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1.
  • Eilertsen, Mary-Elizabeth Bradley, et al. (författare)
  • Impact of Social Support on Bereaved Siblings' Anxiety: A Nationwide Follow-Up
  • 2013
  • Ingår i: Journal of Pediatric Oncology Nursing. - 1043-4542. ; 30:6, s. 301-310
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose:To assess adolescent and young adult siblings' perception of social support prior to and following the loss of their brother or sister to cancer, 2 to 9 years earlier, and their anxiety at follow-up. Method: In 2009, 174 (73%) bereaved siblings (12-25 years) participated in a nationwide, long-term follow-up study in Sweden using an anonymous study-specific questionnaire. The Hospital Anxiety and Depression Scale was used to measure self-assessed anxiety. Results: Siblings had a higher risk of anxiety if they perceived their need for social support was unsatisfied during their brother or sisters' last month before death, relative risk (RR) = 3.6 (95% confidence interval [CI] = 1.8-7.3); time after death, RR = 2.9 (95% CI = 1.5-5.6); and at follow-up, RR = 3.8 (95% CI = 2.0-7.2). Furthermore, a higher risk for anxiety was shown for siblings if they did not perceive that their parents and neighbors cared for them after their brother or sisters' death, RR = 2.7 (95% CI = 1.3-5.5), RR = 5.4 (95% CI = 1.3-21.9), respectively. Conclusion: Bereaved siblings had a greater probability to report self-assessed anxiety if they perceived that their need for social support was not satisfied prior to and following death. Information from both nurses and other health care professionals to families about the impact of social support may contribute to lessen the siblings' risk of anxiety.
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2.
  • Mosallanezhad, Zahra, et al. (författare)
  • A structural equation model of the relation between socioeconomic status, physical activity level, independence and health status in older Iranian people
  • 2017
  • Ingår i: Archives of Gerontology and Geriatrics. - 0167-4943. ; 70, s. 123-129
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aim: Health status is an independent predictor of mortality, morbidity and functioning in older people. The present study was designed to evaluate the link between socioeconomic status (SES), physical activity (PA), independence (I) and the health status (HS) of older people in Iran, using structural equation modelling.Methods: Using computerized randomly selection, a representative sample of 851 75-year-olds living in Tehran (2007–2008), Iran, was included. Participants answered questions regarding indicators of HS, SES and also PA and I through interviews. Both measurement and conceptual models of our hypotheses were tested using Mplus 5. Maximum-likelihood estimation with robust standard errors (MLR estimator), chi-square tests, the goodness of fit index (and degrees of freedom), as well as the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RSMEA) were used to evaluate the model fit.Results: The measurement model yielded a reasonable fit to the data, χ2 = 110.93, df = 38; CFI = 0.97; RMSEA = 0.047, with 90% C.I. = 0.037–0.058. The model fit for the conceptual model was acceptable; χ2 = 271.64, df = 39; CFI = 0.91; RMSEA = 0.084, with 90% C.I. = 0.074–0.093. SES itself was not a direct predictor of HS (β = 0.13, p = 0.059) but it was a predictor of HS either through affecting PA (β = 0.31, p < 0.001) or I (β = 0.57, p < 0.001).Conclusion: Socioeconomic status appeared to influence health status, not directly but through mediating some behavioral and self-confidence aspects including physical activity and independence in ADL.
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3.
  • Ahlgren, Jennie, 1978-, et al. (författare)
  • Ethical considerations in relation to personalised nutrition : An overview of Work Package 5, with respect to ethics
  • 2015
  • Rapport (övrigt vetenskapligt)abstract
    • The objectives of Food4Me work package 5 included a baseline assessment of the ethical and legal aspects of personalised nutrition at the start of the project in 2011, as well as a final assessment at the end of the project (2015), taking into account results achieved in other work packages. The initial assessment made a number of ethical issues visible, most of them relating to the consumer of personalised nutrition service. The results depicted in this publication indicate that many of the questions raised in relation to these issues remain unsolved, and in some cases they seem to be neglected in relation to the services offered by internet companies.
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4.
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5.
  • Söderström, Marie, et al. (författare)
  • Weekday and weekend patterns of diurnal cortisol, activation and fatigue among people scoring high for burnout
  • 2006
  • Ingår i: SJWEH Supplements. - 1795-9926. ; :2, s. 35-40
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives The present pilot study attempted to investigate the diurnal pattern of cortisol, subjective activation, and mental fatigue among workers scoring high for burnout. The purpose was also to relate the cortisol data to objective sleep data.Methods One group with high (N=9) burnout scores and one with low (N=11) such scores were compared during a workday and a day off.Results The high-burnout group showed higher awakening cortisol during the workday than during the weekend. They also showed higher ratings for activation and mental fatigue during the weekend than the low-burnout group. A higher frequency of arousals during the prior sleep was associated with a higher diurnal amplitude and an earlier diurnal peak of cortisol during the workday.Conclusions The present results, which, due to the small sample size, should be interpreted with caution, may indicate that stress-induced frequency of arousal during sleep could contribute to the diurnal amplitude of cortisol. Furthermore, increased activation and mental fatigue during the weekend may reflect impaired recovery, which is of possible importance in the burnout process.
6.
  • Gerdle, Björn, et al. (författare)
  • Who benefits from multimodal rehabilitation - an exploration of pain, psychological distress, and life impacts in over 35,000 chronic pain patients identified in the Swedish Quality Registry for Pain Rehabilitation
  • 2019
  • Ingår i: Journal of Pain Research. - DOVE MEDICAL PRESS LTD. - 1178-7090. ; 12, s. 891-908
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Chronic pain patients frequently suffer from psychological symptoms. There is no consensus concerning the prevalence of severe anxiety and depressive symptoms and the strength of the associations between pain intensity and psychological distress. Although an important aspect of the clinical picture is understanding how the pain condition impacts life, little is known about the relative importance of pain and psychological symptoms for individuals life impact. The aims of this study were to identify subgroups of pain patients; to analyze if pain, psychological distress, and life impact variables influence subgrouping; and to investigate how patients in the subgroups benefit from treatments. Methods: Background variables, pain aspects (intensity/severity and spreading), psychological distress (depressive and anxiety symptoms), and two life impact variables (pain interference and perceived life control) were obtained from the Swedish Quality Registry for Pain Rehabilitation for chronic pain patients and analyzed mainly using advanced multivariate methods. Results: Based on amp;gt;35,000 patients, 35%-40% had severe anxiety or depressive symptoms. Severe psychological distress was associated with being born outside Europe (21%-24% vs 6%-8% in the category without psychological distress) and low education level (20.7%-20.8% vs 26%-27% in the category without psychological distress). Dose relationships existed between the two psychological distress variables and pain aspects, but the explained variances were generally low. Pain intensity/severity and the two psychological distress variables were significantly associated (R-2 =0.40-0.48; Pamp;gt;0.001) with the two life impact variables (pain interference and life control). Two subgroups of patients were identified at baseline (subgroup 1: n=15,901 16,119; subgroup 2: n=20,690-20,981) and the subgroup with the worst situation regarding all variables participated less in an MMRP (51% vs 58%, Pamp;lt;0.001) but showed the largest improvements in outcomes. Conclusion: The results emphasize the need to assess both pain and psychological distress and not take for granted that pain involves high psychological stress in the individual case. Not all patients benefit from MMRP. A better matching between common clinical pictures and the content of MMRPs may help improve results. We only partly found support for treatment resistance in patients with psychological distress burden.
7.
  • Nilsson, Lisbeth, et al. (författare)
  • Driving to Learn in a Powered Wheelchair: The Process of Learning Joystick Use in People With Profound Cognitive Disabilities
  • 2011
  • Ingår i: American Journal of Occupational Therapy. - American Occupational Therapy Association. - 0272-9490. ; 65:6, s. 652-660
  • Tidskriftsartikel (refereegranskat)abstract
    • The Driving to Learn project explored ways to help people with profound cognitive disabilities practice operating a joystick-operated powered wheelchair. The project used a grounded theory approach with constant comparative analysis and was carried out over 12 yr. The participants were 45 children and adults with profound cognitive disabilities. Reference groups included 17 typically developing infants and 64 participants with lesser degrees of cognitive disability. The data sources included video recordings, field notes, open interviews, and a rich mixture of literature. The findings that emerged yielded strategies for facilitating achievements, an 8-phase learning process, an assessment tool, and a grounded theory of deplateauing explaining the properties necessary for participants to exceed expected limitations and plateaus. Eight participants with profound cognitive disabilities reached goal-directed driving or higher. Participants were empowered by attaining increased control over tool use, improving their autonomy and quality of life.
8.
  • Hallberg, Lillemor R-M, 1942-, et al. (författare)
  • Facing a moral dilemma--introducing a dental care insurance within the public dental service.
  • 2012
  • Ingår i: Swedish dental journal. - 0347-9994. ; 36:3, s. 149-56
  • Tidskriftsartikel (refereegranskat)abstract
    • Through the reform entitled "Dental care insurance dental care at a fixed price", patients are offered a dental insurance, a capitation plan, that ensures that they can visit the dentist regularly during a period of three years at a fixed price per month (Frisktandvard). This insurance may be offered to all patients. The aim of this study was to generate a theory explaining the main concern for the staff at the public dental service when they have to introduce and advocate dental care insurance to patients. Interview data from 17 persons, representing different professions within the public dental service, were collected and analyzed simultaneously in line with guidelines for grounded theory. The results indicated that dentists/dental hygienists experienced several difficult standpoints concerning the implementation of the dental insurance, somewhat of a moral dilemma. The staff generally had a "cautiously positive attitude" to the forthcoming dental care insurance, but had perceptions how and when the patients should be offered the insurance and what that may mean to the clinic. The respondents reflected about the economic aspects for the clinic and how the oral health may be affected over time for the patients.
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9.
  • Heikkilä, Katriina, et al. (författare)
  • Job strain and COPD exacerbations an individual-participant meta-analysis
  • 2014
  • Ingår i: European Respiratory Journal. - 0903-1936. ; 44:1, s. 247-251
  • Tidskriftsartikel (refereegranskat)abstract
    • To the Editor:Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and disability worldwide (1). The clinical course of COPD is characterised by exacerbations, which can be minor and manageable at home or in primary care, or severe, leading to hospitalisation or even death. Known causes of exacerbations include tobacco smoke, air pollution, dusts and fumes, and respiratory infections (1, 2). One less well understood risk factor is stress, which could plausibly lead to COPD exacerbations as it can trigger inflammation (3, 4) and is associated with increased smoking (5), which are both implicated in COPD pathology (2). Work is an important source of stress in the age groups in which COPD is typically diagnosed (1, 6). However, we are not aware of previous investigations of work-related stress and the risk of COPD exacerbations.In this study, we examined the associations between job strain (the most widely studied conceptualisation of work-related stress) and severe COPD exacerbations using individual-level data from 10 prospective cohort studies from the Individual Participant Data Meta-analysis in Working Populations (IPD-Work) Consortium (7). Job strain is defined as a combination of high demands (excessive amounts of work) and low control (having little influence on what tasks to.
10.
  • Rovner, Graciela S., et al. (författare)
  • Chronic pain and sex-differences; women accept and move, while men feel blue.
  • 2017
  • Ingår i: PloS one. - 1932-6203. ; 12:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose The aim of this study is to explore differences between male and female patients entering a rehabilitation program at a pain clinic in order to gain a greater understanding of different approaches to be used in rehabilitation. Method 1371 patients referred to a specialty pain rehabilitation clinic, completed sociodemographic and pain related questionnaires. They rated their pain acceptance (CPAQ-8), their kinesiophobia (TSK), the impact of pain in their life (MPI), anxiety and depression levels (HAD) and quality of life scales: the SF-36, LiSat-11, and the EQ-5D. Because of the large sample size of the study, the significance level was set at the p amp;lt;= .01. Results Analysis by t-test showed that when both sexes experience the same pain severity, women report significantly higher activity level, pain acceptance and social support while men report higher kinesiophobia, mood disturbances and lower activity level. Conclusion Pain acceptance (CPAQ-8) and kinesiophobia (TSK) showed the clearest differences between men and women. Pain acceptance and kinesiophobia are behaviorally defined and have the potential to be changed.
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