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Mjåset C, Solberg TK, Zwart JA, Småstuen MC, Kolstad F, Grotle M. Correction to: Anterior surgical treatment for cervical degenerative radiculopathy: a prediction model for non‑success. Acta Neurochir (Wien) 2024; 166:149. [PMID: 38526633 DOI: 10.1007/s00701-024-06045-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Affiliation(s)
- Christer Mjåset
- Faculty of Medicine, University of Oslo, Oslo, Norway.
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, P.O. Box 4956, 0424, Oslo, Nydalen, Norway.
| | - Tore K Solberg
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
- Department of Neurosurgery and The Norwegian Registry for Spine Surgery (NORspine), The University Hospital of North Norway, Tromsø, Norway
| | - John-Anker Zwart
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, P.O. Box 4956, 0424, Oslo, Nydalen, Norway
| | - Milada C Småstuen
- Department of Rehabilitation and Technology, Faculty of Health Science, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
| | - Frode Kolstad
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Margreth Grotle
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, P.O. Box 4956, 0424, Oslo, Nydalen, Norway
- Department of Rehabilitation and Technology, Faculty of Health Science, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
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Hanssen KT, Brevik EJ, Småstuen MC, Stubberud J. Improvement of anxiety in ADHD following goal-focused cognitive remediation: a randomized controlled trial. Front Psychol 2023; 14:1212502. [PMID: 38046113 PMCID: PMC10690829 DOI: 10.3389/fpsyg.2023.1212502] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/16/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Despite the high prevalence and detrimental consequences of cognitive and executive dysfunction in ADHD, the evidence base of cognitive remediation in the adult ADHD population is sparse. Executive problems can increase both anxiety and depression in ADHD. Thcus, it is important to develop treatment options for adults with ADHD, aiming to improve goal-directed behavior and mood. Goal Management Training (GMT) is an intervention that has received empirical support in improving executive functions and mood in normal aging and for various neurological and psychiatric conditions. The present randomized controlled trial investigated the effects of a goal-focused intervention combining 1) group-based GMT incorporating psychoeducation about ADHD and 2) guidance in implementing individual goals for coping with executive problems in everyday life, compared to treatment as usual (TAU). The primary outcome was perceived executive functioning in everyday life. Secondary outcomes included psychological well-being (anxiety, depression, and coping with ADHD symptoms). Methods We recruited 81 adult participants with a verified ADHD diagnosis (Mage = 31 years). Inclusion was based upon the presence of executive functioning complaints. The participants were randomly assigned to either the intervention or TAU. The intervention group (n = 41) received 16 hours of GMT and psychoeducation, in addition to 4 individual sessions focusing on formulating goals. The goals were assessed in 6 bi-weekly phone calls in the first three months following the group sessions. Participants in the TAU group (n = 40) received standard, individually-adapted follow-up in an outpatient psychiatric health care setting. All participants were assessed at baseline, post-intervention, and at 8-month follow-up (main measurement time point). Results Significant improvements in everyday executive functioning, psychological wellbeing, and symptoms of ADHD from baseline to 8-month follow-up were reported in both groups. The intervention group reported a significantly higher reduction in symptoms of anxiety compared to TAU. Conclusions. Our findings provide support for considering cognitive remediation as a treatment option for patients with ADHD.Clinical Trial Registration: https://clinicaltrials.gov/study/NCT04638283?term=NCT04638283&rank=1, identifier: NCT04638283.
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Affiliation(s)
- Kjersti T. Hanssen
- District Psychiatric Center Nedre Romerike, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Erlend J. Brevik
- District Psychiatric Center Nedre Romerike, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | | | - Jan Stubberud
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
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Svanevik M, Lorentzen J, Borgeraas H, Sandbu R, Seip B, Medhus AW, Hertel JK, Kolotkin RL, Småstuen MC, Hofsø D, Hjelmesæth J. Patient-reported outcomes, weight loss, and remission of type 2 diabetes 3 years after gastric bypass and sleeve gastrectomy (Oseberg); a single-centre, randomised controlled trial. Lancet Diabetes Endocrinol 2023:S2213-8587(23)00127-4. [PMID: 37414071 DOI: 10.1016/s2213-8587(23)00127-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 04/19/2023] [Accepted: 05/04/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Little is known about the comparative effects of various bariatric procedures on patient-reported outcomes. We aimed to compare 3-year effects of gastric bypass and sleeve gastrectomy on patient-reported outcome measures in patients with obesity and type 2 diabetes. METHODS The Oseberg trial was a single-centre, parallel-group, randomised trial at Vestfold Hospital Trust, a public tertiary obesity centre in Tønsberg, Norway. Eligible patients were aged 18 years or older with previously verified BMI 35·0 kg/m2 or greater. Diabetes was diagnosed if glycated haemoglobin was at least 6·5% (48 mmol/mol) or by their use of anti-diabetic medications with glycated haemoglobin at least 6·1% (43 mmol/mol). Eligible patients were randomly assigned (1:1) to gastric bypass or sleeve gastrectomy. All patients received identical preoperative and postoperative treatment. Randomisation was done with a computerised random number generator and a block size of ten. Study personnel, patients, and the primary outcome assessor were blinded to allocations for 1 year. The prespecified secondary outcomes reported here were 3-year changes in several clinically important patient-reported outcomes, weight loss, and diabetes remission. Analyses were done in the intention to treat population. This trial is ongoing, closed to recruitment and is registered with ClinicalTrials.gov, NCT01778738. FINDINGS Between Oct 15, 2012 and Sept 1, 2017, 319 consecutive patients with type 2 diabetes scheduled for bariatric surgery were assessed for eligibility. 101 patients were not eligible (29 did not have type 2 diabetes according to inclusion criteria and 72 other exclusion criteria) and 93 declined to participate. 109 patients were enrolled and randomly assigned to sleeve gastrectomy (n=55) or gastric bypass (n=54). 72 (66%) of 109 patients were female and 37 (34%) were male. 104 (95%) of patients were White. 16 patients were lost to follow up and 93 (85%) patients completed the 3-year follow-up. Three additional patients were contacted by phone for registration of comorbidities Compared with sleeve gastrectomy, gastric bypass was associated with a greater improvement in weight-related quality of life (between group difference 9·4, 95% CI 3·3 to 15·5), less reflux symptoms (0·54, 0·17 to -0·90), greater total bodyweight loss (8% difference, 25% vs 17%), and a higher probability of diabetes remission (67% vs 33%, risk ratio 2·00; 95% CI 1·27 to 3·14). Five patients reported postprandial hypoglycaemia in the third year after gastric bypass versus none after sleeve-gastrectomy (p=0·059). Symptoms of abdominal pain, indigestion, diarrhoea, dumping syndrome, depression, binge eating, and appetitive drive did not differ between groups. INTERPRETATION At 3 years, gastric bypass was superior to sleeve gastrectomy in patients with type 2 diabetes and obesity regarding weight related quality of life, reflux symptoms, weight loss, and remission of diabetes, while symptoms of abdominal pain, indigestion, diarrhoea, dumping, depression and binge eating did not differ between groups. This new patient-reported knowledge can be used in the shared decision-making process to inform patients about similarities and differences between expected outcomes after the two surgical procedures. FUNDING Morbid Obesity Centre, Vestfold Hospital Trust. TRANSLATION For the Norwegian translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Marius Svanevik
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway; Department of Gastrointestinal Surgery, Vestfold Hospital Trust, Tønsberg, Norway.
| | - Jolanta Lorentzen
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway; Department of Medicine, Vestfold Hospital Trust, Tønsberg, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Heidi Borgeraas
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway
| | - Rune Sandbu
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway; Department of Gastrointestinal Surgery, Vestfold Hospital Trust, Tønsberg, Norway
| | - Birgitte Seip
- Department of Medicine, Vestfold Hospital Trust, Tønsberg, Norway
| | - Asle W Medhus
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Jens K Hertel
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway
| | - Ronette L Kolotkin
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway; Quality of Life Consulting, Durham, NC, USA; Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA; Førde Hospital Trust, Førde, Norway
| | - Milada C Småstuen
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway; Department of Nutrition and Management, Oslo Metropolitan University, Oslo, Norway
| | - Dag Hofsø
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway; Department of Endocrinology, Vestfold Hospital Trust, Tønsberg, Norway
| | - Jøran Hjelmesæth
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Wiken TH, Høivik ML, Buer L, Warren DJ, Bolstad N, Moum BA, Anisdahl K, Småstuen MC, Medhus AW. Switching from intravenous to subcutaneous vedolizumab maintenance treatment in patients with inflammatory bowel disease followed by therapeutic drug monitoring. Scand J Gastroenterol 2023; 58:863-873. [PMID: 36799155 DOI: 10.1080/00365521.2023.2176252] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/09/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVE Vedolizumab (VDZ) for subcutaneous (SC) administration has recently become available. We aimed to assess feasibility, safety and clinical outcome when switching from intravenous (IV) to SC VDZ maintenance treatment in a real world cohort of patients with inflammatory bowel disease (IBD) followed by therapeutic drug monitoring (TDM). METHODS Eligible IBD patients were switched from IV to SC treatment and assessed six months prior to switch, at baseline and six, twelve and twenty-six weeks after switch. Primary outcome was proportion of patients on SC treatment after 26 weeks. Secondary outcomes included adverse events (AEs), clinical disease activity, biochemical markers, treatment interval, serum-VDZ (s-VDZ), preferred route of administration and health-related quality of life. RESULTS In total, 108 patients were switched. After 26 weeks, 100 patients (92.6%) were still on SC treatment and median s-VDZ was 47.6 mg/L (IQR 41.3 - 54.6). The most frequent AE was injection site reaction (ISR), reported by 20 patients (18.5%). There were no clinically significant changes in disease activity, biochemical markers and quality of life. The proportion of patients preferring SC administration increased from 28.0% before switch to 59.4% after 26 weeks (p < 0.001). CONCLUSIONS Nine out of ten patients still received SC treatment after 26 weeks. No change in disease activity occurred, and levels of serum VDZ increased. Although almost one fifth of patients experienced ISRs, a higher proportion favored SC administration at 26 weeks. This study demonstrates that SC maintenance treatment is a safe and feasible alternative to IV treatment.
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Affiliation(s)
- Thea H Wiken
- Departement of Gastroenterology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marte L Høivik
- Departement of Gastroenterology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lydia Buer
- Departement of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - David J Warren
- Department of Medical Biochemistry, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Nils Bolstad
- Department of Medical Biochemistry, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Bjørn A Moum
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Karoline Anisdahl
- Departement of Gastroenterology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Milada C Småstuen
- Departement of Gastroenterology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Asle W Medhus
- Departement of Gastroenterology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Barstad LH, Johnson LK, Borgeraas H, Hofsø D, Svanevik M, Småstuen MC, Hertel JK, Hjelmesæth J. Changes in dietary intake, food tolerance, hedonic hunger, binge eating problems, and gastrointestinal symptoms after sleeve gastrectomy compared with after gastric bypass; 1-year results from the Oseberg study-a randomized controlled trial. Am J Clin Nutr 2023; 117:586-598. [PMID: 36811476 DOI: 10.1016/j.ajcnut.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 11/15/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The randomized Oseberg study compared the effects of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), on the 1-y remission of type 2 diabetes and β-cell function (primary outcomes). However, little is known about the comparable effects of SG and RYGB on the changes in dietary intakes, eating behavior, and gastrointestinal discomfort. OBJECTIVES To compare 1-y changes in intakes of macro- and micronutrients, food groups, food tolerance, hedonic hunger, binge eating, and gastrointestinal symptoms after SG and RYGB. METHODS Among others, prespecified secondary outcomes were dietary intake, food tolerance, hedonic hunger, binge eating, and gastrointestinal symptoms assessed with a food frequency questionnaire, food tolerance questionnaire, Power of food scale, Binge eating scale, and Gastrointestinal symptom rating scale, respectively. RESULTS A total of 109 patients (66% females), with mean (SD) age 47.7 (9.6) y and body mass index of 42.3 (5.3) kg/m2, were allocated to SG (n = 55) or RYGB (n = 54). The SG group had, compared with the RYGB group, greater 1-y reductions in the intakes of: protein, mean (95% CI) between-group difference, -13 (-24.9, -1.2) g; fiber, -4.9 (-8.2, -1.6) g; magnesium, -77 (-147, -6) mg; potassium, -640 (-1237, -44) mg; and fruits and berries, -65 (-109, -20) g. Further, the intake of yogurt and fermented milk products increased by >2-folds after RYGB but remained unchanged after SG. In addition, hedonic hunger and binge eating problems declined similarly after both surgeries, whereas most gastrointestinal symptoms and food tolerance remained stable at 1 y. CONCLUSIONS The 1-y changes in dietary intakes of fiber and protein after both surgical procedures, but particularly after SG, were unfavorable with regard to current dietary guidelines. For clinical practice, our findings suggest that health care providers and patients should focus on sufficient intakes of protein, fiber, and vitamin and mineral supplementation after both SG and RYGB. This trial was registered at [clinicaltrials.gov] as [NCT01778738].
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Affiliation(s)
- Lisa H Barstad
- Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway.
| | - Line K Johnson
- Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway
| | - Heidi Borgeraas
- Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway
| | - Dag Hofsø
- Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway; Department of Medicine, Vestfold Hospital Trust, Tønsberg, Norway
| | - Marius Svanevik
- Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway; Department of Gastrointestinal Surgery, Vestfold Hospital Trust, Tønsberg, Norway
| | | | - Jens K Hertel
- Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway
| | - Jøran Hjelmesæth
- Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Øygarden AMU, Småstuen MC, Abudayya A, Glavin K, Saether KM, Solberg BL, Brekke M, Strøm BS. Prevalence and predictive factors of depressive symptoms among primiparae in antenatal care: A cross-sectional study in the new families programme. J Clin Nurs 2023. [PMID: 36599809 DOI: 10.1111/jocn.16608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/26/2022] [Accepted: 12/05/2022] [Indexed: 01/06/2023]
Abstract
AIM/OBJECTIVE To estimate the prevalence and assess the strength of associations between antenatal depressive symptoms and selected possible predictive factors among women attending antenatal care for the first time at the Child Health Centre. BACKGROUND Evidence suggests that antenatal depression is a health problem as prevalent as postpartum depression. Antenatal depressive symptoms may persist into the postpartum period and potentially disturb the attachment between mother and family. DESIGN Cross-sectional. METHODS A sample of 228 women who participated in the New Families research programme answering a questionnaire at Week 28 of pregnancy were included. The Edinburgh Postnatal Depression Scale was used as outcome measure. Prevalence was estimated, and backward stepwise logistic regression analysis was performed to examine associations with somatic, psychiatric and social factors. STROBE checklist was followed. RESULTS Prevalence of depressive symptoms in this sample was 17.9%. Women reporting not sleeping enough had significantly higher odds of having depressive symptoms. Pregnant women with high relationship satisfaction were less likely to have depressive symptoms. Neither maternal age, education, previous depression, coming from a non-Nordic country nor having complications during pregnancy were statistically significantly associated with depressive symptoms. CONCLUSIONS High prevalence of depressive symptoms may also be present in low-risk populations. Sleep and relationship satisfaction are topics that need to be addressed during pregnancy. RELEVANCE TO CLINICAL PRACTICE The prevalence of depressive symptoms in this sample of low-risk pregnant women indicates that health personnel needs to be aware of depressive symptoms among women with no risk indicators. Identifying predictive factors associated with depressive symptoms may help midwives, public health nurses and general practitioners support parents. Our results indicate a potential need for screening for depressive symptoms in pregnancy and underscore the importance of involving partners in antenatal care. PATIENT/PUBLIC CONTRIBUTION Parents and health personnel participated in designing the New Family research programme.
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Affiliation(s)
| | - Milada C Småstuen
- Institute of Health, VID Specialized University, Oslo, Norway.,Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Kari Glavin
- Institute of Health, VID Specialized University, Oslo, Norway
| | | | - Beate L Solberg
- Institute of Health, VID Specialized University, Oslo, Norway
| | - Malene Brekke
- Institute of Health, VID Specialized University, Oslo, Norway
| | - Benedicte S Strøm
- Bachelor in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
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Aanesen F, Grotle M, Rysstad TL, Tveter AT, Tingulstad A, Løchting I, Småstuen MC, van Tulder MW, Berg R, Foster NE, Wynne-Jones G, Sowden G, Fors E, Bagøien G, Hagen R, Storheim K, Øiestad BE. Effectiveness of adding motivational interviewing or a stratified vocational advice intervention to usual case management on return to work for people with musculoskeletal disorders: the MI-NAV randomised controlled trial. Occup Environ Med 2023; 80:42-50. [PMID: 36428098 PMCID: PMC9763188 DOI: 10.1136/oemed-2022-108637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/26/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To evaluate if adding motivational interviewing (MI) or a stratified vocational advice intervention (SVAI) to usual case management (UC), reduced sickness absence over 6 months for workers on sick leave due to musculoskeletal disorders. METHODS We conducted a three-arm parallel pragmatic randomised controlled trial including 514 employed workers (57% women, median age 49 (range 24-66)), on sick leave for at least 50% of their contracted work hours for ≥7 weeks. All participants received UC. In addition, those randomised to UC+MI were offered two MI sessions from social insurance caseworkers and those randomised to UC+SVAI were offered vocational advice from physiotherapists (participants with low/medium-risk for long-term sickness absence were offered one to two sessions, and those with high-risk were offered three to four sessions). RESULTS Median sickness absence was 62 days, (95% CI 52 to 71) in the UC arm (n=171), 56 days (95% CI 43 to 70) in the UC+MI arm (n=169) and 49 days (95% CI 38 to 60) in the UC+SVAI arm (n=169). After adjusting for predefined potential confounding factors, the results showed seven fewer days in the UC+MI arm (95% CI -15 to 2) and the UC+SVAI arm (95% CI -16 to 1), compared with the UC arm. The adjusted differences were not statistically significant. CONCLUSIONS The MI-NAV trial did not show effect on return to work of adding MI or SVAI to UC. The reduction in sickness absence over 6 months was smaller than anticipated, and uncertain due to wide CIs. TRIAL REGISTRATION NUMBER NCT03871712.
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Affiliation(s)
- Fiona Aanesen
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Margreth Grotle
- Centre for Intelligent Musculoskeletal Health, Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway,Research and Communication Unit for MSK Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Tarjei Langseth Rysstad
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Anne Therese Tveter
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway,Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Alexander Tingulstad
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Ida Løchting
- Research and Communication Unit for MSK Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Milada C Småstuen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Maurits W van Tulder
- Faculty Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rigmor Berg
- Reviews and Health Technology Assessments, Norwegian Institute of Public Health, Oslo, Norway,Department of Community Medicine, University of Tromsø, Tromsø, Norway
| | - Nadine E Foster
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, Queensland, Australia,School of Medicine, Keele University, Keele, UK
| | | | - Gail Sowden
- School of Medicine, Keele University, Keele, UK,Connect Health, Newcastle upon Tyne, UK
| | - Egil Fors
- General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gunnhild Bagøien
- Nidelv Community Mental Health Center, Tiller, Clinic of Mental Health, St Olavs University Hospital, Trondheim, Norway
| | - Roger Hagen
- Department of Psychology, University of Oslo, Oslo, Norway,Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway,Modum Bad, Research Institute, Vikersund, Norway
| | - Kjersti Storheim
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway,Research and Communication Unit for MSK Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Britt Elin Øiestad
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
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Mjåset C, Solberg TK, Zwart JA, Småstuen MC, Kolstad F, Grotle M. Anterior surgical treatment for cervical degenerative radiculopathy: a prediction model for non-success. Acta Neurochir (Wien) 2023; 165:145-157. [PMID: 36481873 PMCID: PMC9840586 DOI: 10.1007/s00701-022-05440-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE By using data from the Norwegian Registry for Spine Surgery, we wanted to develop and validate prediction models for non-success in patients operated with anterior surgical techniques for cervical degenerative radiculopathy (CDR). METHODS This is a multicentre longitudinal study of 2022 patients undergoing CDR surgery and followed for 12 months to find prognostic models for non-success in neck disability and arm pain using multivariable logistic regression analysis. Model performance was evaluated by area under the receiver operating characteristic curve (AUC) and a calibration test. Internal validation by bootstrapping re-sampling with 1000 repetitions was applied to correct for over-optimism. The clinical usefulness of the neck disability model was explored by developing a risk matrix for individual case examples. RESULTS Thirty-eight percent of patients experienced non-success in neck disability and 35% in arm pain. Loss to follow-up was 35% for both groups. Predictors for non-success in neck disability were high physical demands in work, low level of education, pending litigation, previous neck surgery, long duration of arm pain, medium-to-high baseline disability score and presence of anxiety/depression. AUC was 0.78 (95% CI, 0.75, 0.82). For the arm pain model, all predictors for non-success in neck disability, except for anxiety/depression, were found to be significant in addition to foreign mother tongue, smoking and medium-to-high baseline arm pain. AUC was 0.68 (95% CI, 0.64, 0.72). CONCLUSION The neck disability model showed high discriminative performance, whereas the arm pain model was shown to be acceptable. Based upon the models, individualized risk estimates can be made and applied in shared decision-making with patients referred for surgical assessment.
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Affiliation(s)
- Christer Mjåset
- Faculty of Medicine, University of Oslo, Oslo, Norway.
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, P.O. Box 4956, 0424, Oslo, Nydalen, Norway.
| | - Tore K Solberg
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
- Department of Neurosurgery and The Norwegian Registry for Spine Surgery (NORspine), The University Hospital of North Norway, Tromsø, Norway
| | - John-Anker Zwart
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, P.O. Box 4956, 0424, Oslo, Nydalen, Norway
| | - Milada C Småstuen
- Department of Rehabilitation and Technology, Faculty of Health Science, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
| | - Frode Kolstad
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Margreth Grotle
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, P.O. Box 4956, 0424, Oslo, Nydalen, Norway
- Department of Rehabilitation and Technology, Faculty of Health Science, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
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Nordhagen LS, Løfsgaard VS, Småstuen MC, Glavin K, Carlsen K, Carlsen MH, Granum B, Gubrandsgard M, Haugen G, Hedlin G, Jonassen CM, Nordlund B, Rehbinder EM, Rudi K, Saunders CM, Skjerven HO, Staff AC, Söderhäll C, Vettukattil R, Aaneland H, Lødrup Carlsen KC. Maternal food-avoidance diets and dietary supplements during breastfeeding. Nurs Open 2022; 10:230-240. [PMID: 35866582 PMCID: PMC9748056 DOI: 10.1002/nop2.1298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 05/18/2022] [Accepted: 06/27/2022] [Indexed: 01/04/2023] Open
Abstract
AIMS To identify maternal food-avoidance diets and dietary supplement use during breastfeeding, and to explore factors associated with food avoidance diets. DESIGN A prospective mother-child birth cohort study. METHODS Electronic questionnaires were answered by 1,462 breastfeeding mothers 6 months postpartum in the Preventing Atopic Dermatitis and Allergies in Children (PreventADALL) study from 2014-2016. Demographic and antenatal factors were analysed for associations with food avoidance diets in 1,368 women by multiple logistic regression. RESULTS Overall, 289 breastfeeding women (19.8%) avoided at least one food item in their diet, most commonly cow's milk in 99 women (6.8%). Foods were most often avoided due to conditions in the child, maternal factors or lifestyle choice. The odds for food avoidance diets were 2.1 (95% CI: 1.3, 3.4) for food allergy (presumed or diagnosed) and 19.4 (5.4, 70.1) for celiac disease in the mother. Dietary supplements were reported by nearly 80%, most commonly cod liver oil.
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Affiliation(s)
- Live S. Nordhagen
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway,VID Specialized UniversityOsloNorway
| | | | | | | | | | | | - Berit Granum
- Department of Environmental HealthNorwegian Institute of Public HealthOsloNorway
| | - Malén Gubrandsgard
- Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Guttorm Haugen
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Obstetrics and GynaecologyOslo University HospitalOsloNorway
| | - Gunilla Hedlin
- Astrid Lindgren Children's HospitalKarolinska University HospitalStockholmSweden,Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Christine M. Jonassen
- Faculty of Chemistry, Biotechnology and Food Scienceorwegian University of Life SciencesÅsNorway,Genetic Unit, Centre for Laboratory MedicineØstfold Hospital TrustNorway
| | - Björn Nordlund
- Astrid Lindgren Children's HospitalKarolinska University HospitalStockholmSweden,Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Eva Maria Rehbinder
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Department of Dermatology and VenerologyOslo University HospitalOsloNorway
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Scienceorwegian University of Life SciencesÅsNorway
| | - Carina M. Saunders
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Håvard O. Skjerven
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Anne Cathrine Staff
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Obstetrics and GynaecologyOslo University HospitalOsloNorway
| | - Cilla Söderhäll
- Astrid Lindgren Children's HospitalKarolinska University HospitalStockholmSweden,Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Riyas Vettukattil
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Hilde Aaneland
- Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Karin C. Lødrup Carlsen
- Institute of Clinical MedicineUniversity of OsloOsloNorway,Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway
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10
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Killingmo RM, Chiarotto A, van der Windt DA, Storheim K, Bierma-Zeinstra SMA, Småstuen MC, Zolic-Karlsson Z, Vigdal ØN, Koes BW, Grotle M. Modifiable prognostic factors of high costs related to healthcare utilization among older people seeking primary care due to back pain: an identification and replication study. BMC Health Serv Res 2022; 22:793. [PMID: 35717179 PMCID: PMC9206382 DOI: 10.1186/s12913-022-08180-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Back pain is an extensive burden to our healthcare system, yet few studies have explored modifiable prognostic factors associated with high costs related to healthcare utilization, especially among older back pain patients. The aims of this study were to identify modifiable prognostic factors for high costs related to healthcare utilization among older people seeking primary care with a new episode of back pain; and to replicate the identified associations in a similar cohort, in a different country. METHODS Data from two cohort studies within the BACE consortium were used, including 452 and 675 people aged ≥55 years seeking primary care with a new episode of back pain. High costs were defined as costs in the top 25th percentile. Healthcare utilization was self-reported, aggregated for one-year of follow-up and included: primary care consultations, medications, examinations, hospitalization, rehabilitation stay and operations. Costs were estimated based on unit costs collected from national pricelists. Nine potential modifiable prognostic factors were selected based on previous literature. Univariable and multivariable binary logistic regression models were used to identify and replicate associations (crude and adjusted for selected covariates) between each modifiable prognostic factor and high costs related to healthcare utilization. RESULTS Four modifiable prognostic factors associated with high costs related to healthcare utilization were identified and replicated: a higher degree of pain severity, disability, depression, and a lower degree of physical health-related quality of life. Kinesiophobia and recovery expectations showed no prognostic value. There were inconsistent results across the two cohorts with regards to comorbidity, radiating pain below the knee and mental health-related quality of life. CONCLUSION The factors identified in this study may be future targets for intervention with the potential to reduce high costs related to healthcare utilization among older back pain patients. TRIAL REGISTRATION ClinicalTrials.gov NCT04261309, 07 February 2020. Retrospectively registered.
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Affiliation(s)
| | - Alessandro Chiarotto
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | | | - Kjersti Storheim
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.,Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Department of Orthopedics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Milada C Småstuen
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | | | - Ørjan N Vigdal
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Bart W Koes
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark
| | - Margreth Grotle
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.,Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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11
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Stigen L, Mørk G, Carstensen T, Magne TA, Gramstad A, Johnson SG, Småstuen MC, Bonsaksen T. Perceptions of the academic learning environment among occupational therapy students - changes across a three-year undergraduate study program. BMC Med Educ 2022; 22:313. [PMID: 35468788 PMCID: PMC9040257 DOI: 10.1186/s12909-022-03291-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 03/24/2022] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Although the learning environment influences students' motivation, learning outcomes, and satisfaction with the study program, less is known about how these factors change as the students' progress through the study program. AIM The aim of this study was to examine changes in occupational therapy students' perceptions of the academic learning environment during their three-year study program and to examine factors associated with the students' perceptions of the learning environment. MATERIALS AND METHODS A longitudinal cohort study was conducted throughout the three-year study program. Data were collected annually using the Course Experience Questionnaire (CEQ). In total, 263 students from six occupational therapy programs participated in at least one data gathering point. The number of participants was 186 in the first year, 168 in the second year and 200 in the third year. Of the 263 students who participated in the study, 87 participated in only one point of data collection, 58 at two points and 118 at all three points of the data collection. Data were analyzed with linear mixed models. RESULTS The results showed statistically significant temporal changes on the "Emphasis on independence", "Good teaching" and "Generic skills" scales. There was a significant decrease in scores from the first to the second year of study and the scores remained at this level in the third study year on both the "Emphasis on independence" and "Good teaching" scales. In addition, associations were found between study effort and educational institution related to the "Appropriate workload" scale, as well as between age and the "Generic skills" scale. CONCLUSION The temporal changes of the students' perceptions of the "Emphasis on independence" as well as "Good teaching" scales are noteworthy. Both scales indicated a significant decrease in scores, indicating that the students perceived that they were less independent from first to second and third year, as well as a perceived decline in the quality of teaching from first to second and third year. The results of this study are central when planning to facilitate learning, especially related to independence and perceptions of good teaching for students in occupational therapy programs.
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Affiliation(s)
- Linda Stigen
- Norwegian University of Science and Technology (NTNU), Gjøvik, Norway.
| | - Gry Mørk
- Faculty of Health Studies, VID Specialized University, Sandnes, Norway
| | - Tove Carstensen
- Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Trine A Magne
- Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Astrid Gramstad
- UiT - The Arctic University of Tromsø, Tromsø, Norway
- Centre for Care Research North, Tromsø, Norway
| | - Susanne G Johnson
- Department of Health and Social Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Milada C Småstuen
- Department of Nursing and Health Promotion, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Tore Bonsaksen
- Faculty of Health Studies, VID Specialized University, Sandnes, Norway
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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12
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Smeland AH, Twycross A, Lundeberg S, Småstuen MC, Rustøen T. Educational Intervention to Strengthen Pediatric Postoperative Pain Management: A Cluster Randomized Trial. Pain Manag Nurs 2021; 23:430-442. [PMID: 34836822 DOI: 10.1016/j.pmn.2021.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/24/2021] [Accepted: 09/30/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Pediatric postoperative pain is still undertreated. AIMS To assess whether educational intervention increases nurses' knowledge and improves pediatric postoperative pain management. DESIGN Cluster randomized controlled trial with three measurement points (baseline T1, 1 month after intervention T2, and 6 months after intervention T3). PARTICIPANTS/SUBJECTS The study was conducted in postanesthesia care units at six hospitals in Norway. Nurses working with children in the included units and children who were undergoing surgery were invited to participate in this study. METHODS Nurses were cluster randomized by units to an intervention (n = 129) or a control group (n = 129). This allocation was blinded for participants at baseline. Data were collected using "The Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain: Norwegian Version" (primary outcome), observations of nurses' clinical practice, and interviews with children. The intervention included an educational day, clinical supervision, and reminders. RESULTS At baseline 193 nurses completed the survey (75% response rate), 143 responded at T2, and 107 at T3. Observations of nurses' (n = 138) clinical practice included 588 children, and 38 children were interviewed. The knowledge level increased from T1 to T3 in both groups, but there was no statistically significant difference between the groups. In the intervention group, there was an improvement between T1 and T2 in the total PNKAS-N score (70% vs. 83%), observed increase use of pain assessment tools (17% vs. 39%), and children experienced less moderate-to-severe pain. CONCLUSIONS No significant difference was observed between the groups after intervention, but a positive change in knowledge and practice was revealed in both groups. Additional studies are needed to explore the most potent variables to strengthen pediatric postoperative pain management.
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Affiliation(s)
- Anja H Smeland
- Children's Surgical Department, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Norway; Institute of Health and Society, University of Oslo, Norway.
| | - Alison Twycross
- Children and Young People's Nursing School of Health, The Open University, UK
| | - Stefan Lundeberg
- Pain Treatment Service, Astrid Lindgren Children's Hospital, Sweden
| | - Milada C Småstuen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Norway; Department of Health, Nutrition and Management, Faculty of Health Sciences, OsloMet, Oslo Metropolitan University, Norway
| | - Tone Rustøen
- Institute of Health and Society, University of Oslo, Norway; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Norway
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13
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Petosic A, Småstuen MC, Beeckman D, Flaatten H, Sunde K, Wøien H. Multifaceted intervention including Facebook-groups to improve guideline-adherence in ICU: A quasi-experimental interrupted time series study. Acta Anaesthesiol Scand 2021; 65:1466-1474. [PMID: 34368947 DOI: 10.1111/aas.13969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/16/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The impact of social media, with its speed, reach and accessibility, in interventions aimed to improve adherence to guidelines such as assessment of Pain, Agitation/Sedation and Delirium (PAD) in intensive care is not described. Therefore, the primary objective of this quality improvement study was to evaluate the impact of a multifaceted intervention including audit and feedback of quality indicators (QI) via Facebook-groups, educational events and engagement of opinion leaders on adherence to PAD-guidelines in four ICUs. METHODS A quasi-experimental interrupted time series study with eight monthly data points in the two phases Before and Intervention was designed. Proportion of nursing shifts with documented PAD-assessment (PAD-QIs) were retrieved from the electronical medical chart from included adult ICU patient-stays in four participating ICUs. Difference between the two time periods was assessed using generalised mixed model for repeated measures with unstructured covariance matrix, and presented as Beta (B) with 95% confidence interval (CI). RESULTS Finally, 1049 ICU patient-stays were analysed; 534 in Before and 515 in Intervention. All three PAD-QIs significantly increased in Intervention by 31% (B = 30.7, 95%CI [25.7 to 35.8]), 26% (B = 25.8, 95%CI [19.4 to 32.2]) and 34% (B = 33.9, 95%CI [28.4 to 39.4]) in pain, agitation/sedation and delirium, respectively. CONCLUSION A multifaceted intervention including use of Facebook-groups was associated with improved guideline-adherence in four ICUs, as measured with process PAD-QIs of PAD assessment. Further research on use of social media to improve guideline adherence is warranted, particularly as social distancing impacts clinical education and training and new approaches are needed.
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Affiliation(s)
- Antonija Petosic
- Division of Emergencies and Critical Care Department of Postoperative and Intensive Care Oslo University Hospital Oslo Norway
- Institute of Health and Society University of Oslo Oslo Norway
| | - Milada C. Småstuen
- Department of Public Health Oslo Metropolitan University Oslo Norway
- Division of Emergencies and critical care Department of Research and Development Oslo University Hospital Oslo Norway
| | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT) Department of Public Health and Primary Care University Centre for Nursing and MidwiferyGhent University Ghent Belgium
- Swedish Centre for Skin and Wound Research (SCENTR) School of Health Sciences Örebro University Örebro Sweden
- Research Unit of Plastic Surgery Department of Clinical Research Faculty of Health Sciences Odense University Odense Denmark
| | | | - Kjetil Sunde
- Division of Emergencies and Critical Care Department of Anaesthesiology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Hilde Wøien
- Division of Emergencies and Critical Care Department of Postoperative and Intensive Care Oslo University Hospital Oslo Norway
- Institute of Health and Society University of Oslo Oslo Norway
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14
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Munk Killingmo R, Tveter AT, Småstuen MC, Storheim K, Grotle M. Comparison of self-reported and public registered absenteeism among people on long-term sick leave due to musculoskeletal disorders: criterion validity of the iMTA Productivity Cost Questionnaire. Eur J Health Econ 2021; 22:865-872. [PMID: 34061299 PMCID: PMC8275498 DOI: 10.1007/s10198-021-01294-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate criterion validity of the iMTA Productivity Cost Questionnaire (iPCQ) by comparing iPCQ-reported occurrence and duration of long-term absenteeism (> 4 weeks) with public registry data collected from the Norwegian Labour and Welfare Administration (NAV) among people on sick leave due to musculoskeletal disorders. METHOD Baseline data from a cohort study was used, in which people on sick leave for at least 4 weeks due to musculoskeletal disorders were recruited electronically through the NAV website. To compare the occurrence of long-term absenteeism overall agreement between the two methods was measured by percentages. To compare the duration (number of days with absenteeism) and adjusted duration (number of days with complete absenteeism) of long-term absenteeism we conducted intraclass correlation coefficient (ICC) two-way random average agreement, descriptive statistic and Wilcoxon signed-rank test. RESULTS In total, 144 participants with a median age (range) of 49 (24-67) were included. The overall agreement on the occurrence of long-term absenteeism was 100%. The ICC value was 0.97 and 0.86 for duration and adjusted duration of long-term absenteeism, respectively. The median difference(iPCQ-registry) between the two methods was 0 and 17 days for long-term absenteeism duration and adjusted duration, respectively. A significant difference between the two methods was observed (Wilcoxon signed-rank test, p < 0.001) with regards to adjusted duration of long-term absenteeism. CONCLUSION The iPCQ showed good agreement with public registry data regarding the occurrence and duration of long-term absenteeism among people with musculoskeletal disorders on long-term sick-leave in Norway. However, the iPCQ does not cover part-time sick-leave and thereby potentially overestimate the total amount of long-term absenteeism. TRIAL REGISTRATION ClinicalTrials.gov Identifier no. NCT04196634.
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Affiliation(s)
| | - Anne Therese Tveter
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- National Advisory Unit on Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Milada C Småstuen
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Kjersti Storheim
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Oslo, Norway
| | - Margreth Grotle
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Oslo, Norway
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15
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Laake JH, Buanes EA, Småstuen MC, Kvåle R, Olsen BF, Rustøen T, Strand K, Sørensen V, Hofsø K. Characteristics, management and survival of ICU patients with coronavirus disease-19 in Norway, March-June 2020. A prospective observational study. Acta Anaesthesiol Scand 2021; 65:618-628. [PMID: 33501998 PMCID: PMC8014826 DOI: 10.1111/aas.13785] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Norwegian hospitals have operated within capacity during the COVID-19 pandemic. We present patient and management characteristics, and outcomes for the entire cohort of adult (>18 years) COVID-19 patients admitted to Norwegian intensive care units (ICU) from 10 March to 19 June 2020. METHODS Data were collected from The Norwegian intensive care and pandemic registry (NIPaR). Demographics, co-morbidities, management characteristics and outcomes are described. ICU length of stay (LOS) was analysed with linear regression, and associations between risk factors and mortality were quantified using Cox regression. RESULTS In total, 217 patients were included. The male to female ratio was 3:1 and the median age was 63 years. A majority (70%) had one or more co-morbidities, most frequently cardiovascular disease (39%), chronic lung disease (22%), diabetes mellitus (20%), and obesity (17%). Most patients were admitted for acute hypoxaemic respiratory failure (AHRF) (91%) and invasive mechanical ventilation (MV) was used in 86%, prone ventilation in 38% and 25% of patients received a tracheostomy. Vasoactive drugs were used in 79% and renal replacement therapy in 15%. Median ICU LOS and time of MV was 14.0 and 12.0 days. At end of follow-up 45 patients (21%) were dead. Age, co-morbidities and severity of illness at admission were predictive of death. Severity of AHRF and male gender were associated with LOS. CONCLUSIONS In this national cohort of COVID-19 patients, mortality was low and attributable to known risk factors. Importantly, prolonged length-of-stay must be taken into account when planning for resource allocation for any next surge.
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Affiliation(s)
- Jon H. Laake
- Department of Anaesthesiology Division of Emergencies and Critical Care Rikshospitalet Medical Centre Oslo University Hospital Oslo Norway
- Department of Research and Development Division of Emergencies and Critical Care Oslo University Hospital Oslo Norway
| | - Eirik A. Buanes
- Department of Intensive Care Haukeland University Hospital Bergen Norway
- Norwegian Intensive Care and Pandemic Registry Haukeland University Hospital Bergen Norway
| | | | - Reidar Kvåle
- Department of Intensive Care Haukeland University Hospital Bergen Norway
- Norwegian Intensive Care and Pandemic Registry Haukeland University Hospital Bergen Norway
- University of Bergen Bergen Norway
| | - Brita F. Olsen
- Intensive and Postoperative Unit Østfold Hospital Trust Grålum Norway
- Faculty of Health and Welfare Østfold University College Halden Norway
| | - Tone Rustøen
- Department of Research and Development Division of Emergencies and Critical Care Oslo University Hospital Oslo Norway
- Institute of Health and Society Faculty of Medicine University of Oslo Oslo Norway
| | - Kristian Strand
- Department of Intensive Care Stavanger University Hospital Stavanger Norway
| | | | - Kristin Hofsø
- Department of Research and Development Division of Emergencies and Critical Care Oslo University Hospital Oslo Norway
- Lovisenberg Diaconal University College Oslo Norway
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16
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Valeberg BT, Dihle A, Småstuen MC, Endresen AO, Rustøen T. The effects of a psycho-educational intervention to improve pain management after day surgery: A randomised clinical trial. J Clin Nurs 2021; 30:1132-1143. [PMID: 33432643 DOI: 10.1111/jocn.15659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 11/17/2020] [Accepted: 12/31/2020] [Indexed: 12/17/2022]
Abstract
AIMS AND OBJECTIVES To evaluate the effectiveness of a psycho-educational intervention for shoulder and breast day surgery patients in decreasing pain intensity and pain interference with function and strengthening adherence with the analgesic regimen; and further to identify factors that influence average pain intensity and pain interference with function. BACKGROUND Pain is one of the most prevalent symptoms after day surgery. However, pain management is left to the patients and family, and interventions to help patients are needed. DESIGN Randomised clinical trial with an intervention (n = 101) and a usual care group (n = 119) using multiple measurements during 6 months postoperatively. The CONSORT checklist is used. METHODS Patients in the intervention group received a booklet about pain and pain management and coaching by research nurses on postoperative days 2, 3 and 7. Differences between groups were identified using the chi-squared analysis and t tests. Changes with time were identified using a linear mixed model with repeated measures. RESULTS After controlling for covariates, group differences at any time in average pain intensity and pain interference with function were not statistically significant. Changes over time within any one group in average pain intensity and pain interference with function were statistically significant and decreased with time. Higher levels of average pain intensity and pain interference over time were associated with shoulder surgery, female, younger, pain expectation, preoperative pain and poorer adherence. CONCLUSIONS No group differences related to the intervention were revealed, and preoperative teaching together with a pain management booklet and coaching may help to strengthen the intervention's effects. Further research on interventions directed towards pain management is needed. RELEVANCE TO CLINICAL PRACTICE Day surgery patients' postoperative pain and pain management is not satisfactorily handled. To encourage and educate patients to use the prescribed analgesics in the immediate postoperative days may be necessary to enhance pain management. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (NCT01595035).
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Affiliation(s)
- Berit T Valeberg
- Oslo Metropolitan University, Oslo, Norway.,University of South-East, Borre, Norway
| | | | - Milada C Småstuen
- Oslo Metropolitan University, Oslo, Norway.,University in Oslo, Oslo, Norway
| | | | - Tone Rustøen
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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17
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Olsen BF, Valeberg BT, Jacobsen M, Småstuen MC, Puntillo K, Rustøen T. Pain in intensive care unit patients-A longitudinal study. Nurs Open 2021; 8:224-231. [PMID: 33318830 PMCID: PMC7729640 DOI: 10.1002/nop2.621] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/20/2020] [Accepted: 08/06/2020] [Indexed: 11/10/2022] Open
Abstract
Aim To assess occurrence of pain during the first 6 days of intensive care unit (ICU) stay and evaluate associations between occurrence of pain and selected patient-related variables. Design A longitudinal study. Methods Adult ICU patients from three units were included. Patients' pain was assessed with valid pain assessment tools every 8 hr during their first 6 days in ICU. Possible associations between occurrence of pain and selected patient-related variables were modelled using multiple logistic regression. Results When pain was assessed regularly with pain assessment tools, 10% of patients were in pain at rest and 27% were in pain during turning. The proportions of patients who were in pain were significantly higher for patients able to self-report pain, compared with patients not able to self-report (p < .001). Several predictors were associated with being in pain. It is important to be aware of these predictors in order to improve pain management.
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Affiliation(s)
- Brita F. Olsen
- Intensive and Post Operative UnitØstfold Hospital TrustGrålumNorway
- Faculty of Health and WelfareØstfold University CollegeHaldenNorway
| | - Berit T. Valeberg
- Faculty of Health SciencesOslo Metropolitan UniversityOsloNorway
- Faculty of Health and Social SciencesUniversity of South‐Eastern NorwayKongsbergNorway
| | - Morten Jacobsen
- Medical DepartmentØstfold Hospital TrustGrålumNorway
- Faculty of MedicineUniversity of OsloOsloNorway
- Norwegian University of Life SciencesÅsNorway
| | | | - Kathleen Puntillo
- Department of Physiological NursingUniversity of California San Francisco School of NursingSan FranciscoCAUSA
| | - Tone Rustøen
- Faculty of MedicineUniversity of OsloOsloNorway
- Division of Emergencies and Critical CareOslo University HospitalOsloNorway
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18
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Nordhagen LS, Kreyberg I, Bains KES, Carlsen K, Glavin K, Skjerven HO, Småstuen MC, Hilde K, Nordlund B, Vettukattil R, Hedlin G, Granum B, Jonassen CM, Gudmundsdóttir HK, Haugen G, Rehbinder EM, Söderhäll C, Staff AC, Lødrup Carlsen KC, Asarnoj A, Lødrup Carlsen OC, Wik Despriée Å, Dyrseth V, Endre KA, Granlund PA, Holmstrøm H, Håland G, Mägi CO, Nygaard UC, Rudi K, Saunders CM, Sjøborg KD, Skrindo I, Tedner SG, Værnesbranden MR, Wiik J. Maternal use of nicotine products and breastfeeding 3 months postpartum. Acta Paediatr 2020; 109:2594-2603. [PMID: 32274823 DOI: 10.1111/apa.15299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 03/27/2020] [Accepted: 04/01/2020] [Indexed: 01/19/2023]
Abstract
AIM We aimed to determine the prevalence of and factors associated with maternal use of nicotine products in relation to breastfeeding. METHODS Nicotine use 3 months postpartum was determined in the Scandinavian PreventADALL mother-child birth cohort study recruiting 1837 women from 2014 to 2016. Electronic questionnaires at 18 weeks pregnancy and 3 months postpartum provided information on snus use, smoking or other nicotine use, infant feeding and socio-economic factors. The risk of nicotine use in relation to breastfeeding was analysed with logistic regression. RESULTS Overall, 5.6% of women used snus (2.9%), smoked (2.7%) or both (n = 2) 3 months postpartum, while one used other nicotine products. Among the 1717 breastfeeding women, 95.1% reported no nicotine use, while 2.4% used snus, 2.5% smoked and one dual user. Compared to 3.7% nicotine use in exclusively breastfeeding women (n = 1242), the risk of nicotine use increased by partly (OR 2.26, 95% CI 1.45-3.52) and no breastfeeding (OR 4.58, 95% CI 2.57-8.21). Nicotine use before (14.5% snus, 16.4% smoking) or in pregnancy (0.2% snus, 0.4% smoking) significantly increased the risk of using nicotine during breastfeeding. CONCLUSION Few breastfeeding women used snus or smoked 3 months postpartum, with increased risk by nicotine use before or during pregnancy.
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Affiliation(s)
- Live S. Nordhagen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- VID Specialized University Oslo Norway
| | - Ina Kreyberg
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | - Karen Eline S. Bains
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | - Kai‐Håkon Carlsen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | | | - Håvard O. Skjerven
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | | | - Katarina Hilde
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Riyas Vettukattil
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Berit Granum
- Department of Environmental Health Norwegian Institute of Public Health Oslo Norway
| | - Christine M. Jonassen
- Faculty of Chemistry, Biotechnology and Food Science Norwegian University of Life Sciences Ås Norway
- Genetic Unit Centre for Laboratory Medicine Østfold Hospital Trust Kalnes Norway
| | - Hrefna K. Gudmundsdóttir
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Eva Maria Rehbinder
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Department of Dermatology Oslo University Hospital Oslo Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Anne Cathrine Staff
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Karin C. Lødrup Carlsen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
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19
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Øiestad BE, Aanesen F, Løchting I, Storheim K, Tingulstad A, Rysstad TL, Småstuen MC, Tveter AT, Sowden G, Wynne-Jones G, Fors EA, van Tulder M, Berg RC, Foster NE, Grotle M. Study protocol for a randomized controlled trial of the effectiveness of adding motivational interviewing or stratified vocational advice intervention to usual case management on return to work for people with musculoskeletal disorders. The MI-NAV study. BMC Musculoskelet Disord 2020; 21:496. [PMID: 32723318 PMCID: PMC7385885 DOI: 10.1186/s12891-020-03475-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/03/2020] [Indexed: 11/25/2022] Open
Abstract
Background Little research exists on the effectiveness of motivational interviewing (MI) on return to work (RTW) in workers on long term sick leave. The objectives of this study protocol is to describe a randomized controlled trial (RCT) with the objectives to compare the effectiveness and cost-effectiveness of usual case management alone with usual case management plus MI or usual case management plus stratified vocational advice intervention (SVAI), on RTW among people on sick leave due to musculoskeletal (MSK) disorders. Methods A multi-arm RCT with economic evaluation will be conducted in Norway with recruitment of 450 participants aged 18–67 years on 50–100% sick leave for > 7 weeks due to MSK disorders. Participants will be randomized to either usual case management by the Norwegian Labour and Welfare Administration (NAV) alone, usual case management by NAV plus MI, or usual case management by NAV plus SVAI. Trained caseworkers in NAV will give two MI sessions, and physiotherapists will give 1–4 SVAI sessions depending upon risk of long-term sick leave. The primary outcome is the number of sick leave days from randomization to 6 months follow-up. Secondary outcomes are number of sick leave days at 12 months follow-up, time until sustainable RTW (≥4 weeks of at least 50% of their usual working hours) at 12 months, proportions of participants receiving sick leave benefits during 12 months of follow-up, and MSK symptoms influencing health at 12 months. Cost-utility evaluated by the EuroQoL 5D-5L and cost-benefit analyses will be performed. Fidelity of the interventions will be assessed through audio-recordings of approximately 10% of the intervention sessions. Discussion The results from this RCT will inform stakeholders involved in supporting RTW due to MSK disorders such as staff within NAV and primary health care. Trial registration ClinicalTrials.gov ID: NCT03871712 registered March 12th 2020.
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Affiliation(s)
- Britt Elin Øiestad
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway.
| | - Fiona Aanesen
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway
| | - Ida Løchting
- Research and Communication Unit for MSK Health (FORMI), Oslo University Hospital and Oslo Metropolitan University, Oslo, Norway
| | - Kjersti Storheim
- Department of Physiotherapy, Research and Communication Unit for MSK Health (FORMI), Oslo University Hospital, Oslo Metropolitan University, Oslo, Norway
| | - Alexander Tingulstad
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway
| | - Tarjei L Rysstad
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway
| | - Milada C Småstuen
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway.,Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Anne Therese Tveter
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway.,National Advisor Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Gail Sowden
- School of Primary, Community & Social Care, Keele University, Keele, UK.,Connect Health, Newcastle upon Tyne, UK
| | - Gwenllian Wynne-Jones
- Faculty of Medicine and Health Sciences, School of Primary, Community and Social Care, and School of Nursing and Midwifery, Keele University, Keele, UK
| | - Egil A Fors
- General Practice Research Unit, Department of Public Health and Nursing Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Maurits van Tulder
- Department Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Rigmor C Berg
- Norwegian Institute of Public Health, Oslo, Norway.,Department of Community Medicine, The University of Tromsø, Tromsø, Norway
| | - Nadine E Foster
- School of Primary, Community & Social Care, Keele University, Keele, UK
| | - Margreth Grotle
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway
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20
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Holmberg Fagerlund B, Helseth S, Andersen LF, Småstuen MC, Glavin K. The use of a communication tool about diet at the child health centre: A cluster randomized controlled trial. Nurs Open 2020; 7:1217-1232. [PMID: 32587742 PMCID: PMC7308697 DOI: 10.1002/nop2.498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 03/17/2020] [Indexed: 02/01/2023] Open
Abstract
Aim To investigate the effect of a communication tool about diet used in public health nurse consultations with parents compared with standard consultations concerning the 2-year-old child's diet. Design A cluster randomized controlled trial. Methods Ten municipalities were selected randomly and matched in pairs. In each pair, the control or intervention group was randomly allocated. Parents were recruited to participate from January 2015 to January 2017. In intervention clusters, a communication tool about diet was used to help the parents (N = 140) to focus on a healthy diet for their child. In the control clusters, parents (N = 110) attended standard consultations. The participants completed semi-quantitative food frequency questionnaires at baseline and end point. Results No effect of the intervention was seen on the child's daily intake of vegetables or saturated fat, or body mass index. Significantly fewer parents desired more information about food for toddlers in the intervention than in the control group.
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Affiliation(s)
- Bettina Holmberg Fagerlund
- Department of Nursing and Health PromotionFaculty of Health SciencesOsloMet – Oslo Metropolitan UniversityOsloNorway
| | - Sølvi Helseth
- Department of Nursing and Health PromotionFaculty of Health SciencesOsloMet – Oslo Metropolitan UniversityOsloNorway
| | - Lene F. Andersen
- Department of NutritionInstitute of Basic Medical SciencesFaculty of MedicineUniversity of OsloOsloNorway
| | - Milada C. Småstuen
- Department of Nursing and Health PromotionFaculty of Health SciencesOsloMet – Oslo Metropolitan UniversityOsloNorway
| | - Kari Glavin
- Department of HealthVID Specialized UniversityOsloNorway
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21
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Sundar TKB, Riiser K, Småstuen MC, Opheim R, Løndal K, Glavin K, Helseth S. Health-related quality of life among 13-14 year old adolescents with overweight-a mixed methods approach. Health Qual Life Outcomes 2020; 18:161. [PMID: 32471437 PMCID: PMC7260808 DOI: 10.1186/s12955-020-01413-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overweight and obesity are public concerns with risk of adverse health outcomes. Health-related quality of life (HRQoL) is lower in adolescents than children in general. An increase in body mass index (BMI) is associated with a decrease in HRQoL. The purpose of this study was to measure and explore the HRQoL among adolescents with overweight or obesity who had participated in an intervention study, Young & Active, with the aim of increasing physical activity (PA), reducing BMI and promoting HRQoL. METHODS Mixed methods, with a convergent design, were used to investigate how different methodological approaches could expand our understanding of the adolescents' HRQoL. Quantitative post-intervention data on HRQoL were collected among the 84 intervention participants, aged 13-14 years, using the KIDSCREEN 52 questionnaire. The data were compared with a Norwegian reference population of 244 individuals, and analysed using a non-parametric Mann-Whitney test. Qualitative semi-structured interviews were conducted with 21 adolescents from the intervention. A directed approach to content analysis was adopted, using the ten sub-scales from KIDSCREEN 52. RESULTS HRQoL in the intervention sample was significantly reduced on the sub-scale of physical well-being compared to the reference population. The reference population scored significantly lower than the intervention sample on the sub-scale of parent relation and home life. No significant differences were found on the other sub-scales. The qualitative data supported the quantitative findings on the sub-scale of physical well-being, but showed that perceptions of fitness, energy level or health could vary. Regarding parent relations, the interviewees extended this to include relationships to other family members as equally important. Most of the interviewees expressed a negative view of their bodies, but not their clothing or accessories. This may explain why no statistically significant differences were found on these aspects in the results from the KIDSCREEN questionnaire. CONCLUSION The use of the KIDSCREEN 52 instrument gave important indications about the adolescents' HRQoL and need for additional follow up. The qualitative data provided an in-depth understanding that nuanced the findings and widened our knowledge of the adolescents HRQoL. Combining methods enabled a comprehensive approach to research on HRQoL.
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Affiliation(s)
- T K B Sundar
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway.,Department of Nursing Science, Institute of Health and Society, University of Oslo, P. O. Box 1130, Blindern, N-0318, Oslo, Norway
| | - K Riiser
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, N-0130, Oslo, Norway
| | - M C Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - R Opheim
- Department of Nursing Science, Institute of Health and Society, University of Oslo, P. O. Box 1130, Blindern, N-0318, Oslo, Norway
| | - K Løndal
- Department of Primary and Secondary Teacher Education, Faculty of Education and International Studies, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, N-0130, Oslo, Norway
| | - K Glavin
- VID Specialized University, Faculty of Health Studies, P.O. Box 184, Vinderen, NO-0319, Oslo, Norway
| | - S Helseth
- Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, N-0130, Oslo, Norway.
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22
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Munk R, Storheim K, Småstuen MC, Grotle M. Measuring Productivity Costs in Patients With Musculoskeletal Disorders: Measurement Properties of the Institute for Medical Technology Assessment Productivity Cost Questionnaire. Value Health 2019; 22:1410-1416. [PMID: 31806198 DOI: 10.1016/j.jval.2019.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/21/2019] [Accepted: 07/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The Institute for Medical Technology Assessment Productivity Cost Questionnaire (iPCQ) was recently developed to cover all domains of productivity costs; absenteeism, presenteeism and productivity costs related to unpaid work. The original iPCQ has not been tested with respect to neither content or construct validity, nor reliability, and there is no Norwegian version of the questionnaire. OBJECTIVES To translate and cross-culturally adapt the iPCQ into Norwegian and to test its measurement properties among patients with musculoskeletal disorders. METHODS Translation and cross-cultural adaptation was conducted according to guidelines, and measurement properties were investigated using a cross-sectional design including a test-retest assessment. Patients with musculoskeletal disorders were recruited from secondary care. Data quality, content validity (10 patients evaluated comprehensibility, 2 researchers and 1 clinician evaluated relevance and comprehensiveness), construct validity (factor analysis, internal consistency, divergent hypothesis testing), and test-retest reliability (intraclass correlation coefficient two-way random average agreement, Cohen's unweighted kappa) were assessed. RESULTS In total, 115 patients with a mean age (SD) of 46 (9) years were included, and 62 responded to the retest. The questionnaire was feasible, with little missing data and no floor or ceiling effects. Content validity displayed good comprehensibility and relevance and sufficient comprehensiveness. Factor analysis revealed a 3-component solution accounting for 82% of the total variance; items loaded as expected and supported the original structure of the iPCQ. Internal consistency was acceptable for the 3 components of productivity cost, with an inter-item correlation ranging from 0.42 to 0.62. Further, a total of 91% of our hypotheses were verified. The intraclass correlation coefficient values ranged from 0.88 to 0.99 for all items except one; kappa ranged from 0.61 to 0.92, indicating overall good reliability of the questionnaire. CONCLUSIONS The Norwegian iPCQ showed good measurement properties among patients with musculoskeletal disorders from secondary care in Norway. We therefore recommend the iPCQ as a useful tool for measuring productivity costs in patients with musculoskeletal disorders.
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Affiliation(s)
- Rikke Munk
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.
| | - Kjersti Storheim
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway; Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway
| | - Milada C Småstuen
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Margreth Grotle
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway; Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway
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23
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Fjeld OR, Grotle M, Matre D, Pedersen LM, Lie MU, Småstuen MC, Storheim K, Heuch I, Stubhaug A, Zwart JA, Nilsen KB. Predicting the outcome of persistent sciatica using conditioned pain modulation: 1-year results from a prospective cohort study. Scand J Pain 2019; 20:69-75. [DOI: 10.1515/sjpain-2019-0112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 08/28/2019] [Indexed: 02/06/2023]
Abstract
Abstract
Background and aims
Recovery in patients hospitalised with severe sciatica is unpredictable. Prognostic tools to aid clinicians in the early identification of patients at risk of developing chronic sciatic pain are warranted. Conditioned pain modulation (CPM) is a psychophysical measure of the endogenous pain modulatory pathways. Several studies have suggested CPM as a potentially important predictive biomarker for the development of chronic pain. The aim of the study was to determine whether CPM effect in patients still suffering from leg pain 6 weeks after hospital discharge for severe sciatica is associated with persistent leg pain at 12 months. A potential association would suggest that measuring CPM effect could be a valuable prognostic tool in the hospital management of sciatica.
Methods
A prospective cohort study in which CPM effect was measured 6 weeks after hospital discharge following an acute admission with sciatica as the main complaint. The impact of CPM effect on the outcome was analysed using logistic regression. The outcome measured was self-reported leg pain score of ≥1 in the past week on a 0–10 numeric rating scale (NRS) at 12 months post discharge.
Results
A total of 111 patients completed the entire study, 51 of whom received non-randomised surgical treatment. Crude and confounder adjusted analyses showed no significant association between CPM effect and leg-pain measured at 12 months, crude Odds Ratio 0.87, 95% CI 0.7–1.1, p = 0.23.
Conclusions
Our results suggest that CPM assessment has limited prognostic value for the long-term outcome in severe sciatica when measured 6 weeks after hospital discharge.
Implications
The present study adds important knowledge concerning the limited clinical use of late CPM testing in sciatica patients. The heterogeneity in patients, the wide range of treatments received and a generally favourable outcome are factors that may affect CPM’s clinical value as a prognostic factor for severe sciatica.
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Affiliation(s)
- Olaf R. Fjeld
- Research and Communication Unit for Musculoskeletal Health (FORMI) , Oslo University Hospital, Ullevål , Oslo , Norway
- Department of Neurology , Oslo University Hospital , Oslo , Norway
- Institute of Clinical Medicine , Faculty of Medicine, University of Oslo , Oslo , Norway
| | - Margreth Grotle
- Research and Communication Unit for Musculoskeletal Health (FORMI) , Oslo University Hospital, Ullevål , Oslo , Norway
- Faculty of Health Science , OsloMet - Oslo Metropolitan University , Oslo , Norway
| | - Dagfinn Matre
- Department of Work Psychology and Physiology , National Institute of Occupational Health , Oslo , Norway
| | - Linda M. Pedersen
- Research and Communication Unit for Musculoskeletal Health (FORMI) , Oslo University Hospital, Ullevål , Oslo , Norway
| | - Marie U. Lie
- Research and Communication Unit for Musculoskeletal Health (FORMI) , Oslo University Hospital, Ullevål , Oslo , Norway
| | - Milada C. Småstuen
- Research and Communication Unit for Musculoskeletal Health (FORMI) , Oslo University Hospital, Ullevål , Oslo , Norway
- Institute of Physiotherapy, Faculty of Health Science , Oslo and Akershus University College , Oslo , Norway
| | - Kjersti Storheim
- Research and Communication Unit for Musculoskeletal Health (FORMI) , Oslo University Hospital, Ullevål , Oslo , Norway
| | - Ingrid Heuch
- Research and Communication Unit for Musculoskeletal Health (FORMI) , Oslo University Hospital, Ullevål , Oslo , Norway
| | - Audun Stubhaug
- Department of Pain Management and Research, Faculty of Medicine , University of Oslo, Oslo , Norway
| | - John-Anker Zwart
- Research and Communication Unit for Musculoskeletal Health (FORMI) , Oslo University Hospital, Ullevål , Oslo , Norway
- Department of Neurology , Oslo University Hospital , Oslo , Norway
- Norway Institute of Clinical Medicine, Faculty of Medicine , University of Oslo , Oslo , Norway
| | - Kristian Bernhard Nilsen
- Research and Communication Unit for Musculoskeletal Health (FORMI) , Oslo University Hospital, Ullevål , Oslo , Norway
- Department of Neurology , Oslo University Hospital , Oslo , Norway
- Department of Neuromedicine and Movement Science , Norwegian University of Science and Technology , Trondheim , Norway
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24
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Valsø Å, Rustøen T, Skogstad L, Schou-Bredal I, Ekeberg Ø, Småstuen MC, Myhren H, Sunde K, Tøien K. Post-traumatic stress symptoms and sense of coherence in proximity to intensive care unit discharge. Nurs Crit Care 2019; 25:117-125. [PMID: 31418993 DOI: 10.1111/nicc.12466] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Post-traumatic stress (PTS) symptoms following intensive care unit (ICU) treatment can lead to post-traumatic stress disorder and represent a severe health burden. In trauma patients, a strong sense of coherence (SOC) is associated with fewer PTS symptoms. However, this association has not been investigated in a general ICU sample. AIMS AND OBJECTIVES To examine the occurrence of PTS symptoms in general ICU patients early after ICU discharge and to assess possible associations between PTS symptoms and SOC, ICU memory, pain, and demographic and clinical characteristics. DESIGN This was a cross-sectional study. METHODS Adult patients aged ≥18 years admitted for ≥24 hours to five ICUs between 2014 and 2016 were recruited. PTS symptoms and SOC were measured at the ward within the first week after discharge from the ICU using the Posttraumatic Stress Scale-10 and Sense of Coherence Scale-13. Multiple linear regression analysis was used to identify associations between PTS symptoms and SOC and the selected independent variables. RESULTS A total of 523 patients were included (17.8% trauma patients; median age 57 years [range 18-94]; 53.3% male). The prevalence of clinically significant PTS symptoms was 32%. After adjustments for gender and age, lower SOC (P < 0.001), more ICU delusional memories (P < 0.001), greater pain interference (P < 0.001), not being a trauma patient (P = 0.02), and younger age (P = 0.03) were significantly associated with more PTS symptoms. CONCLUSIONS One third of patients experienced clinically relevant PTS symptoms early after discharge from the ICU. In the present study, SOC, delusional memory, pain interference, younger age, and not being a trauma patient were factors associated with more PTS symptoms. RELEVANCE TO CLINICAL PRACTICE Early individual follow up after ICU discharge focusing on pain relief and delusional memory may reduce PTS symptoms, with a potential of improving rehabilitation.
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Affiliation(s)
- Åse Valsø
- Department of Postoperative and Intensive Care, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Tone Rustøen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Laila Skogstad
- Department of Nursing and Health Promotion, Prehospital Trauma Care - Bachelor paramedics, OsloMet - Oslo Metropolitan University of Oslo, Oslo, Norway
| | - Ingerl Schou-Bredal
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,Unit for Breast- and Endocrine Surgery, Division of Cancer, Oslo University Hospital, Oslo, Norway
| | - Øivind Ekeberg
- Department of Behavioral Sciences in Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Milada C Småstuen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Department of Public Health, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Hilde Myhren
- Department of Acute medicine, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Kjetil Sunde
- Department of Anesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kirsti Tøien
- Department of Postoperative and Intensive Care, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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25
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Torbjørnsen A, Småstuen MC, Jenum AK, Årsand E, Ribu L. The Service User Technology Acceptability Questionnaire: Psychometric Evaluation of the Norwegian Version. JMIR Hum Factors 2018; 5:e10255. [PMID: 30578191 PMCID: PMC6324518 DOI: 10.2196/10255] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 09/11/2018] [Accepted: 09/14/2018] [Indexed: 01/17/2023] Open
Abstract
Background When developing a mobile health app, users’ perception of the technology should preferably be evaluated. However, few standardized and validated questionnaires measuring acceptability are available. Objective The aim of this study was to assess the validity of the Norwegian version of the Service User Technology Acceptability Questionnaire (SUTAQ). Methods Persons with type 2 diabetes randomized to the intervention groups of the RENEWING HEALTH study used a diabetes diary app. At the one-year follow-up, participants in the intervention groups (n=75) completed the self-reported instrument SUTAQ to measure the acceptability of the equipment. We conducted confirmatory factor analysis for evaluating the fit of the original five-factor structure of the SUTAQ. Results We confirmed only 2 of the original 5 factors of the SUTAQ, perceived benefit and care personnel concerns. Conclusions The original five-factor structure of the SUTAQ was not confirmed in the Norwegian study, indicating that more research is needed to tailor the questionnaire to better reflect the Norwegian setting. However, a small sample size prevented us from drawing firm conclusions about the translated questionnaire.
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Affiliation(s)
- Astrid Torbjørnsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.,General Practice Research Unit, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Milada C Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Eirik Årsand
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lis Ribu
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
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Myhrvold T, Småstuen MC. Undocumented migrants' life situations: An exploratory analysis of quality of life and living conditions in a sample of undocumented migrants living in Norway. J Clin Nurs 2018; 28:2073-2087. [PMID: 30552720 DOI: 10.1111/jocn.14743] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 11/16/2018] [Accepted: 11/30/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To gather insight in conditions important to an understanding of undocumented migrants' life situations and more specifically to explore undocumented migrants' quality of life and how we can understand the various domains of quality of life related to demographics, living conditions, migration history and inflicted burden. BACKGROUND Undocumented migrants suffer from economic hardship and acculturative stress, limited psychological and social support and at the same time restricted access to health care and social welfare. DESIGN An exploratory mixed methods design using primarily quantitative data with a qualitative component was implemented. METHODS Sociodemographic data on 90 undocumented migrants were collected, and self-report questionnaires on quality of life and psychological distress were completed, supplemented by qualitative data obtained through interviews and additional qualitative questions. The STROBE checklist for cross-sectional studies was used for reporting this study. RESULTS Quality of life in our group of undocumented migrants was poor. Leaving their home country because of war or persecution, hunger, having experienced abuse, homelessness and higher age were statistically significantly associated with poorer quality of life. Having membership in a local association and having a partner were statistically significantly associated with better quality of life. Qualitative data indicate that marginal living conditions, fear of death and suffering and conditions associated with dependency were the main components comprising the burden to our respondents, reflecting their precarious juridical status as undocumented migrants. CONCLUSION Our respondents' poor quality of life was related to the complex interplay between possible exposures to traumatic experiences before and during flight and post-migration traumatisation in relation to our respondents' experiences of economic, social and acculturative hardship in Norway. RELEVANCE TO CLINICAL PRACTICE Responses called for to improve undocumented migrants' quality of life and eliminate barriers to their health care appeal more to nurses as a professional group and to those in positions of authority than each individual nurse on duty.
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Affiliation(s)
- Trine Myhrvold
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Met - Oslo Metropolitan University, Oslo, Norway
| | - Milada C Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Met - Oslo Metropolitan University, Oslo, Norway
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Bonsaksen T, Småstuen MC, Thørrisen MM, Fong K, Lim HB, Brown T. Factor analysis of the Approaches and Study Skills Inventory for Students in a cross-cultural occupational therapy undergraduate student sample. Aust Occup Ther J 2018; 66:33-43. [PMID: 30062739 DOI: 10.1111/1440-1630.12504] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIM The Approaches and Study Skills Inventory for Students (ASSIST) has been used previously to assess the learning approaches among students in higher education, but reports of its use with occupational therapy students are rare. This study investigated the factor structure of the ASSIST in a cross-cultural sample of undergraduate occupational therapy students, and examined whether the factor structure from specific participant groups from different cross-cultural contexts was consistent. METHODS Occupational therapy students (n = 712) from education programmes in Australia, Norway, Hong Kong and Singapore completed the ASSIST. To assess the factor structure of the instrument, a Principal Components Analysis (PCA) using a confirmatory approach, was completed. Cronbach's coefficient α and inter-item correlations were used to assess the internal consistency of the ASSIST and its subscales. RESULTS For the whole sample, the PCA confirmed the three primary factors as previously established. Five subscales loaded on the first factor (strategic approach). Four subscales loaded on the second factor (surface approach), whereas the remaining four subscales loaded on the third factor (deep approach). Repeating the analysis for each of the country-specific samples produced slightly diverging factor structures for the samples from Australia and Hong Kong. CONCLUSION Considering all the data, the ASSIST subscales that emerged from the PCA used with a confirmatory approach in this study revealed a good degree of concordance with the established original factor, scale and subscale structure. The slightly deviating results obtained for the Hong Kong student group indicate that the established factor structure may not be the best fit across all settings, cultural contexts and sample groups.
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Affiliation(s)
- Tore Bonsaksen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Faculty of Health Sciences, VID Specialized University, Sandnes, Norway
| | - Milada C Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Mikkel M Thørrisen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Kenneth Fong
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong
| | - Hua Beng Lim
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Ted Brown
- Department of Occupational Therapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University - Peninsula Campus, Frankston, Victoria, Australia
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Alfheim HB, Rosseland LA, Hofsø K, Småstuen MC, Rustøen T. Multiple Symptoms in Family Caregivers of Intensive Care Unit Patients. J Pain Symptom Manage 2018; 55:387-394. [PMID: 28864399 DOI: 10.1016/j.jpainsymman.2017.08.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 08/17/2017] [Accepted: 08/17/2017] [Indexed: 11/28/2022]
Abstract
CONTEXT Intensive care unit (ICU) patients experience physical and psychological challenges related to ICU admission in the acute and recovery phases after a critical illness. Involvement of family caregivers (FCs) is essential in the patients' struggle to survive critical illness. FCs report a high symptom burden related to ICU admission. Previous research has investigated mainly single symptoms. Little is known about multiple symptom burden related to FC experiences in an ICU. OBJECTIVE This study aimed: 1) to describe the occurrence, severity, and distress related to multiple symptoms in FCs of ICU patients, and 2) to identify associations between the background characteristics and symptom burden of FCs. METHODS This cross-sectional study investigated multiple symptoms in adult FCs of ICU patients. FCs completed a self-report symptom assessment questionnaire within 2 weeks after the patient's admission to the ICU. RESULTS FCs (N=211) experienced a median of 9 (range 0-24) symptoms, among which, worrying (91%) was the most occurring. Severity and distress varied between symptoms. Younger age, being a spouse of an ICU patient, and having more comorbidities were significantly associated with the number of symptoms. CONCLUSIONS FCs of ICU patients experience multiple symptoms, among which, psychological symptoms are most occurring. Age, relationship to the patient, and comorbidities were significantly associated with the number of symptoms reported by FCs. Comprehensive symptom assessment may identify FCs who are at risk of developing a high symptom burden when the patient is admitted to the ICU.
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Affiliation(s)
- Hanne B Alfheim
- Postoperative and Intensive Care and Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway.
| | - Leiv A Rosseland
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo and Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Kristin Hofsø
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Norway and Lovisenberg Diaconal University College, Oslo, Norway
| | - Milada C Småstuen
- Department of Public Health, Faculty of Nursing Science Oslo and Akershus University College of Applied Sciences and Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Tone Rustøen
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway and Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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Pedersen M, Ekstedt M, Småstuen MC, Wyller VB, Sulheim D, Fagermoen E, Winger A, Pedersen E, Hrubos-Strøm H. Sleep-wake rhythm disturbances and perceived sleep in adolescent chronic fatigue syndrome. J Sleep Res 2017; 26:595-601. [PMID: 28470767 DOI: 10.1111/jsr.12547] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/24/2017] [Indexed: 12/23/2022]
Abstract
Chronic fatigue syndrome (CFS) is characterized by long-lasting, disabling and unexplained fatigue that is often accompanied by unrefreshing sleep. The aim of this cross-sectional study was to investigate sleep-wake rhythm and perceived sleep in adolescent CFS patients compared to healthy individuals. We analysed baseline data on 120 adolescent CFS patients and 39 healthy individuals included in the NorCAPITAL project. Activity measures from a uniaxial accelerometer (activPAL) were used to estimate mid-sleep time (mid-point of a period with sleep) and time in bed. Scores from the Karolinska Sleep Questionnaire (KSQ) were also assessed. The activity measures showed that the CFS patients stayed significantly longer in bed, had a significantly delayed mid-sleep time and a more varied sleep-wake rhythm during weekdays compared with healthy individuals. On the KSQ, the CFS patients reported significantly more insomnia symptoms, sleepiness, awakening problems and a longer sleep onset latency than healthy individuals. These results might indicate that disrupted sleep-wake phase could contribute to adolescent CFS; however, further investigations are warranted.
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Affiliation(s)
- Maria Pedersen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Pediatrics, Akershus University Hospital, Lorenskog, Norway
| | - Mirjam Ekstedt
- School of Health and Caring Sciences, Linneaus University, Kalmar, Sweden.,Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Milada C Småstuen
- Faculty of Health, Akershus University College of Applied Sciences, Oslo, Norway
| | - Vegard B Wyller
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Pediatrics, Akershus University Hospital, Lorenskog, Norway
| | - Dag Sulheim
- Department of Pediatrics, Innlandet Hospital Trust, Brumunddal, Norway
| | - Even Fagermoen
- Department of Anesthesiology and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Anette Winger
- Faculty of Health, Akershus University College of Applied Sciences, Oslo, Norway
| | - Edvard Pedersen
- Department of Computer Science, UiT-The Arctic University of Norway, Tromso, Norway
| | - Harald Hrubos-Strøm
- Division of Surgery, Department of Otorhinolaryngology, Akershus University Hospital, Lorenskog, Norway
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Valderhaug TG, Aasheim ET, Sandbu R, Jakobsen GS, Småstuen MC, Hertel JK, Hjelmesæth J. The association between severity of King's Obesity Staging Criteria scores and treatment choice in patients with morbid obesity: a retrospective cohort study. BMC Obes 2016; 3:51. [PMID: 27980795 PMCID: PMC5142276 DOI: 10.1186/s40608-016-0133-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 11/30/2016] [Indexed: 01/06/2023]
Abstract
Background The King’s Obesity Staging Criteria (KOSC) comprises of a four-graded set of health related domains. We aimed to examine whether, according to KOSC, patients undergoing bariatric surgery differed from those opting for conservative treatment. Methods We graded 2142 consecutive patients with morbid obesity attending our centre from 2005-10 into the following KOSC domains: airway/apnoea, body mass index (BMI), cardiovascular risk (CV-risk), diabetes mellitus, economic complications, functional limitations, gonadal dysfunction, and perceived health status/body image. Both patients and physicians agreed upon treatment choice through a shared decision making process. Results A total of 1329 (62%) patients opted for lifestyle intervention and 813 (37%) for bariatric surgery as their first treatment choice. The patients treated with bariatric surgery were younger (42 vs. 44 years, p < 0.001), had a higher BMI (45.4 vs. 43.8 kg/m2, p < 0.001) and had a lower ten year estimated CV-risk (9.4 vs. 10.7%, p = 0.004) than the lifestyle intervention group. Compared with having BMI < 40 kg/m2, BMI ≥ 40 kg/m2 was associated with 85% increased odds of bariatric surgery (OR 1.85 [95% CI 1.48, 2.30]). Conversely, patients with ≥20% ten year CV-risk, had lower odds of bariatric surgery than patients with <20% CV-risk (0.68 [0.53, 0.87]). Conclusion BMI was the strongest KOSC-domain associated with subsequent bariatric surgery after a shared decision making process. Prospective studies are required to assess whether the use of KOSC can help guide patients and clinicians to identify the most appropriate choice of treatment for morbid obesity.
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Affiliation(s)
- Tone G Valderhaug
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway ; Department of Endocrinology, Akershus University Hospital, Nordbyhagen, Norway ; Division of Medicine and Laboratory Sciences, Institute of Clinical Medicine, University of Oslo, Oslo, Norway ; Tone Gretland Valderhaug, Division of Medicine, Department of Endocrinology, Akershus University Hospital HF, Sykehusveien 25, 1478 Nordbyhagen, Norway
| | - Erlend T Aasheim
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway ; Imperial Weight Centre, Imperial College London, London, UK
| | - Rune Sandbu
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway ; Department of Surgery, Vestfold Hospital Trust, Tønsberg, Norway
| | - Gunn S Jakobsen
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway ; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Jens K Hertel
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway
| | - Jøran Hjelmesæth
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway ; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Andenæs R, Helseth S, Misvær N, Småstuen MC, Ribu L. Psychosocial factors are strongly associated with insomnia in users and nonusers of prescribed sleep medication: evidence from the HUNT3 study. J Multidiscip Healthc 2016; 9:547-555. [PMID: 27799781 PMCID: PMC5077243 DOI: 10.2147/jmdh.s116462] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The aim of this study was to examine how neuroticism, stressful life events, self-rated health, life satisfaction, and selected lifestyle factors were related to insomnia both by sex and among users and nonusers of prescribed sleep medication (PSM). Design Cross-sectional data from the Norwegian Nord-Trøndelag Health Study (HUNT3, 2006–2008), a population-based health survey, were linked to individual data from the Norwegian Prescription Database. Methods Logistic regression analyses were used to investigate the associations between the selected variables and insomnia in both males and females and among subjects using and not using PSM. Individuals were considered to have a presumptive diagnosis of insomnia disorder if they reported difficulty with sleep initiation, sleep maintenance, or early morning awakening several days per week for the last 3 months. PSMs were categorized as anxiolytics or hypnotics; the dose was estimated according to defined daily dose (DDD). Results Of the total 50,805 participants, 6,701 (13.2%) used PSM. The proportions of PSM users were larger among elderly participants. Increased risk of insomnia was strongly associated with poor self-rated health and higher level of neuroticism. These associations were evident for both sexes and were similar among both users and nonusers of PSM. Low satisfaction with life was strongly related to insomnia, but only among nonusers of PSM. Increased doses of PSM were not associated with reduced likelihood of insomnia. Conclusion Insomnia is a problem among both users and nonusers of PSM and is associated with psychosocial factors. Our findings suggest that successful treatment for sleep problems should take individual variation into account, such as age, sex, personality traits, satisfaction with life, and health perception.
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Affiliation(s)
- Randi Andenæs
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Sølvi Helseth
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Nina Misvær
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Milada C Småstuen
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Lis Ribu
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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Olbjørn C, Nakstad B, Småstuen MC, Thiis-Evensen E, Vatn MH, Perminow G. Early anti-TNF treatment in pediatric Crohn's disease. Predictors of clinical outcome in a population-based cohort of newly diagnosed patients. Scand J Gastroenterol 2014; 49:1425-31. [PMID: 25310799 DOI: 10.3109/00365521.2014.966316] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Pediatric Crohn's disease (CD) is often debilitating, with upper gastrointestinal (GI) involvement and complications over time. Treatment with tumor necrosis factor (TNF) blockers can induce and maintain remission. We wanted to evaluate the outcome of patients medically treated for CD to investigate whether clinical, endoscopic and biochemical factors at diagnosis are associated with the early initiation of treatment with the TNF blocker infliximab. MATERIALS AND METHODS Patients aged <18 years, diagnosed with CD were characterized according to the Porto criteria, with endoscopy, magnetic resonance imaging and biochemical tests before individual treatment. They were followed prospectively until a prescheduled examination within 2 years. RESULTS Thirty-six pediatric patients were included, 18 (50%) received infliximab. Infliximab-treated patients had shorter disease duration, more upper GI involvement (p = 0.03) and higher median C-reactive protein (CRP) (28 vs. 7.5 mg/l, p = 0.02), erythrocyte sedimentation rate (ESR) (32 vs. 18 mm/h, p = 0.01) and fecal calprotectin (1506 vs. 501 mg/kg, p = 0.01) levels. Infliximab treatment was well tolerated, and 15/18 of patients achieved clinical remission. At follow-up, 11/17 in the infliximab group and 8/13 in the non-infliximab group achieved ileocolonic mucosal healing. A majority in the infliximab group had a marked reduction of CD-specific upper GI lesions but persistence of unspecific upper GI inflammation at follow-up. CONCLUSION High levels of inflammatory markers and upper GI lesions were associated with initiation of infliximab treatment. A substantial proportion of patients still had unspecific lesions in the upper GI tract regardless of treatment. Future studies must clarify the prognostic role of persistent upper GI-involvement despite mucosal healing in the ileocolon.
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Affiliation(s)
- Christine Olbjørn
- Department of Pediatric and Adolescent Medicine, Akershus University Hospital , Lørenskog , Norway
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Johnsen SJ, Brun JG, Gøransson LG, Småstuen MC, Johannesen TB, Haldorsen K, Harboe E, Jonsson R, Meyer PA, Omdal R. Risk of Non-Hodgkin's Lymphoma in Primary Sjögren's Syndrome: A Population-Based Study. Arthritis Care Res (Hoboken) 2013; 65:816-21. [DOI: 10.1002/acr.21887] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 10/11/2012] [Indexed: 12/26/2022]
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Skarstein S, Rosvold EO, Helseth S, Kvarme LG, Holager T, Småstuen MC, Lagerløv P. High-frequency use of over-the-counter analgesics among adolescents: reflections of an emerging difficult life, a cross-sectional study. Scand J Caring Sci 2013; 28:49-56. [PMID: 23517110 DOI: 10.1111/scs.12039] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 01/31/2013] [Indexed: 01/09/2023]
Abstract
AIMS To examine characteristics of 15- to 16-year-old adolescents who used over-the-counter analgesics daily to weekly (high-frequency users) as compared to those who used less or no analgesics (low-frequency users). Further to analyse the differences in pain experience, lifestyle, self-esteem, school attendance and educational ambition. METHODS An anonymous cross-sectional questionnaire-based study. The questionnaire covered the use of over-the-counter analgesics, pain experience, sociodemographics, lifestyle factors, self-esteem, school absence and future educational plans. The study took place in the 10th grade in six junior high schools in a medium-sized town in Norway. The local sales data for analgesics and antipyretics were close to the national average. We invited 626 adolescents to participate. Of the 367 adolescents (59%) who responded, 51% were girls. Associations between the frequency of use of over-the-counter analgesic and the mentioned variables were analysed using multiple logistic regression. RESULTS In total, 26% (42 boys and 48 girls) used over-the-counter analgesics daily to weekly. These high-frequency users experienced more widespread pain, slept less, had more paid spare-time work, drank more caffeinated drinks, participated more often in binge drinking, had lower self-esteem, less ambitious educational plans and more frequent school absence than did the low-frequency users. These associations remained significant when controlling for gender, cultural background and self-evaluated economic status. CONCLUSION Adolescent, who are high-frequency users of over-the-counter analgesics, suffer more pain and have identifiable characteristics indicative of complex problems. Their ability to handle stress appears to be discordant with the kind of situations to which they are exposed. The wear and tear associated with allostatic mechanisms counteracting stress may heighten their pain experience.
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Affiliation(s)
- Siv Skarstein
- Department of Nursing, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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35
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Bjerkehagen B, Småstuen MC, Hall KS, Skjeldal S, Smeland S, Fosså SD. Why do patients with radiation-induced sarcomas have a poor sarcoma-related survival? Br J Cancer 2011; 106:297-306. [PMID: 22173669 PMCID: PMC3261679 DOI: 10.1038/bjc.2011.559] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND This study aims to provide reasons for the poor sarcoma-related survival in patients with radiation-induced sarcoma (RIS). METHODS We performed a case-control study comparing sarcoma-related survival of 98 patients with RIS to that of 239 sporadic high-grade malignant sarcomas. RESULTS The cumulative sarcoma-related 5-year survival was 32% (95% confidence interval (CI): 22-42) for patients with RIS vs 51% (95% CI: 44-58) for controls (P<0.001). Female gender, central tumour site and incomplete surgical remission were significantly more frequent among RIS patients than in controls. In multivariate analysis incomplete surgical remission (hazard ratio (HR) 4.48, 95% CI: 3.08-6.52), metastases at presentation (HR 2.93, 95% CI: 1.95-4.41), microscopic tumour necrosis (HR 1.88, 95% CI: 1.27-2.78) and central tumour site (HR 1.71, 95% CI: 1.18-2.47) remained significant adverse prognostic factors, but not sarcoma category (RIS vs sporadic). CONCLUSION The poor prognosis of RIS patients are not due to the previous radiotherapy per se, but related to the unfavourable factors - central tumour site, incomplete surgical remission, microscopic tumour necrosis and the presence of metastases, the two former factors overrepresented in RIS.
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Affiliation(s)
- B Bjerkehagen
- Department of Pathology, Postboks 4953, NO-0424 Oslo, Norway.
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