| 1. |
- Sylwander, Charlotte, 1992-, et al.
(författare)
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The impact of chronic widespread pain on health status and long-term health predictors: a general population cohort study
- 2020
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Ingår i: BMC Musculoskeletal Disorders. - London : Springer Science and Business Media LLC. - 1471-2474. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Chronic widespread pain (CWP) has a negative impact on health status, but results have varied regarding gender-related differences and reported health status. The aim was to study the impact of CWP on health status in women and men aged 35-54 years in a sample of the general population. The aim was further to investigate lifestyle-related predictors of better health status in those with CWP in a 12- and 21-year perspective. Method A general population cohort study including 975 participants aged 35-54 years, with a 12- and 21-year follow-up. CWP was measured with a pain mannequin, and the questionnaire included questions on lifestyles factors with SF-36 for measurement of health status. Differences in health status were analysed with independent samples t-test and health predictors with logistic regression analysis. Results The prevalence of CWP was higher in women at all time points, but health status was reduced in both women and men with CWP (p < 0.001) with no gender differences of clinical relevance. At the 12-year follow-up, a higher proportion of women than men had developed CWP (OR 2.04; CI 1.27-3.26), and at the 21-year follow-up, a higher proportion of men had recovered from CWP (OR 3.79; CI 1.00-14.33). In those reporting CWP at baseline, a better SF-36 health status (Physical Functioning, Vitality or Mental Health) at the 12-year follow-up was predicted by male gender, having personal support, being a former smoker, and having no sleeping problems. In the 21-year follow-up, predictors of better health were male gender, a weekly intake of alcohol, and having no sleeping problems. Conclusion Women and men with CWP have the same worsening of health status, but men recover from CWP to a greater extent in the long-term. Being male, having social support, being a former smoker, and having no sleeping problems were associated with better health status in those with CWP.
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| 2. |
- Hommel, Ami, et al.
(författare)
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Influence of optimised treatment of people with hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year
- 2008
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Ingår i: Injury. - : Elsevier. - 0020-1383 .- 1879-0267. ; 39:10, s. 1164-1174
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Tidskriftsartikel (refereegranskat)abstract
- Hip fractures are a major cause of hospital stay among the elderly, and result in increased disability and mortality. In this study from 1 April 2003 to 31 March 2004, the influence of optimised treatment of hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year were investigated. Comparisons were made between the first 210 patients in the period and the last 210 patients, who followed the new clinical pathway introduced at the University Hospital in Lund, Sweden. Early surgery, within 24h, was not associated with reduced mortality, but was significantly associated with reduced length of stay (p<0.001). Significantly more cases of osteosynthesis for femoral neck fracture were reoperated compared with all other types of surgery (p<0.001) when reoperations with extraction of the hook pins in healed fractures were excluded. Mortality was significantly higher among men than women at 4 (p=0.025) and 12 (p=0.001) months after fracture and among medically fit patients with administrative delay to surgery compared with patients with no delay (p<0.001).
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| 3. |
- Grimby-Ekman, Anna, 1967, et al.
(författare)
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Comorbidities, intensity, frequency and duration of pain, daily functioning and health care seeking in local, regional, and widespread pain-a descriptive population-based survey (SwePain)
- 2015
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Ingår i: Bmc Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: The clinical knowledge of factors related to the spread of pain on the body has increased and understanding these factors is essential for effective pain treatment. This population-based study examines local (LP), regional (RP), and widespread pain (WSP) on the body regarding comorbidities, pain aspects, and impact of pain and elucidates how the spread of pain varies over time. Material and methods: A postal questionnaire that addressed pain aspects (intensity, frequency, duration and anatomical spreading on a body manikin), comorbidities and implications of pain (i.e., work situation, physical activity, consumption of health care and experience of hospitality and treatment of health care) was sent to 9000 adults living in southeastern Sweden. Of these, 4774 (53 %) completed and returned the questionnaire. After 9 weeks, a follow-up questionnaire was sent to the 2983 participants who reported pain in the first questionnaire (i.e. 62 % of 4774 subjects). Of these, 1940 completed and returned the questionnaire (i.e. 65 % of 2983 subjects). The follow-up questionnaire included the same items as the first questionnaire. Results: This study found differences in intensity, frequency and duration of pain, comorbidities, aspects of daily functioning and health care seeking in three pain categories based on spreading of pain: LP, RP and WSP. Compared to the participants with RP and LP, the participants with WSP had lower education and worse overall health, including more frequent heart disease and hypertension. In addition, participants with WSP had more intense, frequent, and long-standing pain, required more medical consultations, and experienced more impact on work. The participants with RP constituted an intermediate group regarding frequency and intensity of pain, and impact on work. The participants with LP were the least affected group regarding these factors. A substantial transition to RP had occurred by the 9-week follow-up. Conclusions: This study shows an association between increased spread of pain and prevalence of heart disease, hypertension, more severe pain characteristics (i.e., intensity, frequency and duration), problems with common daily activities and increased health care seeking. The WSP group was the most affected group and the LP group was the least affected group. Regarding these factors, RP was an obvious intermediate group. The transitions between the pain categories warrant research that broadly investigates factors that increase and decrease pain.
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| 4. |
- Gustafsson, Kristin, et al.
(författare)
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Socioeconomic status of patients in a Swedish national self-management program for osteoarthritis compared with the general population-a descriptive observational study
- 2020
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background First-line treatment for hip and knee osteoarthritis (OA) including education and supervised exercises, delivered as a self-management program, is considered one of the mainstays in OA treatment. However, the socioeconomic profile of the population that utilizes first-line treatment for hip and knee OA is unclear. The aim of this study was to describe the socioeconomic status (SES) of a population referred to a self-management program for OA, in comparison with that of the general Swedish population. Methods This is a cross-sectional study including 72,069 patients with hip or knee OA enrolled in the National Quality Register for Better management of patients with Osteoarthritis (BOA) between 2008 and 2016, and registered before participation in a structured OA self-management program. A reference cohort (n = 216,207) was selected from the general Swedish population by one-to-three matching by year of birth, sex and residence. Residential municipality, country of birth, marital status, family type, educational level, employment, occupation, disposable income and sick leave were analyzed. Results The BOA population had higher educational level than the reference group, both regarding patients with hip OA (77.5% vs 70% with >= 10 years of education), and with knee OA (77% vs 72% with >= 10 years of education). Their average disposable income was higher (median [IQR] in Euro (euro), for hip euro17,442 [10,478] vs euro15,998 [10,659], for knee euro17,794 [10,574] vs euro16,578 [11,221]). Of those who worked, 46% of patients with hip OA and 45% of the reference group had a blue-collar occupation. The corresponding numbers for knee OA were 51 and 44% respectively. Sick leave was higher among those with hip and knee OA (26%) than those in the reference groups (13% vs 12%). Conclusions The consistently higher SES in the BOA population compared with the general population indicates that this self-management program for OA may not reach the more socioeconomically disadvantaged groups, who are often those with a higher disease burden.
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| 5. |
- Arvidsson, Linnea, et al.
(författare)
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Virtual Follow up After Distal Radius Fracture Surgery — Patient Experiences During the COVID-19 Pandemic
- 2023
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Ingår i: Journal of Patient Experience. - Thousand Oaks, CA : Sage Publications. - 2374-3735 .- 2374-3743. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- The majority of patients with a distal radius fracture (DRF) are elderly, a group known to experience difficulties with new technology, partly due to a low level of digital literacy. At the beginning of the coronavirus disease 2019 pandemic, during the spring 2020, patients that underwent DRF surgery had regular follow-ups replaced by video calls from their surgeon and physiotherapist. Afterward, patients answered questionnaires regarding health and digital literacy and took part in semistructured interviews regarding the experience of the virtual follow-up. By systemic text condensation, 2 major categories were identified: (1) The video call—new, but surprisingly simple: All but 1 found it easier than expected, and (2) Video calls—the patient's choice: All but 1 patient preferred video calls to physical visits for follow-up. This is the first mixed methods study to assess patients’ experiences of digital follow-up after DRF surgery. This study indicates that digital follow-up was highly appreciated, even among patients with low levels of digital literacy. Digital technologies must be made suitable even for patients with inadequate levels of digital literacy. © The Author(s) 2023.
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| 6. |
- Haglund, Emma, et al.
(författare)
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Educational needs in patients with spondyloarthritis in Sweden - a mixed-methods study
- 2017
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Ingår i: Bmc Musculoskeletal Disorders. - London : Springer Science and Business Media LLC. - 1471-2474. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is a demand for a flexible and individually tailored patient education to meet patients' specific needs and priorities, but this area has seldom been studied in patients with spondyloarthritis (SpA), a family of inflammatory rheumatic diseases. The aim of the present study was to identify needs and priorities in patient education in patients with SpA. A second aim was to investigate patients' experiences and preferences of receiving patient education. Methods: Data collection included a questionnaire survey with the Educational Needs Assessment Tool (ENAT) and interviews, using a mixed-methods design. Patients were identified through a specialist clinic register. Descriptive data are presented as mean with standard deviation, or frequencies. Chi-square test and independent-samples t-test were used for group comparisons. A manifest qualitative conventional content analysis was conducted to explore patients' experiences and needs in patient education, based on two focus groups (n = 6) and five individual interviews. Results: Almost half (43%) of the 183 SpA patients had educational needs, particularly regarding aspects of self-help, feelings, and the disease process. More educational needs were reported by women and in patients with higher disease activity, while duration of disease did not affect the needs. The qualitative analysis highlighted the importance of obtaining a guiding, reliable, and easily available patient education for management of SpA. Individual contacts with healthcare professionals were of importance, but newer media were also requested. Conclusion: There are considerable educational needs in patients with SpA, and education concerning self-help, feelings, and the diseases process were raised as important issues. Healthcare professionals need to consider the importance of presenting varied formats of education based on the experiences and preferences of patients with SpA.
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| 7. |
- Sylwander, Charlotte, 1992-, et al.
(författare)
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Pressure pain thresholds in individuals with knee pain: a cross-sectional study
- 2021
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Ingår i: Bmc Musculoskeletal Disorders. - London : Springer Science and Business Media LLC. - 1471-2474. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundKnee osteoarthritis (KOA), chronic widespread pain (CWP) and overweight/obesity are public health problems that often coincide, and there is a multifactorial and unclear relationship between them. The study aimed to (1) investigate pain sensitivity, assessed by pressure pain thresholds (PPTs), among women and men with knee pain and (2) associations with, respectively, radiographic KOA (rKOA), CWP, and overweight/obesity.MethodsBaseline data from an ongoing longitudinal study involving 280 individuals with knee pain in the 30-60 age group. Pain sensitivity was assessed by PPTs on eight different tender points using a pressure algometer. The participants' knees were x-rayed. Self-reported CWP and number of pain sites were assessed with a pain figure, and overweight/obesity was measured using body mass index (BMI), visceral fat area (VFA), and body fat percentage, assessed with a bioimpedance. Associations were analysed using regression analyses.ResultsWomen reported lower PPTs than men (p<0.001), but no PPTs differences were found between those with and without rKOA. Low PPTs was associated with female sex, more pain sites, CWP, and a higher VFA and body fat percentage. The tender points second rib and the knees were most affected. The prevalence of CWP was 38%.ConclusionsThe modifiable factors, increased VFA, and body fat could be associated with increased pain sensitivity among individuals with knee pain. Longitudinal studies are needed to further investigate the associations.
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| 8. |
- Damm, Henrik, et al.
(författare)
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Prevalence and morbidity of neck pain: a cross-sectional study of 3000 elderly men
- 2023
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Ingår i: Journal of Orthopaedic Surgery and Research. - : Springer Science and Business Media LLC. - 1749-799X. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe purpose of this study is to determine the prevalence and morbidity of neck pain with or without cervical rhizopathy, upper extremity motor deficit and/or thoracolumbar pain in elderly men.MethodsWe conducted a cross-sectional questionnaire study of 3,000 community-dwelling older men with a mean age of 75.4 +/- 3.2 years (range 69-81) to determine if they had experienced neck pain with or without cervical rhizopathy/upper extremity motor deficit/thoracolumbar pain (yes/no) during the preceding 12 months, and if so, morbidity with the condition (no/minor/moderate/severe).ResultsAmong the participants, 865 (29%) reported they had experienced neck and 1,619 (54%) thoracolumbar pain. Among the men with neck pain, 59% had experienced only neck pain, 17% neck pain and cervical rhizopathy and 24% neck pain, rhizopathy and motor deficit. For men with only neck pain, the morbidity was severe in 13%, for men with neck pain and rhizopathy it was 24%, and for men with pain, rhizopathy and motor deficit it was 46% (p < 0.001). Among the men with neck pain, 23% had experienced only neck pain and no thoracolumbar pain; the remaining 77% had both neck and thoracolumbar pain. The morbidity was severe in 10% of the men with neck pain but no thoracolumbar pain and 30% in men with neck and thoracolumbar pain (p < 0.001).ConclusionNeck pain in elderly men is common but symptoms and morbidity vary. For men who only have neck pain, 1/8 rated their morbidity as severe, while almost half who also had cervical rhizopathy and motor deficit and almost 1/3 of those who also had thoracolumbar pain reported severe morbidity.
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| 9. |
- Cronström, Anna, et al.
(författare)
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"I was considering surgery because I believed that was how it was treated" : a qualitative study on willingness for joint surgery after completion of a digital management program for osteoarthritis.
- 2019
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Ingår i: Osteoarthritis and Cartilage. - : Elsevier. - 1063-4584 .- 1522-9653. ; 27:7, s. 1026-1032
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore, using a qualitative approach, reasons for patients' continued willingness or their shift in willingness for total joint replacement (TJR) surgery, following participation in Joint Academy, a Swedish, digital, non-surgical treatment program for osteoarthritis (OA).DESIGN: Nineteen patients with hip or knee OA were interviewed after finishing their first six weeks in the treatment program, using a semi-structured interview guide. The interviews were transcribed verbatim and analyzed using a systematic text condensation method.RESULTS: Analysis of the interview data revealed three main categories of reasons provided for the participants' decisions regarding surgery: 1) Various reasons for participating in Joint Academy with three sub-categories: (a) longstanding pain affects daily life, (b) last chance for improvement and (c) mandatory treatment to be eligible for TJR; 2) Willingness for TJR following treatment, which included four sub-categories: (a) surgery - the last resort, (b) reduced pain and improved functioning, (c) no perceived improvements after treatment, and (d) trust in healthcare providers; and 3) Expectations of TJR. The shift in willingness towards or away from TJR was mainly due to the perceived success of Joint Academy in improving their functioning.CONCLUSION: Several patients reconsidered their options and had changed their attitude to TJR after participation in a digital program aimed at reducing OA symptoms and improving functioning. These results highlight the importance of providing patients with adequate information about non-surgical management options to facilitate shared decision-making, and possibly reduce the need for surgery.
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| 10. |
- Lindström, Ulf, et al.
(författare)
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Back pain and health status in patients with clinically diagnosed ankylosing spondylitis, psoriatic arthritis and other spondyloarthritis: a cross-sectional population-based study
- 2016
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Ingår i: Bmc Musculoskeletal Disorders. - London : Springer Science and Business Media LLC. - 1471-2474. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: In the broader spectrum of back pain, inflammatory back pain (IBP) is a symptom that may indicate axial spondyloarthritis (SpA). The objectives of this study were to determine the frequency of current IBP, as a hallmark sign of possible axial SpA, in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA) and other SpA and to compare self-reported health between the groups with current IBP. Methods: Five-thousand seven hundred seventy one patients identified in the regional healthcare register of the most southern county of Sweden, diagnosed at least once by a physician (based on ICD-codes) with any type of SpA in 2003-2007, were sent a postal survey in 2009. Patients with current IBP were identified, based on self-reported back pain >= 3 months in the preceding year and fulfilling the Berlin criteria for IBP. The frequencies of IBP in AS, PsA and other SpA (including the remaining subgroups of SpA) were determined, and the groups were compared with regard to patient reported outcome measures (PROMs). Results: The frequency and proportion of patients with current IBP in AS, PsA and other SpA were 319 (43 %), 409 (31 %) and 282 (39 %) respectively, within the responders to the survey (N = 2785). The proportion was statistically higher in AS, compared to PsA (p < 0.001), but not for AS compared to other SpA (p = 0.112). PsA and other SpA, with current IBP, had similar (BASFI, EQ-5D, patients global assessment, fatigue, spinal pain) or worse (BASDAI) PROMs, compared to AS with current IBP. PsA with current IBP received pharmacological, anti-rheumatic, treatment more frequently than AS with current IBP, while AS and other SpA received treatment to a similar degree. Conclusion: The proportion of patients with current IBP was substantial in all three groups and health reports in the non-AS groups were similar or worse compared to the AS group supporting the severity of IBP in these non-AS SpA groups. These findings may indicate a room for improvement concerning detection of axial disease within different subtypes of non-AS SpA, and possibly also for treatment.
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