| 1. |
- Bränström, Richard, et al.
(författare)
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Physical activity following a breast cancer diagnosis : Implications for self-rated health and cancer-related symptoms
- 2015
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 19:6, s. 680-5
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Studies have consistently shown an association between physical activity and increased health and well-being after a cancer diagnosis. Nevertheless, large proportions of breast cancer survivors do not meet recommended levels of physical activity. The aim of this study was to describe physical activity levels during the first two years after being diagnosed with breast cancer, and to explore the predictive ability of physical inactivity on longer-term self-rated health, physical symptoms, and psychological distress.METHOD: Study participants were women recently having had a first breast cancer surgery at one of the three main hospitals in Stockholm between 2007 and 2009. A total of 726 women were included and responded to six questionnaire assessments during the 24 months following diagnosis.RESULTS: Less than one third of the participants were sufficiently physically active at baseline. Physical activity decreased after surgery, increased at 8 month follow-up, and subsequently decreased slightly during the subsequent follow-up period. Physical inactivity was related to reduced health, increased symptoms such as pain, depression, and anxiety.CONCLUSION: This study provides additional support for the beneficial consequences of being physically active after a breast cancer diagnosis and highlights a potential target for intervention. This study provides additional support showing that being physically active even at a very low level seems to result in health benefits. Physical activity should be encouraged among patients treated for breast cancer.
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| 2. |
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| 3. |
- Gottvall, Maria, 1980-, et al.
(författare)
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Health-related quality of life among Syrian refugees resettled in Sweden
- 2020
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Ingår i: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 29:2, s. 505-514
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The main purpose of this study was to assess health-related quality of life (HRQoL) among Syrian refugees resettled in Sweden. Further, we wanted to investigate whether sex, age, education, area of residence, cohabitation and social support were associated with HRQoL in this population. Methods This is a cross-sectional study including 1215 Syrian refugees from a randomly selected sample frame resettled in Sweden between the years 2011 and 2013. HRQoL was measured by the EQ-5D-5L descriptive system, and EQ-5D-5L index values were calculated. Associations between sex, age, education, area of residence, cohabitation, social support and EQ-5D-5L were investigated using multiple linear regression analysis. Results Depression/anxiety was the most commonly (61.9%) reported EQ-5D-5L problem among the group of Syrian refugees. The mean EQ-5D-5L index value was found to be 0.754. Male sex, younger age, cohabitation and social support were found associated with a higher EQ-5D-5L index score. Conclusions Our results concerning long-lasting health problems among the study population indicate that there is a profound need for policies and interventions promoting refugees' health. Our results also show that social support, a modifiable factor, is relevant to refugees' overall health, pointing to the importance of public health interventions and policies targeting the facilitation, mobilization and enhancing of refugees' social support.
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| 4. |
- Gottvall, Maria, 1980-, et al.
(författare)
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Social support attenuates the link between torture exposure and post-traumatic stress disorder among male and female Syrian refugees in Sweden
- 2019
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Ingår i: BMC International Health and Human Rights. - : Springer Science and Business Media LLC. - 1472-698X. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:The aim of this study is threefold: (i) to establish the psychometric properties and gender invariance of ENRICHD Social Support Inventory (ESSI), which was used for the first time in the present study in the population of Syrian refugees resettled in Sweden; (ii) to assess whether gender moderates the associations between social support, exposure to torture and PTSD; (iii) to assess whether social support mediates the association between exposure to torture and PTSD, and whether this mediation is in turn moderated by gender.METHODS:Data from a cross-sectional and population-based study of a random sample of Syrian refugees (n = 1215) resettled in Sweden 2011-2013 was analyzed within a Structural Equation Modeling (SEM) framework.RESULTS:Our results indicate adequate fit and gender invariance for a unidimensional model of ESSI. Exposure to torture was associated with lower social support (B = -0.22, p < 0.01) and with higher odds ratio (OR) for PTSD (OR 2.52, 95% Confidence interval (CI) 1.83-3.40). Furthermore, higher social support was associated with less likelihood for PTSD (B = -0.56, p < 0.001). Social support partially mediated the effect of torture exposure on PTSD (OR 1.13, 95% bias corrected bootstrap CI 1.06-1.26). Gender did not moderate this pattern.CONCLUSION:The results indicate that social support attenuates the link between torture exposure and PTSD, and may function as a protective factor for PTSD among both torture-exposed refugee men and women.
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| 5. |
- Helgesson, Magnus, et al.
(författare)
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Disability pension and mortality in individuals with specific somatic and mental disorders : examining differences between refugees and Swedish-born individuals
- 2021
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ Publishing Group Ltd. - 0143-005X .- 1470-2738. ; 75:8, s. 721-728
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Tidskriftsartikel (refereegranskat)abstract
- Background More than half a million refugees have arrived to Sweden during the last decade. The aim was to investigate differences between refugees and Swedish-born individuals regarding different specific somatic and mental disorders, and subsequent disability pension and mortality. Methods All refugees (n=239 742) and Swedish-born individuals (n=4 133 898), aged 19-60 years, resident in Sweden on 31st of December in 2009 were included in this population-based prospective cohort study. Data from six nationwide Swedish registers were linked by the unique anonymised identification number. HRs with 95% CIs were computed for disability pension and mortality 2010-2013 by Cox regression models. Results Compared with their Swedish-born counterparts with mental or somatic diagnoses, refugees with these diagnoses had a higher risk of subsequent disability pension and a lower risk of mortality. Highest estimates for disability pension were seen for refugees with neoplasm (HR: 1.72; 95% CI: 1.56 to 1.91), musculoskeletal disorders (HR: 1.57; 95% CI: 1.47 to 1.67), diseases of the circulatory system (HR: 1.33; 95% CI: 1.22 to 1.45), depressive disorders (HR: 1.31; 95% CI: 1.21 to 1.41) and diabetes mellitus (HR: 1.30; 95% CI: 1.15 to 1.47). The risk of mortality was lowest for refugees with regard to bipolar disorders (HR: 0.37; 95% CI: 0.16 to 0.82), post-traumatic stress disorder (HR: 0.37; 95% CI: 0.25 to 0.54) and least pronounced in regard to neoplasm (HR: 0.69; 95% CI: 0.61 to 0.77) compared with Swedish-born with similar disorders. Conclusion Refugees have a generally higher risk of disability pension compared with Swedish-born with specific somatic and mental disorders. Despite this, refugees with all specific disorders have lower risk estimates of mortality, probably due to a healthy selection. The higher risk of disability pension might therefore be due to other causes besides poor health.
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| 7. |
- Helgesson, Magnus, et al.
(författare)
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Labour-market marginalisation after mental disorders among young natives and immigrants living in Sweden
- 2017
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim was to investigate the associations between mental disorders and three different measures of labour-market marginalisation, and differences between native Swedes and immigrants.METHODS: The study comprised 1,753,544 individuals, aged 20-35 years, and resident in Sweden 2004. They were followed 2005-2011 with regard to disability pension, sickness absence (≥90 days) and unemployment (≥180 days). Immigrants were born in Western countries (Nordic countries, EU, Europe outside EU or North-America/Oceania), or in non-Western countries (Africa, Asia or South-America). Mental disorders were grouped into seven subgroups based on a record of in- or specialised outpatient health care 2001-2004. Hazard ratios (HRs) with 95% confidence intervals (CIs) were computed by Cox regression models with both fixed and time-dependent covariates and competing risks. We also performed stratified analyses with regard to labour-market attachment.RESULTS: Individuals with mental disorders had a seven times higher risk of disability pension, a two times higher risk of sickness absence, and a 20% higher risk of unemployment than individuals without mental disorders. Individuals with personality disorders and schizophrenia/non-affective psychoses had highest risk estimates for having disability pension and long-term sickness absence, while the risk estimates of long-term unemployment were similar among all subgroups of mental disorders. Among persons with mental disorders, native Swedes had higher risk estimates for disability pension (HR:6.6; 95%CI:6.4-6.8) than Western immigrants (4.8; 4.4-5.2) and non-Western immigrants (4.8; 4.4-5.1), slightly higher risk estimates for sickness absence (2.1;2.1-2.2) than Western (1.9;1.8-2.1), and non-Western (1.9;1.7-2.0) immigrants but lower risk estimates for unemployment (1.4;1.3-1.4) than Western (1.8;1.7-1.9) and non-Western immigrants (2.0;1.9-2.1). There were similar risk estimates among sub-regions within both Western and non-Western countries. Stratification by labour-market attachment showed that the risk estimates for immigrants were lower the more distant individuals were from gainful employment.CONCLUSIONS: Mental disorders were associated with all three measures of labour-market marginalisation, strongest with subsequent disability pension. Native Swedes had higher risk estimates for both disability pension and sickness absence, but lower risk estimates for unemployment than immigrants. Previous labour-market attachment explained a great part of the association between immigrant status and subsequent labour-market marginalisation.
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| 8. |
- Helgesson, Magnus, et al.
(författare)
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Labour market marginalisation among refugees from different countries of birth : a prospective cohort study on refugees to Sweden
- 2019
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ Publishing Group Ltd. - 0143-005X .- 1470-2738. ; 73:5, s. 407-415
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim was to elucidate if the risk of labour market marginalisation (LMM), measured as long-term unemployment, long-term sickness absence, disability pension and a combined measure of these three measures, differed between refugees and non-refugee migrants with different regions of birth compared with native Swedes.Methods: All non-pensioned individuals aged 19-60 years who were resident in Sweden on 31 December 2009 were included (n= 4 441 813, whereof 216 930 refugees). HRs with 95% CIs were computed by Cox regression models with competing risks and time-dependent covariates with a follow-up period of 2010-2013.Results: Refugees had in general a doubled risk (HR: 2.0, 95% CI 1.9 to 2.0) and non-refugee migrants had 70% increased risk (HR: 1.7, 95% CI 1.7 to 1.7) of the combined measure of LMM compared with native Swedes. Refugees from Somalia (HR: 2.7, 95% CI 2.6 to 2.8) and Syria (HR: 2.5, 95% CI 2.5 to 2.6) had especially high risk estimates of LMM, mostly due to high risk estimates of long-term unemployment (HR: 3.4, 95% CI 3.3 to 3.5 and HR: 3.2, 95% CI 3.1 to 3.2). African (HR: 0.7, 95% CI 0.6 to 0.7) and Asian (HR: 1.0, 95% CI 1.0 to 1.1) refugees had relatively low risk estimates of long-term sickness absence compared with other refugee groups. Refugees from Europe had the highest risk estimates of disability pension (HR: 1.9, 95% CI 1.8 to 2.0) compared with native Swedes.Conclusion: Refugees had in general a higher risk of all measures of LMM compared with native Swedes. There were, however, large differences in risk estimates of LMM between subgroups of refugees and with regard to type of LMM. Actions addressing differences between subgroups of refugees is therefore crucial in order to ensure that refugees can obtain as well as retain a position on the labour market.
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| 9. |
- Helgesson, Magnus, et al.
(författare)
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Trajectories of work disability and unemployment among young adults with common mental disorders
- 2018
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundLabour-market marginalisation (LMM) and common mental disorders (CMDs) are serious societal problems. The aims were to describe trajectories of LMM (both work disability and unemployment) among young adults with and without CMDs, and to elucidate the characteristics associated with these trajectories.MethodsThe study was based on Swedish registers and consisted of all individuals 19-30years with an incident diagnosis of a CMD in year 2007 (n=7245), and a matched comparison group of individuals without mental disorders during the years 2004-07 (n=7245). Group-based trajectory models were used to describe patterns of LMM both before, and after the incident diagnosis of a CMD. Multinomial logistic regressions investigated the associations between sociodemographic and medical covariates and the identified trajectories.ResultsTwenty-six percent (n=1859) of young adults with CMDs followed trajectories of increasing or constant high levels of work disability, and 32 % (n=2302) followed trajectories of increasing or constant high unemployment. In the comparison group, just 9 % (n=665) followed increasing or constant high levels of work disability and 21 % (n=1528) followed trajectories of increasing or constant high levels of unemployment. A lower share of young adults with CMDs followed trajectories of constant low levels of work disability (n=4546, 63%) or unemployment (n=2745, 38%), compared to the level of constant low work disability (n=6158, 85%) and unemployment (n=3385, 50%) in the comparison group. Remaining trajectories were fluctuating or decreasing. Around 50% of young adults with CMDs had persistent levels of LMM at the end of follow-up. The multinomial logistic regression revealed that educational level and comorbid mental disorders discriminated trajectories of work disability, while educational level, living area and age determined differences in trajectories of unemployment (R-difference(2)=0.02-0.05, p<0.001).ConclusionsA large share, nearly 50%, of young adults with CMDs, substantially higher than in the comparison group of individuals without mental disorders, display increasing or high persistent levels of either work disability or unemployment throughout the follow-up period. Low educational level, comorbidity with other mental disorders and living in rural areas were factors that increased the probability for LMM.
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| 10. |
- Jaghult, Susanna, et al.
(författare)
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Stress as a trigger for relapses in IBD : A case-crossover study
- 2013
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Ingår i: Gastroenterology Research. - : Elmer Press, Inc.. - 1918-2805 .- 1918-2813. ; 6:1, s. 10-16
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is important to identify factors that influence the risk of relapses in inflammatory bowel disease. Few studies have been conducted and with limited methodology. This prospective case-crossover study, aims to examine whether perceived stress has a short-term acute effect, namely whether it acts as a trigger, on the risk of relapse in inflammatory bowel disease.Methods: Sixty patients with inflammatory bowel disease and in remission were included. The case-crossover design was employed, which is an epidemiological design developed to study triggers for acute events and diseases. To collect information regarding symptoms and potential trigger factors, such as perceived stress, a structured diary was constructed. The participants were instructed to fill in the diary daily during six months. Fifty patients completed the study.Results: The analysis showed an effect for high level of perceived stress. Being exposed to “quite a lot” of stress, yield an increase in risk for relapse during the forthcoming day (OR = 4.8, 95% CI 1.09 - 21.10). No statistically increased risk for lower levels of perceived stress was found, although elevated effect estimates were found for “some” stress.Conclusion: This study supports earlier findings regarding perceived stress as an important factor in triggering relapses in IBD. However, this is the first case-crossover study performed to explore the trigger risk of stress in this population. Further investigations with larger patient samples are needed to confirm the findings.
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