| 1. |
- Janson Fagring, Annika, 1949, et al.
(författare)
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Depression, anxiety, stress, social interaction and health-related quality of life in men and women with unexplained chest pain
- 2008
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 8:165
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Unexplained chest pain (UCP) is a common reason for emergency hospital admission and generates considerable health-care costs for society. Even though prior research indicates that psychological problems and impaired quality of life are common among UCP patients, there is lack of knowledge comparing UCP patients with a reference group from the general population. The aim of this study was to analyse differences between men and women with UCP and a reference group in terms of psychosocial factors as depression, anxiety, stress, social interaction and health-related quality of life (HRQOL). METHODS: A self-administered questionnaire about psychosocial factors was completed by 127 men and 104 women with acute UCP admitted consecutively to the Emergency Department (ED) or as in-patients on a medical ward. A reference group from the general population, 490 men and 579 women, participants in the INTERGENE study and free of clinical heart disease, were selected. RESULTS: The UCP patients were more likely to be immigrants, have a sedentary lifestyle, report stress at work and have symptoms of depression and trait-anxiety compared with the reference group. After adjustment for differences in age, smoking, hypertension and diabetes, these factors were still significantly more common among patients with UCP. In a stepwise multivariate model with mutual adjustment for psychosocial factors, being an immigrant was associated with a more than twofold risk in both sexes. Stress at work was associated with an almost fourfold increase in risk among men, whereas there was no independent impact for women. In contrast, depression only emerged as an independent risk factor in women. Trait-anxiety and a low level of social interaction were not independently associated with risk in either men or women. Patients with UCP were two to five times more likely to have low scores for HRQOL. CONCLUSION: Both men and women with UCP had higher depression scores than referents, but an independent association was only found in women. Among men, perceived stress at work emerged as the only psychosocial variable significantly associated with UCP.
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| 2. |
- Janson Fagring, Annika, 1949, et al.
(författare)
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Twenty-year trends in incidence and 1-year mortality in Swedish patients hospitalised with non-AMI chest pain. Data from 1987-2006 from the Swedish hospital and death registries
- 2010
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Ingår i: Heart. - : BMJ Publishing Group. - 1355-6037 .- 1468-201X. ; 96:13, s. 1043-1049
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Tidskriftsartikel (refereegranskat)abstract
- Objective To study trends for 20 years in incidence and 1-year mortality in hospitalised patients who received a diagnosis of either angina or unexplained chest pain (UCP) in Sweden. Design and setting Register study of all patients aged 25–84 years identified from the Swedish National Hospital Discharge Register who were hospitalised with a first-time diagnosis of UCP or angina pectoris during 1987 to 2006. Participants A total of 378454 patients, 235855 with UCP and 142599 with angina. Main outcome measures 1-Year mortality and standardised mortality ratios (SMRs). Results From the period 1987–1991 to 2002–2006, the observed 1-year mortality rate in men and women with UCP aged 25–74 years decreased from 2.19% to 1.45% and from 1.85% to 0.91%, respectively. SMRs decreased from 1.67 (95% CI 1.39 to 1.95) and 1.63 (1.27 to 2.00) to 1.09 (0.96 to 1.23) and 0.88 (0.75 to 1.00). Corresponding decreases in 1-year mortality for a discharge diagnosis of angina were from 6.50% to 2.49% in men and from 4.80% to 1.68% in women, with SMRs decreasing from 2.69 (2.33–3.05) and 2.59 (2.06–3.12) to 1.09 (0.93–1.25) and 1.05 (0.81–1.29), respectively. Similar changes occurred in patients aged 75–84 years. Only men with UCP aged 75–84 years still retained a slightly increased mortality (SMR 1.14 (1.01–1.28)). Conclusions The prognosis of patients admitted with chest pain in which acute myocardial infarction has been ruled out has improved for the past 20 years, such that the 1-year mortality of these patients is now similar to that in the general population.
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| 3. |
- Malmberg, Leona, 1973-, et al.
(författare)
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Endodontic follow-up practices, sources of knowledge, and self-assessed treatment outcome among general dental practitioners in Sweden and Norway
- 2020
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 78:7, s. 547-552
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To reduce the gap between what can be achieved in endodontic treatments and the observed treatment outcome among general dental practitioners, the present study set out to assess the status of the endodontic practices as regards to knowledge and self-assessed skills among general dental practitioners in Sweden and Norway. Material and method: The questionnaire was sent to 1384 general dental practitioners. It contained questions regarding access to continuing education in endodontics, sources of knowledge for clinical management of patients, post-operative follow-ups, self-assessed success-rate, and the initial diagnosis impact on the outcome of endodontic treatments. Results: The response rate was 61.4%. Almost half estimated their endodontic success-rate to be 90%. About two-thirds of the respondents did not know, or did not believe, that the initial diagnosis could affect the outcome of their endodontic treatments. Respondents who did not believe the diagnosis could impact the outcome were more likely to estimate their success rate as the highest (p<.001). Less than half performed post-operative follow-ups a year after treatment. A third of the respondents had not attended any continuing endodontic education. Conclusion: Dentists who do not receive regular feedback on their treatments may lack insight into their own shortcomings. If this is combined with insufficient knowledge and understanding it may result in sub-par endodontic treatments being performed. It is important to have reliable ways to communicate current endodontic knowledge and to establish robust methods that may help dentists accurately assess their own performance in endodontics. © 2020, © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Acta Odontologica Scandinavica Society.
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| 4. |
- Janson Fagring, Annika, 1949, et al.
(författare)
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Description of unexplained chest pain and its influence on daily life in men and women.
- 2005
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Ingår i: European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology. - : Oxford University Press (OUP). - 1474-5151. ; 4:4, s. 337-44
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with unexplained chest pain have seldom organic pathology. Although both physical and psychological factors have been studied and suggested as causes of chest pain. AIM: The aim was to describe the experience of unexplained chest pain and its influence on daily life situation in men and women. METHODS: Nine women and eleven men with unexplained chest pain, aged 31-62 years were interviewed. A qualitative descriptive design was used. The interviews were analyzed by content analysis focusing on experience by gender. RESULTS: The results embraced two domains descriptions and consequences of chest pain and daily life situation. Words like pressure, cramp, strong, or burning were used in the descriptions of the chest pain experienced with more similarities than variations between men and women. Physical, psychological and social consequences due to chest pain influenced daily life. The men specifically reported having a 'fast tempo' in their lives, with stress at work being seen as a feature experienced by both men and women. CONCLUSIONS: This study shows that men and women had more similarities than variations in descriptions of chest pain. Their unexplained chest pain influenced their functions in daily life that led to, especially for the men, few contacts outside the family and therefore a weak social network.
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| 5. |
- Janson Fagring, Annika, 1949
(författare)
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Unexplained chest pain in men and women - symptom perception and outcome
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Patients with chest pain account for a large number of all patients seeking health care. The majority of these patients are referred to emergency departments (ED) and many of them are given a discharge diagnosis of unexplained chest pain (UCP). Our knowledge of this increasing number of patients with UCP is limited. The overall aim of the thesis was to describe and analyse symptom perception, psychosocial factors, health-related quality of life (HRQOL) and outcome of unexplained chest pain (UCP) in men and women. The UCP patients’ symptoms and their influence on daily life in a gender perspective were explored in Paper I using open interview questions (11 men and 9 women). A cross-sectional design was used in Paper II, assessing pain characteristics using the Pain-O-Meter and measuring psychosocial factors and HRQOL with a self-administered questionnaire. The results were based on 101 men and 78 women consecutively admitted to an ED. In Paper III, psychosocial factors and HRQOL were compared between the UCP patients (127 men and 104 women) and a reference group, i.e. a subsample (490 men and 579 women) from the INTERGENE population study. Paper IV was a register study with data from the Swedish National Hospital Discharge Register, investigating trends in incidence and outcome among patients hospitalised with UCP, angina pectoris or acute myocardial infarction (AMI) in Sweden in 1987-2003 (n=559 879). The results showed that the men and women with UCP are generally middle-aged. More than a third of both UCP men and women were born outside Sweden and, compared with the reference group, the percentage of immigrants was significantly higher. UCP impacted negatively on the patients’ daily life, which was filled with worries due to the chest pain. Feelings of panic and fear of death in connection with the chest pain were reported. Words like “pressure” and “cramp” were used when describing the chest pain, with few gender differences. Significant correlations were found between pain intensity and smoking in men (p<0.01) and between pain intensity and age in women (p<0.05). Chest pain intensity was not significantly associated with the UCP patients’ reported HRQOL, apart from physical functioning in men (p<0.05), but it was rated lower than the reference group of both UCP men and women. The UCP men in particular reported stress at work. The women with UCP presented more depressive symptoms and more symptoms of trait anxiety than the men. Mental strain in marriage/cohabitation and a low level of social integration were significant risk factors only among women. Compared with the reference group, both men and women with UCP perceived more stress at work, symptoms of depression and trait anxiety and had less social interaction. Gender differences in physical activity during leisure time were reported, as more UCP males than females were physically active, although the UCP patients, both genders, were significantly more sedentary compared with the reference group. The UCP patients, both sexes, had a higher BMI and reported a lower alcohol consumption/week than the reference group. After increasing until about 2000, the number of hospitalisations with a discharge diagnosis of UCP appears to have stabilised, while hospitalisations for angina and AMI have continuously declined. Compared with patients with angina and AMI, the overall one-year observed mortality rate in UCP patients was lower. Between 1997 and 2003 the oneyear mortality among men with UCP was elevated by about one third, whereas women with UCP had no significant increase. In conclusion, UCP was related to symptoms that influenced life in several ways. In general the gender differences were few and the mortality within one year was low. The thesis illustrates the importance of a deeper understanding of symptom perception to achieve an individualised care of patients with UCP.
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| 6. |
- Janson Fagring, Annika, 1949, et al.
(författare)
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Unexplained chest pain in relation to psychosocial factors and health-related quality of life in men and women.
- 2007
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Ingår i: European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 6:4, s. 329-36
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Unexplained chest pain is a frequent and increasingly common complaint among patients admitted to Emergency Departments. Previous studies have defined unexplained chest pain as non-cardiac or non-coronary artery disease, i.e. patients with other organic causes explaining the chest pain could be included. To increase the knowledge of unexplained chest pain, this study only includes patients without any known explanation for their chest pain. AIM: To analyze gender differences regarding pain characteristics, psychosocial factors and health-related quality of life among patients diagnosed unexplained chest pain. METHODS AND RESULTS: The results are based on 179 patients (101 men, 78 women) between 16 and 69 years old (mean age 45.3) consecutively admitted to Emergency Department. Pain characteristics were assessed by Pain-O-Meter. Social relationships, depression, anxiety, and health-related quality of life were measured by a self-administered questionnaire. There were no gender differences regarding chest pain intensity; however women described their pain as burning (p<0.01) and frightening (p<0.03) more often than men. Men reported less depression (p<0.01) and less trait anxiety (p=0.01) than women. Chest pain intensity did not significantly impact health-related quality of life except physical functioning in men (p=0.05). CONCLUSION: Gender differences were few. Chest pain intensity did not significantly impact health-related quality of life.
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| 7. |
- Kjellgren, Karin I, 1950, et al.
(författare)
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Oförklarad bröstsmärta ur ett patientperspektiv
- 2009
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Ingår i: Vaskulär medicin. ; 25:4, s. 211-213
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- De senaste tjugo åren har antalet patienter med oförklarad bröstsmärta mer än fördubblats. Patienterna är oftast i medelåldern och mer än en tredjedel är födda utanför Sverige. Smärtan orsakar oro, ångest, osäkerhet och kraftlöshet. Två avhandlingar från Sahlgrenska akademin vid Göteborgs universitet [1, 2] har studerat oförklarad bröstsmärta, främst ur patientens synvinkel.
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