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Sökning: AMNE:(MEDICAL AND HEALTH SCIENCES Clinical Medicine General Practice) > Högskolan i Halmstad

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1.
  • Milos Nymberg, Veronica, et al. (författare)
  • HEAD-MIP–(HEAlth Dialogues for patients with Mental Illness in Primary care)—a feasibility study
  • 2023
  • Ingår i: Pilot and Feasibility Studies. - London : BioMed Central (BMC). - 2055-5784. ; 9
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Patients with mental illness have an increased risk of cardiovascular morbidity and mortality compared to the rest of the population, which is partly related to unhealthy lifestyle habits. To individualise lifestyle counselling in primary care, the Swedish-developed Health Dialogue (HD) can be used as an educative tool at recurrent measurement points with the goal to improve non-healthy lifestyle habits. HD has not been aimed specifically at patients with mental illness, and the effect of a systematic approach with repeated HDs in patients with mental illness in primary care has not been previously studied. The aim of this pilot study was to assess the feasibility of the study design for a larger-scale cohort study using repeated HDs focused on the improvement of lifestyle habits in patients seeking primary care due to anxiety, depression, sleeping problems or stress-related symptoms. Methods: Patients were recruited after a visit to a Primary Health Care Center due to mental illness between October 2019 until November 2021 and received a Health Dialogue, including an assessment of cardiovascular risk factors through a Health Curve. Specific feasibility objectives measured were dropout rate, time to follow-up, and risk improvement rate for different lifestyle changes. Results: A total of 64 patients were recruited and 29 (45%) attended a second HD, with a mean follow-up time of 15 months. All participants had at least one elevated cardiovascular risk level on the Health Curve for the assessed lifestyles. Risk level improvement rate was good except for tobacco use. Conclusion: Despite a higher dropout rate than expected, we suggest that the proposed methodology for a full cohort study within general practice of patients with mental illness in primary care is both acceptable to practice and feasible. © 2023, BioMed Central Ltd., part of Springer Nature.
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2.
  • Wendt, Eva, 1958, et al. (författare)
  • Young women's perceptions of being asked questions about sexuality and sexual abuse : a content analysis
  • 2011
  • Ingår i: Midwifery. - Amsterdam : Elsevier. - 0266-6138 .- 1532-3099. ; 27:2, s. 250-256
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: to describe young women's perceptions of being asked questions by midwives or doctors pertaining to sexuality and sexual abuse in connection with visits for gynaecological examination. DESIGN: a qualitative study. Data comprised responses to open-ended questions in a questionnaire and were analysed by qualitative content analysis. SETTING: a county in the south-west of Sweden. PARTICIPANTS: all of the 23-, 26- and 29-year-old women who attended eight midwife and youth centres for cervical screening during the period between March and July 2006 were invited to participate. The open-ended question about sexuality was answered by 413 women, and 409 women answered the question about sexual abuse, representing approximately 84% of the women who answered the questionnaire as a whole. FINDINGS: the data resulted in a total of eight categories and 31 codes, which showed the women's perceptions of being asked questions about sexuality and sexual abuse. Six of the categories dealt with why it was considered natural to be questioned. Health professionals can be trusted and questions can open up a dialogue as well as clarify the woman's situation. The context of a visit for a gynaecological examination is relevant and questions will make it possible for the professionals to strengthen the woman. Another reason was that sexuality is an essential part of life. Those women who felt that it would not feel natural to be asked questions about sexuality and sexual abuse considered that the context is wrong and that such questions will encroach on the woman's personal sphere. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: women's responses indicate that there are good reasons for midwives and doctors to raise questions about sexuality and sexual abuse when they meet young women. Taking opportunity to find those who have sexual problems and/or experience of sexual abuse could reduce the suffering of these women and lead to an economic gain to society. The provision of training and supervision for midwives and doctors is important to enhance the quality of conversations about sexual matters. In order to deal with such issues, it is necessary to have knowledge of sexual health, relationships and violence, as well as a professional stance and a good conversational technique.
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3.
  • Pikkemaat, Miriam, et al. (författare)
  • Structured assessment of modifiable lifestyle habits among patients with mental illnesses in primary care
  • 2022
  • Ingår i: Scientific Reports. - London : Nature Publishing Group. - 2045-2322. ; 12
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients with mental illness have an increased risk of cardiovascular morbidity. The Swedish-developed Health Dialogue is a pedagogical tool to individualize lifestyle counselling, used in specific age-groups to improve lifestyle habits and decrease mortality, but not tested specifically for patients with mental illness. Patients > 18 years old seeking primary care due to symptoms related to mental illness and diagnosed with depression, sleeping disorders, stress and anxiety, were included. A nurse-led health dialogue was conducted, focusing on lifestyle habits, anthropometric measurements, and blood samples, resulting in tailored advice regarding the individual’s risk profile. All 64 participants had lifestyle areas with increased risk level. Approximately 20% had elevated fasting glucose, blood pressure or cholesterol levels, and over 40% had highest risk level in Waist–Hip-Ratio. 30% were overweight, or physical inactive. The results suggest the need of a larger cohort study with long-term follow up, to establish potentially positive effects on wellbeing, and decreased cardiovascular risk in patients with mental illness. © 2022, The Author(s).
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4.
  • Andersson, Maria L.E. 1968-, et al. (författare)
  • Associations between chronic widespread pain, pressure pain thresholds, leptin, and metabolic factors in individuals with knee pain
  • 2023
  • Ingår i: BMC Musculoskeletal Disorders. - London : BioMed Central (BMC). - 1471-2474. ; 24:1
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The aim was to study associations between chronic widespread pain, widespread pain sensitivity, leptin, and metabolic factors in individuals with knee pain. A secondary aim was to study these associations in a subgroup of individuals with normal BMI.METHOD: This cross-sectional study included 265 individuals. The participants were categorised into three different pain groups: Chronic widespread pain (CWP), chronic regional pain (ChRP), or no chronic pain (NCP). The pressure pain thresholds (PPTs) were assessed using computerised pressure algometry. Low PPTs were defined as having PPTs in the lowest third of all tender points. Leptin and metabolic factors such as BMI, visceral fat area (VFA), lipids, and glucose were also assessed.RESULT: Sixteen per cent reported CWP, 15% had low PPTs, and 4% fulfilled both criteria. Those who fulfilled the criteria for CWP were more often women, more obese, and had increased leptin levels. In logistic regression, adjusted for age and gender, leptin was associated with fulfilling criteria for CWP, OR 1.015 (95% CI 1.004-1.027, p = 0.008). In logistic regression, adjusted for age and gender, leptin was associated with low PPTs, OR 1.016 (95% CI 1.004-1.029, p = 0.012). Leptin was also associated with fulfilling both criteria, adjusted for age, sex, and visceral fat area (VFA), OR 1.030 (95% CI 1.001-1.060), p = 0.040.CONCLUSION: Leptin was associated with fulfilling the combined criteria for chronic widespread pain and low PPTs, even after adjusting for the visceral fat area (VFA). Longitudinal studies are needed to study the causal relationships between leptin and the development of widespread pain.
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5.
  • Lydell, Marie, 1961-, et al. (författare)
  • Thoughts and feelings of future working life as a predictor of return to work : a combined qualitative and quantitative study of sick-listed persons with musculoskeletal disorders
  • 2011
  • Ingår i: Disability and Rehabilitation. - London : Taylor & Francis Group. - 0963-8288 .- 1464-5165. ; 33:13-14, s. 1262-1271
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose. The main aim of this study was to describe the thoughts and feelings of future working life related to return to work (RTW) in sick-listed persons due to musculoskeletal disorders (MSD). Further aim was to compare these descriptions with the person’s actual working situation 1, 5 and 10 years after a rehabilitation period.Methods. This study consisted of two parts. The first part had an explorative design, and qualitative content analysis was chosen in order to analyse the response to an open question regarding future working life answered before, persons sick-listed due to MSD (n = 320), took part in a rehabilitation programme 10 years ago. The second part had a prospective design and quantitative analysis was used to compare the results of the qualitative analysis with RTW and the working situation 1, 5 and 10 years after baseline.Results. Three categories emerged from the data with a total of nine subcategories. In the categories Motivation and optimism and Limitations to overcome, there were significantly more persons who had RTW 1 year after baseline when compared with the category Hindrance and hesitation. There were also some significant differences between the subcategories.Conclusions. The question, regarding thoughts and feelings of future working life, may be a simple screening method to predict RTW in persons sick-listed with MSD. This will guide the rehabilitation team to adjust the rehabilitation to each person’s needs and facilitating RTW.
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6.
  • Nymberg, Peter, 1971-, et al. (författare)
  • Association between changed self-rated health and the risk of venous thromboembolism in Malmö Preventive Program : a cohort study
  • 2024
  • Ingår i: Journal of Thrombosis and Thrombolysis. - New York : Springer-Verlag New York. - 0929-5305 .- 1573-742X.
  • Tidskriftsartikel (refereegranskat)abstract
    • Poor self-rated health (SRH) is associated with incident arterial cardiovascular disease in both sexes. Studies on the association between SRH and incident venous thromboembolism (VTE) show divergent results in women and no association in men. This study focuses on the association between change in SRH and incident VTE in a cohort of 11,558 men and 6682 women who underwent a baseline examination and assessment of SRH between 1974 and 1992 and a re-examination in 2002–2006. To investigate if changes in SRH over time affect the risk of incident VTE in men and women. During a follow-up time from the re-examination of more than 16 years, there was a lower risk for incident VTE among women if SRH changed from poor at baseline to very good/excellent (HR 0.46, 95% CI 0.28; 0.74) at the re-examination. Stable good SRH (good to very good/excellent at the re-examination, HR 0.60, 95% CI 0.42; 0.89), or change from good SRH at baseline into poor/fair at the re-examination (HR 0.68, 95% CI 0.51; 0.90) were all significantly associated with a reduced risk for VTE. All comparisons were done with the group with stable poor SRH. This pattern was not found among men. Regardless of a decreased or increased SRH during life, having an SRH of very good/excellent at any time point seems to be associated with a decreased risk of VTE among women. © 2024, The Author(s).
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7.
  • Nymberg, Peter, 1971-, et al. (författare)
  • Association between self-rated health and venous thromboembolism in Malmö Preventive Program: A cohort study
  • 2022
  • Ingår i: Preventive Medicine. - : Elsevier BV. - 0091-7435 .- 1096-0260. ; 159
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Venous thromboembolism (VTE) and cardiovascular disease (CVD) share some risk factors such as smoking, obesity, and dietary habits. Poor self-rated health (SRH) has been shown to be a predictor of arterial CVD and mortality for both men and women. The association between SRH and VTE has only been investigated in one previous Swedish study with a cohort that just contained women. This Swedish study did not show any significant associations between poor SRH and VTE in women. Methods: A cohort of 22,444 men and 10,902 women in the Malmö Preventive Program was followed for a period of 44 years. All participants in the baseline screening with measurements including SRH were traced in national registers. Data on VTE events were collected from national hospital registries. Cox proportional regression analysis was used to calculate the association between SRH and time to VTE. Results: During a follow-up time of 44.31 years, a total of 2612 individuals were affected by VTE. Good SRH was associated with a lower risk for VTE in women both in the univariate model (HR = 0.75, CI = 0.65–0.85) and after adjustments for age, smoking, BMI and varicose veins (HR = 0.81, CI 0.70–0.93). SRH was not a predictor for VTE in men, neither in the unadjusted (HR = 1.05, CI 0.90–1.13) nor in the fully adjusted model (HR = 1.00, CI = 0.88–1.14). Conclusion: In this cohort study, SRH was associated with VTE in women but not among men. The association was significant even when adjusting for well-known risk factors such as varicose veins, BMI and smoking. © 2022 The Authors
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8.
  • Ahmadi, Nasser, 1958, et al. (författare)
  • Breathlessness in everyday life from a patient perspective: A qualitative study using diaries
  • 2014
  • Ingår i: Palliative & supportive care. - Cambridge, United Kingdom : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 12:3, s. 189-194
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Breathlessness is a subjective symptom, which makes it difficult to define and understand. The aim of the present study was to illuminate how patients suffering from breathlessness experience their everyday life. Method: The study was a qualitative study, and the focus of the analysis was the patients’ descriptions of their experiences of breathlessness using a diary with two unstructured questions for a period of 7 consecutive days. Sixteen participants: 7men, mean age 65+7 (range 55–73 years old), and 9 women, mean age 65+9 (range 50–72 years old) participated in the study. Results: Two themes emerged from the analysis: 1) Impaired quality of life and 2) symptom tolerance and adaptation. The theme “impaired quality of life” included the categories limited physical ability, psychological burdens, and social life barriers. The theme “symptom tolerance and adaptation” included importance of health care, social support, hobbies and leisure activities, and coping strategies. Significance of results: The findings in our study showed that patients, in spite of considerable difficulties with shortness of breath, found relief in several types of activities, in addition to drug therapy. The result indicates that the “biopsychosocial model” is an appealing approach that should be discussed further to gain a better understanding of breathlessness.
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9.
  • Davidge, Jason, et al. (författare)
  • Clinical characteristics and mortality of patients with heart failure in Southern Sweden from 2013 to 2019 : a population-based cohort study
  • 2022
  • Ingår i: BMJ Open. - London : BMJ Publishing Group Ltd. - 2044-6055. ; 12:12
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To describe clinical characteristics and prognosis related to heart failure (HF) phenotypes in a community-based population by applying a novel algorithm to obtain ejection fractions (EF) from electronic medical records. DESIGN: Retrospective population-based cohort study. SETTING: Data were collected for all patients with HF in Southwest Sweden. The region consists of three acute care hospitals, 40 inpatient wards, 2 emergency departments, 30 outpatient specialty clinics and 48 primary healthcare. PARTICIPANTS: 8902 patients had an HF diagnosis based on the International Classification of Diseases, Tenth Revision during the study period. Patients <18 years as well as patients declining to participate were excluded resulting in a study population of 8775 patients. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was distribution of HF phenotypes by echocardiography. The secondary outcome measures were 1 year all-cause mortality and HR for all-cause mortality using Cox regression models. RESULTS: Out of 8775 patients with HF, 5023 (57%) had a conclusive echocardiography distributed into HF with reduced EF (35%), HF with mildly reduced EF (27%) and HF with preserved EF (38%). A total of 43% of the cohort did not have a conclusive echocardiography, and therefore no defined phenotype (HF-NDP). One-year all-cause mortality was 42% within the HF-NDP group and 30% among those with a conclusive EF. The HR of all-cause mortality in the HF-NDP group was 1.27 (95% CI 1.17 to 1.37) when compared with the confirmed EF group. There was no significant difference in survival within the HF phenotypes. CONCLUSIONS: This population-based study showed a distribution of HF phenotypes that varies from those in selected HF registries, with fewer patients with HF with reduced EF and more patients with HF with preserved EF. Furthermore, 1-year all-cause mortality was significantly higher among patients with HF who had not undergone a conclusive echocardiography at diagnosis, highlighting the importance of correct diagnostic procedure to improve treatment strategies and outcomes. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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10.
  • Eklund, Mona, et al. (författare)
  • Rasch analysis of an instrument for measuring occupational value : Implications for theory and practice
  • 2009
  • Ingår i: Scandinavian Journal of Occupational Therapy. - London, UK : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 16:2, s. 118-128
  • Tidskriftsartikel (refereegranskat)abstract
    • This study investigated psychometric properties of an instrument for assessing perceived occupational value, the 26-item OVal-pd. Data from 225 Swedish subjects with and without known mental illness were analysed regarding fit to the Rasch measurement model (partial credit model), differential item functioning (DIF), and functioning of the OVal-pd four-category response scale. The reliability (index of person separation, analogous to Cronbach's alpha) was good (0.92) but there were signs of overall and item level (six items) misfit. There was DIF between people with and without mental illness for three items. Iterative deletion of misfitting items resulted in a new 18-item DIF-free scale with good overall and individual item fit and maintained reliability (0.91). There were no disordered response category thresholds. These observations also held true in separate analyses among people with and without mental illness. Thus, the first steps of ensuring that occupational value can be measured in a valid and reliable way have been taken. Still, occupational value is a dynamic construct and the aspects that fit the construct may vary between contexts. This has implications for, e.g., cross-cultural research and calls for identification of a core set of culture-free items to allow for valid cross-cultural comparisons. Copyright © 2009 Informa UK Limited
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