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- Clason van de Leur, Jakob, et al.
(författare)
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Mediators during a multimodal intervention for stress-induced exhaustion disorder
- 2023
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Ingår i: Cognitive Behaviour Therapy. - : Routledge. - 1650-6073 .- 1651-2316.
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Tidskriftsartikel (refereegranskat)abstract
- Our understanding of the underlying psychological processes of development, maintenance, and treatments for stress-induced exhaustion disorder (ED) remains limited. Therefore, the current study aimed to explore whether sleep concerns, pathological worry, perfectionistic concerns, and psychological flexibility mediate change in exhaustion symptoms during a Multimodal intervention for ED based on Cognitive behavioral therapy principles. Participants (N = 913) were assessed at three time points, and mediation was explored using a two-criteria analytical model with linear mixed-effects models (criterion one) and random intercepts cross-lagged panel modeling (criterion 2). Criterion one for mediation was successfully met, as the findings indicated significant associations between time in treatment, with all suggested mediators, and exhaustion symptoms (significant ab-products). However, criterion two was not satisfied as changes in the mediators did not precede changes in exhaustion symptoms. Therefore, mediation could not be established. Instead, changes in the suggested mediators appeared to result from changes in exhaustion symptoms. Consequently, sleep concerns, pathological worry, perfectionistic concerns, and psychological flexibility appear to improve in conjunction with exhaustion symptoms during treatment, where improvement in exhaustion is indicated as the main driving factor, based on this exploratory analysis. The implications of these findings are contextualized within a broader framework of process-based therapy.
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| 2. |
- Cools, Ann M, et al.
(författare)
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The challenge of the sporting shoulder : From injury prevention through sport-specific rehabilitation toward return to play
- 2021
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Ingår i: Annals of Physical and Rehabilitation Medicine. - : Elsevier BV. - 1877-0657 .- 1877-0665. ; 64:4
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Forskningsöversikt (refereegranskat)abstract
- Shoulder injuries and sports-related shoulder pain are substantial burdens for athletes performing a shoulder loading sport. The burden of shoulder problems in the athletic population highlights the need for prevention strategies, effective rehabilitation programs, and a individually based return-to-play (RTP) decision. The purpose of this clinical commentary is to discuss each of these 3 challenges in the sporting shoulder, to assist the professional in: (1) preventing injury; (2) providing evidence-based practice rehabilitation and; (3) to guide the athlete toward RTP. The challenges for injury prevention may be found in the search for (the interaction between) relevant risk factors, develop valid screening tests, and implement feasible injury prevention programmes with maximal adherence from the athletes. Combined analytical and functional testing seems mandatory screening an athlete's performance. Many questions arise when rehabilitating the overhead athlete, from exercise selection, over the value of stretching, toward kinetic chain implementation and progression to high performance training. Evidence-based practice should be driven by the available research, clinical expertise and the patient's expectations. Deciding when to return to sport after a shoulder injury is complex and multifactorial. The main concern in the RTP decision is to minimize the risk of re-injury. In the absence of a "gold standard", clinicians may rely on general guidelines, based on expert opinion, regarding cutoff values for normal range of motion, strength and function, with attention to risk tolerance and load management.
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| 3. |
- Forde, Rita, et al.
(författare)
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The Impact of the COVID-19 pandemic on people with diabetes and diabetes services : A pan-European survey of diabetes specialist nurses undertaken by the Foundation of European Nurses in Diabetes survey consortium
- 2021
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 38:5
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe diabetes nurses' perspectives on the impact of the COVID-19 pandemic on people with diabetes and diabetes services across Europe.METHODS: An online survey developed using a rapid Delphi method. The survey was translated into 17 different languages and disseminated electronically in 27 countries via national diabetes nurse networks.RESULTS: Survey responses from 1829 diabetes nurses were included in the analysis. The responses indicated that 28% (n=504) and 48% (n=873) of diabetes nurses felt the COVID-19 pandemic had impacted 'a lot' on the physical and psychological risks of people with diabetes, respectively. The following clinical problems were identified as having increased 'a lot': anxiety 82% (n=1486); diabetes distress 65% (n=1189); depression 49% (n= 893); acute hyperglycaemia 39% (n=710); and foot complications 17% (n=323). Forty-seven percent (n=771) of respondents identified that the level of care provided to people with diabetes had declined either extremely or quite severely. Self-management support, diabetes education and psychological support were rated by diabetes nurse respondents as having declined extremely or quite severely during the COVID-19 pandemic by 31% (n=499), 63% (n=1,027) and 34% (n=551), respectively.CONCLUSION: The findings show that diabetes nurses across Europe have seen significant increases in both physical and psychological problems in their patient populations during COVID-19. The data also show that clinical diabetes services have been significantly disrupted. As the COVID-19 situation continues we need to adapt care systems with some urgency to minimise the impact of the pandemic on the diabetes population.
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| 8. |
- Winterling, J, et al.
(författare)
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Occupational status among adult survivors following allo-SCT
- 2014
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Ingår i: Bone Marrow Transplantation. - : Springer Science and Business Media LLC. - 0268-3369 .- 1476-5365. ; 49:6, s. 836-42
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Tidskriftsartikel (refereegranskat)abstract
- Being in work or the equivalent is an important goal after allo-SCT and is used as an indicator of recovery. The aim was to elucidate occupational status and factors associated with work among SCT survivors. Adults in working age with a haematological disease (n=177) were followed up within a median of 8 (range 28) years post allo-SCT. Predictors of not being in work at all or working part-time because of sick leave, disability pension or early old-age pension were analyzed using logistic regression analyses. At diagnosis, 82% of the participants were working full-time and 2% were on sick leave or old-age pension. At follow-up, 52% were working full-time, 27% were working part-time and 17% were on sick leave, disability pension or old-age pension. Not working at all was associated with multi-morbidity (P=0.01) and poorer health (P=0.00). Working part-time was associated with a higher age at diagnosis (P=0.00), being a woman (P=0.03), being born abroad (P=0.03) and multi-morbidity (P=0.00). In conclusion, the majority of survivors were in paid work at follow-up; however, a substantial number were not working or worked part-time.
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