| 1. |
- Berthelsen, Ole, et al.
(författare)
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An evaluation of two different methods for preoperative physical therapy information before abdominal surgery
- 2020
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Ingår i: Journal of Communication in Healthcare. - : Informa UK Limited. - 1753-8068 .- 1753-8076. ; 13:2, s. 102-110
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Tidskriftsartikel (refereegranskat)abstract
- © 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group. Introduction: Patients are often given preoperative information by a physical therapist with the aim of decreasing the risk of developing postoperative pulmonary complications and to facilitate recovery after major abdominal surgery. Studies are scarce about the effect. The aim of this study was to evaluate two different approaches for preoperative information. Design: Randomized controlled trial. Setting: University Hospital. Methods: This is a study comparing information by the Teach-Back Method (TBM) with traditional information. Fifty patients were included. They were randomized to either of the groups when attending the preoperative visit. A follow up by telephone was conducted a few days after. The patients were asked to recall the information received. A list of 29 statements was used to record whether participants recalled the given information. Results: The number of correct answers for the 29 statements was, in average 30.0% after TBM compared to 25.4% after traditional information (P = 0.179). In total, the patients recalled 27% of the information given. There were no significant differences between those who spontaneously gave positive feed-back regarding the information or not, those younger or older than 65 years of age, or for those who had read the written information. Conclusion: The patients recalled no more than 27% of the preoperative information and there were only minor and non-significant differences between the groups given information by TBM or traditionally. It is of importance to further discuss and evaluate when to inform the patients and which information to give when preparing patients prior to abdominal surgery.
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| 2. |
- Oldsberg, Linnea, et al.
(författare)
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Geographical variations in patient-reported outcomes after total hip arthroplasty between 2008 - 2012
- 2019
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 The Author(s). Background: Health care on equal terms is a cornerstone of the Swedish health care system. Total hip arthroplasty (THA) is considered a success story in Sweden with low frequency of reoperations and restored health-related quality of life (HRQoL). Administratively, health care in Sweden is locally self-governed by 21 counties. In this longitudinal nation-wide observational study we assessed the possible geographical variations in 1-year follow-up patient-reported outcomes (PROs): EQ-5D index, EQ VAS, Pain VAS and Satisfaction VAS. Methods: Study population consisted of 36,235 Swedish THA patients, operated during 2008 to 2012 due to hip osteoarthritis. Individual data came from Swedish Hip Arthroplasty Register, Statistics Sweden and National Board of Health and Welfare. We used descriptive statistics together with multivariable regression analysis to analyse the data. Results: We observed county level differences in both preoperative and postoperative PROs. The results showed that the differences observed in preoperative PROs could not fully explain the differences observed in postoperative PROs, even after adjustment for patient demographics (age, sex, BMI, Elixhauser comorbidity index, marital status, educational level and disposable income). This indicates that other factors might influence the outcome after THA. Conclusion: Likely, structural and process differences such as indication for surgery have an influence on PROs after surgery. Standardization of care at hospital levels may decrease geographical variations in postoperative HRQoL. Remaining differences will then possibly be associated to patient demographics.
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| 3. |
- Samulowitz, Anke, 1965, et al.
(författare)
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"Brave Men" and "Emotional Women": A Theory-Guided Literature Review on Gender Bias in Health Care and Gendered Norms towards Patients with Chronic Pain
- 2018
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Ingår i: Pain Research & Management. - : Hindawi Limited. - 1203-6765 .- 1918-1523. ; 2018, s. 1-14
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Forskningsöversikt (refereegranskat)abstract
- Background. Despite the large body of research on sex differences in pain, there is a lack of knowledge about the influence of gender in the patient-provider encounter. The purpose of this study was to review literature on gendered norms about men and women with pain and gender bias in the treatment of pain. The second aim was to analyze the results guided by the theoretical concepts of hegemonic masculinity and andronormativity. Methods. A literature search of databases was conducted. A total of 77 articles met the inclusion criteria. The included articles were analyzed qualitatively, with an integrative approach. Results. The included studies demonstrated a variety of gendered norms about men's and women's experience and expression of pain, their identity, lifestyle, and coping style. Gender bias in pain treatment was identified, as part of the patient-provider encounter and the professional's treatment decisions. It was discussed how gendered norms are consolidated by hegemonic masculinity and andronormativity. Conclusions. Awareness about gendered norms is important, both in research and clinical practice, in order to counteract gender bias in health care and to support health-care professionals in providing more equitable care that is more capable to meet the need of all patients, men and women.
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| 4. |
- Samulowitz, Anke, 1965, et al.
(författare)
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General self-efficacy and social support in men and women with pain – irregular sex patterns of cross-sectional and longitudinal associations in a general population sample
- 2022
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- Background: The study of sex and gender patterns in psychosocial resources is a growing field of interest in pain research with importance for pain rehabilitation and prevention. The aims of this study were first, to estimate cross-sectional differences in psychosocial resources (general self-efficacy and social support) across men and women in a population with frequent musculoskeletal pain (pain in the back or neck/shoulder nearly every day or now and again during the week for the last 12 months) and to compare these differences with a population with no frequent pain. Second, to examine if psychosocial resources at baseline were associated with pain at follow-up among men and women in the frequent pain population. Methods: This study was based on survey data from the Swedish Health Assets Project, including The General Self-Efficacy Scale and social support questions. Participants (n = 4010, 55% women) were divided into no frequent pain (n = 2855) and frequent pain (n = 1155). General self-efficacy and social support were analyzed (cross-sectional and longitudinal data) with linear and logistic regressions. Results: Men, with and without frequent pain, had higher general self-efficacy than the corresponding groups in women. Women, with and without frequent pain, had stronger emotional social support than the corresponding groups in men. Men with no frequent pain had weaker instrumental social support than women with no frequent pain (OR = 0.64 (95% CI 0.47–0.87)), men with frequent pain did not (OR = 1.32 (95% CI 0.86–2.01)). In the frequent pain population, the interaction between sex and strong (compared to weak) emotional social support was statistically significant (p = 0.040) for no frequent pain at follow-up, with women having OR = 1.81 and men OR = 0.62. Among women, strong emotional social support was associated with no frequent pain at follow-up. Among men, strong emotional social support was associated with frequent pain at follow-up. Conclusion: Some of the associations between general self-efficacy, social support and musculosceletal pain showed unexpected sex patterns. Gendered expectations might have relevance for some of the results.
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| 5. |
- Samulowitz, Anke, 1965
(författare)
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Pain, gender norms and psychosocial resources. A critical appraisal of taken for granted ideas on men and women with pain
- 2023
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Background: Gender norms concerning pain are important to consider as they might lead to unequal treatment of men and women in health care. Aim: The overall aim of this thesis was to explore and describe gender norms concerning long-lasting pain, and to estimate associations between psychosocial resources and pain in men and women. Methods: In study I, a theory-guided, integrative literature review, patterns of gender norms in pain research were analysed qualitatively. In study II, individual interviews with 5 women and 3 men were analysed using qualitative content analysis. In study III (n=4010; n=881) and study IV (n=2263), cross-sectional and longitudinal data from a Swedish general population sample were analysed with linear and logistic regressions. Sex differences in the psychosocial resources general self-efficacy, instrumental and emotional social support among individuals with and without frequent pain were estimated, as well as the associations between baseline psychosocial resources and pain at follow-up, among men and women. Results: Study I showed that men and women with pain were depicted by means of gender norms in scientific articles. These patterns were in line with hegemonic masculinity and andronormativity in pain research and health care. Gender norms in social support, shown in study I were not reflected by patients’ experiences in study II. In study III, general population samples with and without frequent pain did not share the same sex patterns in instrumental social support. In study III and IV, instrumental and emotional social support predicted pain differently for men and women with and without frequent pain. In the frequent pain group, women with strong (compared to weak) emotional social support had 55% higher chance of no frequent pain at follow-up; men with strong (compared to weak) emotional social support had a 28% lower chance of no frequent pain at follow-up (study III). Among individuals with no frequent pain at baseline, women with weak instrumental social support had a 62% higher risk of frequent pain at follow-up than women with strong support. Men with weak emotional social support had a 100% higher risk of frequent pain at follow-up than men with strong support (study IV). Conclusions: This thesis demonstrated a variety of gender norms. In addition, some of the results challenged expected gender norms related to men’s and women’s social support, in this thesis referred to as gender norm disruptions. Raised awareness about gender norms and gender norm disruptions might be a starting point to redefine or dissipate gender norms and may give the paradigm shift towards equity in pain prevention, treatment and research a push forward.
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| 6. |
- Samulowitz, Anke, 1965, et al.
(författare)
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Psychosocial resources predict frequent pain differently for men and women: A prospective cohort study
- 2023
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Psychosocial resources, psychological and social factors like self-efficacy and social support have been suggested as important assets for individuals with chronic pain, but the importance of psychosocial resources for the development of pain is sparsely examined, especially sex and gender differences. The aim of this study was to investigate associations between psychosocial resources and sex on the development of frequent pain in a general population sample, and to deepen the knowledge about sex and gender patterns. Methods A sample from the Swedish Health Assets Project, a longitudinal cohort study, included self-reported data from 2263 participants, 53% women, with no frequent pain at baseline. The outcome variable was frequent pain at 18-months follow-up. Psychosocial resources studied were general self-efficacy, instrumental and emotional social support. Log binomial regressions in a generalised linear model were used to calculate risk ratios (RRs), comparing all combinations of men with high psychosocial resources, men with low psychosocial resources, women with high psychosocial resources and women with low psychosocial resources. Results Women with low psychosocial resources had higher risk of frequent pain at follow-up compared to men with high resources: general self-efficacy RR 1.82, instrumental social support RR 2.33 and emotional social support RR 1.94. Instrumental social support was the most important protective resource for women, emotional social support was the most important one for men. Results were discussed in terms of gender norms. Conclusions The psychosocial resources general self-efficacy, instrumental and emotional support predicted the risk of developing frequent pain differently among and between men and women in a general population sample. The results showed the importance of studying sex and gender differences in psychological and not least social predictors for pain.
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| 7. |
- Samulowitz, Anke, 1965, et al.
(författare)
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“Sense of control": Patients experiences of multimodel pain rehabilitation and its impact in their everyday lives
- 2019
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Ingår i: Journal of Rehabilitation Medicine Clinical Communications. - : Medical Journals Sweden AB. - 2003-0711. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Long-lasting pain is a challenge for patients’ everyday lives. The aim of this study was to examine how women and men who have participated in multimodal pain rehabilitation experience its impact in their everyday lives. Patients and methods: Individual semi-structured interviews with 5 women and 3 men who had participated in multimodal pain rehabilitation at a clinic in Sweden, analysed using qualitative content analysis. Results: Participants perceived that their “sense of control” increased, which had a positive impact in their everyday life. Sense of control consisted of 3 categories: importance of the patient–provider relationship, knowledge gained (especially on body functions and medication), and pain in a social context. Three results were discussed in particular: (i) a trustful patient–provider relationship based on confidence in the provider’s expertise was a prerequisite for pain acceptance; (ii) patients were aware of gender norms in healthcare; (iii) social support was not stressed as important to cope with pain. Conclusion: The importance of patients’ confidence in the provider’s expertise and patients’ awareness about gender norms need consideration in terms of the patient–provider encounter. The value of social support for pain rehabilitation was found to be less important compared with previous research; this should be explored further.
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