| 1. |
- Calling, Susanna, et al.
(författare)
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Lung function, respiratory symptoms and incident venous thromboembolism during a 44-year follow-up
- 2023
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Ingår i: Thrombosis Update. - Oxford : Elsevier. - 2666-5727. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic obstructive pulmonary disease (COPD) and infections are risk factors for venous thromboembolism (VTE), but the reasons behind the associations are not fully known. Few studies have investigated whether lung function and respiratory symptoms in individuals without COPD are associated with VTE. Objectives: To study the incidence of VTE in individuals without COPD and other major VTE risk factors, in relation to baseline lung function and respiratory symptoms, through a 44-year follow-up prospective cohort study. Methods: As part of a health screening program, a total of 20,253 men and 7361 women underwent a baseline examination from 1974 to 1992, including a spirometry test and a self-administered questionnaire about respiratory symptoms, e.g., chronic bronchitis, cough, phlegm, and dyspnoea. Lung function was assessed through quartiles of forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC). Through linkage with national registers, all individuals were followed for incidence of VTE. Results: Respiratory symptoms (cough and dyspnoea) at baseline were associated with an increased risk of incident VTE in women after adjustments for age, height, BMI, smoking status, varicose veins, and FEV1/FVC. The adjusted hazard ratio in relation to chronic bronchitis was 1.57 (95% confidence interval 1.17–2.11). Poor lung function was not associated with an increased risk of VTE after adjustments for potential confounders. Conclusion: Women with respiratory symptoms of cough and dyspnoea without COPD have an increased risk of VTE, independent of lung function and major VTE risk factors. Further studies are needed to confirm the association and to study the clinical applicability of the results. © 2023 The Authors
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| 2. |
- Nymberg, Peter, 1971-, et al.
(författare)
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Association between changed self-rated health and the risk of venous thromboembolism in Malmö Preventive Program : a cohort study
- 2024
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Ingår i: Journal of Thrombosis and Thrombolysis. - New York : Springer-Verlag New York. - 0929-5305 .- 1573-742X. ; 57:3, s. 497-502
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Tidskriftsartikel (refereegranskat)abstract
- Poor self-rated health (SRH) is associated with incident arterial cardiovascular disease in both sexes. Studies on the association between SRH and incident venous thromboembolism (VTE) show divergent results in women and no association in men. This study focuses on the association between change in SRH and incident VTE in a cohort of 11,558 men and 6682 women who underwent a baseline examination and assessment of SRH between 1974 and 1992 and a re-examination in 2002–2006. To investigate if changes in SRH over time affect the risk of incident VTE in men and women. During a follow-up time from the re-examination of more than 16 years, there was a lower risk for incident VTE among women if SRH changed from poor at baseline to very good/excellent (HR 0.46, 95% CI 0.28; 0.74) at the re-examination. Stable good SRH (good to very good/excellent at the re-examination, HR 0.60, 95% CI 0.42; 0.89), or change from good SRH at baseline into poor/fair at the re-examination (HR 0.68, 95% CI 0.51; 0.90) were all significantly associated with a reduced risk for VTE. All comparisons were done with the group with stable poor SRH. This pattern was not found among men. Regardless of a decreased or increased SRH during life, having an SRH of very good/excellent at any time point seems to be associated with a decreased risk of VTE among women. © 2024, The Author(s).
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| 3. |
- Nymberg, Peter, 1971-, et al.
(författare)
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Association between self-rated health and venous thromboembolism in Malmö Preventive Program: A cohort study
- 2022
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Ingår i: Preventive Medicine. - : Elsevier BV. - 0091-7435 .- 1096-0260. ; 159
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Venous thromboembolism (VTE) and cardiovascular disease (CVD) share some risk factors such as smoking, obesity, and dietary habits. Poor self-rated health (SRH) has been shown to be a predictor of arterial CVD and mortality for both men and women. The association between SRH and VTE has only been investigated in one previous Swedish study with a cohort that just contained women. This Swedish study did not show any significant associations between poor SRH and VTE in women. Methods: A cohort of 22,444 men and 10,902 women in the Malmö Preventive Program was followed for a period of 44 years. All participants in the baseline screening with measurements including SRH were traced in national registers. Data on VTE events were collected from national hospital registries. Cox proportional regression analysis was used to calculate the association between SRH and time to VTE. Results: During a follow-up time of 44.31 years, a total of 2612 individuals were affected by VTE. Good SRH was associated with a lower risk for VTE in women both in the univariate model (HR = 0.75, CI = 0.65–0.85) and after adjustments for age, smoking, BMI and varicose veins (HR = 0.81, CI 0.70–0.93). SRH was not a predictor for VTE in men, neither in the unadjusted (HR = 1.05, CI 0.90–1.13) nor in the fully adjusted model (HR = 1.00, CI = 0.88–1.14). Conclusion: In this cohort study, SRH was associated with VTE in women but not among men. The association was significant even when adjusting for well-known risk factors such as varicose veins, BMI and smoking. © 2022 The Authors
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| 4. |
- Milos Nymberg, Veronica, et al.
(författare)
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HEAD-MIP–(HEAlth Dialogues for patients with Mental Illness in Primary care)—a feasibility study
- 2023
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Ingår i: Pilot and Feasibility Studies. - London : BioMed Central (BMC). - 2055-5784. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with mental illness have an increased risk of cardiovascular morbidity and mortality compared to the rest of the population, which is partly related to unhealthy lifestyle habits. To individualise lifestyle counselling in primary care, the Swedish-developed Health Dialogue (HD) can be used as an educative tool at recurrent measurement points with the goal to improve non-healthy lifestyle habits. HD has not been aimed specifically at patients with mental illness, and the effect of a systematic approach with repeated HDs in patients with mental illness in primary care has not been previously studied. The aim of this pilot study was to assess the feasibility of the study design for a larger-scale cohort study using repeated HDs focused on the improvement of lifestyle habits in patients seeking primary care due to anxiety, depression, sleeping problems or stress-related symptoms. Methods: Patients were recruited after a visit to a Primary Health Care Center due to mental illness between October 2019 until November 2021 and received a Health Dialogue, including an assessment of cardiovascular risk factors through a Health Curve. Specific feasibility objectives measured were dropout rate, time to follow-up, and risk improvement rate for different lifestyle changes. Results: A total of 64 patients were recruited and 29 (45%) attended a second HD, with a mean follow-up time of 15 months. All participants had at least one elevated cardiovascular risk level on the Health Curve for the assessed lifestyles. Risk level improvement rate was good except for tobacco use. Conclusion: Despite a higher dropout rate than expected, we suggest that the proposed methodology for a full cohort study within general practice of patients with mental illness in primary care is both acceptable to practice and feasible. © 2023, BioMed Central Ltd., part of Springer Nature.
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| 5. |
- Milos Nymberg, Veronica, et al.
(författare)
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Lifestyle and cardiovascular risk factors in a Swedish primary care population with self-reported psychiatric symptoms
- 2024
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Ingår i: Preventive Medicine Reports. - Amsterdam : Elsevier. - 2211-3355. ; 37
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveIndividuals with psychiatric illness suffer from poorer physical health compared with the general population and have a higher risk of developing cardiovascular and metabolic diseases. This cross-sectional study aims to describe the prevalence of lifestyle and cardiovascular risk factors and the association with self-reported psychiatric symptoms in a population of 40-year-old individuals screened with targeted Health Dialogues in southern Sweden.MethodsAll 40-year-old individuals registered at 99 primary healthcare centers in southern Sweden were invited to participate. Self-reported lifestyle habits on a web questionnaire, anthropometric measurements, blood pressure, and blood tests were collected. The Health Dialogue resulted in a risk level assessment for different lifestyle habits and a meeting with a trained coach.ResultsA total of 1831 individuals completed a Health Dialogue between 1st January 2021 and 30th June 2022. There were more individuals with high-risk levels for several lifestyle habits in the group with self-reported psychiatric illness compared with the rest of the study population. The analysis showed that physical inactivity, unhealthy diet, high-risk alcohol intake, tobacco use, psychosocial strain, higher BMI, and waist-hip ratio were associated with increased levels of psychiatric symptoms after adjustment for sex and socioeconomic factors.ConclusionUnhealthy lifestyle habits were associated with self-reported psychiatric symptoms in 40-year-old individuals assessed with targeted Health Dialogues in a primary care context. Organized screening might contribute to early detection of modifiable risk factors for cardiovascular disease. Individuals with psychiatric symptoms should be prioritized for screening of unhealthy lifestyle behaviors. © 2023 The Author(s)
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| 6. |
- Nymberg, Peter, 1971-, et al.
(författare)
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How do patients experience and use home blood pressure monitoring? A qualitative analysis with UTAUT 2
- 2024
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Ingår i: Scandinavian Journal of Primary Health Care. - Abingdon : Taylor & Francis. - 0281-3432 .- 1502-7724. ; , s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Background: hypertension is an important cardiovascular risk factor with potentially harmfulconsequences. home blood pressure monitoring is a promising method for following the effectof hypertension treatment. the use of technology-enabled care and increased patient involvementmight contribute to more effective treatment methods. however, more knowledge is needed toexplain the motivations and consequences of patients engaging in what has been called ‘do-it-yourself healthcare’.Aim: this study aimed to investigate patients’ experiences of home blood pressure monitoringthrough the theoretical frame of the Unified theory of acceptance and Use of technology(UtaUt 2). Methods: the study had a qualitative design, with focus group interviews using theweb-based platform Zoom. the data were analysed using qualitative deductive content analysis,inspired by Graneheim and lundman.Results: the results are presented using the seven theoretical constructs of UtaUt 2: Performanceexpectancy, effort expectancy, social influence, Facilitating conditions, hedonistic Motivation,Price Value and habit. We found one overarching theme ‒ ‘it’s all about the feeling of security’.the patients were influenced by relatives or healthcare personnel and experienced the homemonitoring process as being easy to conduct. the patients emphasised that the quality of theblood pressure monitor was more important than the price. Patients reported home monitoringof blood pressure as a feasible method to follow-up care of their hypertension.Discussion: this study indicates that among motivated patients, home blood pressuremeasurement entails minimal effort, increases security, and leads to better communication aboutblood pressure between healthcare personnel and patients. © 2024 the author(s). Published by informa uK limited, trading as taylor & francis Group
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| 7. |
- Pikkemaat, Miriam, et al.
(författare)
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HEAD-MIP - HEAlth Dialogue for patients with Mental Illness in Primary care
- 2022
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Konferensbidrag (refereegranskat)abstract
- BackgroundPatients with mental illness have an increased risk of cardiovascular morbidity and mortality. Targeted health conversations can identify individuals at risk and then offer help reducing the risk of disease and complications. The Swedish-developed Health Dialogue is a health conversation including a pedagogical tool to visualize the parts of the patient's lifestyle that might benefit most from improvements. Its use in primary health care has shown improvement of lifestyle habits as well as reduced mortality. Despite a higher expected benefit for patients with mental illness, the Health Dialogue is not aimed specifically or tested for this patient group.MethodsPatients > 18 years old seeking primary care for mental illness (depression, anxiety, sleep disorders, or stress-related problems) were included. A trained nurse performed a Health Dialogue with the patients, including both questionnaires of lifestyle habits, stress, mental illness, and measurements of body mass index, blood pressure, blood glucose, and cholesterol. Individually tailored advice based on the risk profile was provided.ResultsAll participants had at least one lifestyle area with an increased risk level. There were over 20% of the patients who had abnormal fasting glucose values, elevated blood pressure, or cholesterol levels. Three-quarters were overweight or obese. More than 40% had the highest risk level for Waist-Hip-Ratio and high-risk levels in the physical inactivity lifestyle area. Compared to an ongoing population screening of 40-year-olds, we found higher proportions of overweight or obesity, physical inactivity, and elevated blood pressure or glucose values.ConclusionOur results with a large proportion of unhealthy lifestyle habits in patients with mental illness in primary care show the importance of interventions in this patient group with potentially positive effects on improved mental wellbeing and decreased metabolic and cardiovascular risk. Studying a larger cohort with long-term follow-up is highly motivated.
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| 8. |
- Pikkemaat, Miriam, et al.
(författare)
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Structured assessment of modifiable lifestyle habits among patients with mental illnesses in primary care
- 2022
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Ingår i: Scientific Reports. - London : Nature Publishing Group. - 2045-2322. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Patients with mental illness have an increased risk of cardiovascular morbidity. The Swedish-developed Health Dialogue is a pedagogical tool to individualize lifestyle counselling, used in specific age-groups to improve lifestyle habits and decrease mortality, but not tested specifically for patients with mental illness. Patients > 18 years old seeking primary care due to symptoms related to mental illness and diagnosed with depression, sleeping disorders, stress and anxiety, were included. A nurse-led health dialogue was conducted, focusing on lifestyle habits, anthropometric measurements, and blood samples, resulting in tailored advice regarding the individual’s risk profile. All 64 participants had lifestyle areas with increased risk level. Approximately 20% had elevated fasting glucose, blood pressure or cholesterol levels, and over 40% had highest risk level in Waist–Hip-Ratio. 30% were overweight, or physical inactive. The results suggest the need of a larger cohort study with long-term follow up, to establish potentially positive effects on wellbeing, and decreased cardiovascular risk in patients with mental illness. © 2022, The Author(s).
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| 9. |
- Carlsson, Ing-Marie, 1961-, et al.
(författare)
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Building up bit by bit, parent's experiences of equine-assisted intervention among children and adolescents with mental illness : a grounded theory study
- 2024
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - Abingdon : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Mental ill health among children and adolescents has increased worldwide. Mental health difficulties from a young age are associated with school absence and educational underachievement. A holistic perspective of treatments besides medical treatment is essential Thus, there is a need for research regarding equine-assisted intervention (EAI).PURPOSE: The present study aimed to understand the outcomes of an equine-assisted intervention for children and adolescents with mental ill health from the perspectives of parents and close relatives.METHODS: This study used a qualitative research design informed by Charmaz's Grounded Theory, with a purposive sample including six in-depth interviews.RESULTS: The theory "building up bit by bit" was constructed, explaining the recognition that their children/adolescents were built up bit by bit and created a stronger self-identity. The participants referred to changes in the child's or adolescent's way of being and emotional regulation, which constituted building blocks leading to the child's or adolescent's increased Harmony, enhanced Self-identity, and improved Capability.CONCLUSION: Parents and close relatives experienced that their child or adolescent was built up bit by bit and gained a stronger foundation to stand on. This led to increased harmony in everyday life with stronger self-worth, better performance, and reduced school absenteeism.
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