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- Flink, Ida K., 1980-, et al.
(författare)
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Expecting the uncertain : The applicability of the intolerance of uncertainty model on fear of childbirth
- 2023
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Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Taylor & Francis. - 0167-482X .- 1743-8942. ; 44:1
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Tidskriftsartikel (refereegranskat)abstract
- A considerable number of pregnant women experience fear of childbirth (FOC), characterized by worries and fear of the unpredictable. Despite this, the psychological processes in FOC have received notably little attention. The aim of this study was to advance the understanding by exploring the applicability of the Intolerance of Uncertainty (IU) model on FOC. Anonymous data was collected in a sample of pregnant women (N = 357) with varying levels of FOC. Analyses supported the associations between FOC and all proposed psychological processes: IU, negative problem orientation, positive beliefs about worry and avoidance of inner experiences. The exploration of potential mediators of the relation between IU and FOC revealed that, of the three processes from the model, only positive beliefs about worry were a mediator, and more specifically, a partial mediator between IU and FOC. These findings add to the theoretical understanding of FOC, by indicating that the role of IU may be similar to other conditions inflicted by worry and anxiety, which may inform treatment development. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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- Grönkvist, Rode, et al.
(författare)
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Measurement error, minimal detectable change, and minimal clinically important difference of the Short Form-36 Health Survey, Hospital Anxiety and Depression Scale, and Pain Numeric Rating Scale in patients with chronic pain
- 2024
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Ingår i: Journal of Pain. - 1526-5900 .- 1528-8447.
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Tidskriftsartikel (refereegranskat)abstract
- In both pain research and clinical practice, patient-reported outcome measures are used to assess dimensions of health. Interpreting these instruments requires understanding their measurement error and what magnitude of change has subjective importance for patients. This study estimated the standard error of measurement (SEM), one-year minimal detectable change, and one-year minimal clinically important difference (MCID) for the Short Form-36 Health Survey physical component summary (SF-36 PCS) and mental (SF36 MCS), the Hospital Anxiety and Depression Scale anxiety symptoms (HADS-A) and depression symptoms (HADS-D) subscales, and the Numeric Rating Scale (NRS) for past-week average pain intensity. MCIDs for these instruments have not previously been estimated in a large sample of chronic pain patients participating in interdisciplinary pain rehabilitation. Data were drawn from the Swedish Quality Registry for Pain Rehabilitation (n=8854 patients). MCID was estimated as average change and change difference, based on three different anchors. MCID estimates were 2.62-4.69 for SF-36 PCS, 4.46-6.79 for SF-36 MCS, 0.895-1.48 for NRS, 1.17-2.13 for HADS-A, and 1.48-2.54 for HADS-D. The common assumption of an identical SEM for pre- and post-treatment measurements was not always applicable. When estimating MCID, researchers should select an estimation method and anchor aligned with the study's context and objectives.PERSPECTIVE: This article presents estimates of minimal clinically important difference and minimal detectable change for several commonly used patient-reported outcome measures among patients with chronic pain. These estimates can help clinicians and researchers to determine when a measured health improvement is subjectively important to the patient and greater than measurement error.DATA AVAILABILITY: Data Availability Statement: The data utilized in this study are not available due to ethical considerations and the need for appropriate ethical approval.
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- Järnbert-Pettersson, Hans, et al.
(författare)
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Labour pain - poorly analysed and reported : a systematic review
- 2018
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Modelling and analysing repeated measures data, such as women's experiences of pain during labour, is a complex topic. Traditional end-point analyses such as t-tests, ANOVA, or repeated measures [rANOVA] have known disadvantages. Modern and more sophisticated statistical methods such as mixed effect models provide flexibility and are more likely to draw correct conclusions from data. The aim of this study is to study how labour pain is analysed in repeated measures design studies, and to increase awareness of when and why modern statistical methods are suitable with the aim of encouraging their use in preference of traditional methods.METHODS: Six databases were searched with the English language as a restriction. Study eligibility criteria included: Original studies published between 1999 and 2016, studying pregnant women in labour with the aim to compare at least two methods for labour pain management, with at least two measurements of labour pain separated by time, and where labour pain was analysed. After deduplication, all records (n = 2800) were screened by one of the authors who excluded ineligible publication types, leaving 737 records remaining for full-text screening. A sample of 309 studies was then randomly selected and screened by both authors.RESULTS: Among the 133 (of 309) studies that fulfilled the study eligibility criteria, 7% used mixed effect models, 20% rANOVA, and 73% used end-point analysis to draw conclusions regarding treatment effects for labour pain between groups. The most commonly used end-point analyses to compare groups regarding labour pain were t-tests (57, 43%) and ANOVA (41, 31%). We present a checklist for clinicians to clarify when mixed effect models should be considered as the preferred choice for analysis, in particular when labour pain is measured.CONCLUSIONS: Studies that aim to compare methods for labour pain management often use inappropriate statistical methods, and inaccurately report how the statistical analyses were carried out. The statistical methods used in analyses are often based on assumptions that are not fulfilled or described. We recommend that authors, reviewers, and editors pay greater attention to the analysis when designing and publishing studies evaluating methods for pain relief during labour.
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| 7. |
- Leijon, Anna, et al.
(författare)
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Content validity and feasibility of the BABITT questionnaire : assisted infant toilet training and bowel and bladder function in children
- 2024
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Functional bowel and bladder disorders are prevalent among children. The impact of assisted infant toilet training on the prevalence of childhood bowel and bladder disorders has not previously been investigated. As self-reported bowel and bladder symptoms can be unreliable, robust tools are essential to evaluate interventions. The ROME Foundation offers diagnostic criteria for functional gastrointestinal disorders, while the International Children's Continence Society (ICCS) provides definitions for functional bladder disorders. Our research group has launched the BABITT study, a two-armed intervention study to investigate whether assisted infant toilet training reduces the prevalence of functional bowel and bladder disorders.Aim: To construct a questionnaire, assessing bowel and bladder function in children introduced to infant toilet training and to evaluate content validity as well as feasibility.Methods: In three consecutive steps, a web-based questionnaire was developed. In Step 1, the questionnaire was outlined based on literature review and consensus panel discussions. In Step 2, the questionnaire was validated regarding relevance and simplicity by the content validity index (CVI) method. In Step 3, a pilot phase allowed for assessment of feasibility in the clinical study setting.Results: In Step 1, the Rome criteria and ICCS frameworks were selected for primary outcomes. After the final assessment round in Step 2, the i-CVI ranged from 0.88-1.00 in most items, in all domains, for both relevance and simplicity. Generally lower scores on simplicity emphasized revisions of this aspect of the items. In the pilot phase Step 3, respondent burden was analysed and feasibility assessed. The response rate at the 2-months questionnaire was 95% and acceptability of the intervention was satisfactory.Conclusion: A web- based questionnaire for assessment of parent-reported bladder and bowel function in children who are introduced to infant toilet training was developed. The questionnaire emerged as valid and feasible in its context.
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- Lo Martire, Riccardo, et al.
(författare)
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Predictors of Sickness Absence in a Clinical Population With Chronic Pain
- 2021
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Ingår i: Journal of Pain. - Philadelphia, PA, United States : Churchill Livingstone. - 1526-5900 .- 1528-8447. ; 22:10, s. 1180-1194
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Tidskriftsartikel (refereegranskat)abstract
- Chronic pain-related sickness absence is an enormous socioeconomic burden globally. Optimized interventions are reliant on a lucid understanding of the distribution of social insurance benefits and their predictors. This register-based observational study analyzed data for a 7-year period from a population-based sample of 44,241 chronic pain patients eligible for interdisciplinary treatment (IDT) at specialist clinics. Sequence analysis was used to describe the sickness absence over the complete period and to separate the patients into subgroups based on their social insurance benefits over the final 2 years. The predictive performance of features from various domains was then explored with machine learning-based modeling in a nested cross-validation procedure. Our results showed that patients on sickness absence increased from 17% 5 years before to 48% at the time of the IDT assessment, and then decreased to 38% at the end of follow-up. Patients were divided into 3 classes characterized by low sickness absence, sick leave, and disability pension, with eight predictors of class membership being identified. Sickness absence history was the strongest predictor of future sickness absence, while other predictors included a 2008 policy, age, confidence in recovery, and geographical location. Information on these features could guide personalized intervention in the specialized healthcare. PERSPECTIVE: This study describes sickness absence in patients who visited a Swedish pain specialist interdisciplinary treatment clinic during the period 2005 to 2016. Predictors of future sickness absence are also identified that should be considered when adapting IDT programs to the patient's needs.
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| 10. |
- Lo Martire, Riccardo, et al.
(författare)
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Psychometric properties of Short Form-36 Health Survey, EuroQol 5-dimensions, and Hospital Anxiety and Depression Scale in patients with chronic pain
- 2020
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Ingår i: Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0304-3959 .- 1872-6623. ; 161:1, s. 83-95
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Tidskriftsartikel (refereegranskat)abstract
- Recent research has highlighted a need for the psychometric evaluation of instruments targeting core domains of the pain experience in chronic pain populations. In this study, the measurement properties of Short Form-36 Health Survey (SF-36),EuroQol 5-dimensions (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) were analyzed within the item response-theory framework based on data from 35,908 patients. To assess the structural validity of these instruments, the empirical representations of several conceptually substantiated latent structures were compared in a cross-validation procedure. The most structurally sound representations were selected from each questionnaire and their internal consistency reliability computed as a summary of their precision. Finally, questionnaire scores were correlated with each other to evaluate their convergent and discriminant validity. Our results supported that SF-36 is an acceptable measure of 2 independent constructs of physical and mental health. By contrast, although the approach to summarize the health-related quality of life construct of EQ-5D as a unidimensional score was valid, its low reliability rendered practical model implementation of doubtful utility. Finally, rather than being separated into 2 subscales of anxiety and depression, HADS was a valid and reliable measure of overall emotional distress. In support of convergent and discriminant validity, correlations between questionnaires showed that theoretically similar traits were highly associated, whereas unrelated traits were not. Our models can be applied to score SF-36 and HADS in chronic pain patients, but we recommend against using the EQ-5D model due to its low reliability. These results are useful for researchers and clinicians involved in chronic pain populations because questionnaires' properties determine their discriminating ability in patient status assessment.
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