| 1. |
- Björk, Jonas, et al.
(författare)
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Predicting participation in the population-based Swedish cardiopulmonary bio-image study (SCAPIS) using register data
- 2017
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 45, s. 45-49
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To illustrate the importance of access to register data on determinants and predictors of study participation to assess validity of population-based studies. In the present investigation, we use data on sociodemographic conditions and disease history among individuals invited to the Swedish cardiopulmonary bio-image study (SCAPIS) in order to establish a model that predicts study participation. Methods: The pilot study of SCAPIS was conducted within the city of Gothenburg, Sweden, in 2012, with 2243 invited individuals (50% participation rate). An anonymous data set for the total target population (n = 24,502) was made available by register authorities (Statistics Sweden and the National Board of Health and Welfare) and included indicators of invitation to and participation in SCAPIS along with register data on residential area, sociodemographic variables, and disease history. Propensity scores for participation were estimated using logistic regression. Results: Residential area, country of birth, civil status, education, occupational status, and disposable income were all associated with participation in multivariable models. Adding data on disease history only increased overall classification ability marginally. The associations with disease history were diverse with some disease groups negatively associated with participation whereas some others tended to increase participation. Conclusions: The present investigation stresses the importance of a careful consideration of selection effects in population-based studies. Access to detailed register data also for non-participants can in the statistical analysis be used to control for selection bias and enhance generalizability, thereby making the results more relevant for policy decisions.
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| 2. |
- 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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| 3. |
- Grimby-Ekman, Anna, et al.
(författare)
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Different DHEA-S Levels and Response Patterns in Individuals with Chronic Neck Pain, Compared with a Pain Free Group-a Pilot Study.
- 2017
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Ingår i: Pain medicine (Malden, Mass.). - : Oxford University Press. - 1526-2375 .- 1526-4637. ; 18:5, s. 846-855
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To test, in this pilot study, whether DHEA-S (Dehydroepiandrosterone, sulfated form) plasma levels are lower among persons with chronic neck pain, compared to control persons, and to investigate the DHEA-S response after a physical exercise.SUBJECTS: Included were 12 persons with chronic neck pain and eight controls without present pain, all 18 and 65 years of age. Exclusion criteria for both groups were articular diseases or tendinosis, fibromyalgia, systemic inflammatory and neuromuscular diseases, pain conditions due to trauma, or severe psychiatric diseases.DESIGN AND METHODS: The participants arm-cycled on an ergometer for 30 minutes. Blood samples were taken before, 60 minutes, and 150 minutes after this standardized physical exercise.RESULTS: The estimated plasma DHEA-S levels at baseline were 2.0 µmol/L (95% confidence interval [CI] 1.00; 4.01) in the pain group and 4.1 µmol/L (95% CI2.0; 8.6) in the control group, adjusted for sex, age, body mass index (BMI), and Shirom-Melamed Burnout Questionnaire (SMBQ), with a ratio of 0.48 (P = 0.094).The total DHEA-S (AUCG) in the pain group were 183 min*µmol/L lower than in the control group (P = 0.068). For the response to the exercise (AUCI), the difference between the pain group and the control group was 148 min*µmol/L (P = 0.011).CONCLUSIONS: In this pilot study, the plasma DHEA-S levels appeared to be lower among the persons with chronic neck pain, compared with the control group. It was indicated that DHEA-S decreased during the physical exercise in the control group, and either increased or was unaffected in the chronic pain group.
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| 4. |
- Grimby-Ekman, Anna, 1967, et al.
(författare)
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Pain intensity and pressure pain thresholds after a light dynamic physical load in patients with chronic neck-shoulder pain
- 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 To investigate the development of pain intensity and pressure pain thresholds during and 24 h after a light dynamic physical load among patients with chronic neck-shoulder pain. Methods Twenty-six patients with chronic neck-shoulder pain and 12 healthy controls were included. The participants arm-cycled on an ergometer. Effort was rated with the Borg Rating of Perceived Exertion scale (RPE), and pain intensity with an numeric rating scale (NRS). Pressure pain thresholds were measured by an algometer. Participants started a pain diary 1 week before the physical exercise and continued until 1 week after. Pain intensity was assessed before, during and the following two evenings after arm-cycling. Pressure pain thresholds were assessed before, 15 min after, 105 min after and 24 h after. Results The chronic pain group showed increased pain intensity during, and the following two evenings after the arm cycling, and decreased pain thresholds immediately after the arm cycling involving painful regions. In the patient group there were no impact on pain thresholds in the neck the following day. Conclusions Patients with chronic neck-shoulder pain reported increased pain intensity during and in the evenings after a light dynamic load involving painful regions. In addition, they showed decreased pain thresholds close to the exercise, indicating mechanical hyperalgesia.
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| 5. |
- Jöud, Anna, et al.
(författare)
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The association between pain characteristics, pain catastrophizing and health care use – Baseline results from the SWEPAIN cohort
- 2017
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Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter GmbH. - 1877-8860 .- 1877-8879. ; 16, s. 122-128
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim Pain is common and adds to the global burden of disease. However, individuals suffering from pain are a heterogeneous group in terms of pain spreading, intensity and duration. While pain influences overall health care consultation not everyone with pain consult health care. To be able to provide health care matching the patients’ needs increased knowledge about what factors determines the decision to consult health care is essential. The aim of this study was to explore the combined importance of pain spreading, intensity, duration and pain catastrophizing for consulting health care. Methods In this cross-sectional study we used population based survey data from southeast Sweden (SWEPAIN) including 7792 individuals’ aged 16–85 reporting pain. We used Modified Poisson regressions to analyse factors of importance related to the decision to consult health care. Results High and moderate pain intensity, as compared to low, increases the probability of consulting health care (High PR = 1.7 [95% CI 1.51–1.88], moderate PR = 1.2 [1.15–1.41]). Having widespread pain, as compared to localised pain, increased the probability of consulting health (PR = 1.2 [1.03–1.36). Pain duration was not associated with increased probability of consulting health care (PR = 1.0 CI0.88–1.07). However an interaction (p = 0.05) between pain duration and pain catastrophizing beliefs was seen indicating a combined importance of the two when consulting health care. Conclusion Our result suggests that pain intensity, pain spreading and pain catastrophizing independently influence the decision to consult health care while there is an interaction effect between pain duration and pain catastrophizing beliefs where the importance of pain catastrophizing believes differ with pain duration; the importance of pain catastrophizing believes differ with pain duration. Implications Treatment and rehabilitation strategies should incorporate this finding in order to meet the individual's needs focusing on the biopsychosocial model within health care focusing not only on actual pain reliefs but also on for example acceptance and behavioural changes.
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| 6. |
- Larsson, Britt, et al.
(författare)
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Pain Sensitivity and its Relation to Spreading on the Body, Intensity, Frequency, and Duration of Pain A Cross-Sectional Population-based Study (SwePain)
- 2017
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Ingår i: The Clinical Journal of Pain. - : LIPPINCOTT WILLIAMS & WILKINS. - 0749-8047 .- 1536-5409. ; 33:7, s. 579-587
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Tidskriftsartikel (refereegranskat)abstract
- Objectives:Individuals with chronic pain often report increased pain sensitivity compared with pain-free individuals; hence, it is crucial to determine whether and how different pain characteristics influence or interact with pain sensitivity. An alternative to experimental pain sensitivity testing is the self-reported pain sensitivity questionnaire (PSQ), which captures pain sensitivity in various body areas.This study compares PSQ in individuals with and without pain and clarifies how pain sensitivity relates to spreading of pain on the body, and to intensity, frequency, duration of pain and to age and sex.Materials and Methods:A total of 5905 individuals with pain and 572 individuals without pain from the general population in southeastern Sweden completed and returned a postal questionnaire.Results:The mean PSQ score was 3.9 (95% confidence interval [CI], 3.88-3.98) in individuals with pain and 3.5 (95% CI, 3.38-3.64) in pain-free individuals. Hence, PSQ was the highest among individuals with pain, with a difference of 0.4 (95% CI, 0.30-0.56). There was a considerable variation in the PSQ values (mean=3.5; SD=1.54) among pain-free individuals. Pain sensitivity was positively related to spreading, intensity, and frequency of pain, with a correlation coefficient of 0.3. PSQ was higher in widespread pain, 4.5 (95% CI, 4.27-4.69) in women and 4.3 (95% CI, 3.94-4.71) in men, than in local pain, 3.7 (95% CI, 3.61-3.91) in women and 3.8 (95% CI, 3.66-3.95) in men. The score for women with regional pain was between local and widespread pain at 4.0 (95% CI, 3.95-4.11) and that for men with regional pain was 3.8 (95% CI, 3.69-3.87), which is equal to that of local pain.Discussion:The positive association between pain sensitivity and spreading of pain on the body provides some evidence that the extent of spreading may be related to the degree of pain sensitivity. Before clinical use of PSQ, psychometric development and further research are needed.
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| 7. |
- Larsson, Britt, 1953-, et al.
(författare)
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Predictors of chronic pain intensity, spread and sensitivity in the general population: A two-year follow-up study from the swepain cohort
- 2019
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Ingår i: Journal of Rehabilitation Medicine. - Uppsala, Sweden : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 51:3, s. 183-192
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 Foundation of Rehabilitation Information. Objective: To determine whether the intensity, spread and sensitivity of chronic pain can be predicted using demographic features, socioeconomic conditions and comorbidities. Design: A longitudinal study design was employed. Data was collected at baseline and at 2-year followup. Setting: General population in south-eastern Sweden. Subjects: A representative stratified random sample of 34,000 individuals, between 18 and 85 years of age, selected from a sampling frame of 404,661 individuals based on the Swedish Total Population Register. Methods: Eligible individuals were sent postal surveys in 2013 and 2015. The 2 surveys included the same questions about basic demographic data, comorbidities, and chronic pain intensity, spread and sensitivity. Results: Several socio-demographic features and comorbidities at baseline were significant predictors of characteristics of pain (intensity, spread and sensitivity) at the 2-year follow-up. When characteristics of pain at baseline were included in the regression analyses they were relatively strong significant predictors of characteristics of pain after 2 years. After this adjustment there were fewer socio-demographic and comorbidity predictors; the effect estimates for those significant predictors had decreased. Conclusion: Clinical assessment should focus on several characteristics of pain and include a broad medical screening to capture the overall burden of pain in adults from a longitudinal perspective.
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