| 1. |
- Gelin, Johan, 1948, et al.
(författare)
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Treatment efficacy of intermittent claudication by surgical intervention, supervised physical exercise training compared to no treatment in unselected randomised patients I: one year results of functional and physiological improvements.
- 2001
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Ingår i: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. - : Elsevier BV. - 1078-5884. ; 22:2, s. 107-13
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: to compare the effect of surgery, exercise and simple observation on maximum exercise power in claudicants. Design: prospective, randomised study. METHODS: a total of 264 unselected claudicants were randomised to supervised exercise training, invasive treatment (open surgical or endovascular procedures) or observation. One year treatment outcomes were analysed on an intention to-treat basis. RESULTS: invasively treated patients showed a significant improvement in maximum walking power, stopping distance, post-ischaemic blood flow and big toe pressure at one year. Patients randomised to physical exercise training or to the control group did not improve in any outcome measure. CONCLUSION: invasive treatment increased walking capacity, leg blood pressure and flow. Supervised physical exercise training offered no therapeutic advantage compared to untreated controls.
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| 2. |
- Karlsson, Jan, 1950, et al.
(författare)
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Psychosocial functioning in the obese before and after weight reduction: construct validity and responsiveness of the Obesity-related Problems scale.
- 2003
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Ingår i: International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity. - : Springer Science and Business Media LLC. - 0307-0565. ; 27:5, s. 617-30
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The Obesity-related Problems scale (OP) is a self-assessment module developed to measure the impacts of obesity on psychosocial functioning. Our principal aim was to evaluate the construct validity and responsiveness of the OP scale. Our specific aims were to test: (1). the psychometric performance of OP; (2). if OP scores differed by gender and weight category; (3). if OP scores are inversely related to mental well-being; (4). if weight reduction in the obese is accompanied by improvements in psychosocial functioning (OP). SUBJECTS: Four samples were used: 6863 subjects in the SOS cross-sectional study; 2128 in the SOS intervention study; 1017 nonobese in the SOS reference study; and 3305 obese subjects in the XENDOS study. MEASUREMENTS: Psychosocial functioning was measured by OP. Overall mood was measured by MACL. Anxiety and depression symptoms were measured by HAD. RESULTS: Psychometric testing provided strong support for the construct validity of OP. Factor analysis confirmed the homogeneity of the construct and multitrait/multi-item scaling analysis demonstrated strong item-convergent/discriminant validity. Reliability coefficients were high and floor and ceiling effects were small. Psychometric results were cross-validated and replicated in subgroups by gender, age and body mass index (BMI). As expected, large differences in OP were observed between obese and nonobese (P<0.0001). Obese women reported more weight-related psychosocial problems than obese men (P<0.0001). Psychosocial disturbances (OP) among the obese were significantly related to poor mood (MACL; P<0.0001) and anxiety and depression symptoms (HAD; P<0.0001). Change in OP over time was strongly correlated with weight loss (P<0.0001). A distinct dose-response effect between weight reduction and improvements in OP was demonstrated. Scores on psychosocial functioning (OP) and mental well-being (MACL, HAD) in nonobese (BMI<30) surgical patients at 4-y follow-up were equal to scores observed in nonobese reference subjects (NS). CONCLUSION: OP is a psychometrically valid obesity-specific measure suitable for evaluating HRQL effects of obesity interventions. The negative impact of obesity on psychosocial functioning is considerable and disturbances are connected with poor mental well-being. Weight reduction in the obese is followed by improvements in both psychosocial functioning and mental well-being.
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| 3. |
- Karlsson, Jan, 1950, et al.
(författare)
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Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study.
- 2007
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Ingår i: International journal of obesity (2007). - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 31:8, s. 1248-61
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine trends and effects of weight loss treatment on health-related quality of life (HRQL) in the severely obese over 10 years. DESIGN: Swedish obese subjects (SOS) intervention study is a controlled, longitudinal trial of the health effects of weight loss in the severely obese. Subjects: A total of 655 of 851 surgically treated and 621 of 852 conventionally treated obese men (body mass index, BMI>or=34) and women (BMI>or=38) who completed 10 years of the study. MEASUREMENTS: HRQL was assessed before treatment and after 0.5, 1, 2, 3, 4, 6, 8 and 10 years. RESULTS: HRQL change during the 10-year observation period largely followed phases of weight loss, weight regain and weight stability. Improvements and deteriorations in HRQL were associated with the magnitude of weight loss or regain, except regarding anxiety. Peak improvements in the surgical group were observed during the first year of weight loss, whereas the weight regain phase (mainly between 1- and 6-year follow-up) was accompanied by a gradual decline in HRQL. The period from 6- to 10-year follow-up was characterized by relatively stable observations in both weight and HRQL. At 10 years, net gains were noted in all HRQL domains compared to baseline. Comparisons of treatment effects on HRQL in the surgical vs conventional group after 10 years showed significantly better outcome in the surgical group on current health perceptions, social interaction, psychosocial functioning and depression, whereas no significant differences were found for overall mood and anxiety. Long-term results of the study suggest that a maintained weight loss of about 10% is sufficient for positive long-term effects on HRQL, a limit that was reached in about two-thirds of the surgically treated patients who completed 10 years of the study. CONCLUSION: Long-lasting weight reduction in the severely obese has a general long-standing positive outcome on HRQL. Bariatric surgery is a favorable option for the treatment of severe obesity, resulting in long-term weight loss and HRQL improvements in a majority of patients. However, difficulties among some surgical patients to control and maintain weight loss over time should not be ignored. Future research should study if the long-term efficacy of bariatric surgery may be further enhanced by implementing lifestyle modification techniques in the postoperative management of patients.
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| 4. |
- Larsson, Ulf, et al.
(författare)
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Gender and age differences in the relative burden of rhinitis and asthma on health-related quality of life--a Swedish population study.
- 2006
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Ingår i: Respiratory medicine. - : Elsevier BV. - 0954-6111. ; 101:6, s. 1291-8
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the relative burden of rhinitis and asthma on health-related quality of life (HRQL) as a function of gender and age in the general population. A cross-sectional, general population survey was conducted, comprising 5918 men and women aged 16-64 years. The SF-36 Health Survey was administered by mail, along with questions regarding nasal complaints after 15 years of age and physician-diagnosed asthma. Overall, rhinitis and asthma were each associated with impaired HRQL compared with non-cases and the burden of these illnesses in combination was incremental. In the age group 16-49 years, men and women with rhinitis alone had significantly worse health profiles on most scales than non-cases, while asthmatics, with or without rhinitis, showed further decrements on only a few scales. In the age group 50-64 years, men with rhinitis did not differ from non-cases and no differences were found between asthmatics and rhinitis victims on any scale. In contrast, women aged 50-64 years with rhinitis had significantly worse scores than non-cases on bodily pain and general well-being scales (GH, VT), and asthmatics scored much lower on all scales than those with rhinitis alone. The negative association of rhinitis and asthma with HRQL differs by age and sex in the general population. Women aged 50-64 years with one or both ailments are particularly affected. Such gender and age differences should be taken into consideration in the care and treatment of patients with rhinitis and asthma.
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| 7. |
- Rydén, Anna, 1957, et al.
(författare)
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Coping and distress: what happens after intervention? A 2-year follow-up from the Swedish Obese Subjects (SOS) study.
- 2003
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Ingår i: Psychosomatic medicine. - 1534-7796. ; 65:3, s. 435-42
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The study examined effects of weight change on coping and distress in severely obese subjects treated conventionally or undergoing weight reduction surgery. METHODS: We used the Obesity Coping (OC) scale measuring emotion-focused, maladaptive coping (Wishful Thinking) and problem-focused, adaptive coping (Social Trust and Fighting Spirit). We also used the Obesity Distress (OD) scale (Intrusion and Helplessness) and the Hospital Anxiety and Depression (HAD) scale. A total of 1146 surgical candidates and 1085 conventionally treated patients completed the OC and OD before treatment and after 24 months. RESULTS: Weight gainers reduced their use of both problem- and emotion-focused coping, thus leaving distress levels unchanged. All participants who lost weight decreased in emotion-focused coping and distress. Participants losing 20 kg or more also increased in problem-focused coping, resulting in even greater improvements regarding distress. CONCLUSIONS: Two years after starting treatment, the pattern and magnitude of change in coping and distress was the same irrespective of type of treatment and was, instead, related to the amount of weight change (the more weight change the greater the changes in coping and distress). Increases in problem-focused coping required major weight reduction, whereas minor weight gain led to a decrease. Emotion-focused coping decreased irrespective of direction of weight change, suggesting a general intervention effect of receiving professional help and support. These results have implications concerning behavior-based interventions of obese patients.
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| 8. |
- Rydén, Anna, 1957, et al.
(författare)
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Obesity-related coping and distress and relationship to treatment preference.
- 2001
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Ingår i: The British journal of clinical psychology / the British Psychological Society. - 0144-6657. ; 40:2, s. 177-88
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The primary purpose was to define obesity-related strategies for coping with psychological problems connected with obesity. We also wanted to identify obesity-related distress and explore the effect of coping on distress. Thirdly, we wanted to investigate differences in coping and distress related to choice of surgery or conventional treatment. DESIGN: Cross-sectional data from patients in the Swedish Obese Subjects (SOS) intervention study. METHODS: An obesity-related questionnaire concerning coping and distress was created and evaluated in 2510 patients from the SOS study, using multitrait, exploratory and confirmatory factor analysis procedures. RESULTS: Three coping factors were defined. Social Trust and Fighting Spirit were problem-focused, whereas Wishful Thinking was emotion-focused. Surgical candidates displayed lower levels of problem-focused and higher levels of emotion-focused coping. We also identified two distress factors: Intrusion and Helplessness. Wishful Thinking was positively related to distress, and Social Trust and Fighting Spirit were inversely related, thus explaining the higher levels of distress reported by the surgical candidates. CONCLUSIONS: In our sample, emotion-focused coping proved maladaptive and was associated with increased distress. Problem-focused coping, however, was adaptive and associated with reduced distress. These findings partly explain psychological morbidity and should be taken into consideration in the treatment of obese people.
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| 9. |
- Rydén, Anna, 1957, et al.
(författare)
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Severe obesity and personality: a comparative controlled study of personality traits.
- 2003
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Ingår i: International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity. - : Springer Science and Business Media LLC. - 0307-0565. ; 27:12, s. 1534-40
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The primary purpose was to assess personality trait differences between the severely obese seeking treatment and a mainly non-obese reference group. We also investigated gender differences and differences between obese patients and obese not seeking treatment. METHOD: Personality traits were assessed using 7 of 15 scales from the Karolinska Scales of Personality (KSP): Somatic Anxiety, Muscular Tension, Psychastenia, Psychic Anxiety, Monotony Avoidance, Impulsiveness, and Irritability. Patients from the Swedish Obese Subjects (SOS) intervention study (n=3270, ages 37-57, 71% women) and the SOS reference study (n=1135, 54% women) completed the survey. Data presented in this study were gathered prior to treatment. Significance tests and effects sizes were calculated. RESULTS: Although statistically significant differences were found between obese patients and reference subjects on nearly all personality traits, effect sizes were at most moderate. Of the three scales with moderate effects sizes, differences on Somatic Anxiety and Psychastenia could be traced to items tapping condition-specific symptoms, e.g., problems with sweating and breathing as indicators of Somatic Anxiety. Moderate differences on the Impulsiveness scale (men alone) could not be explained by item composition. Further, the obese patients differed from obese in the reference group, and both obese and reference women reported significantly higher levels on Somatic Anxiety, Muscular Tension and Psychic Anxiety compared to men (effect size: small). CONCLUSIONS: Our results provided no evidence of a general obese personality profile, instead considerable heterogeneity in personality traits was observed across our obese samples (treatment seekers vs non-seekers, men vs women) and generally only small differences were noted compared to a reference study population. Further research is needed to investigate if the somewhat elevated levels of Impulsiveness, particularly among male obese patients, is affected by weight loss. When assessing personality traits in diseased groups consideration should be given to possible confounding from, e.g., somatic symptoms.
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