| 1. |
- Bremander, Ann, 1957-, et al.
(författare)
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Cultural adaptation, validity, reliability and responsiveness of the Swedish version of the effective musculoskeletal consumer scale (EC-17)
- 2012
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Ingår i: Musculoskeletal Care. - Chichester : John Wiley & Sons. - 1478-2189 .- 1557-0681. ; 10:1, s. 43-50
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Endorsed by the Outcome MEasures in Rheumatoid Arthritis in Clinical Trials (OMERACT) group, The Effective Consumer Scale (EC-17) was developed in English for patients with musculoskeletal diseases to assess the skills and perceptions important for participating in and managing health care. The objective of this study was culturally to adapt the questionnaire into Swedish and to study its psychometric properties.METHODS: After translation of the questionnaire into Swedish, two different groups of outpatients from two specialist rheumatology departments participated in the study. Face validity was assessed, together with internal consistency, test-retest and responsiveness of the questionnaire. Construct validity was assessed using the Arthritis Self-Efficacy Scale (ASES), and responsiveness to a five day educational intervention was analysed using the standardized response mean (SRM).RESULTS: Analyses were based on 124 patients with inflammatory rheumatic diseases, of whom 50 attended the intervention. Data quality met the requirements, with missing values <5%, and floor and ceiling effects <15%. Item total correlations were all >0.4, ranging from 0.49 to 0.88. Cronbach's alpha was 0.93 and 0.95 for the two groups. The test-retest correlation (ICC₂.₁) was 0.94, and there was a significant improvement as a result of the intervention, with an SRM of 0.43. However, the questionnaire had a higher construct validity with the ASES subscale 'other symptoms' than hypothesized a priori (r(s) 0.75).CONCLUSION: The Swedish version of the EC-17 met the required recommendations for face validity, internal consistency, test-retest reliability and responsiveness. Its construct validity needs to be further established, and the questionnaire needs further testing in different groups of patients and in different interventions. © 2012 John Wiley & Sons, Ltd.
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| 2. |
- Grotle, Margreth, et al.
(författare)
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What's in the black box of arthritis rehabilitation? : A comparison of rehabilitation practice for patients with inflammatory arthritis in northern europe
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - Uppsala : Foundation Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 45:5, s. 458-466
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Tidskriftsartikel (refereegranskat)abstract
- Background: In evaluating complex interventions, it is a challenge for researchers to provide transparent reporting of the intervention content with sufficient detail and clarity such that effects can be compared across studies or countries. Objective: To describe and compare the content of current rehabilitation for patients with inflammatory arthritis across 4 northern European countries. Patients and methods: A total of 731 patients with inflammatory rheumatic diseases participated in a multicentre, longitudinal observational study carried out in Sweden, The Netherlands, Denmark and Norway. Data on context, structure and process were reported by patients and teams at the different participating study sites according to the Scandinavian Team Arthritis Register European Team Intiative for Care Research (STAR-ETIC) framework. Results: Although large similarities were found in the context, there were important differences between the Netherlands and the Scandinavian countries. Regarding structure, there were considerable differences in the length of the rehabilitation period across settings and countries. The most evident differences concerned process variables, especially the type and dosage of individual treatment modalities. Conclusion: The variation in important aspects of arthritis rehabilitation found in the present study underline the need for transparent and standardized description of these variables when comparing effects across settings and countries. A standardized description of current practice can be achieved by the STAR-ETIC framework.
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| 3. |
- Hagel, Sofia, et al.
(författare)
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Which patients improve the most after arthritis rehabilitation? A study of predictors in patients with inflamatory arthritis in northern Europe, the STAR-ETIC collaboration
- 2014
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Ingår i: Journal of Rehabilitation Medicine. - Uppsala : Foundation of Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 46:3, s. 250-257
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study health-related quality of life (HRQoL) in arthritis rehabilitation performed by multidisciplinary teams in patients with chronic inflammatory arthritis. Predictors of change in health-related quality of life and the proportion of patients with clinical improvement were investigated.DESIGN: Multicentre prospective observational study in 4 European countries.METHODS: HRQoL was measured with the European Quality 5 Dimensions (EQ-5D) and the Short Form 36 Health Survey (SF-36) in 731 patients who underwent multidisciplinary rehabilitation. Potential predictors were physical functioning (Health Assessment Questionnaire (HAQ)), self-efficacy (Arthritis Self Efficacy Scale (ASES)), psychological health (Hopkins Symptom Check List (HSCL-25)), pain/fatigue (numeric rating scales (NRS)), age, sex, diagnosis, comorbidity, education, clinical setting and change of medication during rehabilitation. Analysis of covariance (ANCOVA) was used to assess for potential predictors and interactions. The minimal important differences for HRQoL were analysed.RESULTS: Reporting worse function (b 0.05, p = 0.01), less psychological well-being (b 0.09, p = 0.000), and experiencing more pain (b 0.03, p = 0.000) or fatigue (b 0.02, p = 0.000) at admission predicted improved HRQoL. Change in medication during rehabilitation (b 0.08, p = 0.013) was associated with greater improvement in HRQoL. These EQ-5D findings were supported by SF-36 findings. Positive minimal important differences were noted in 46% (EQ-5D) and 23-47% (SF-36 subscales) of the patients.CONCLUSION: Patients with more severe symptoms experienced the largest gain in HRQoL post-intervention. The results of this study are of value for selecting the right patients for rheumatological team rehabilitation. © 2014 The Authors
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| 4. |
- Hagel, Sofia, et al.
(författare)
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Which patients improve the most from arthritis rehabilitation? Results from patients with inflammatory arthritis in northern Europe, the STAR-ETIC collaboration.
- 2014
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 46:3, s. 250-257
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study health-related quality of life (HRQoL) in arthritis rehabilitation performed by multidisciplinary teams in patients with chronic inflammatory arthritis. Predictors of change in health-related quality of life and the proportion of patients with clinical improvement were investigated. Design: Multicentre prospective observational study in 4 European countries. Methods: HRQoL was measured with the European Quality 5 Dimensions (EQ-5D) and the Short Form 36 Health Survey (SF-36) in 731 patients who underwent multidisciplinary rehabilitation. Potential predictors were physical functioning (Health Assessment Questionnaire (HAQ)), self-efficacy (Arthritis Self Efficacy Scale (ASES)), psychological health (Hopkins Symptom Check List (HSCL-25)), pain/fatigue (numeric rating scales (NRS)), age, sex, diagnosis, comorbidity, education, clinical setting and change of medication during rehabilitation. Analysis of covariance (ANCOVA) was used to assess for potential predictors and interactions. The minimal important differences for HRQoL were analysed. Results: Reporting worse function (b 0.05, p = 0.01), less psychological well-being (b 0.09, p = 0.000), and experiencing more pain (b 0.03, p = 0.000) or fatigue (b 0.02, p = 0.000) at admission predicted improved HRQoL. Change in medication during rehabilitation (b 0.08, p = 0.013) was associated with greater improvement in HRQoL. These EQ-5D findings were supported by SF-36 findings. Positive minimal important differences were noted in 46% (EQ-5D) and 23-47% (SF-36 subscales) of the patients. Conclusion: Patients with more severe symptoms experienced the largest gain in HRQoL post-intervention. The results of this study are of value for selecting the right patients for rheumatological team rehabilitation.
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| 5. |
- Haglund, Emma, 1970-, et al.
(författare)
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Differences in physical activity patterns in patients with spondylarthritis
- 2012
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Ingår i: Arthritis Care and Research. - Hoboken : John Wiley & Sons. - 0893-7524 .- 1529-0123 .- 2151-464X .- 2151-4658. ; 64:12, s. 1886-1894
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study patient-reported physical activity in patients with spondylarthritis (SpA) and possible differences in physical activity patterns between the SpA subtypes and sexes.METHODS: In 2009, a questionnaire including inquiries concerning physical activity was sent to patients with a SpA diagnosis (n = 3,711). The World Health Organization (WHO) global recommendations of physical activity for health requiring 150 minutes of moderate-intensity physical activity (MI-PA) or 75 minutes of vigorous-intensity physical activity (VI-PA) per week were used as recommended levels. Standardized risk ratios (RRs) were calculated by using physical activity data from the Swedish population. The association within the SpA group between sex, age, disease-related variables, anxiety, and depression and meeting recommended levels of MI-PA and VI-PA (dependent variables) was studied with multivariate analysis.RESULTS: A total of 2,167 patients with SpA (48% men, mean ± SD age 55 ± 14 years) responded to the questionnaire. Sixty-eight percent of the patients met the WHO recommendations, more frequently in women than in men (70% versus 66%). The recommendations were more often met in the SpA group (RR 1.09, 95% confidence interval [95% CI] 1.04-1.15) compared with the Swedish population. There was a tendency for young women to meet the WHO recommendations less often than the Swedish population (RR 0.94, 95% CI 0.63-1.25). Different factors were found to influence whether the patients were exercising with a moderate or vigorous intensity.CONCLUSION: Seven of 10 patients with SpA met the WHO recommendations of physical activity for health, but we found sex and disease subtype differences. This information can be useful in clinical practice when coaching patients to have a healthier lifestyle. © 2012 by the American College of Rheumatology.
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| 6. |
- Haglund, Emma, et al.
(författare)
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Prevalence of spondyloarthritis and its subtypes in southern Sweden
- 2011
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ. - 1468-2060 .- 0003-4967. ; 70, s. 943-948
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To estimate the prevalence of spondyloarthritis and its subtypes. METHODS: The Swedish healthcare organisation comprises a system where all inpatient and outpatient care is registered by a personal identifier. For the calendar years 2003-7, all residents aged ≥15 years in the southernmost county of Sweden (1.2 million inhabitants) diagnosed by a physician with spondyloarthritis (ankylosing spondylitis (AS), psoriatic arthritis (PsA), inflammatory arthritis associated with inflammatory bowel disease (Aa-IBD) or undifferentiated spondylarthritis (USpA)) were identified. To obtain valid point estimates of prevalence by the end of 2007, identification numbers were cross-referenced with the population register to exclude patients who had died or relocated. RESULTS: The authors estimated the prevalence of spondyloarthritis (not including chronic reactive arthritis) as 0.45% (95% CI 0.44% to 0.47%). The mean (SD) age of patients with prevalent spondyloarthritis by the end of 2007 was 53 (15) years. Among the component subtypes, PsA accounted for 54% of cases, AS 21.4%, USpA 17.8% and Aa-IBD 2.3% with a prevalence of 0.25%, 0.12%, 0.10% and 0.015%, respectively. The remaining 6.4% had some form of combination of spondyloarthritis diagnoses. The prevalence of spondyloarthritis at large was about the same in men and women. However, the subtype PsA was more prevalent in women and AS was more prevalent in men. CONCLUSION: In Sweden the prevalence of spondyloarthritis leading to a doctor consultation is not much lower than rheumatoid arthritis. PsA was the most frequent subtype followed by AS and USpA, and the two most frequent subtypes PsA and AS also display some distinct sex patterns.
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| 7. |
- Haglund, Emma, 1970-, et al.
(författare)
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Work productivity in a population based cohort of patients with Spondyloarthritis
- 2012
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Ingår i: Arthritis and Rheumatism. - Hoboken : Wiley-Blackwell. - 0004-3591 .- 1529-0131. ; 64:10, s. S1015-S1015
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Tidskriftsartikel (refereegranskat)abstract
- Background: Spondyloarthritis (SpA) often causes impaired function, activity limitations, affected health related quality of life and work disability. Work disability has been shown to be affected both in terms of absenteeism and in impaired productivity while working (presenteeism). In this group with increased socioeconomic costs there is also an increase in the use of expensive pharmacotherapies. Thus, it is important to study factors related to the ability to stay productive while at work.Objective: The aim was to study factors associated with presenteeism in patients with SpA. Also to analyse possible differences in age, gender and SpA subtypes (ankylosing spondylitis, psoriatic arthritis and undifferentiated SpA).Methods: The analysis was based on 1773 patients seeking health care for SpA aged 18-67 years from southern Sweden, identified by a health care register. A questionnaire survey in 2009 included questions concerning self-reported presenteeism, defined as the percentage of impairment due to SpA while working 0-100, (0=no impact), was answered by 1447 individuals. Patients´ characteristics: disease duration, disease activity (BASDAI), physical function (BASFI), health related quality of life (EQ-5D), anxiety (HAD-a), depression (HAD-d), self-efficacy pain and symptom (ASES) and register based sick leave. The Pearson’s correlation coefficient and univariate analyses with ANOVA were used to study factors associated with presenteeism and t-test was used for group comparisons.Results: Fifty-five percent (n=802/1447) reported no impact on work presenteeism, while mean impairment was 20 (95% CI 18-21) (n=1447). Women reported higher impact on work presenteeism than men (mean impairment 23 vs. 17, p<0.001) but no statistically significant differences were found between the SpA subtype groups. Twenty-eight percent (n=504/1773) were registered for any sick leave (absenteeism > 14 days). Worse outcome in quality of life (EQ-5D), disease activity (BASDAI) and physical function (BASFI) all correlated to higher impact on work presenteeism (r >0.5, p <0.001), while sick leave (absenteeism) did not. In the univariate analyses experiencing worse outcome in EQ-5D (β-est -9.6, p<0.001) BASDAI (β-est 7.8, p<0.001) and BASFI (β-est 7.3, p<0.001) were all associated to higher impact on presenteeism regardless of age, gender and disease subtype. Worse outcome of EQ-5D was associated to a higher degree impact on presenteeism in the younger women (18-52 yrs). Self-efficacy, anxiety, depression, disease duration and education level <12 years were all associated to higher impact on presenteeism but were not significant in all strata for age, gender and disease subtype.Conclusion: Quality of life, disease activity and physical function all affect work presenteeism in patients with SpA, regardless of age, gender and disease subtype. The results indicate that work presenteeism is affected in patients with all types of SpA and more affected in women. We also find that presenteeism and register based sick leave (absenteeism) may be related to different dimensions of the individuals and their disease.
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| 8. |
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| 9. |
- Stoffer, Michaela A, et al.
(författare)
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Development of patient-centred standards of care for osteoarthritis in Europe: the eumusc.net-project.
- 2015
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 74:6, s. 1145-1149
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Tidskriftsartikel (refereegranskat)abstract
- The eumusc.net project is an initiative founded by the European Community and the European League Against Rheumatism. One aim of the project was to facilitate equal standards for musculoskeletal health across Europe. The aim of this work-package was to develop patient-centred and consensus based standards of care (SOC) for osteoarthritis (OA), which should be available in a professional and a patient version.
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| 10. |
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