| 1. |
- Calner, Tommy, et al.
(författare)
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Effects of a self-guided, web-based activity programme for patients with persistent musculoskeletal pain in primary healthcare : A randomized controlled trial
- 2017
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Ingår i: European Journal of Pain. - : John Wiley & Sons. - 1090-3801 .- 1532-2149. ; 21:6, s. 1110-1120
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDWeb-based interventions for pain management are increasingly used with possible benefits, but never used in addition to multimodal rehabilitation (MMR). MMR is recommended treatment for persistent pain in Sweden. The aim was to evaluate the effects of a self-guided, web-based programme added to MMR for work ability, pain, disability and health-related quality of life.METHODSWe included 99 participants with persistent musculoskeletal pain in a randomized study with two intervention arms: (1) MMR and web-based intervention, and (2) MMR. Data was collected at baseline, 4 and 12 months. Outcome measures were work ability, working percentage, average pain intensity, pain-related disability, and health-related quality of life.RESULTSThere were no significant effects of adding the web-based intervention to MMR regarding any of the outcome variables.CONCLUSIONSThis trial provides no support for adding a self-guided, web-based activity programme to MMR for patients with persistent musculoskeletal pain.SIGNIFICANCEThe comprehensive self-guided, web-based programme for activity, Web-BCPA, added to multimodal treatment in primary health care had no effect on work ability, pain, disability or health-related quality of life. Future web-based interventions should be tailored to patients' individual needs and expectations
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| 2. |
- Calner, Tommy, et al.
(författare)
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Physiotherapy in combination with personalized counseling and a web-based programme for persistent pain : an early stage evaluation
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- ObjectiveWe evaluated first a self-managed web-based programme for activity compared to waiting list for persons with persistent musculoskeletal pain suited for primary health care. Thereafter, we evaluated the effects and process of a novel multimodal treatment intervention combining the web programme with counselling and physiotherapy. DesignA weekly comparison of measures of outcome data between those using the self-managed web-based programme to those on a waiting list. After that a Single Subject Experimental Design (SSED) evaluation of the multimodal intervention, structured interviews and log data. SettingClinical setting in primary health care. SubjectsTen participants with persistent musculoskeletal pain. InterventionFirst, only a self-managed web-based programme for activity. Thereafter a multimodal intervention combining the web programme with counselling and physiotherapy. Main measuresEffect measures were work ability, pain intensity, disability and self-efficacy. Process evaluation by interviews of the participants and log data of usage of the modalities. ResultsThere were no conclusive effects of the self-managed web-based programme as compared to waiting list. The SSED analyses of the multi-modal showed promising short-term results regarding disability and pain intensity, but no conclusive results for work ability or self-efficacy. The multimodal intervention process seemed successfully implemented, and the importance of physiotherapy and to some extent counselling was emphasized by the participants. Conclusion For persons with persistent musculoskeletal pain, the newly designed multimodal intervention in primary care seemed feasible and showed some promising short-terms effects, while the implementation of a self-managed web-based programme as a single intervention seemed without effect.
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| 3. |
- Ekdahl, Natascha, et al.
(författare)
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Investigating cognitive reserve, symptom resolution and brain connectivity in mild traumatic brain injury
- 2023
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Ingår i: BMC Neurology. - : BioMed Central (BMC). - 1471-2377. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundA proportion of patients with mild traumatic brain injury (mTBI) suffer long-term consequences, and the reasons behind this are still poorly understood. One factor that may affect outcomes is cognitive reserve, which is the brain's ability to maintain cognitive function despite injury. It is often assessed through educational level or premorbid IQ tests. This study aimed to explore whether there were differences in post-concussion symptoms and symptom resolution between patients with mTBI and minor orthopedic injuries one week and three months after injury. Additional aims were to explore the relationship between cognitive reserve and outcome, as well as functional connectivity according to resting state functional magnetic resonance imaging (rs-fMRI).MethodFifteen patients with mTBI and 15 controls with minor orthopedic injuries were recruited from the emergency department. Assessments, including Rivermead Post-Concussion Questionnaire (RPQ), neuropsychological testing, and rs-fMRI scans, were conducted on average 7 days (SD = 2) and 122 days (SD = 51) after injury.ResultsAt the first time point, significantly higher rates of post-concussion symptoms (U = 40.0, p = 0.003), state fatigue (U = 56.5, p = 0.014), and fatigability (U = 58.5, p = 0.025) were observed among the mTBI group than among the controls. However, after three months, only the difference in post-concussion symptoms remained significant (U = 27.0, p = 0.003). Improvement in post-concussion symptoms was found to be significantly correlated with cognitive reserve, but only in the mTBI group (Spearman's rho = -0.579, p = .038). Differences in the trajectory of recovery were also observed for fatigability between the two groups (U = 36.5, p = 0.015). Moreover, functional connectivity differences in the frontoparietal network were observed between the groups, and for mTBI patients, functional connectivity differences in an executive control network were observed over time.ConclusionThe findings of this pilot study suggest that mTBI, compared to minor orthopedic trauma, is associated to both functional connectivity changes in the brain and concussion-related symptoms. While there is improvement in these symptoms over time, a small subgroup with lower cognitive reserve appears to experience more persistent and possibly worsening symptoms over time. This, however, needs to be validated in larger studies.Trial registrationNCT05593172. Retrospectively registered.
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| 4. |
- Enberg, Birgit, 1956-, et al.
(författare)
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Work experiences of novice occupational therapists and physiotherapists in public sector employment : analyses using two occupational stress models
- 2010
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Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 12:1, s. 42-49
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate how recently graduated occupational therapists and physiotherapists, employed by the Swedish county councils and municipalities, experience working in public sector healthcare organization. The study group, 262 occupational therapists and physiotherapists who graduated in 1999, is a sub-sample drawn from a national cross-sectional survey. Data were collected in their third year after graduation. The Swedish Demand-control Questionnaire and the Effort-reward Imbalance Questionnaire together with self-constructed questions were used to evaluate psychosocial factors at work. The results reveal that few were exposed to job strain or effort-reward imbalance (ERI). More were defined as having work-related overcommitment (WOC). Logistic regression analyses revealed a significant association between WOC and ERI, sex, degree of effort and degree of reward. One quarter was dissatisfied with their work and this dissatisfaction was significantly associated with ERI, reward (in the ERI questionnaire), control (in the Demand-control Questionnaire) and type of employer. In conclusion, combining the Demand-control model and the ERI model made it possible to describe and analyse varying aspects of the work of novice occupational therapists and physiotherapists in public sector healthcare.
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| 5. |
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| 6. |
- Lindberg, Malin, Professor, 1978-, et al.
(författare)
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Inclusive funding for enhanced impact of social sciences and humanities
- 2019
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Ingår i: fteval Journal for Research and Technology Policy Evaluation. - : Austrian Platform for Research and Technology Policy Evaluation (fteval). - 1726-6629. ; :48, s. 82-87
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Tidskriftsartikel (refereegranskat)abstract
- In order to expand the knowledge on how societal impact of social sciences and humanities (SSH) can be enhanced through public funding of research and innovation, a process of designing digitalised tools for inclusive funding is scrutinised, involving four Swedish funding agencies and an Non-Governmental Organisation (NGO) of SSH researchers. The agencies shared the challenge to attract a broader range of SSH researchers to apply for their funding. Excluding and including mechanisms were identified in the interactions, texts and images of the formulation, communication and processing of calls for funding. The developed tools digitally guide the user through queries regarding the present and potential diversity of SSH representation among applicants, reviewers, agencystaff, etc. and regarding the formulation and communication of call texts, assessmentcriteria and reviewer instructions. The tools thus enhance SSH impact by making funding more available, but fail to demonstrate how concrete interaction with societal actors may enhance this.
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| 7. |
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| 8. |
- Nord, Catharina, et al.
(författare)
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Explorations of urban residential quality : situations of dwelling, ageing and healthcaring. Inquiries of transdisciplinary nature
- 2015
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Konferensbidrag (refereegranskat)abstract
- Many assisted living facilities are located on the outskirts of urban areas. This might be due to lack of available land in central urban areas and the higher land costs associated with central areas of an urban structure. It might also be a result of a presumption that older people need a peaceful and quiet surrounding in old age, close to green areas, which would then be a better alternative than the city centre. However, research has shown that urban living is more health promoting than rural living to older people. This presentation aims to discuss pros and cons of the location of assisted living facilities in central or peripheral urban places. Different aspects will be highlighted with support of the three researchers’ studies of assisted living.
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| 9. |
- Nordin, Catharina, et al.
(författare)
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Being in an exchange process : experiences of patient participation in multimodal pain rehabilitation
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 45:6, s. 580-586
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore primary healthcare patients' experiences of patients participation in multimodal pain rehabilitation.Patients and methods: A total of 17 patients who had completed multimodal rehabilitation for persistent pain were interviewed. The interviews were analysed using qualitative content analysis.Results: One theme, Being in an exchange process, and 4 categories emerged. The theme depicted patient participation as a continuous exchange of emotions, thoughts and knowledge. The category Fruitful encounters represented the basic prerequisites for patient participation through dialogue and platforms to meet. Patients' emotional and cognitive resources and restrictions, as well as knowledge gaps, were conditions influencing patient participation in the category Inequality in co-operation. Mutual trust and respect were crucial conditions in patient's personal relationships with the health professionals, forming the category Confidence-inspiring alliance. In the category Competent health professionals, the health professionals' expertise, empathy and personal qualities, were emphasized to favour patient participation.Conclusion: Patient participation can be understood as complex and individualized. A confidence-inspiring alliance enables a trusting relationship to be formed between patients and health professionals. Patients emphasized that health professionals need to play an active role in building common ground in the interaction. Understanding each patient's needs in the participation process may favour patient participation.
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| 10. |
- Nordin, Catharina, et al.
(författare)
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Effects of the Web Behavior Change Program for Activity and Multimodal Pain Rehabilitation : Randomized Controlled Trial
- 2016
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 18:10, s. 24-41
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Web-based interventions with a focus on behavior change have been used for pain management, but studies of Web-based interventions integrated in clinical practice are lacking. To emphasize the development of cognitive skills and behavior, and to increase activity and self-care in rehabilitation, the Web Behavior Change Program for Activity (Web-BCPA) was developed and added to multimodal pain rehabilitation (MMR).OBJECTIVE:The objective of our study was to evaluate the effects of MMR in combination with the Web-BCPA compared with MMR among persons with persistent musculoskeletal pain in primary health care on pain intensity, self-efficacy, and copying, as part of a larger collection of data. Web-BCPA adherence and feasibility, as well as treatment satisfaction, were also investigated.METHODS:A total of 109 participants, mean age 43 (SD 11) years, with persistent pain in the back, neck, shoulder, and/or generalized pain were recruited to a randomized controlled trial with two intervention arms: (1) MMR+WEB (n=60) and (2) MMR (n=49). Participants in the MMR+WEB group self-guided through the eight modules of the Web-BCPA: pain, activity, behavior, stress and thoughts, sleep and negative thoughts, communication and self-esteem, solutions, and maintenance and progress. Data were collected with a questionnaire at baseline and at 4 and 12 months. Outcome measures were pain intensity (Visual Analog Scale), self-efficacy to control pain and to control other symptoms (Arthritis Self-Efficacy Scale), general self-efficacy (General Self-Efficacy Scale), and coping (two-item Coping Strategies Questionnaire; CSQ). Web-BCPA adherence was measured as minutes spent in the program. Satisfaction and Web-BCPA feasibility were assessed by a set of items.RESULTS:Of 109 participants, 99 received the allocated intervention (MMR+WEB: n=55; MMR: n=44); 88 of 99 (82%) completed the baseline and follow-up questionnaires. Intention-to-treat analyses were performed with a sample size of 99. The MMR+WEB intervention was effective over time (time*group) compared to MMR for the two-item CSQ catastrophizing subscale (P=.003), with an effect size of 0.61 (Cohen d) at 12 months. There were no significant between-group differences over time (time*group) regarding pain intensity, self-efficacy (pain, other symptoms, and general), or regarding six subscales of the two-item CSQ. Improvements over time (time) for the whole study group were found regarding mean (P<.001) and maximum (P=.002) pain intensity. The mean time spent in the Web-based program was 304 minutes (range 0-1142). Participants rated the items of Web-BCPA feasibility between 68/100 and 90/100. Participants in the MMR+WEB group were more satisfied with their MMR at 4 months (P<.001) and at 12 months (P=.003).CONCLUSIONS:Adding a self-guided Web-based intervention with a focus on behavioral change for activity to MMR can reduce catastrophizing and increase satisfaction with MMR. Patients in MMR may need more supportive coaching to increase adherence in the Web-BCPA to find it valuable.
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