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Sökning: WFRF:(Wallman Thorne)

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1.
  • Bardel, Annika, 1952-, et al. (författare)
  • Age and sex related self-reported symptoms in a general population across 30 years Patterns of reporting and secular trend
  • 2019
  • Ingår i: PLoS ONE. - PUBLIC LIBRARY SCIENCE. - 1932-6203 .- 1932-6203. ; 14:2
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Objective To study age and sex specific prevalence of 30 symptoms in random samples from the general population and to analyze possible secular trends across time. Study population The study was based on data from eight on-going Swedish cohort studies, with baseline investigations performed between 1973 and 2003. Samples were drawn from the general population of the cities of Gothenburg and Eskilstuna, and of Uppsala County. Overall, 20,160 subjects were sampled, 14,470 (71.8%) responded, of whom 12.000 were unique subjects, and 2548 were part of more than one sample. Methods The Complaint score sub-scale of the Gothenburg Quality of Life instrument, listing 30 general symptoms was used. Responders were asked to indicate which symptoms they had experienced during the last three months. Results Women reported on average 7.8 symptoms, and men 5.3 (p&lt;0.0001). Women reported higher prevalence than men for 24 of the 30 symptoms. In multivariate analyses four patterns of prevalence across age were identified in both men and women; increasing prevalence, decreasing, stable and biphasic prevalence. The symptoms in the various pattern groups differed somewhat between men and women. However, symptoms related to strain were prominent among symptoms decreasing with age. Moreover, there were secular trends. Across all symptoms reporting prevalence increased over time in men (p&lt;0.001) as well as in women (p&lt;0.0001). Conclusions Women reported higher total symptom prevalence than men. Symptoms related to health generally increased with age, while symptoms related to stress decreased markedly. Significant secular trends across time regarding symptom prevalence were found.</p>
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2.
  • Berglund, Erik, et al. (författare)
  • Multidisciplinary Intervention and Acceptance and Commitment Therapy for Return-to-Work and Increased Employability among Patients with Mental Illness and/or Chronic Pain A Randomized Controlled Trial
  • 2018
  • Ingår i: International Journal of Environmental Research and Public Health. - 1661-7827 .- 1660-4601. ; 15:11
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background: People on long-term sick leave often have a long-lasting process back to work, where the individuals may be in multiple and recurrent states; i.e., receiving different social security benefits or working, and over time they may shift between these states. The purpose of this study was to evaluate the effects of two vocational rehabilitation programs, compared to a control, on return-to-work (RTW) or increased employability in patients on long-term sick leave due to mental illness and/or chronic pain. Methods: In this randomized controlled study, 427 women and men were allocated to either (1) multidisciplinary team management, i.e., multidisciplinary assessments and individual rehabilitation management, (2) acceptance and commitment therapy (ACT), or (3) control. A positive outcome was defined as RTW or increased employability. The outcome was considered negative if the (part-time) wage was reduced or ceased, or if there was an indication of decreased employability. The outcome was measured one year after entry in the project and analyzed using binary and multinomial logistic regressions. Results: Participants in the multidisciplinary team group reported having RTW odds ratio (OR) 3.31 (95% CI 1.39-7.87) compared to the control group in adjusted models. Participants in the ACT group reported having increased employability OR 3.22 (95% CI 1.13-9.15) compared to the control group in adjusted models. Conclusions: This study of vocational rehabilitation in mainly female patients on long-term sick leave due to mental illness and/or chronic pain suggests that multidisciplinary team assessments and individually adapted rehabilitation interventions increased RTW and employability. Solely receiving the ACT intervention also increased employability.</p>
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5.
  • Carlsson, Lars, et al. (författare)
  • Early multidisciplinary assessment was associated with longer periods of sick leave : A randomized controlled trial in a primary health care centre
  • 2013
  • Ingår i: Scandinavian Journal of Primary Health Care. - 0281-3432 .- 1502-7724. ; 31:3, s. 141-146
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>Objective</strong></p><p>To study the effects on sick leave from an early multidisciplinary assessment at a primary health care centre. Design. Randomized controlled trial.</p><p><strong>Setting</strong></p><p>Patients who saw GPs at a primary health care centre in mid-Sweden and asked for a sickness certificate for psychiatric or musculoskeletal diagnoses were invited to participate. Patients included were sick-listed for less than four weeks; 33 patients were randomized either to an assessment within a week by a physiotherapist, a psychotherapist, and an occupational therapist or to "standard care". The therapists used methods and tools they normally use in their clinical work.</p><p><strong>Main outcome measure</strong></p><p>Proportion of patients still sick-listed three months after randomization, total and net days on sick leave, and proportion who were on part-time sick leave.</p><p><strong>Results</strong></p><p>At follow-up after three months, in contrast to the pre-trial hypothesis, there was a trend toward a higher proportion of patients still sick-listed in the intervention group (7/18) as compared with the control group (3/15). The intervention group also had significantly longer sick-listing periods (mean 58 days) than the control group (mean 36 days) (p = 0.038). The proportion of patients who were part time sick-listed was significantly higher in the intervention group (10/18) than in the control group (2/15) (p = 0.027).</p><p><strong>Conclusions</strong></p><p>In this study an early multidisciplinary assessment was associated with longer periods on sick leave and more individuals on part-time sick leave.</p>
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6.
  • Carlsson, Lars, et al. (författare)
  • General practitioners' perceptions of working with the certification of sickness absences following changes in the Swedish social security system a qualitative focus-group study
  • 2015
  • Ingår i: BMC Family Practice. - 1471-2296 .- 1471-2296. ; 16
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background: Many physicians in Sweden, as well as in other countries, find the matter of certification of sickness absence (COSA) particularly burdensome. The issuing of COSAs has also been perceived as a work-environment problem among physicians. Among general practitioners (GPs) are the highest proportion of physicians in Sweden who experience difficulties with COSA. Swedish authorities have created several initiatives, by changing the social security system, to improve the rehabilitation of people who are ill and decrease the number of days of sick leave used. The aim of this study was to describe how GPs in Sweden perceive their work with COSA after these changes. Methods: A descriptive design with a qualitative, inductive focus-group discussion (FGD) approach was used. Results: Four categories emerged from the analysis of FGDs with GPs in Sweden: 1) Physicians' difficulties in their professional role; 2) Collaboration with other professionals facilitates the COSA; 3) Physicians' approach in relation to the patient; 4) An easier COSA process. Conclusions: Swedish GPs still perceived COSA to be a burdensome task. However, system changes in recent years have facilitated work related to COSA. Cooperation with other professionals on COSA was perceived positively.</p>
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7.
  • Carlsson, Lars (författare)
  • Healthcare and patient factors affecting sick leave From a primary health care perspective
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p><em>Background</em>: For indeterminate reasons, there have been major variations in sick leave in Sweden, and many physicians have perceived sick leave assignments as burdensome.</p><p><em>Aim:</em> To gain more knowledge and understanding, from a perspective of primary health care, about factors in health care and patients that affect sick leave. Thereby help patients in the best way, facilitate the work of physicians and other health professionals involved in the rehabilitation process, and use the health care resources optimally.</p><p><em>Methods</em>: This thesis is based on a randomised controlled trial (RCT) in a primary health care centre with participants on short-term sick leave, due to pain and/or mental illness, who received a multidisciplinary assessment. Qualitative focus-group discussions with physicians in primary health care centres. A cohort of women on very long-term sick leave due to pain and/or mental illness, who lost sickness benefits due to a new time limit on sickness insurance, were randomised to multidisciplinary assessment and multimodal intervention (TEAM), or to Acceptance and Commitment Therapy (ACT). In an extended cohort, including some men on very long-term sick leave due to pain and/or mental illness, the importance of the motivation for return to work (RTW) was investigated.</p><p><em>Results. </em>Very early multidisciplinary assessment increased days on sick leave in the first three month period. Physicians at primary health care centres perceived sick leave assignments as burdensome, but clearer rules and cooperation with other professionals have made sick leave assignments less burdensome. TEAM intervention resulted in an increase in working hours per week as well as an increase in work-related engagements, compared to control in the RCT. Motivation for RTW was associated with RTW or increased employability in the rehabilitation of patients</p><p><em>Conclusions: </em>Continued studies are needed to find those who are at risk of long-term sick leave, the time when rehabilitation efforts should be started, and the content of rehabilitation. Collaboration in teams facilitates sick leave assignments for physicians at primary care health centres. Motivation for RTW might be a factor of importance for the effect of rehabilitation and needs to be studied further.</p>
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8.
  • Carlsson, Lars, et al. (författare)
  • Motivation for return to work and actual return to work among people on long-term sick leave due to pain syndrome or mental health conditions
  • 2019
  • Ingår i: Disability and Rehabilitation. - 0963-8288 .- 1464-5165. ; 41:25, s. 3061-3070
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>Purpose:</strong> The purpose of this study was to investigate associations between motivation for return to work and actual return to work, or increased employability among people on long-term sick leave.</p><p><strong>Materials and methods:</strong> Data by responses to questionnaires was collected from 227 people on long-term sick leave (mean = 7.9 years) due to pain syndrome or mild to moderate mental health conditions who had participated in a vocational rehabilitation intervention. The participants’ motivation for return to work was measured at baseline. At 12-month follow-up, change in the type of reimbursement between baseline and at present was assessed and used to categorise outcomes as: “decreased work and employability”, “unchanged”, “increased employability”, and “increased work”. Associations between baseline motivation and return to work outcome were analysed using logistic and multinomial regression models.</p><p><strong>Results:</strong> Motivation for return to work at baseline was associated with return to work or increased employability at 12-month follow-up in the logistic regression model adjusting for potential confounders (OR 2.44, 95% CI 1.25–4.78).</p><p><strong>Conclusions:</strong> The results suggest that motivation for return to work at baseline was associated with actual chances of return to work or increased employability in people on long-term sick leave due to pain syndrome or mild to moderate mental health conditions.</p><ul><li><strong>Implication for rehabilitation</strong></li><li><p>High motivation for return to work seems to increase the chances of actual return to work or increased employability in people on sick leave due to pain syndrome or mild to moderate mental health conditions.</p></li><li><p>The potential impact of motivation for return to work is suggested to be highlighted in vocational rehabilitation.</p></li><li><p>Rehabilitation professionals are recommended to recognise and take into consideration the patient’s stated motivation for return to work.</p></li><li><p>Rehabilitation professionals should be aware of that the patient’s motivation for return to work might have an impact on the outcome of vocational rehabilitation.</p></li></ul>
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9.
  • Eriksson, Hans-G., et al. (författare)
  • Sickness absence and self-reported health a population-based study of 43,600 individuals in central Sweden
  • 2008
  • Ingår i: BMC Public Health. - 1471-2458 .- 1471-2458. ; 8, s. 426
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>BACKGROUND</p><p>Sickness absence is very high in Sweden. The reasons for this phenomenon are not well known. The aim of this study was to investigate the association between degree of self-reported sickness absence and health. The hypothesis was that individuals with long-term sickness absence would report more symptoms and lower self-rated health. Another hypothesis was that women are more likely to self-rate psychiatric diagnoses compared to men, who are more likely to self-rate musculoskeletal diagnoses.</p><p>METHODS</p><p>The data was obtained with a postal survey questionnaire answered by 43,589 individuals, a Swedish random population sample of men and women aged 18-84 years. The response rate was 65%. This study included 19,826 individuals aged 18-64 years old and still at work. They were divided into four groups, based on the number of reported days of sickness absence during the past year.</p><p>RESULTS</p><p>Approximately 40% of the individuals at work mentioned that they had been absent due to illness sometime during the past year. Of those who had been absent 90 days or more, two thirds were women. There was a significant difference between the groups in self-rated health (p &lt; 0.05). Every fifth woman (19.4%) and every fourth man (25.9%) in the group with a sickness absence of more than 89 days rated their health as poor or very poor, but a large proportion, 43.5% of the women and 31.6% of the men, rated their health as good. Long-term illnesses and complaints differed between the groups. The correlations between the groups and illness were mostly significant (p &lt; 0.01). Two thirds of the subjects had both psychiatric and musculoskeletal symptoms. There was a significant difference among them, as men more often had musculoskeletal diagnoses. One third had only psychiatric or musculoskeletal symptoms and in those groups there were no significant diagnosis differences between the sexes.</p><p>CONCLUSION</p><p>Individuals with long-term sickness absence reported more symptoms and lower self-rated health than did those who had not been absent at all, and than those who had been ill 1-28 days. Men and women sick-listed 29 days or more generally reported more illness and complaints. No sex differences among psychiatric and musculoskeletal diagnoses were found, but when reported both psychiatric and musculoskeletal symptoms the musculoskeletal diagnoses were significant among men.</p>
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10.
  • Halford, Christina, et al. (författare)
  • A population-based study of nearly 15 000 observations among Swedish women and men during 1973-2003
  • 2012
  • Ingår i: BMJ Open. - 2044-6055 .- 2044-6055. ; 2:6, s. e001353
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>OBJECTIVES:</strong></p><p>Global self-rated health (SRH) has become extensively used as an outcome measure in population health surveillance. The aim of this study was to analyse the effects of age and secular trend (year of investigation) on SRH.</p><p><strong>DESIGN:</strong></p><p>Prospective cohort study, using population-based data from eight ongoing cohort studies, with sampling performed between 1973 and 2003.</p><p><strong>SETTING:</strong></p><p>Sweden.</p><p><strong>PARTICIPANTS:</strong></p><p>11 880 women and men, aged 25-99 years, providing 14 470 observations.</p><p><strong>PRIMARY OUTCOME MEASURE:</strong></p><p>Global SRH.</p><p><strong>RESULTS:</strong></p><p>In multiple ordinal logistic regression analyses, adjusted for the effects of covariates, there were independent effects of age (p&lt;0.0001) and of year of investigation (p&lt;0.0001) on SRH. In women the association was linear, showing lower levels of SRH with increased age, and more recent year of investigation. In men the association was curvilinear, and thus more complex. The final model explained 76.2% of the SRH variance in women and 74.5% of the variance in men.</p><p><strong>CONCLUSIONS:</strong></p><p>SRH was strongly and inversely associated with age in both sexes, after adjustment for other outcome-affecting variables. There was a strongly significant effect of year of investigation indicating a change in SRH, in women towards lower levels over calendar time, in men with fluctuations across time.</p>
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