).
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Affiliation(s)
- Gulnara Kassymova
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, and Linköping University, Linköping, Sweden
| | - Gunilla Sydsjö
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, and Linköping University, Linköping, Sweden
| | - Ninnie Borendal Wodlin
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, and Linköping University, Linköping, Sweden
| | - Lena Nilsson
- Department of Biomedical and Clinical Sciences, and Linköping University, Linköping, Sweden.,Department of Anesthesiology and Intensive Care, Linköping University, Linköping, Sweden
| | - Preben Kjølhede
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, and Linköping University, Linköping, Sweden
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111
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Mohlin Å, Axelsson U, Bendahl PO, Borrebaeck C, Hegardt C, Johnsson P, Rahm Hallberg I, Rydén L. Psychological Resilience and Health-Related Quality of Life in Swedish Women with Newly Diagnosed Breast Cancer. Cancer Manag Res 2020; 12:12041-12051. [PMID: 33269004 PMCID: PMC7701364 DOI: 10.2147/cmar.s268774] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 09/17/2020] [Indexed: 12/13/2022] Open
Abstract
Purpose Psychological resilience appears to be an important influencing factor in various aspects of health-related quality of life (HRQoL) in a context of adversity, eg, being informed of a cancer diagnosis. The purpose was to investigate psychological resilience and HRQoL in Swedish women with newly diagnosed breast cancer in relation to demographic and clinicopathological characteristics. Methods A population-based cross-sectional study was conducted including 517 women with breast cancer in the South Swedish Health Care Region. Participants were enrolled at the time of consultation for the diagnosis. Psychological resilience was assessed with the Connor-Davidson Resilience Scale 25 (CD-RISC25), and HRQoL was assessed with the Short Form Health Survey. The participants responded to questions regarding demographic variables. Clinicopathological data were collected from the Swedish National Quality Register for Breast Cancer. Results The mean score for psychological resilience was 70.6, identifying 15% of included patients with a score lower than 58 (-1 standard deviation). The study cohort had significantly lower mean scores for several aspects of HRQoL compared with Swedish normative data. Regression analyses demonstrated that psychological resilience was significantly associated with all domains of HRQoL after adjustment for demographic and clinicopathological factors. Conclusion Higher levels of psychological resilience were significantly related to higher levels of HRQoL in Swedish women with newly diagnosed breast cancer and no modifying factor was identified. The assessment of psychological resilience at the time of breast cancer diagnosis might allow for early identification of women in need of more intense psychosocial support. Future studies are needed to identify a clinically relevant threshold of the CD-RISC25.
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Affiliation(s)
- Åsa Mohlin
- Department of Clinical Sciences Lund, Division of Medical History, Lund University, Lund 221 84, Sweden.,Healthcare Center Laröd, Helsingborg 252 86, Sweden
| | - Ulrika Axelsson
- Department of Immunotechnology and CREATE Health Translational Cancer Center, Lunds University, Lund 223 81, Sweden
| | - Pär-Ola Bendahl
- Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Lund 223 81, Sweden
| | - Carl Borrebaeck
- Department of Immunotechnology and CREATE Health Translational Cancer Center, Lunds University, Lund 223 81, Sweden
| | - Cecilia Hegardt
- Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Lund 223 81, Sweden
| | - Per Johnsson
- Department of Psychology, Lund University, Lund 221 00, Sweden
| | | | - Lisa Rydén
- Department of Clinical Sciences Lund, Division of Surgery, Lund University, Lund 223 81, Sweden.,Department of Surgery, Skåne University Hospital, Malmö, 214 28, Sweden
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112
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Walfridsson U, Brohede D, Walfridsson H. ASK FOR IT: An Internet-based educational program for patients with atrial fibrillation – Results from a pilot study and design of the randomized, controlled, multicenter ASK FOR IT study. CARDIOVASCULAR DIGITAL HEALTH JOURNAL 2020; 1:160-168. [PMID: 35265887 PMCID: PMC8890055 DOI: 10.1016/j.cvdhj.2020.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Taylor Spatial Frame or Reamed Intramedullary Nailing for Closed Fractures of the Tibial Shaft: A Randomized Controlled Trial. J Orthop Trauma 2020; 34:612-619. [PMID: 33065663 DOI: 10.1097/bot.0000000000001802] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To compare a modern ring fixator [Taylor Spatial Frame (TSF)] and reamed intramedullary nailing (IMN) for the treatment of closed tibial shaft fractures. DESIGN Randomized controlled trial. SETTING Two university hospitals. PATIENTS Patients between 18 and 70 years of age surgically treated for an acute tibial shaft fracture. INTERVENTION TSF (n = 31) versus a reamed intramedullary nail (n = 32). The patients were followed up for 2 years. MAIN OUTCOME MEASUREMENTS The physical component summary of Short Form 36 (SF-36) at 2 years was the primary outcome measure. Secondary outcomes included the other components of the SF-36, pain assessed by a visual analogue scale (VAS), complications, and resource consumption. RESULTS The mean age was 43 years (SD 14.0), and 42 (67%) were men. The physical component summary at 2 years was 52.4 (SD 6.3) in the TSF group and 53.3 (SD 8.0) in the IMN group (P = 0.35). There were modest differences in the other SF-36 scores during the follow-up period. Up to and including 12 months, the TSF group had less knee pain [at 12 months: VAS 0.5 (SD 1.2) vs. VAS 2.4 (SD 2.2; P < 0.001)], but this was not statistically significant at 24 months [VAS 0.7 (SD 1.4) vs. VAS 1.5 (SD 2.0; P = 0.11)]. Superficial skin infections were more frequent in the TSF group [22 (71%) vs. 4 (13%); P < 0.001]. The number of other complications was similar between the groups. CONCLUSIONS Both TSF and IMN provided good clinical results. TSF had more pin-track infections but less knee pain the first year. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Karlsson J, Galavazi M, Jansson S, Jendle J. Effects on body weight, eating behavior, and quality of life of a low-energy diet combined with behavioral group treatment of persons with class II or III obesity: A 2-year pilot study. Obes Sci Pract 2020; 7:4-13. [PMID: 33680487 PMCID: PMC7909592 DOI: 10.1002/osp4.464] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/24/2020] [Accepted: 10/13/2020] [Indexed: 12/23/2022] Open
Abstract
Objective Obesity is associated with reduced health‐related quality of life (HRQoL). Outcomes of nonsurgical weight loss treatment on HRQoL are inconsistent and it is unclear how much weight reduction, or what type of treatment, is required for significant improvements. This study aimed to evaluate the effects of a lifestyle intervention program on weight, eating behaviors, and HRQoL, and to describe participants' experiences of treatment. Methods This 2‐year intervention trial in persons with class II or III obesity comprised a 3‐month liquid low‐energy diet (880 kcal/d) followed by a 3‐month reintroduction to regular foods, combined with behavioral group treatment. Results Fifty‐five participants (73% women) were included, mean (SD) age 43.2 (12.4) years, and mean body mass index 42.0 (6.0) kg/m2. Mean weight loss at 6, 12, and 24 months was 18.9%, 13.7%, and 7.2%, respectively. Short‐ and long‐term effects on eating behavior were favorable. Twelve of 14 HRQoL domains were improved at 6 months, compared to eight domains at 12 months. After 24 months, 2 of 14 domains, physical and psychosocial functioning, were improved. The treatment program was well accepted by the participants. Conclusions Substantial weight loss after 6 months was associated with extensive improvements in HRQoL, comprising the physical, psychosocial, and mental domains. Significant weight regain was observed between 6 and 24 months follow‐up. Modest weight loss after 24 months was associated with moderate improvement in physical functioning and large improvement in psychosocial functioning. The effect on psychosocial functioning is most likely related to both weight loss and behavioral treatment.
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Affiliation(s)
- Jan Karlsson
- University Health Care Research Center Faculty of Medicine and Health Örebro University Örebro Sweden
| | - Marije Galavazi
- School of Medical Sciences Faculty of Medicine and Health Örebro University Örebro Sweden
| | - Stefan Jansson
- University Health Care Research Center Faculty of Medicine and Health Örebro University Örebro Sweden.,School of Medical Sciences Faculty of Medicine and Health Örebro University Örebro Sweden
| | - Johan Jendle
- School of Medical Sciences Faculty of Medicine and Health Örebro University Örebro Sweden
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115
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Bjälkefur K, Nasic S, Bertholds E, Jood K, Rejnö Å. Self-rated health over the first five years after stroke. BMC Neurol 2020; 20:389. [PMID: 33099308 PMCID: PMC7585295 DOI: 10.1186/s12883-020-01956-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 10/13/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Self-rated health (SRH) focuses on the patient's own perception, and represents an important patient-reported outcome. The aim was to investigate SRH one to 5 years after stroke, follow the development over time and search for factors associated with SRH. METHODS Consecutive stroke patients admitted to Stroke Units at the Skaraborg Hospital, Sweden were included 2007-2009 (n = 2190). Patient-reported outcomes were collected annually over 5 years using a postal questionnaire. SRH was assessed by the question about general health from SF-36. Factors associated with SRH were investigated by multiple logistic regression analysis. RESULTS Response-rate was > 90% at all time points. Overall, 40.2, 41.9, 40.7, 45.0 and 46.3% of the patients reported good SRH, 1 to 5 years after stroke. Performance in activities of daily living (ADL) was strongly associated with good SRH; 49.8 and 14.7% after 1 year in independent and dependent survivors respectively, p < 0.001. In independent survivors 1 year after stroke, good SRH was positively associated with female sex (OR = 2.0; p = < 0,001), physical activity (OR = 2.14; p = < 0,001), car driving (OR = 2.25; p = < 0,001), and negatively associated with age (OR = 0.99; p = < 0,001), pain (OR = 0.49; p = < 0,001), depression (OR = 0.30; p = < 0,001), and self-perceived unmet care needs (OR = 0.39; p = < 0,001). In dependent survivors, depression (OR = 0.23; p = < 0,001) and age (OR = 0.96; p = < 0,05), were negatively associated with good SRH 1 year after stroke. Similar patterns were observed throughout the follow-up. CONCLUSION The proportion stroke survivors reporting their health as good is slightly increasing over time. After stroke, SRH is associated with pain, depression, ability to perform activities and self-perceived unmet care needs, indicating that efforts to support stroke survivors in the chronic phase after stroke should concentrate on targeting these factors.
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Affiliation(s)
| | - Salmir Nasic
- Research and Development Centre, Skaraborg Hospital, Skövde, Sweden
| | | | - Katarina Jood
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Neurology, the Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Åsa Rejnö
- Department of Health Sciences, University West, 461 86, Trollhättan, Sweden. .,Department of Medicine, Skaraborg Hospital Skövde, Skövde, Sweden.
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116
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Owiredua C, Flink I, Vixner L, Äng BO, Tseli E, Boersma K. The Context Matters: A Retrospective Analysis of Life Stage at Chronic Pain Onset in Relation to Pain Characteristics and Psychosocial Outcomes. J Pain Res 2020; 13:2685-2695. [PMID: 33122938 PMCID: PMC7591088 DOI: 10.2147/jpr.s263035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/18/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Developmental life stage at chronic pain onset differs among chronic pain patients. Although pain affects multiple life domains, it is unknown whether the timing of chronic pain onset relates to pain characteristics and psychosocial outcomes. The purpose of this retrospective study was to investigate differences in pain characteristics and psychosocial outcomes in patients at different developmental life stages at chronic pain onset. METHODS Cross-sectional baseline data from the Swedish Quality Registry for Pain Rehabilitation (2009 to 2016) were used, selecting the middle-aged patients (45-65 years, n=6225) reporting chronic nonmalignant pain. Patients were categorized into three groups, depending on their developmental life stage at chronic pain onset: early onset (age ≤30 years), intermediate onset (age 31-45 years), and late onset (age ≥46 years). Pain characteristics and psychosocial outcomes were assessed with validated self-reported measures. RESULTS One-way MANCOVA indicated differences in number of pain locations and psychosocial outcomes among the groups. Post hoc analysis showed differences in the trends for how groups differed on outcome domains. Overall, patients with earlier chronic pain onset showed significantly poorer psychosocial outcomes and more spreading of pain. CONCLUSION Developmental life stage at chronic pain onset is associated with different pain outcomes. Pain onset early in life is linked to worse outcomes in multiple domains, pointing to a need for identifying these patients early.
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Affiliation(s)
- Christiana Owiredua
- Center for Health and Medical Psychology (CHAMP), School of Law, Psychology, and Social Work, Örebro University, Örebro, Sweden
| | - Ida Flink
- Center for Health and Medical Psychology (CHAMP), School of Law, Psychology, and Social Work, Örebro University, Örebro, Sweden
| | - Linda Vixner
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Björn O Äng
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden
| | - Elena Tseli
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Katja Boersma
- Center for Health and Medical Psychology (CHAMP), School of Law, Psychology, and Social Work, Örebro University, Örebro, Sweden
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117
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Cassidy L, Hill L, Fitzsimons D, McGaughey J. The impact of psychoeducational interventions on the outcomes of caregivers of patients with heart failure: A systematic review and meta-analysis. Int J Nurs Stud 2020; 114:103806. [PMID: 33248290 DOI: 10.1016/j.ijnurstu.2020.103806] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Heart failure is a global health care problem that causes a significant economic burden. Despite medical advancements, it's prognosis remains poor as many patients with heart failure experience symptoms that negatively impact Quality of Life. Caregivers are often responsible for helping and supporting family members manage their heart failure symptoms at home. In addition to managing their own medical problems and maintaining social and personal lives, significant burden and stress can occur. At present, caregivers receive little guidance or information to support them in their caregiving role. OBJECTIVES This review aims to determine the impact of psychoeducational interventions on the outcomes of caregivers of patients with heart failure. DESIGN Systematic review and meta-analysis. DATA SOURCE Five electronic databases: PsycINFO, Medline, CINAHL Plus, EMBASE and SCOPUS were searched from June 2007 to August 2019. REVIEW METHODS The conduct and reporting of this review was based on the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The Cochrane Risk of Bias Tool was used to assess the risk of bias amongst randomised controlled trials, and the Newcastle Ottawa Scale was used to assess risk of bias in one quasi-experimental study. RESULTS Ten articles met the inclusion criteria, consisting of seven studies, with a total sample size of 953 participants. The pooled result from two studies, conducted in America and China, reported that psychoeducational interventions significantly reduced depression at six months' follow-up (SMD -0.82; 95% CI -1.17 to -0.47; p = 0.73, I2 =0%). The pooled result from two studies conducted in Sweden and Taiwan showed a significant improvement in heart failure knowledge at six months' follow-up (SMD 0.97; 95% CI 0.70 to 1,25; p < 0.00001, I2 =0%). Finally, pooled results from three studies conducted in Sweden, China and Taiwan found a significant improvement in Quality of Life at 3 months' follow- up (SMD 0.25; 95% CI 0.25 to 0.48; p = 0.03). The three most common intervention components included: group based educational sessions, telemonitoring and telephone support, and written resources. CONCLUSIONS There was no specific type of psychoeducational intervention found to have a significant impact on caregiver outcomes, as interventions were heterogeneous consisting of multiple components. Further research is needed to determine the effectiveness of individual and combined components to identify the ideal intervention format and design for caregivers of patients with heart failure.
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Affiliation(s)
- Lorna Cassidy
- Queen's University Belfast, School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland.
| | - Loreena Hill
- Queen's University Belfast, School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland.
| | - Donna Fitzsimons
- Queen's University Belfast, School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland; All-Ireland Institute for Hospice And Palliative Care, Our Lady's Hospice and Care Services, Harold's Cross Rd, Harold's Cross, Dublin, Ireland.
| | - Jennifer McGaughey
- Queen's University Belfast, School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland.
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118
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Exhaustion and Impaired Work Performance in the Workplace: Associations With Presenteeism and Absenteeism. J Occup Environ Med 2020; 61:e438-e444. [PMID: 31478995 DOI: 10.1097/jom.0000000000001701] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association between presenteeism and absenteeism during the previous year and the current levels of exhaustion and impaired work performance in a Swedish university setting. METHODS In a study of 3525 employees, an ordinal logistic regression and general linear model was used to examine the association between presenteeism and absenteeism during the previous year and the current exhaustion and impaired work performance, respectively. RESULTS Presenteeism, but not absenteeism, during the previous year independently increased the risk of having moderate or severe exhaustion. Presenteeism, absenteeism, and exhaustion remained positively associated with impaired work performance when health status and other confounders had been adjusted for. CONCLUSIONS Presenteeism, but not absenteeism, was associated with exhaustion. Both presenteeism and absenteeism were the salient correlates of impaired work performance.
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119
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Lundqvist S, Börjesson M, Cider Å, Hagberg L, Ottehall CB, Sjöström J, Larsson MEH. Long-term physical activity on prescription intervention for patients with insufficient physical activity level-a randomized controlled trial. Trials 2020; 21:793. [PMID: 32933577 PMCID: PMC7493144 DOI: 10.1186/s13063-020-04727-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/06/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Physical activity (PA) can be used to prevent and treat diseases. In Sweden, licensed healthcare professionals use PA on prescription (PAP) to support patients to increase their PA level. The aim of this randomized controlled trial was to evaluate a 2-year intervention of two different strategies of PAP treatment for patients with insufficient PA level, after a previous 6-month period of ordinary PAP treatment in a primary health care setting. METHODS We included 190 patients, 27-77 years, physically inactive with metabolic risk factors where the patients were not responding to a previous 6-month PAP treatment with increased PA. The patients were randomized to either enhanced support from a physiotherapist (PT group) or continued ordinary PAP treatment at the health care centre (HCC group). The PAP treatment included an individualized dialogue; an individually dosed PA recommendation, including a written prescription; and a structured follow-up. In addition to PAP, the PT group received aerobic fitness tests and more frequent scheduled follow-ups. The patient PA level, metabolic health, and health-related quality of life (HRQOL) were measured at baseline and at 1- and 2-year follow-ups. RESULTS At the 2-year follow-up, 62.9% of the PT group and 50.8% of the HCC group had increased their PA level and 31.4% vs. 38.5% achieved ≥ 150 min of moderate-intensity PA/week (difference between groups n.s.). Over 2 years, both groups displayed increased high-density lipoproteins (HDL) (p = 0.004 vs. baseline), increased mental health status (MCS) (p = 0.036), and reduced body mass index (BMI) (p = 0.001), with no difference between groups. CONCLUSION During long-term PAP interventions, the PA level, metabolic health, and HRQOL increased in patients at metabolic risk without significant differences between groups. The results indicate to be independent of any changes in pharmacological treatment. We demonstrated that the PAP treatment was feasible in ordinary primary care. Both the patients and the healthcare system benefitted from the improvement in metabolic risk factors. Future studies should elucidate effective long-term PAP-treatment strategies. TRIAL REGISTRATION ClinicalTrials.gov NCT03012516 . Registered on 30 December 2016-retrospectively registered.
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Affiliation(s)
- Stefan Lundqvist
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Centrum för fysisk aktivitet Göteborg, Gothenburg, Region Västra Götaland, Sweden.
| | - Mats Börjesson
- Center for Health and Performance (CHP), University of Gothenburg, Gothenburg, Sweden.,Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital/Östra, Gothenburg, Region Västra Götaland, Sweden
| | - Åsa Cider
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Hagberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | - Johan Sjöström
- Centrum för fysisk aktivitet Göteborg, Gothenburg, Region Västra Götaland, Sweden
| | - Maria E H Larsson
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Research and Development Primary Health Care, Gothenburg, Region Västra Götaland, Sweden
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120
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Health-related quality of life and emotional well-being in patients with glioblastoma and their relatives. J Neurooncol 2020; 149:347-356. [PMID: 32909116 PMCID: PMC7541353 DOI: 10.1007/s11060-020-03614-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/31/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE The health-related quality of life (HRQoL) for patients with glioblastoma is known to be largely affected. Little is known about the HRQoL for relatives and the relationship between these two. To optimize family care, such issues need to be addressed early on, preferably from the time of diagnosis. This study aimed to describe and compare the HRQoL of patients with glioblastoma and their relatives before surgery. METHODS A prospective cohort study including 89 patients diagnosed with glioblastoma and their relatives. HRQoL (Short Form Health Survey, SF-36) and emotional well-being (hospital anxiety and depression scale, HADS) were analysed with descriptive, comparative and multivariable regression analyses. RESULTS Relatives scored worse for mental HRQoL (p < 0.001) and for symptoms of anxiety (p < 0.001) and depression (p = 0.022) compared to patients. The multivariable regression showed an increased risk of affected mental HRQoL in relatives of patients with poor functional status (WHO) (p = 0.01) and higher levels in symptoms of anxiety (p = 0.03), or when relatives had low physical HRQoL themselves (p = 0.01). There was increased risk of affected mental HRQoL in patients with comorbidities (p = 0.003), and when the respective relative showed higher levels in symptoms of anxiety (p = 0.005). CONCLUSION Relatives scored worse for mental HRQoL and emotional well-being than patients, suggesting that HRQoL in patients and relatives might be connected to symptoms of anxiety in the respective individual at disease onset. The results illustrate the need to screen HRQoL and emotional well-being in both patients and relatives from an early stage-before surgery.
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121
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Samefors M, Scragg R, Nystrom FH, Östgren CJ. Is there an association between serum 25(OH)D 3 and mental well-being in patients with type 2 diabetes? Results from a cohort study in primary care. Hormones (Athens) 2020; 19:361-367. [PMID: 32440752 PMCID: PMC7426318 DOI: 10.1007/s42000-020-00190-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 03/18/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE There are limited and inconsistent results on the correlation between vitamin D and mental health in patients with type 2 diabetes (T2D). Thus, our aim was to explore the association between vitamin D and mental well-being in a community-based sample of participants with T2D. METHODS We analyzed serum 25-hydroxyvitamin D3 (25(OH)D3) in 698 patients with T2D at the baseline examination. The cohort was reinvestigated after 4 years. Data from SF-36 questionnaires measuring vitality and mental health at baseline and after 4 years were used for analyses. RESULTS Serum 25(OH)D3 was inversely associated with poor mental health at baseline (odds ratio (OR) for 10 nmol/l increase in 25(OH)D3, 0.90 (95% confidence interval (CI) 0.83-0.96, p = 0.003)) but not at follow-up (p > 0.05). Serum 25(OH)D3 was not associated with vitality at baseline (p > 0.05). At follow-up, there was an inverse association between 25(OH)D3 and low vitality (OR for 10 nmol/l increase in 25(OH)D3, 0.89 (95% CI 0.82-0.97, p = 0.009)) but not after adjustment. CONCLUSION We found an inverse association between 25(OH)D3 and mental health in patients with T2D at baseline. We found no association between 25(OH)D3 and vitality after adjustment. Future studies are needed to determine the association between vitamin D and mental well-being in patients with T2D.
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Affiliation(s)
- Maria Samefors
- Department of Health, Medicine and Caring Sciences, Linköping University, SE 581 83, Linköping, Sweden.
| | - Robert Scragg
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Fredrik H Nystrom
- Department of Health, Medicine and Caring Sciences, Linköping University, SE 581 83, Linköping, Sweden
| | - Carl Johan Östgren
- Department of Health, Medicine and Caring Sciences, Linköping University, SE 581 83, Linköping, Sweden
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Development and validation of a revised trauma-specific quality of life instrument. J Trauma Acute Care Surg 2020; 88:501-507. [PMID: 31626032 DOI: 10.1097/ta.0000000000002505] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND The National Academies of Science has called for routine collection of long-term outcomes after injury. One of the main barriers for this is the lack of practical trauma-specific tools to collect such outcomes. The only trauma-specific long-term outcomes measure that applies a biopsychosocial view of patient care, the Trauma Quality-of-Life (T-QoL), has not been adopted because of its length, lack of composite scores, and unknown validity. Our objective was to develop a shorter version of the T-QoL measure that is reliable, valid, specific, and generalizable to all trauma populations. METHODS We used two random samples selected from a prospective registry developed to follow long-term outcomes of adult trauma survivors (Injury Severity Score ≥9) admitted to three level I trauma centers. First, we validated the original T-QoL instrument using the 12-Item Short-Form Health Survey (SF-12) version 2.0 and Breslau post-traumatic stress disorder screening (B-PTSD) tools. Second, we conducted a confirmatory factor analysis to reduce the length of the original T-QoL instrument, and using a different sample, we scored and performed internal consistency and validity assessments of the revised T-QoL (RT-QoL) components. RESULTS All components of the original T-QoL were significantly correlated negatively with the B-PTSD and positively with the SF-12 mental and physical composite scores. After confirmatory factor analysis, a three-component structure using 18 items (six items/component) most appropriately represented the data. Each component in the revised instrument demonstrated a high level of internal consistency (Cronbach's α ≥0.8) and correlated negatively with the B-PTSD and positively with the SF-12, demonstrating concurrent validity. In addition, each of the RT-QoL components was able to distinguish between individuals based on their work status, with those who have returned to work reporting better health. CONCLUSION This more practical RT-QoL measure greatly increases the ability to evaluate long-term outcomes in trauma more efficiently and meaningfully, without sacrificing the validity and psychometric properties of the original instrument. LEVEL OF EVIDENCE Prognostic and epidemiological, level III.
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Rindner L, Nordeman L, Strömme G, Svenningsson I, Premberg Å, Hange D, Gunnarsson R, Rembeck G. Prognostic factors for future mental, physical and urogenital health and work ability in women, 45-55 years: a six-year prospective longitudinal cohort study. BMC Womens Health 2020; 20:171. [PMID: 32787825 PMCID: PMC7425146 DOI: 10.1186/s12905-020-01015-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 07/07/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Impaired health due to stress is a common cause of long-term illness in women aged 45-55 years. It is a common cause for visits to primary health care (PHC) and may influence work-ability. The aim of this study was to investigate prognostic factors for future mental, physical and urogenital health as well as work-ability in a population of average women aged 45-55 years. METHODS This longitudinal cohort study initially assessed 142 women from PHC centers in southwestern Sweden. One houndred and ten accepted participation and were followed for 6 years. They were assessed using the self-reported questionnaires: the Menopause Rating Scale (MRS), the Montgomery-Asberg Depression Rating Scale (MADRS-S), the Short-Form Health Survey (SF-36). Descriptive data are presented of health, education, relationships and if they are working. Multicollinearity testing and logistic regression were used to test the explanatory variables. RESULT Severity of symptoms in the MRS somatic and urogenital domains decreased while they increased in the psychological and depressive domains. Having tertiary education was associated with decreased overall mental health, vitality and social role functioning. Living with a partner was associated with increased physical role functioning, social role functioning and emotional role functioning. CONCLUSION Quality of life seems to be enhanced by a good relationship with the partner, social support and work/life balance. Therefore, to improve women health women should early discuss ways in which these issues can be incorporated as they pursue their academic or career goals. Hence, we emphasize the importance of supporting women to gain increased awareness about a healthy life balance and to have realistic goals in work as well as in their social life.
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Affiliation(s)
- Lena Rindner
- Närhälsan, Södra Torget Health Care Center, Kvarngatan 4, SE-503 36 Borås, Sweden
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden
- Primary Health Care, Public Health and Community Medicine, School of Public Health, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Nordeman
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden
- Institute of Neuroscience and Physiology Department of Health and Rehabilitation, Unit of Physiotherapy, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Gunilla Strömme
- Närhälsan, Södra Torget Health Care Center, Kvarngatan 4, SE-503 36 Borås, Sweden
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden
| | - Irene Svenningsson
- Primary Health Care, Public Health and Community Medicine, School of Public Health, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Fyrbodal, Gothenburg, Sweden
| | - Åsa Premberg
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Gothenburg, Gothenburg, Sweden
- Institute of Health and Care Sciences, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Dominique Hange
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden
- Primary Health Care, Public Health and Community Medicine, School of Public Health, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Närhälsan, Svenljunga Health Care Center, Svenljunga, Sweden
| | - Ronny Gunnarsson
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden
- Primary Health Care, Public Health and Community Medicine, School of Public Health, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gun Rembeck
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden
- Primary Health Care, Public Health and Community Medicine, School of Public Health, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Närhälsan Borås Youth Centre, Region Västra Götaland, Borås, Sweden
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Emilson C, Åsenlöf P, Demmelmaier I, Bergman S. Association between health care utilization and musculoskeletal pain. A 21-year follow-up of a population cohort. Scand J Pain 2020; 20:533-543. [PMID: 32755105 DOI: 10.1515/sjpain-2019-0143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/24/2020] [Indexed: 11/15/2022]
Abstract
Background and aims Few studies have reported the long-term impact of chronic pain on health care utilization. The primary aim of this study was to investigate if chronic musculoskeletal pain was associated with health care utilization in the general population in a 21-year follow-up of a longitudinal cohort. The secondary aim was to identify and describe factors that characterize different long-term trajectories of health care utilization. Methods A prospective cohort design with a baseline sample of 2,425 subjects (aged 20-74). Data were collected by self-reported questionnaires, and three time points (1995, 2007, and 2016) were included in the present 21-year follow up study. Data on health care utilization were dichotomized at each time point to either high or low health care utilization. High utilization was defined as >5 consultations with at least one health care provider, or ≥1 consultation with at least 3 different health care providers during the last 12 months. Low health care utilization was defined as ≤5 consultations with one health care provider and <3 consultations with different health care providers. The associations between baseline variables and health care utilization in 2016 were analyzed by multiple logistic regression. Five different trajectories for health care utilization were identified by visual analysis, whereof four of clinical relevance were included in the analyses. Results Baseline predictors for high health care utilization at the 21-year follow-up in 2016 were chronic widespread pain (OR: 3.2, CI: 1.9-5.1), chronic regional pain (OR:1.8, CI: 1.2-2.6), female gender (OR: 2.0, CI: 1.4-3.0), and high age (OR: 1.6, CI:0.9-2.9). A stable high health care utilization trajectory group was characterized by high levels of health care utilization, and a high prevalence of chronic pain at baseline and female gender (n = 23). A stable low health care utilization trajectory group (n = 744) was characterized by low health care utilization, and low prevalence of chronic pain at baseline. The two remaining trajectories were: increasing trajectory group (n = 108), characterized by increasing health care utilization, chronic pain at baseline and female gender, and decreasing trajectory group (n = 107) characterized by decreasing health care utilization despite a stable high prevalence of chronic pain over time. Conclusions The results suggest that chronic pain is related to long-term health care utilization in the general population. Stable high health care utilization was identified among a group characterized by female gender and a report of chronic widespread pain. Implications This cohort study revealed that chronic widespread pain predicted high health care utilization over a 21-year follow-up period. The results indicate the importance of early identification of musculoskeletal pain to improve the management of pain in the long run.
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Affiliation(s)
- Christina Emilson
- Department of Neuroscience, Uppsala University, 75237 Uppsala, Sweden, Phone: +46 18 471 4779, Fax: +46 18 511 540
| | | | | | - Stefan Bergman
- Department of Public Health, and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
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Influences of Sex, Education, and Country of Birth on Clinical Presentations and Overall Outcomes of Interdisciplinary Pain Rehabilitation in Chronic Pain Patients: A Cohort Study from the Swedish Quality Registry for Pain Rehabilitation (SQRP). J Clin Med 2020; 9:jcm9082374. [PMID: 32722367 PMCID: PMC7466148 DOI: 10.3390/jcm9082374] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 12/31/2022] Open
Abstract
This study investigates the effects of sex, education, and country of birth on clinical presentations and outcomes of interdisciplinary multimodal pain rehabilitation programs (IMMRPs). A multivariate improvement score (MIS) and two retrospective estimations of changes in pain and ability to handle life situations were used as the three overall outcomes of IMMRPs. The study population consisted of chronic pain patients within specialist care in the Swedish Quality Registry for Pain Rehabilitation (SQRP) between 2008 and 2016 at baseline (n = 39,916), and for the subset participating in IMMRPs (n = 14,666). A cluster analysis based on sex, education, and country of origin revealed significant differences in the following aspects: best baseline clinical situation was for European women with university educations and the worst baseline clinical situation was for all patients born outside Europe of both sexes and different educations (i.e., moderate-large effect sizes). In addition, European women with university educations also had the most favorable overall outcomes in response to IMMRPs (small effect sizes). These results raise important questions concerning fairness and equality and need to be considered when optimizing assessments and content and delivery of IMMRPs for patients with chronic pain.
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Wijk K, Bergsten EL, Hallman DM. Sense of Coherence, Health, Well-Being, and Work Satisfaction before and after Implementing Activity-Based Workplaces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145250. [PMID: 32708136 PMCID: PMC7400008 DOI: 10.3390/ijerph17145250] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/09/2020] [Accepted: 07/17/2020] [Indexed: 12/22/2022]
Abstract
Activity-based workplaces (ABWs) are implemented with possible implications for health, well-being, and work satisfaction in the workplace. Drawing on the theoretical framework, i.e., sense of coherence (SOC), the aim was to investigate how indicators pf SOC-meaningfulness, manageability and comprehensibility-are associated with, or function as barriers or facilitators for, health, well-being and work satisfaction during relocation to an ABW. We followed the implementation of ABWs at the Swedish Transport Administration (2018-2019). Questionnaires were administered before (n = 536), 3 months (n = 409) and 9 months (n = 373) after relocation. Focus group interviews (15) were conducted before and after. Data were analyzed using repeated measures ANOVA and content analysis. Relocation to an ABW was associated with a reduced work satisfaction (physical p < 0.001; psychosocial p < 0.001), and minor changes in health and occupational well-being during relocation (p > 0.001). The reduction in work satisfaction was smaller among employees with high meaningfulness in the relocation process (p < 0.001). All SOC indicators were positively associated with overall health, well-being and work satisfaction (p < 0.001). Interviews suggested that meaningfulness was facilitated by participation in the presented activities and that communication before relocation was crucial. The results indicate that organizations implementing ABWs should promote perceived meaningfulness in the process to mitigate possible declines in satisfaction with the physical and psychosocial work environment.
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Affiliation(s)
- Katarina Wijk
- Centre for Research and Development, Region Gavleborg/Uppsala University, 801 87 Gavle, Sweden
- Faculty of Health and Occupational Studies, Department of Occupational Health Sciences and Psychology, University of Gavle, 801 76 Gävle, Sweden; (E.L.B.); (D.M.H.)
- Department of Public Health and Caring Sciences, Uppsala University, 751 23 Uppsala, Sweden
- Correspondence: ; Tel.: +46-70-313-5884
| | - Eva L. Bergsten
- Faculty of Health and Occupational Studies, Department of Occupational Health Sciences and Psychology, University of Gavle, 801 76 Gävle, Sweden; (E.L.B.); (D.M.H.)
| | - David M. Hallman
- Faculty of Health and Occupational Studies, Department of Occupational Health Sciences and Psychology, University of Gavle, 801 76 Gävle, Sweden; (E.L.B.); (D.M.H.)
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Jarl G, Tranberg R, Johansson U, Alnemo J, Lundqvist LO. Predictors of adherence to wearing therapeutic footwear among people with diabetes. J Foot Ankle Res 2020; 13:45. [PMID: 32660610 PMCID: PMC7359292 DOI: 10.1186/s13047-020-00413-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/06/2020] [Indexed: 01/22/2023] Open
Abstract
Aims People at increased risk of developing diabetic foot ulcers often wear therapeutic footwear less frequently than is desirable. The aims were to identify patient groups prone to nonadherence to wearing therapeutic footwear and modifiable factors associated with adherence. Materials and methods A questionnaire was mailed to 1230 people with diabetes who had been fitted with therapeutic footwear. Independent variables were categorized into five domains. For each domain, variables that were associated with adherence in a univariate regression analysis were entered into a multiple regression analysis. Results A total of 429 (34.9%) questionnaires were analyzed. Multiple regression analyses showed significant associations (p < 0.05) between higher adherence and paid employment, current foot ulcer, previous foot ulcer, satisfaction with follow-up, self-efficacy, understanding of lost/reduced sensation as a risk factor for foot ulcerations, visible storage of therapeutic footwear at home, storage of conventional footwear out of sight, consistent choices about which footwear type to wear, and a belief that therapeutic footwear promotes ulcer healing. The five multivariate models explained 2–28% of the variance in adherence, with the strategies for footwear use domain explaining the most. Conclusions Patients without paid employment or without foot ulcer experience are more prone to nonadherence. To improve adherence, clinicians should advise patients to store therapeutic footwear in a visible place at home and put conventional footwear away and encourage patients’ self-efficacy and habitual use of therapeutic footwear. Future studies should investigate this topic further and explore ways to promote changes in habits. A study limitation was that all variables were self-reported.
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Affiliation(s)
- Gustav Jarl
- Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. .,University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
| | - Roy Tranberg
- Department of Orthopaedics, Institute of Clinical Sciences, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Ulf Johansson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - John Alnemo
- Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lars-Olov Lundqvist
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Molander P, Novo M, Hållstam A, Löfgren M, Stålnacke BM, Gerdle B. Ehlers-Danlos Syndrome and Hypermobility Syndrome Compared with Other Common Chronic Pain Diagnoses-A Study from the Swedish Quality Registry for Pain Rehabilitation. J Clin Med 2020; 9:jcm9072143. [PMID: 32645981 PMCID: PMC7408708 DOI: 10.3390/jcm9072143] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 01/02/2023] Open
Abstract
Although chronic pain is common in patients with Ehlers–Danlos syndrome (EDS) and hypermobility syndromes (HMS), little is known about the clinical characteristics of these groups. The main aim was to compare EDS/HMS with common local and generalized pain conditions with respect to Patient Reported Outcome Measures (PROMs). Data from the Swedish Quality Register for Chronic Pain (SQRP) from 2007 to 2016 (n = 40,518) were used, including patients with EDS/HMS (n = 795), fibromyalgia (n = 5791), spinal pain (n = 6693), and whiplash associated disorders (WAD) (n = 1229). No important differences in the PROMs were found between EDS and HMS. Women were represented in > 90% of EDS/HMS cases and fibromyalgia cases, and in about 64% of the other groups. The EDS/HMS group was significantly younger than the others but had a longer pain duration. The pain intensity in EDS/HMS was like those found in spinal pain and WAD; fibromyalgia had the highest pain intensity. Depressive and anxiety symptoms were very similar in the four groups. Vitality—a proxy for fatigue—was low both in EDS/HMS and fibromyalgia. The physical health was lower in EDS/HMS and fibromyalgia than in the two other groups. Patients with EDS/HMS were younger, more often female, and suffered from pain for the longest time compared with patients who had localized/regional pain conditions. Health-care clinicians must be aware of these issues related to EDS/HMS both when assessing the clinical presentations and planning treatment and rehabilitation interventions.
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Affiliation(s)
- Peter Molander
- Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden;
- Department of Behavioural Sciences and Learning, Linköping University, 581 83 Linköping, Sweden
- Correspondence: ; Tel.: +4613284704
| | - Mehmed Novo
- Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, SE-905 87 Umeå, Sweden; (M.N.); (B.-M.S.)
| | - Andrea Hållstam
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, SE-182 88 Stockholm, Sweden; (A.H.); (M.L.)
| | - Monika Löfgren
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, SE-182 88 Stockholm, Sweden; (A.H.); (M.L.)
| | - Britt-Marie Stålnacke
- Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, SE-905 87 Umeå, Sweden; (M.N.); (B.-M.S.)
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, SE-182 88 Stockholm, Sweden; (A.H.); (M.L.)
| | - Björn Gerdle
- Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden;
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Forsblad-d'Elia H, Law L, Bengtsson K, Smeds J, Ketonen M, Sundström B, Ljung L, Geijer M, Söderberg S, Lindqvist P. Biomechanical Properties of Common Carotid Arteries Assessed by Circumferential 2D Strain and β Stiffness Index in Patients With Ankylosing Spondylitis. J Rheumatol 2020; 48:352-360. [PMID: 32611672 DOI: 10.3899/jrheum.200146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Ankylosing spondylitis (AS) is associated with an elevated risk of cardiovascular disease (CVD) related to atherosclerosis, preceded by arterial stiffness. We aimed to examine common carotid artery (CCA) biomechanical properties using ultrasound to calculate β stiffness index (indicating arterial stiffness) and, a more recently developed technique, 2-dimensional (2D) speckle tracking strain (indicating arterial motion and deformation, strain) to (1) compare with age- and sex-matched controls, and (2) analyze relationships between strain and stiffness with disease characteristics and traditional risk factors for CVD in patients with AS. METHODS In this cross-sectional study, a cohort of 149 patients with AS, mean age 55.3 ± 11.2 years, 102 (68.5%) men, and 146 (98%) HLA-B27-positive, were examined. Bilateral CCA were examined for circumferential 2D strain and β stiffness index. A subgroup of 46 patients was compared with 46 age- and sex-matched controls, both groups without hypertensive disease, diabetes, myocardial infarction, or stroke. RESULTS Mean bilateral circumferential 2D strain was lower in AS patients compared with controls (7.9 ± 2.6% vs 10.3 ± 1.9%, P < 0.001), whereas mean bilateral β stiffness index was higher (13.1 ± 1.7 mmHg/mm vs 12.3 ± 1.3 mmHg/mm, P = 0.02). In multivariable linear regression analyses, strain was associated with age, erythrocyte sedimentation rate, history of anterior uveitis, and treatment with conventional synthetic disease-modifying antirheumatic drugs (DMARD) and/or biological DMARD (R2 0.33), while stiffness was associated with age (R2 0.19). CONCLUSION Both CCA circumferential 2D strain and β stiffness index differed between patients with AS and controls. Strain was associated with AS-related factors and age, whereas only age was associated with stiffness, suggesting that the obtained results reflect different pathogenic vascular processes.
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Affiliation(s)
- Helena Forsblad-d'Elia
- H. Forsblad-d'Elia, MD, L. Law, BSc, J. Smeds, MD, B. Sundström, RPT, L. Ljung, MD, Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå;
| | - Lucy Law
- H. Forsblad-d'Elia, MD, L. Law, BSc, J. Smeds, MD, B. Sundström, RPT, L. Ljung, MD, Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå
| | - Karin Bengtsson
- K. Bengtsson, MD, Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, and Region Västra Götaland, Sahlgrenska University Hospital, Department of Rheumatology, Gothenburg
| | - Johan Smeds
- H. Forsblad-d'Elia, MD, L. Law, BSc, J. Smeds, MD, B. Sundström, RPT, L. Ljung, MD, Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå
| | - Maria Ketonen
- M. Ketonen, MD, Department of Surgical and Perioperative Sciences, Clinical Physiology, Umeå University, Umeå
| | - Björn Sundström
- H. Forsblad-d'Elia, MD, L. Law, BSc, J. Smeds, MD, B. Sundström, RPT, L. Ljung, MD, Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå
| | - Lotta Ljung
- H. Forsblad-d'Elia, MD, L. Law, BSc, J. Smeds, MD, B. Sundström, RPT, L. Ljung, MD, Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå
| | - Mats Geijer
- M. Geijer, MD, Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, and Region Västra Götaland, Sahlgrenska University Hospital, Department of Radiology, Gothenburg and Faculty of Medicine, Lund University, Lund
| | - Stefan Söderberg
- S. Söderberg, MD, Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå
| | - Per Lindqvist
- P. Lindqvist, BSc, Department of Surgical and Perioperative Sciences, Clinical Physiology, Umeå University, Umeå, Sweden
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Jönsson S, Hange D. Secular Trends in Self-Assessed Health Over 24 Years Among 38-, 50-, 70- and 75-Year-Old Women: Observations from the Prospective Population Study of Women in Gothenburg. Int J Gen Med 2020; 13:261-270. [PMID: 32581568 PMCID: PMC7276321 DOI: 10.2147/ijgm.s243590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 04/08/2020] [Indexed: 01/09/2023] Open
Abstract
Background Throughout the world, women report poorer self-assessed health than men. In Sweden, women’s life circumstances have changed on many levels during the past decades. While cognition and bodily health have improved, mental health has deteriorated. During the 1980s and 1990s, Swedish women’s self-rated health was deteriorating with an increase of psychosomatic diseases. Common mental disorders have increased most rapidly and contributed to an increase in sick leaves. Purpose The aim of this study was to study secular trends in self-assessed health in SF-36, in three different cohorts of women examined in 1992–1993, 2000–2001, 2004–2006 and 2016–2017. Participants and Methods Data from the Population Study of Women in Gothenburg were used where 38-, 50-, 70- and 75-year-old women had responded to SF-36 over a period of 24 years. SF-36 is a questionnaire concerning self-assessed health that consists of eight different subcategories, ie, four about physical health and four about mental health. This study made a comparison between the different results in SF-36 during 24 years. Results Results showed that today’s 38-year-old women had poorer self-rated health in four subcategories, social functioning (SF), mental health (MH), vitality (VT) and general health (GH), compared to 24 years ago. Fifty-year-old women rated their health better in one subcategory, physical functioning (PF), and worse in another subcategory, VT. Seventy-year-old women rated their health better in two subcategories, physical role (RP) and emotional role (RE). Conclusion This study indicates that poor mental health is increasing among middle-aged women and that increased mental stress levels can be an underlying factor.
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Affiliation(s)
- Sofia Jönsson
- Region Vastra Gotaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Dominique Hange
- Primary Health Care/School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Narhalsan Research and Development Primary Health Care, Region Vastra Gotaland, Gothenburg, Sweden
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Granstam E, Rosenblad A, Modher Raghib A, Granström T, Eriksson JW, Lindholm Olinder A, Leksell J. Long-term follow-up of antivascular endothelial growth factor treatment for diabetic macular oedema: a four-year real-world study. Acta Ophthalmol 2020; 98:360-367. [PMID: 31656056 DOI: 10.1111/aos.14290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/03/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE To evaluate visual acuity (VA) and central retinal thickness (CRT) on optical coherence tomography during a 4-year period in patients treated for sight-threatening diabetic macular oedema (DMO) at two Swedish county hospitals. Additionally, to compare health-related quality of life and subjective visual functioning before and after 4 years of treatment. METHODS Fifty-eight patients with DMO were evaluated after 4 years of antivascular endothelial growth factor (VEGF) treatment. VA, CRT and clinical data were retrospectively reviewed. Health-related quality of life and subjective visual functioning were evaluated with Short Form Health Survey (SF-36) and National Eye Institute Vision Functioning Questionnaire 25 (VFQ-25). Comparisons between independent groups were performed using Pearson's χ2 test, Fisher's exact test or Mann-Whitney U test. Spearman's ρ was used for correlation analyses. Wilcoxon signed-rank test was used for comparison between dependent groups. Logistic regression analysis was applied for analysis of VA and CRT over 4 years. RESULTS Follow-up data were obtained from 37 of 58 (63.8%) patients. Baseline characteristics were similar, regardless of follow-up. VA improvement at 1 year (mean + 4.4, SD 7.5; ETDRS letter score) was maintained over 3 years, then declined. CRT was reduced throughout the study. In the first treatment year, eyes received 5.1 (1.4) anti-VEGF injections, followed by approximately two injections yearly. Additional treatment included laser and dexamethasone implants. SF-36 showed no change at 4 years, compared with baseline. VFQ-25 demonstrated improvement in near vision activities (p = 0.036). CONCLUSION Significant long-term improvement in visual function was present in patients with anti-VEGF-treated DMO.
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Affiliation(s)
- Elisabet Granstam
- Department of Ophthalmology Västmanland County Hospital Västerås Sweden
- Center for Clinical Research Västmanland County Hospital Uppsala University/County Council of Västmanland Västerås Sweden
| | - Andreas Rosenblad
- Department of Statistics Stockholm University Stockholm Sweden
- Department of Medical Sciences Clinical Diabetology and Metabolism Uppsala University Hospital Uppsala University Uppsala Sweden
| | | | - Therese Granström
- Department of Medical Sciences Clinical Diabetology and Metabolism Uppsala University Hospital Uppsala University Uppsala Sweden
- School of Education, Health and Social Studies Dalarna University Falun Sweden
| | - Jan W. Eriksson
- Department of Medical Sciences Clinical Diabetology and Metabolism Uppsala University Hospital Uppsala University Uppsala Sweden
| | - Anna Lindholm Olinder
- Sachs’ Children and Youth's Hospital Södersjukhuset Stockholm Sweden
- Department of Clinical Research and Education Karolinska Institutet Södersjukhuset Stockholm Sweden
| | - Janeth Leksell
- Department of Medical Sciences Clinical Diabetology and Metabolism Uppsala University Hospital Uppsala University Uppsala Sweden
- School of Education, Health and Social Studies Dalarna University Falun Sweden
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Petersson C, Swahnberg K, Peterson U, Oscarsson M. Experience of violence and self-rated health: Do youths disclose their experiences when visiting a Youth Centre in Sweden. Scand J Public Health 2020; 49:277-284. [PMID: 32456530 PMCID: PMC8056714 DOI: 10.1177/1403494820921690] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Being exposed to violence is a global health problem, increasing the risk of suffering from ill health. The main aim of this study was to estimate the prevalence of emotional, physical and sexual violence victimisation and its association to self-rated health among youths. The second aim was to investigate whether the youths had disclosed to healthcare professionals at a Youth Centre or others about being exposed. Methods: The cross-sectional study includes data from a web survey of youths, aged 15–25 (n=500), collected in Sweden. Descriptive statistics and univariate analyses were used for the analyses. Results: In all, emotional, physical or sexual violence during their lifetime was reported by 43.2% and 22.8% of youths during the last year. In total, 88% of the respondents assessed their self-rated health as good, very good or excellent. Those who had been exposed to emotional, physical or sexual violence during their lifetime reported statistically significant lower self-rated health (fair and poor) than those who were not victimised. When healthcare professionals at the Youth Centre asked youths about exposure during their lifetime, one-fifth disclosed having been exposed. Conclusions: Youths who reported any type of violence during their lifetime showed lower self-rated health compared to those who were not exposed. Youth Centres have an important role in identifying youths who are exposed to violence and/or self-report their health as low. Still, only a minority of youths who have been exposed to violence told health professionals at a Youth Centre about it when asked. It is necessary to further investigate how the issues can be best addressed.
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Affiliation(s)
- Carina Petersson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Katarina Swahnberg
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Ulla Peterson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Marie Oscarsson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
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Borland M, Bergfeldt L, Nordeman L, Bollano E, Andersson L, Rosenkvist A, Jakobsson M, Olsson K, Corin M, Landh L, Grüner Sveälv B, Scharin Täng M, Philip Wigh J, Lundwall A, Cider Å. Exercise‐based cardiac rehabilitation improves physical fitness in patients with permanent atrial fibrillation – A randomized controlled study. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.166] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Maria Borland
- Närhälsan Sörhaga Rehabilitation Center Alingsås Sweden
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg Boraas Sweden
- Department of Health and Rehabilitation/Physiotherapy Institute of Neuroscience and Physiology Sahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
| | - Lennart Bergfeldt
- Department of Molecular and Clinical Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Cardiology Sahlgrenska University Hospital Gothenburg Sweden
| | - Lena Nordeman
- Region Västra Götaland, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg Boraas Sweden
- Department of Health and Rehabilitation/Physiotherapy Institute of Neuroscience and Physiology Sahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
| | - Entela Bollano
- Department of Molecular and Clinical Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Cardiology Sahlgrenska University Hospital Gothenburg Sweden
| | | | | | - Marika Jakobsson
- Department of Occupational therapy and Physiotherapy Sahlgrenska University Hospital Gothenburg Sweden
| | - Kristin Olsson
- Department of Occupational therapy and Physiotherapy Sahlgrenska University Hospital Gothenburg Sweden
| | | | | | - Bente Grüner Sveälv
- Department of Molecular and Clinical Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | | | - Julia Philip Wigh
- Department of Occupational therapy and Physiotherapy Sahlgrenska University Hospital Gothenburg Sweden
| | - Adam Lundwall
- Habo Health Center Bra Liv Health Center Habo Sweden
| | - Åsa Cider
- Department of Health and Rehabilitation/Physiotherapy Institute of Neuroscience and Physiology Sahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
- Department of Occupational therapy and Physiotherapy Sahlgrenska University Hospital Gothenburg Sweden
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134
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Dimitroglou Y, Anagnostopoulos F, Aggeli C, Delicou S, Xydaki A, Patsourakos D, Tousoulis D. Severity of heart failure and health-related quality of life in beta-thalassemia patients: a cross-sectional study. Ann Hematol 2020; 99:2037-2046. [PMID: 32436014 DOI: 10.1007/s00277-020-04032-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 04/10/2020] [Indexed: 01/28/2023]
Abstract
Cardiovascular complications account for a substantial increase in morbidity and mortality in beta-thalassemia patients. Many patients have structural heart disease, and some of them present with symptomatic heart failure (HF). Quality of life (QOL) of beta-thalassemia patients is lower than that of the general population. The aim of our study was to explore the relationship between HF stages and QOL in beta-thalassemia patients. Seventy-three consecutive adult beta-thalassemia patients took part in this cross-sectional study. Stages of HF, classified with increasing severity as A, B, and C, were determined based on ACC/AHA guidelines. QOL was assessed using the SF-36 questionnaire. Fifteen patients had stage C HF, twenty-eight had stage B HF, and the remaining were considered stage A patients, as beta thalassemia is a predisposing factor for HF. All QOL domains except for bodily pain were significantly lower in stage C patients than in stage A patients. Stage C patients had significantly lower QOL scores for physical functioning, role physical, and social functioning domains than stage B patients. Stage B patients' QOL differed from stage A patients only in the vitality domain. In the multiple regression analysis which took several demographic and clinical factors into account, stage of HF was the most important factor associated with QOL, and negatively and significantly related to five QOL domains, namely physical functioning, role physical, general health, social functioning, and vitality. In conclusion, QOL is negatively affected by the severity of heart failure in beta-thalassemia patients.
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Affiliation(s)
- Yannis Dimitroglou
- First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece. .,School of Social Sciences, Hellenic Open University, Patras, Greece. .,, Palaio Faliro, 175 64, Athens, Greece.
| | - Fotios Anagnostopoulos
- School of Social Sciences, Hellenic Open University, Patras, Greece.,Panteion University of Social and Political Sciences, Kallithea, Athens, Greece
| | - Constantina Aggeli
- First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Sophia Delicou
- Thalassemia and Sickle Cell Unit, Hippokration General Hospital, Athens, Greece
| | - Aikaterini Xydaki
- Thalassemia and Sickle Cell Unit, Hippokration General Hospital, Athens, Greece
| | - Dimitrios Patsourakos
- First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
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135
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Thorberg FA, Hasking P, Huang YL, Lyvers M, Young RM, Connor JP, London ED, Feeney GFX. The Influence of Alexithymia on Alcohol Craving, Health-Related Quality of Life and Gender in Alcohol-Dependent Outpatients. J Psychoactive Drugs 2020; 52:366-376. [PMID: 32429771 DOI: 10.1080/02791072.2020.1762022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Alexithymia is a vulnerability factor for physical and mental illness that can significantly influence the daily function of alcohol-dependent patients. The aim of this study was to examine the indirect effect of obsessive thoughts and compulsive behaviors involving alcohol craving on the relationship between alexithymia, quality of life (QoL) of psychological well-being and health status. Three hundred and eighty-one outpatients (263 males and 118 females) in treatment for alcohol dependence completed self-report measures of alexithymia, alcohol craving, GHQ-28 (QoL-psychological well-being) and SF-36 (QoL-health status). Males scored significantly higher than females on aspects of alexithymia, and females reported significantly higher levels of alcohol craving. Path analysis showed an indirect effect of alcohol craving on the relationship between alexithymia, QoL-psychological well-being and self-reported QoL-health status for males only. The current study provides important new information about impaired self-reported health status and well-being among male alcohol-dependent treatment seekers with alexithymia.
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Affiliation(s)
- Fred Arne Thorberg
- School of Psychology and Counselling, Queensland University of Technology , Brisbane, QLD, Australia.,School of Psychology, Bond University , Gold Coast, QLD, Australia.,School of Psychology, The University of Queensland , Brisbane, QLD, Australia.,Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles , Los Angeles, CA, USA
| | | | - Ya-Ling Huang
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital , Gold Coast, QLD, Australia.,Department of Respiratory Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital , Gold Coast, QLD, Australia
| | - Michael Lyvers
- School of Psychology, Bond University , Gold Coast, QLD, Australia
| | - Ross McD Young
- Faculty of Health, Queensland University of Technology , Brisbane, QLD, Australia
| | - Jason P Connor
- Centre for Youth Substance Abuse Research, Faculty of Health, The University of Queensland , Brisbane, QLD, Australia.,Discipline of Psychiatry, The University of Queensland , Brisbane, QLD, Australia.,Alcohol & Drug Assessment Unit, The Princess Alexandra Hospital , Brisbane, QLD, Australia
| | - Edythe D London
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles , Los Angeles, CA, USA
| | - Gerald F X Feeney
- Centre for Youth Substance Abuse Research, Faculty of Health, The University of Queensland , Brisbane, QLD, Australia.,Alcohol & Drug Assessment Unit, The Princess Alexandra Hospital , Brisbane, QLD, Australia
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136
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Schweda S, Krauss I. Physical activity promotion for multimorbid patients in primary care settings: a protocol for a systematic review evaluating health benefits and harms. Syst Rev 2020; 9:110. [PMID: 32404199 PMCID: PMC7222306 DOI: 10.1186/s13643-020-01379-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 05/04/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND To date multimorbidity has not received much attention in health policies, even though multiple chronic diseases put high demands on the health care system in industrial nations. Enormous costs of care and a physically, mentally, and socially reduced quality of life are common consequences of multimorbidity. Physical activity (PA) has a positive preventive and therapeutic effect on common non-communicable diseases. The objective of this study will be to evaluate the health benefits and harms of PA interventions for sedentary adults with multimorbidity in primary care settings. METHODS This is the study protocol for a systematic review. We will search PubMed, MEDLINE (Ovid), Web of Science, CINHAL, and the Cochrane Library (from inception onwards). In addition, clinical trial registers and reference lists of included studies will be searched. We will include randomized controlled trials, quasi-experimental, and non-randomized trials examining the health benefits and harms of PA interventions with or without additional lifestyle interventions for sedentary adult patients with multimorbidity (e.g., two or more chronic non-communicable diseases) in primary care. Eligible control groups will be standard care, placebo, or medications. Two reviewers will independently screen all citations, abstracts data, and full-text articles. The primary outcomes will be health-related quality of life and mortality. Secondary outcomes will include cardiovascular fitness, muscular strength and disease-specific outcomes (e.g., depression score), biomarkers as well as control of metabolic risk factors (e.g., blood pressure, HBA1c, body weight) and any adverse event. The methodological quality of the studies will be appraised using appropriate tools. If feasible, we will conduct random effects meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., study design, geographical location, or type of intervention). Strength of the body of evidence will be assessed according to the Grading of Recommendations Assessment (GRADE). DISCUSSION This review will evaluate the evidence on health benefits and harms of PA interventions for sedentary adults with multimorbidity in primary care settings. We anticipate our findings to be of interest to patients, their families, caregivers, and healthcare professionals in selecting and conducting optimal health promotion programs. Possible implications for further research will be discussed. SYSTEMATIC REVIEW REGISTRATION Open Science Framework (registration identifier: osf.io/ka8yu).
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Affiliation(s)
- Simone Schweda
- Medical Clinic Tuebingen, Department of Sports Medicine, Hoppe-Seyler Str. 6, 72076, Tuebingen, Germany. .,Interfaculty Research Institute for Sports and Physical Activity, University Tuebingen, Tuebingen, Germany.
| | - Inga Krauss
- Medical Clinic Tuebingen, Department of Sports Medicine, Hoppe-Seyler Str. 6, 72076, Tuebingen, Germany.,Interfaculty Research Institute for Sports and Physical Activity, University Tuebingen, Tuebingen, Germany
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137
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Associations Among Perceived Control, Depressive Symptoms, and Well-being in Patients With Heart Failure and Their Spouses: A Dyadic Approach. J Cardiovasc Nurs 2020; 36:198-205. [PMID: 32398503 DOI: 10.1097/jcn.0000000000000682] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND High levels of perceived control and lower levels of depressive symptoms are associated with better well-being in both patients with heart failure and their spouses at an individual level. However, there is a knowledge gap about how these individual factors have reciprocal influences on partners' well-being within the patient-spouse dyads. OBJECTIVE The aims of this study were to examine dyads of patients with heart failure and their spouses on whether the patients' perceived control over the management of heart failure and depressive symptoms predicts their own and their spouses' physical and emotional well-being and to examine whether patients' perceived control predicts their own and their spouses' depressive symptoms. METHODS A total 155 patient-spouse dyads (patients: 75% male, mean age of 71 years, 53% classified as New York Heart Association III; spouses: 75% female, mean age of 69 years) were recruited from 2 hospital-based outpatient heart failure clinics. Participants completed the Control Attitude Scale, the Beck Depression Inventory, and the Short-Form 36. Dyadic data were analyzed using multilevel regression of the actor-partner interdependence model. RESULTS Perceived control had an actor effect on emotional well-being only for patients, and there were partner effects of perceived control on emotional well-being for both patients and their spouses. Depressive symptoms exhibited an actor effect on physical and emotional well-being for patients and spouses, but there were no partner effects of depressive symptoms on emotional well-being. Perceived control had partner effects on depressive symptoms for patients and spouses, but an actor effect of depressive symptoms was only found for patients. CONCLUSION In an interdependent relationship within the patient-spouse dyads, each dyad member's perceived control influenced their partner's emotional well-being as well as depressive symptoms. The findings suggest development of dyadic interventions that can increase perceived control over the heart condition.
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138
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Chaouch N, Mechergui N, Aissi W, Essid D, Khemila T, Ladhari N. [Effects of day shift work on quality of life and vigilance in Tunisia]. SANTE PUBLIQUE 2020; 31:623-631. [PMID: 32372601 DOI: 10.3917/spub.195.0623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Alternate work is known to cause physical and mental health disorders for employees that can alter their quality of life and sleep. OBJECTIVE The purpose of this research was to evaluate workers quality of life and sleep in situations of alternate work. RESULTS In total, 391 workers answered the questionnaire. According to the type of schedule, 320 employees worked alternately on a 2×8 shift schedule and 71 worked on a permanent night shift schedule. The group of employees working at night had a better quality of life than the group of employees working in 2×8 in terms of both their physical and mental scores (P < 10-3). Type 2×8 workers were found to have excessive daytime sleepiness as compared to those on fixed night schedules. CONCLUSIONS Shortly, we can deduce from this study that alternating day shift work causes a deterioration of workers' quality of life of and generates sleep disorders..
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139
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Kemani MK, Hägg O, Jakobsson M, Lundberg M. Fear of Movement Is Related to Low Back Disability During a Two-Year Period in Patients Who Have Undergone Elective Lumbar Spine Surgery. World Neurosurg 2020; 137:e416-e424. [DOI: 10.1016/j.wneu.2020.01.218] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 10/25/2022]
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Swedenhammar E, Strigård K, Emanuelsson P, Gunnarsson U, Stark B. Long-term follow-up after surgical repair of abdominal rectus diastasis: A Prospective Randomized Study. SCANDINAVIAN JOURNAL OF SURGERY : SJS : OFFICIAL ORGAN FOR THE FINNISH SURGICAL SOCIETY AND THE SCANDINAVIAN SURGICAL SOCIETY 2020. [PMID: 32299300 DOI: 10.1177/1457496920913677.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Abdominal rectus diastasis can lead to functional disability. There is no consensus regarding treatment. This was a prospective study on patients randomized to surgery using either Quill self-retaining sutures or retromuscular mesh for abdominal rectus diastasis repair. The primary aim of the study was to compare long-term recurrence after surgery. Secondary aims were abdominal muscle strength, pain, and quality of life. METHODS A total of 57 patients were eligible and 52 were investigated. A routine 1-year follow-up ruled out any patient with recurrence and this was followed up by clinical examination for recurrence and assessment of the secondary outcomes a median of 5 years (3.8-6.5 years) after surgery. Quality of life was assessed using the Short Form-36 questionnaire. Pain related to activity was evaluated using the Ventral Hernia Pain Questionnaire. RESULTS No recurrence of abdominal rectus diastasis was found. Significant improvements were seen between index surgery and long-term follow-up in all domains of Short Form-36. There were no significant differences in quality of life or self-reported muscle strength between the two surgical groups. Long-term pain remained unchanged compared to that at the 1-year follow-up. "Pain this week" had decreased significantly at long-term follow-up compared to prior to surgery (mesh p = 0.009, Quill p = 0.003). CONCLUSIONS No recurrence of abdominal rectus diastasis appeared. There was no difference in quality of life or long-term pain between the two surgical groups. Implantation of retromuscular mesh entails more extensive surgery implying potentially higher risk for complications. This leads us to recommend reconstruction with double-row self-retaining sutures for the repair of abdominal rectus diastasis in patients with functional disability.
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Affiliation(s)
- Ebba Swedenhammar
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna (L1:00), Stockholm, SE-171 76, Sweden
| | - Karin Strigård
- Division of Surgery, Department of Surgical and Perioperative Sciences, Umeå University, Karolinska University Hospital, Umeå, Sweden
| | - Peter Emanuelsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Ulf Gunnarsson
- Division of Surgery, Department of Surgical and Perioperative Sciences, Umeå University, Karolinska University Hospital, Umeå, Sweden
| | - Birgit Stark
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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141
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Swedenhammar E, Strigård K, Emanuelsson P, Gunnarsson U, Stark B. Long-term follow-up after surgical repair of abdominal rectus diastasis: a prospective randomized study. Scand J Surg 2020; 110:283-289. [PMID: 32299300 PMCID: PMC8551425 DOI: 10.1177/1457496920913677] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Abdominal rectus diastasis can lead to functional disability. There is no consensus regarding treatment. This was a prospective study on patients randomized to surgery using either Quill self-retaining sutures or retromuscular mesh for abdominal rectus diastasis repair. The primary aim of the study was to compare long-term recurrence after surgery. Secondary aims were abdominal muscle strength, pain, and quality of life. Methods: A total of 57 patients were eligible and 52 were investigated. A routine 1-year follow-up ruled out any patient with recurrence and this was followed up by clinical examination for recurrence and assessment of the secondary outcomes a median of 5 years (3.8–6.5 years) after surgery. Quality of life was assessed using the Short Form-36 questionnaire. Pain related to activity was evaluated using the Ventral Hernia Pain Questionnaire. Results: No recurrence of abdominal rectus diastasis was found. Significant improvements were seen between index surgery and long-term follow-up in all domains of Short Form-36. There were no significant differences in quality of life or self-reported muscle strength between the two surgical groups. Long-term pain remained unchanged compared to that at the 1-year follow-up. “Pain this week” had decreased significantly at long-term follow-up compared to prior to surgery (mesh p = 0.009, Quill p = 0.003). Conclusions: No recurrence of abdominal rectus diastasis appeared. There was no difference in quality of life or long-term pain between the two surgical groups. Implantation of retromuscular mesh entails more extensive surgery implying potentially higher risk for complications. This leads us to recommend reconstruction with double-row self-retaining sutures for the repair of abdominal rectus diastasis in patients with functional disability.
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Affiliation(s)
- E Swedenhammar
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - K Strigård
- Division of Surgery, Department of Surgical and Perioperative Sciences, Umeå University, Karolinska University Hospital, Umeå, Sweden
| | - P Emanuelsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - U Gunnarsson
- Division of Surgery, Department of Surgical and Perioperative Sciences, Umeå University, Karolinska University Hospital, Umeå, Sweden
| | - B Stark
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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142
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Nyberg LA, Sundberg CJ, Wändell P, Kowalski J, Hellénius ML. Long-term effects of group exercise intervention on maximal step-up height in middle-aged female primary care patients with obesity and other cardio-metabolic risk factors. BMC Sports Sci Med Rehabil 2020; 12:11. [PMID: 32190332 PMCID: PMC7074992 DOI: 10.1186/s13102-020-00161-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 02/06/2020] [Indexed: 11/10/2022]
Abstract
Background Low physical performance is a predictor of morbidity and mortality. This study looks at long-term effects of an exercise intervention on maximal step-up height (MSH) in individuals with low physical function. Factors associated with changes in MSH was studied. Methods Female patients (n = 101), mean (SD) age of 52 (11) years, were recruited for a 3-month group exercise intervention including 2–3 sessions/week of mixed aerobic fitness and strength training. MSH, weight, body mass index (BMI), waist circumference, maximal oxygen consumption (VO2-max), self-reported health (SF-36) and physical activity (PA) were measured at baseline (T0), after 3 months (T1) and after 14–30 (mean 22) months (T2). Relationships between changes in MSH (cm) and age, baseline MSH, time to follow-up, changes in anthropometric measurements, VO2-max, SF-36 and PA were studied with regression analyses. Results MSH, significantly, increased from T0 to T1, 27.2 (5.7) to 29.0 (5.5) cm and decreased to 25.2 (5.5) cm at T2. Time to follow-up (B = − 0.42, p < 0.001) and change in BMI (B = − 0.29, p = 0.012) correlated significantly to changes in MSH. Waist circumference, VO2-max, PF and exercise/physical activity levels were significantly improved at T2, while BMI did not change. In a univariate logistic regression model, maintenance of MSH correlated to the extent of mixed training (OR 3.33, 95% CI 1.25–8.89). In a multivariate logistic regression model adjusted for important factors the correlation was not significant. However, MSH was significantly higher in individuals participating in 2–3 session per week compared to one session. Conclusions A 3-month group exercise intervention increased MSH, improved fitness, decreased risk in female patients with elevated cardio-metabolic risk. After an average of 22 months MSH was reduced while positive effects remained for waist circumference, VO2-max, physical function and physical activity. However, regular group exercise 2–3 times per week with mixed aerobic fitness and strength training was associated with maintenance of MSH in a subgroup of patients. We suggest that such an intervention including regular support from healthcare professionals is a successful approach for maintaining improved leg-muscle strength among primary care patients. Trial registration ISRCTN21220201 September 18, 2019, retrospectively registered.
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Affiliation(s)
- Lillemor A Nyberg
- 1Department of Medicine and School of Health Sciences, Örebro University, 70182 Örebro, Sweden.,2Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Karolina Primary Health Care Centre, Karlskoga, Region Örebro County Sweden
| | - Carl Johan Sundberg
- 4Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Per Wändell
- 2Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Jan Kowalski
- 5Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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Biesert M, Johansson A, Kostogiannis I, Roberts D. Self-reported and performance-based outcomes following medial patellofemoral ligament reconstruction indicate successful improvements in knee stability after surgery despite remaining limitations in knee function. Knee Surg Sports Traumatol Arthrosc 2020; 28:934-940. [PMID: 31236635 DOI: 10.1007/s00167-019-05570-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 06/17/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE To evaluate short- to midterm outcomes of medial patellofemoral ligament reconstruction (MPFL) using patient-reported outcome measures and functional testing. METHODS Twenty-four patients were examined regarding knee function after MPFL reconstruction, with a mean follow-up time of 45.3 ± 18.4 months since surgery. Knee function was evaluated using the Tegner score, VAS, the knee injury and osteoarthritis outcome score (KOOS), the Lysholm score, SF-36 and EQ-5D-3L as well as functional scores. A group of uninjured persons of the same age and same gender composition was used for comparison. RESULTS Eight (40%) patients managed to return to their pre-injury activity level. Five (25%) patients stated that they had experienced further patella dislocations after surgery but only two (10%) had sought medical help. Patients showed significantly poorer results in all PROMs compared to controls. The results obtained with SF-36 showed significant differences in physical health between the groups, but not in mental health. The functional performance test results showed overall poorer results for the patients versus controls: 11.5 sets for the square jump (6.7-15.7) versus 21 sets (18-26), 11.5 sets for the step-down test (6.5-15) versus 22 sets (18-26), and 77 cm for the single-leg hop for distance (32.2-110.5) versus 126 cm (115-37); all (P < 0.005). CONCLUSIONS After MPFL reconstruction, patients do not regain normal knee function, as measured by PROMs and functional tests, compared to an uninjured control group. Patients should be informed about residual functional limitations despite improved stability. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Maria Biesert
- Department of Orthopaedics, Clinical Sciences, Skåne University Hospital, Malmö, Sweden.
- Department of Orthopaedics, Clinical Sciences, Lund University Hospital, Lund, Sweden.
- Department of Orthopaedics, Ljungby Lasarett, Kyrkogatan 2, 34135, Ljungby, Sweden.
| | - Anna Johansson
- Department of Orthopaedics, Clinical Sciences, Skåne University Hospital, Malmö, Sweden
- Department of Orthopaedics, Clinical Sciences, Lund University Hospital, Lund, Sweden
| | - Ioannis Kostogiannis
- Department of Orthopaedics, Clinical Sciences, Skåne University Hospital, Malmö, Sweden
- Department of Orthopaedics, Clinical Sciences, Lund University Hospital, Lund, Sweden
| | - David Roberts
- Department of Orthopaedics, Clinical Sciences, Skåne University Hospital, Malmö, Sweden
- Department of Orthopaedics, Clinical Sciences, Lund University Hospital, Lund, Sweden
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144
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von Bahr V, Kalzén H, Frenckner B, Hultman J, Frisén KG, Lidegran MK, Diaz S, Malfertheiner MV, Millar JE, Dobrosavljevic T, Eksborg S, Holzgraefe B. Long-term pulmonary function and quality of life in adults after extracorporeal membrane oxygenation for respiratory failure. Perfusion 2020; 34:49-57. [PMID: 30966900 DOI: 10.1177/0267659119830244] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is a significant long-term burden on survivors after acute respiratory distress syndrome, even 5 years after discharge. This is not well investigated in patients treated with extracorporeal membrane oxygenation. The objective of this study was to describe very-long-term (⩾3 years) disability in lung function and morphology, quality of life, mood disorders, walking capacity, and return to work status in extracorporeal membrane oxygenation survivors. METHODS Single-center retrospective cohort study on long-term survivors treated with extracorporeal membrane oxygenation for respiratory failure between 1995 and 2010 at a tertiary referral center in Sweden. Eligible patients were approached, and those who consented were interviewed and investigated during a day at the hospital. RESULTS A total of 38 patients were investigated with a median follow-up time of 9.0 years. Quality of life was reduced in several Short form 36 (SF-36) subscales and all domains of the St George's Respiratory Questionnaire, similar to previous studies in conventionally managed acute respiratory distress syndrome survivors. A reduced diffusion capacity of carbon monoxide was seen in 47% of patients, and some degree of residual lung parenchymal pathology was seen in 82%. Parenchymal pathology correlated with reductions in quality of life and diffusion capacity. Symptoms of anxiety and depression were seen in 22% and 14%, respectively. CONCLUSION A significant long-term burden remains even 3-17 years after extracorporeal membrane oxygenation treatment, similar to conventionally managed acute respiratory distress syndrome survivors. Future prospective studies are needed to elucidate risk factors for these sequelae.
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Affiliation(s)
- Viktor von Bahr
- 1 Section for Anesthesiology and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Håkan Kalzén
- 1 Section for Anesthesiology and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.,2 Department of Pediatric Anaesthesia, Intensive Care and ECMO Services, Astrid Lindgren Children's Hospital, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Björn Frenckner
- 2 Department of Pediatric Anaesthesia, Intensive Care and ECMO Services, Astrid Lindgren Children's Hospital, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.,3 Division of Pediatric Surgery, Department of Women's and Children's Health, Karolinska Institutet and Astrid Lindgren Children's Hospital, Stockholm, Sweden
| | - Jan Hultman
- 1 Section for Anesthesiology and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.,2 Department of Pediatric Anaesthesia, Intensive Care and ECMO Services, Astrid Lindgren Children's Hospital, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - K Gunilla Frisén
- 2 Department of Pediatric Anaesthesia, Intensive Care and ECMO Services, Astrid Lindgren Children's Hospital, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Marika K Lidegran
- 4 Department of Pediatric Radiology, Astrid Lindgren Children's Hospital, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Sandra Diaz
- 4 Department of Pediatric Radiology, Astrid Lindgren Children's Hospital, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.,5 Department of Radiology and Translational Medicine, Lund University and Skane University Hospital, Lund, Sweden
| | - Maximilian V Malfertheiner
- 6 Department of Internal Medicine II, Cardiology and Pneumology, University Medical Center Regensburg, Regensburg, Germany
| | - Jonathan E Millar
- 7 Department of Anaesthesia, Critical Care & Pain, School of Medicine, University of Glasgow, Glasgow, UK
| | - Tanja Dobrosavljevic
- 2 Department of Pediatric Anaesthesia, Intensive Care and ECMO Services, Astrid Lindgren Children's Hospital, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Staffan Eksborg
- 8 Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet and Astrid Lindgren Children's Hospital, Stockholm, Sweden
| | - Bernhard Holzgraefe
- 2 Department of Pediatric Anaesthesia, Intensive Care and ECMO Services, Astrid Lindgren Children's Hospital, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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145
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Sylwander C, Larsson I, Andersson M, Bergman S. The impact of chronic widespread pain on health status and long-term health predictors: a general population cohort study. BMC Musculoskelet Disord 2020; 21:36. [PMID: 31948483 PMCID: PMC6966859 DOI: 10.1186/s12891-020-3039-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/02/2020] [Indexed: 01/06/2023] Open
Abstract
Background Chronic widespread pain (CWP) has a negative impact on health status, but results have varied regarding gender-related differences and reported health status. The aim was to study the impact of CWP on health status in women and men aged 35–54 years in a sample of the general population. The aim was further to investigate lifestyle-related predictors of better health status in those with CWP in a 12- and 21-year perspective. Method A general population cohort study including 975 participants aged 35–54 years, with a 12- and 21-year follow-up. CWP was measured with a pain mannequin, and the questionnaire included questions on lifestyles factors with SF-36 for measurement of health status. Differences in health status were analysed with independent samples t-test and health predictors with logistic regression analysis. Results The prevalence of CWP was higher in women at all time points, but health status was reduced in both women and men with CWP (p < 0.001) with no gender differences of clinical relevance. At the 12-year follow-up, a higher proportion of women than men had developed CWP (OR 2.04; CI 1.27–3.26), and at the 21-year follow-up, a higher proportion of men had recovered from CWP (OR 3.79; CI 1.00–14.33). In those reporting CWP at baseline, a better SF-36 health status (Physical Functioning, Vitality or Mental Health) at the 12-year follow-up was predicted by male gender, having personal support, being a former smoker, and having no sleeping problems. In the 21-year follow-up, predictors of better health were male gender, a weekly intake of alcohol, and having no sleeping problems. Conclusion Women and men with CWP have the same worsening of health status, but men recover from CWP to a greater extent in the long-term. Being male, having social support, being a former smoker, and having no sleeping problems were associated with better health status in those with CWP.
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Affiliation(s)
- Charlotte Sylwander
- Spenshult Research and Development Centre, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden. .,School of Health and Welfare, Halmstad University, Halmstad, Sweden.
| | - Ingrid Larsson
- Spenshult Research and Development Centre, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden.,School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Maria Andersson
- Spenshult Research and Development Centre, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden.,Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
| | - Stefan Bergman
- Spenshult Research and Development Centre, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden.,Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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146
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Omran M, Blomqvist L, Brandberg Y, Pal N, Kogner P, Ståhlbom AK, Tham E, Bajalica-Lagercrantz S. Whole-body MRI within a surveillance program for carriers with clinically actionable germline TP53 variants - the Swedish constitutional TP53 study SWEP53. Hered Cancer Clin Pract 2020; 18:1. [PMID: 31956380 PMCID: PMC6958585 DOI: 10.1186/s13053-020-0133-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 01/05/2020] [Indexed: 12/14/2022] Open
Abstract
Background The current guidelines in Sweden regarding individuals with a clinically actionable (i.e. pathogenic or likely pathogenic) germline TP53 variant recommend patients to take part of the national Swedish P53 Study (SWEP53). Methods The study comprises a patient registry (mandatory for all participants) and three optional parts: a biobank, a surveillance program and a psychosocial evaluation of the surveillance. All known adult eligible carriers regardless of age are offered to take part of the surveillance program offering MRI yearly of the whole-body, breast, and brain as well as breast ultrasound. A special surveillance program is offered for individuals 15–18 years old with a 50% risk of being a mutation carrier or with a verified TP53 variation, includes ultrasound of the abdomen and urine corticosteroid profiles. Clinically motivated further examinations are performed upon need. The national inclusion is performed through the six clinical genetic units in Sweden at Umeå, Uppsala, Stockholm, Gothenburg, Linköping and Lund, and the surveillance is mainly performed through the oncology clinics. Results To date, a total of 41 adults and 11 children have been included in the study. Conclusions The SWEP53 is the first structured national surveillance program including radiological and clinical routines for TP53 mutation carriers in the Scandinavian setting. The aim of this publication is to present and describe the ongoing Swedish surveillance study to encourage the initiation of similar studies and to contribute to the knowledge of adequate clinical handling of these cancer prone families. Trial registration Trial registration number: ISRCTN13103571, retrospectively registered on 14/10/2019.
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Affiliation(s)
- Meis Omran
- 1Department of Oncology-Pathology, Karolinska Institutet SE-171 77 Stockholm, Sweden AND Cancer Theme, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden
| | - Lennart Blomqvist
- 2Department of Molecular Medicine and Surgery, Karolinska Institutet, SE-171 77 Stockholm, Sweden.,3Department of Imaging and Physiology Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden
| | - Yvonne Brandberg
- 4Department of Oncology-Pathology, Karolinska Institutet, SE-171 64 Stockholm, Sweden
| | - Niklas Pal
- 5Department of Women's and Children's Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden.,6Children and Women's Health Theme, Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden
| | - Per Kogner
- 5Department of Women's and Children's Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden.,6Children and Women's Health Theme, Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden
| | | | - Emma Tham
- 8Department of Molecular Medicine and Surgery, Karolinska Institutet, SE-171 77 Stockholm, Sweden.,9Department of Clinical Genetics, Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden
| | - Svetlana Bajalica-Lagercrantz
- 1Department of Oncology-Pathology, Karolinska Institutet SE-171 77 Stockholm, Sweden AND Cancer Theme, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden
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147
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Niyonsenga T, Carroll SJ, Coffee NT, Taylor AW, Daniel M. Are changes in depressive symptoms, general health and residential area socio-economic status associated with trajectories of waist circumference and body mass index? PLoS One 2020; 15:e0227029. [PMID: 31914169 PMCID: PMC6948738 DOI: 10.1371/journal.pone.0227029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 12/11/2019] [Indexed: 11/18/2022] Open
Abstract
Objective This study sought to assess whether changes in depressive symptoms, general health, and area-level socio-economic status (SES) were associated to changes over time in waist circumference and body mass index (BMI). Methods A total of 2871 adults (18 years or older), living in Adelaide (South Australia), were observed across three waves of data collection spanning ten years, with clinical measures of waist circumference, height and weight. Participants completed the Centre for Epidemiologic Studies Depression (CES-D) and Short Form 36 health questionnaires (SF-36 general health domain). An area-level SES measure, relative location factor, was derived from hedonic regression models using residential property features but blind to location. Growth curve models with latent variables were fitted to data. Results Waist circumference, BMI and depressive symptoms increased over time. General health and relative location factor decreased. Worsening general health and depressive symptoms predicted worsening waist circumference and BMI trajectories in covariate-adjusted models. Diminishing relative location factor was negatively associated with waist circumference and BMI trajectories in unadjusted models only. Conclusions Worsening depressive symptoms and general health predict increasing adiposity and suggest the development of unhealthful adiposity might be prevented by attention to negative changes in mental health and overall general health.
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Affiliation(s)
- Theo Niyonsenga
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
- * E-mail:
| | - Suzanne J. Carroll
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
| | - Neil T. Coffee
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
- School of Architecture and Built Environment, Healthy Cities Research Group, The University of Adelaide, South Australia, Australia
| | - Anne W. Taylor
- Discipline of Medicine, The University of Adelaide, South Australia, Australia
| | - Mark Daniel
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
- Department of Medicine, St Vincent’s Hospital, The University of Melbourne, Fitzroy, Australia
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148
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Gutefeldt K, Hedman CA, Thyberg ISM, Bachrach-Lindström M, Arnqvist HJ, Spångeus A. Low health-related quality of life is strongly linked to upper extremity impairments in type 1 diabetes with a long duration. Disabil Rehabil 2020; 43:2578-2584. [PMID: 31906725 DOI: 10.1080/09638288.2019.1705924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To compare health-related quality of life (HRQOL) in type 1 diabetes and non-diabetic controls and possible links to upper extremity impairments (UEIs). Prevalence of sick-leave and causes were investigated. MATERIALS AND METHODS This Swedish population-based case-control study included type 1 diabetes patients <67 years old and with a diabetes duration ≥20 years. Participants completed a postal questionnaire including Short Form 36, and questions regarding UEIs, and sick-leave. RESULTS In total, 773 patients, aged 50 ± 10 years (diabetes duration 35 ± 10 years), and 708 non-diabetic controls, aged 54 ± 9 years, completed the study. Patients reported significantly lower HRQOL compared with controls. The difference was greatest for general health, vitality, and bodily pain. Patients with shoulder or hand but not finger impairments scored significantly lower than asymptomatic patients. The prevalence of sick leave was higher in patients vs. controls (23% vs. 9%, p < 0.001), and nearly half cited impairments from back, muscles, or joints as the main reason. CONCLUSIONS Health-related quality of life is lower in type 1 diabetes than controls and in patients with shoulder and hand impairments than in asymptomatic. Musculoskeletal impairments (back/muscle/joints) have impact on work ability. Identification of UEIs is important for initiating preventative-, therapeutic-, and rehabilitative interventions.Implications for rehabilitationUpper extremity impairments (UEIs) that are common in type 1 diabetes, and associated with reduced health-related quality of life, should preferably be screened for on a regular basis along with other known diabetes complications.Early identification of UEIs is important to improve health by initiating preventive as well as therapeutic multi-professional rehabilitative interventions.Sick leave is higher in type 1 diabetes than in controls. Musculoskeletal impairments, including the back, muscles, and joints, are a common cause for sick leave warranting further studies.
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Affiliation(s)
- Kerstin Gutefeldt
- Department of Endocrinology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Christina A Hedman
- Department of Endocrinology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Ingrid S M Thyberg
- Department of Rheumatology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Margareta Bachrach-Lindström
- Department of Medical and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping, Sweden
| | - Hans J Arnqvist
- Department of Endocrinology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Anna Spångeus
- Department of Medical and Health Sciences and Department of Acute Internal Medicine and Geriatrics, Linköping University, Linköping, Sweden
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149
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Lotzke H, Gutke A, den Hollander M, Smeets R, Lundberg M. Developing an evidence-based prehabilitation programme designed to improve functional outcomes after lumbar fusion surgery - A feasibility study using the Medical Research Council framework. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2018.1553999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Hanna Lotzke
- Department of Orthopaedics at Sahlgrenska Academy, Institute of the Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Annelie Gutke
- Department of Health and Rehabilitation, Division of Physiotherapy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Marlies den Hollander
- Adelante Centre of Expertise in Rehabilitation, Hoensbroek, The Netherlands
- Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands
| | - Rob Smeets
- Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands
| | - Mari Lundberg
- Department of Health and Rehabilitation, Division of Physiotherapy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
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150
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Jansson SA, Backman H, Andersson M, Telg G, Lindberg A, Stridsman C, Lundbäck B, Rönmark E. Severe asthma is related to high societal costs and decreased health related quality of life. Respir Med 2020; 162:105860. [PMID: 32056670 DOI: 10.1016/j.rmed.2019.105860] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 12/28/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The aim of the present study was to estimate the societal costs and the key cost drivers for patients with severe asthma in Sweden. In addition, health-related quality of life (HRQOL) and morbidity of patients with severe asthma is described. METHODS The study population comprised adults with severe asthma recruited from a large asthma cohort within the Obstructive Lung Disease in Northern Sweden (OLIN) studies. During 2017, patients were interviewed quarterly over telephone regarding their resource utilization and productivity losses. RESULTS Estimated mean annual asthma-related costs per patient with severe asthma amounted to €6,500, of which approximately €2400 and €4100 were direct and indirect costs, respectively. The main cost drivers for direct costs were hospitalizations followed by drugs: approximately €1000 and €800, respectively. Patients on treatment with regular oral corticosteroids (OCS) had greater direct costs compared with those without regular OCS treatment. Co-morbid conditions were common and the costs were substantial also for co-morbid conditions, with a total cost of approximately €4200. The OCS group had significantly lower HRQOL compared to the non-OCS group. CONCLUSIONS The societal costs due to severe asthma were substantial. Costs for co-morbid conditions contributed substantially to both direct and indirect costs. The direct costs were significantly higher in the maintenance OCS-group compared to the non-maintenance OCS-group. These results indicate a need for improved management and treatment regimens for patients with severe asthma.
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Affiliation(s)
- Sven-Arne Jansson
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden.
| | - Helena Backman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden.
| | | | | | - Anne Lindberg
- Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden.
| | - Caroline Stridsman
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
| | - Bo Lundbäck
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden.
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