| 1. |
- Sundström, Anna, 1979-, et al.
(författare)
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Construct validation and normative data for different versions of the Shirom-Melamed burnout questionnaire/measure in a Swedish population sample
- 2023
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Ingår i: Stress and Health. - : John Wiley & Sons. - 1532-3005 .- 1532-2998. ; 39:3, s. 499-515
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Tidskriftsartikel (refereegranskat)abstract
- The overall aim of the present study was to examine the construct validity of different versions of the Shirom-Melamed Burnout Questionnaire/Measure (SMBQ/M) suggested in previous work, as well as to provide normative data for a large population-based sample in Sweden with a broad range in age. Cross-sectional data from the Västerbotten Environmental Health Study in Sweden were used. The 3406 participants (56% women) in this study, aged 18–79 years, constituted a random sample stratified for age and sex. Participants responded to a questionnaire including the 4-factor 22-item version of the SMBM as well as background questions and a number of validated questionnaire instruments assessing for example, sleep disturbance, depression, anxiety, perceived stress, and somatic symptoms. The dimensionality of different versions of the SMBM were examined with confirmatory factor analysis. A modified 4-factor 19-item model of the SMBM provided good model-fit, and two 2-factor models (11-item and 6-item) provided excellent model fit. The relationships to relevant psychological constructs provided support for convergent validity for the suggested versions of the SMBM. Finally, normative data were obtained for a broad age group for the different versions. In conclusion, we suggest that for assessing the core of the burnout construct in terms of emotional and physical exhaustion and cognitive weariness, the SMBM-11 or SMBM-6 for repeated measures, are to be used. For a broader assessment of burnout incorporating both symptoms and information about the process of exhaustion via the subscales of listlessness and tension, we recommend the use of the modified 4-factor SMBM-19.
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| 2. |
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| 3. |
- Lind, Nina, 1989-, et al.
(författare)
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Comorbidity and multimorbidity of asthma and allergy and intolerance to chemicals and certain buildings
- 2017
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Ingår i: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 59:1, s. 80-84
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We tested the hypothesis of high comorbidity between asthma/allergy and chemical intolerance (CI) and between asthma/allergy and building intolerance (BI), and high multimorbidity between asthma/allergy, CI, and BI.Methods: Population-based questionnaire data were used from 530 participants with asthma/allergy (allergic asthma, nonallergic asthma, allergic rhinitis, and/or atopic dermatitis), 414 with self-reported and 112 with physician-diagnosed CI, and 165 with self-reported and 47 with physician-diagnosed BI. Separate reference groups were formed for each of the five case groups.Results: Adjusted odds ratios varied from 4.6 to 13.1 for comorbidity, and from 6.6 to 46.4 for multimorbidity.Conclusion: The large comorbidity and multimorbidity between asthma/allergy, CI, and BI evokes the question as to whether there are similarities in underlying mechanisms between these conditions.
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| 4. |
- Söderholm, Anna, 1979-, et al.
(författare)
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The experience of living with sensory hyperreactivity : accessibility, financial security, and social relationships
- 2011
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Ingår i: Health Care for Women International. - : Taylor & Francis. - 0739-9332 .- 1096-4665. ; 32:8, s. 686-707
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Tidskriftsartikel (refereegranskat)abstract
- Odor intolerance is a frequently reported problem, predominantly among women. Our purpose was to illuminate how individuals living with sensory hyperreactivity (SHR; a form of odor intolerance) experience its impact on accessibility, financial security, and social relationships. Data were collected by having 12 women with SHR write descriptive texts. These texts were analyzed with qualitative content analysis. Six themes were identified: Being limited in participating in society, being forced to behave incompatibly with one’s personality, experiencing lack of understanding and respect from others, experiencing insecurity, being dependent on others, and being forced to choose between the plague and cholera.
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| 5. |
- Hellstrand, Kristoffer, 1956, et al.
(författare)
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Age-Related Efficacy of Immunotherapy with Histamine Dihydrochloride and Interleukin-2 for Relapse Prevention in Acute Myeloid Leukemia
- 2011
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Ingår i: Annals of Hematology. - : Springer Science and Business Media LLC. - 0939-5555 .- 1432-0584. ; 90:Suppl. 1
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Tidskriftsartikel (refereegranskat)abstract
- Recurrence of leukemia after the completion of induction and consolidation chemotherapy is a significant clinical concern in acute myeloid leukemia (AML). Apart from allogeneic bone marrow transplantation there is no consensus about effective relapse-protective therapy beyond the consolidation phase, and the standard of care for the majority of patients in complete remission (CR) hence is no treatment. Here we present updated results from a phase 3 trial (n=320) evaluating the prevention of relapse in AML patients receiving immunotherapy with histamine dihydrochloride (HDC) and low-dose interleukin-2 (IL-2). This trial was previously reported to meet the primary endpoint of improved leukemia-free survival (LFS) in the primary population of all randomized patients. Our results imply that treatment with HDC/IL-2 prevents relapse in patients 40–70 years old in first CR (p=0.008, leukemia-free survival (LFS), n=190, log rank test) with a more than 80% relative increase in the likelihood of LFS at 3 years. HDC/IL-2 was not significantly efficacious in young patients (<40 years old). Further studies are underway to define the impact of HDC/IL-2 on immune function and the putative efficacy of therapy in genetic subgroups of AML.
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| 6. |
- Krachler, Benno, 1966-, et al.
(författare)
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Intensive lifestyle intervention for cardiometabolic prevention implemented in healthcare : higher risk predicts premature dropout
- 2024
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Ingår i: American Journal of Lifestyle Medicine. - : Sage Publications. - 1559-8276 .- 1559-8284.
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Patient characteristics and treatment setting are potential predictors of premature dropout from lifestyle interventions, but their relative importance is unknown.Methods: From the quality registry of the unit for behavioral medicine, Umeå University hospital, we identified 2589 patients who had been enrolled in a multimodal lifestyle intervention for cardiometabolic risk reduction between 2006 and 2015. Baseline characteristics predicting dropout before 1-year follow-up were selected by a stepwise logistic regression algorithm.Results: Better physical health and older age predicted full participation, with odds ratios for premature dropout (ORs) of.44 (95% confidence interval (CI).31-.63), and.47 (95% CI.34-.65) in the highest compared to the lowest quartile, respectively. Odds of premature dropout were also lower among female participants,.71 (95% CI.58-.89). Premature dropout was predicted by higher BMI, snuffing tobacco, and smoking, with ORs of 1.53 (95% CI 1.13-2.08) in the highest compared to the lowest quartile of BMI, 1.37 (95% CI 1.03-1.81) comparing snuff user with non-users and 2.53 (95% CI 1.79-3.61) comparing smokers with non-smokers. Odds ratio for premature dropout among inpatients compared with outpatients was.84 (95% CI.68-1.04).Conclusion: Higher risk at baseline predicts premature dropout.
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| 7. |
- Lindsäter, Elin, et al.
(författare)
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Characterization of exhaustion disorder and identification of outcomes that matter to patients : Qualitative content analysis of a Swedish national online survey
- 2023
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Ingår i: Stress and Health. - : John Wiley & Sons. - 1532-3005 .- 1532-2998. ; 39:4, s. 813-827
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Tidskriftsartikel (refereegranskat)abstract
- Fatigue is a common presenting problem in healthcare settings, often attributed to chronic psychosocial stress. Understanding of fatigue and development of evidence-based treatments is hampered by a lack of consensus regarding diagnostic definitions and outcomes to be measured in clinical trials. This study aimed to map outcome domains of importance to the Swedish diagnosis stress-induced exhaustion disorder (ED; ICD-10, code F43.8 A). An online survey was distributed nationwide in Sweden to individuals who reported to have been diagnosed with ED and to healthcare professionals working with ED patients. To identify outcome domains, participants replied anonymously to four open-ended questions about symptoms and expectations for ED-treatment. Qualitative content analysis was conducted of a randomized subsample of respondents, using a mathematical model to determine data saturation. Six hundred seventy participants (573 with reported ED, 97 healthcare professionals) completed the survey. Qualitative content analysis of answers supplied by 105 randomized participants identified 87 outcomes of importance to ED encompassing physical, cognitive, and emotional symptoms as well as functional disability. Self-rating scales indicated that many ED participants, beyond reporting fatigue, also reported symptoms of moderate to severe depression, anxiety, insomnia, poor self-rated health, and sickness behavior. This study presents a map of outcome domains of importance for ED. Results shed light on the panorama of issues that individuals with ED deal with and can be used as a step to further understand the condition and to reach consensus regarding outcome domains to measure in clinical trials of chronic stress and fatigue. Preregistration: Open Science Framework (osf.io) with DOI https://doi.org/10.17605/OSF.IO/4VUAG
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| 8. |
- Lindsäter, Elin, et al.
(författare)
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Exhaustion disorder : scoping review of research on a recently introduced stress-related diagnosis
- 2022
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Ingår i: BJPsych Open. - : Cambridge University Press. - 2056-4724. ; 8:5
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSymptoms related to chronic stress are prevalent and entail high societal costs, yet there is a lack of international consensus regarding diagnostics and treatment. A new stress-related diagnosis, exhaustion disorder, was introduced into the Swedish version of ICD-10 in 2005. Since then, use of the diagnosis has increased rapidly.AimsTo create the first comprehensive synthesis of research on exhaustion disorder to report on the current state of knowledge. Preregistration: Open Science Framework (osf.io), doi 10.17605/OSF.IO/VFDKW.MethodA PRISMA-guided scoping review of all empirical studies of exhaustion disorder was conducted. Searches were run in the MEDLINE, PsycInfo and Web of Science databases. Data were systematically charted and thematically categorised based on primary area of investigation.ResultsEighty-nine included studies were sorted into six themes relating to lived experience of exhaustion disorder (n = 9), symptom presentation and course (n = 13), cognitive functioning (n = 10), biological measures (n = 24), symptom measurement scales (n = 4) and treatment (n = 29). Several studies indicated that individuals with exhaustion disorder experience a range of psychiatric and somatic symptoms beyond fatigue, but robust findings within most thematic categories were scarce. The limited number of studies, lack of replication of findings and methodological limitations (e.g. small samples and scarcity of specified primary outcomes) preclude firm conclusions about the diagnostic construct.ConclusionsMore research is needed to build a solid knowledge base for exhaustion disorder. International collaboration regarding the conceptualisation of chronic stress and fatigue is warranted to accelerate the growth of evidence.
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| 9. |
- Martner, Anna, 1979, et al.
(författare)
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Immunotherapy with histamine dihydrochloride for the prevention of relapse in acute myeloid leukemia.
- 2010
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Ingår i: Expert review of hematology. - : Informa UK Limited. - 1747-4094 .- 1747-4086. ; 3:4, s. 381-91
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Tidskriftsartikel (refereegranskat)abstract
- Most patients with acute myeloid leukemia (AML) achieve complete remission (CR) after induction chemotherapy. Despite ensuing courses of consolidation chemotherapy, a large fraction of patients will experience relapses with poor prospects of long-term survival. Histamine dihydrochloride (HDC) in combination with the T-cell-derived cytokine IL-2 was recently approved within the EU as a remission maintenance immunotherapy in AML. HDC reduces myeloid cell-derived suppression of anti-leukemic lymphocytes, and aims to unravel a therapeutic benefit of IL-2 in AML by improving natural killer and T-cell activation. A randomized Phase III trial with 320 AML patients in CR demonstrated a significant reduction of relapse risk after immunotherapy with HDC plus low-dose IL-2 in the post-consolidation phase. HDC is the first approved therapeutic to target the state of immunosuppression in AML; further development in this area may comprise supplementary or alternative counter-suppressive agents with the aim to improve the efficacy of cancer immunotherapy.
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| 10. |
- Söderholm, Anna, 1979-
(författare)
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Chemical intolerance : disability and health aspects from a biopsychosocial perspective
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Chemical intolerance (CI) is a term used for individuals experiencing symptoms triggered by odorous and pungent substances such as perfume, cleaning agents, mold smell and tobacco smoke. The prevalence of CI range from 0.5-52% depending on definition, and it is overrepresented among women. Living with CI can cause difficulties in daily life, with work, hobbies, social activities, and reduce quality of life. The International Classification of Functioning, Disability and Health (ICF) is a tool to measure an individual’s life situation related to a health condition, in the areas body functions, body structures, activities and participation, and environmental factors.Aim: The aim of this thesis was to develop a tool that could be used to help persons with CI. Furthermore, the aim was to better understand and describe disability and health aspects of CI in the context of the biopsychosocial model of ICF.Method: This thesis is based on the results from four studies with different methods: 1; The questionnaire development study in which a questionnaire instrument based on the ICF, for persons with CI, was developed and evaluated in terms of validity and reliability. 2; The survey study using the newly developed ICF-questionnaire, with 112 respondents. 3; The qualitative study with data collection from twelve women who wrote descriptive texts that were analyzed with qualitative content analysis. 4; The experimental study of health-related responses to the mold-smelling chemical trichloroanisole, comparing a CI-group (n=14) with a control-group (n=18). During exposure, symptom intensity, odor intensity and odor valence were rated, and physiological measures were recorded.Results: The development of the ICF-based questionnaire resulted in a final version that consisted of 57 items divided in three parts. It showed good content validity, readability and face validity, and all parts showed good internal consistency, Cronbach alpha: 0.73-0.87. Test-retest showed good to very good (≥0.61) Kappa agreement for 37 items, moderate (0.41-0.60) for 17 items, and poor or fair (<0.41) for 3 items. Regarding the ICF areas activities and participation and environmental factors, the results from the survey study showed high ratings on difficulties in activities and participation, and environmental barriers. Six themes were identified in the qualitative study: Being limited in participating in society, being forced to behave incompatibly with one´s personality, experiencing lack of understanding and respect from others, experiencing insecurity, being dependent on others, and being forced to choose between the plague and cholera. Regarding the ICF area body functions, the survey study showed reports of several different symptoms and affective and behavioral reactions in response to odorous and pungent substances. The mean of severity of symptoms, was high, 79 on a scale from 1-100. The severity of symptoms was found to have the strongest association with degree of difficulty in activities and participation. The results of the experimental study did not show more health effects of the trichloranisole exposure in the CI-group than the control-group. However, the results showed a high inter-individual variation in ratings of odor intensity, odor valence and symptom intensity.Conclusions: The ICF-based questionnaire is valid and reliable and can be used as a tool to measure difficulties in activities and participation, and impact of environmental factors. Individuals with relatively severe CI have major difficulties in activities and participation in the society. They also experience large barriers in society, both in form of triggers and in form of negative attitudes from others. The body functions in CI is affected in the form of a large variety of symptoms, as well as affective and behavioral reactions in response to odorous and pungent substances. TriCA does not seem to affect body functions for persons with CI in general, but for some individuals it can affect body functions. Both coping strategies exposing to and avoiding odorous and pungent substances can lead to increased difficulties with activities and participation. The severity of symptoms plays the most important role for the degree of difficulty in activities and participation.
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