| 1. |
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| 2. |
- Marcusson, Jan, et al.
(författare)
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Proactive healthcare for frail elderly persons : study protocol for a prospective controlled primary care intervention in Sweden
- 2019
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 9:5
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Tidskriftsartikel (refereegranskat)abstract
- Introduction The provision of healthcare services is not dedicated to promoting maintenance of function and does not target frail older persons at high risk of the main causes of morbidity and mortality. The aim of this study is to evaluate the effects of a proactive medical and social intervention in comparison with conventional care on a group of persons aged 75 and older selected by statistical prediction.Methods and analysis In a pragmatic multicentre primary care setting (n=1600), a prediction model to find elderly (75+) persons at high risk of complex medical care or hospitalisation is used, followed by proactive medical and social care, in comparison with usual care. The study started in April 2017 with a run-in period until December 2017, followed by a 2-year continued intervention phase that will continue until the end of December 2019. The intervention includes several tools (multiprofessional team for rehabilitation, social support, medical care home visits and telephone support). Primary outcome measures are healthcare cost, number of hospital care episodes, hospital care days and mortality. Secondary outcome measures are number of outpatient visits, cost of social care and informal care, number of prescribed drugs, health-related quality of life, cost-effectiveness, sense of security, functional status and ability. We also study the care of elderly persons in a broader sense, by covering the perspectives of the patients, the professional staff and the management, and on a political level, by using semistructured interviews, qualitative methods and a questionnaire.Ethics and dissemination Approved by the regional ethical review board in Linköping (Dnr 2016/347-31). The results will be presented in scientific journals and scientific meetings during 2019–2022 and are planned to be used for the development of future care models.
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| 3. |
- Andersson, Agneta, 1967-
(författare)
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Health economic studies on advanced home care
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to examine the cost-effectiveness of specific advanced home care and home rehabilitation interventions and to improve economic evaluation methods when applied to advanced home care. This included a comparison of two alternative ways of administering oxygen at home to patients with chronic hypoxaemia, as well as a review of scientific evidence on costs and effects of home rehabilitation after stroke. Also included were studies on prominent methodological issues in advanced home care - the redistribution of care efforts among caregivers and costing of informal care efforts. For patients with chronic hypoxaemia, a randomised, controlled trial showed that mobile liquid oxygen was considerably more costly compared to concentrator treatment. However, the treatment effects showed that liquid oxygen had a better impact on patient quality of life. The literature review revealed that the outcomes and costs of home rehabilitation after stroke are equal to those of alternative treatment strategies. Similar results were obtained in a study comparing hospital-based and home-based stroke rehabilitation, which also showed that there is a considerable redistribution of costs between health care providers and social welfare providers. Studies of patients in advanced home care in the county of Östergötland, Sweden, showed that the cost of informal care constitutes a considerable part of the care effort in all costing approaches used. Also, informal care costs were higher among patients who were men, who were younger, who had their own housing and had a cancer diagnosis. This thesis reveals that advanced home care interventions can differ regarding costs as well as effects, and thus comparisons between alternative home care interventions must also be performed. Further, redistribution effects are important to consider in evaluations. The cost of informal care is substantial in advanced home care. These costs must be included in evaluations with a societal perspective or else the comparisons will be biased.
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| 4. |
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| 5. |
- Andersson, Erik, 1979-, et al.
(författare)
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Kollegialt Lärande i Örebros Skolor – KLÖS-projektet : Hur kan lärares kollegiala lärprocesser stödjas i syfte att skapa hållbara strukturer för utvecklingsarbete?
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Projektet KLÖS har undersökt hur lärares kollegiala lärprocesser kan stödjas i syfte att skapa hållbara strukturer för utvecklingsarbete. Målet var att skapa en Örebromodell för kollegialt lärande. En avslutande reflektion kring resultatet är att etableringen av denna modell kräver ett omfattande engagemang och tar tid att få på plats. Det är vår uppfattning att ett flertal aspekter återstår att undersöka. Bland annat är det intressant att undersöka hur arbetet med det kollegiala lärandet fortskrider på pilotskolan. Frågor som är intressanta är: Vilka faktorer har betydelse för att arbetet med kollegialt lärande ska bli permanent och fungera som ett naturligt sätt att arbeta med utveckling av praktiken? Vad blir resultatet av de utvecklingsomgångar som genomförts? Hur följs detta resultat upp och leder det till bestående gynnsamma förändringar? Frågorna handlar om hållbarhet och därmed om hur projektet går från att vara ett projekt som avslutas och glöms bort till att bli ett levande verktyg för utvecklingsarbete som kan göra en verklig skillnad i och för praktiken över tid. Eftersom mycket tid och resurser används till utvecklingsarbete i skolan är det viktigt att det arbete som görs verkligen leder till en konkret och för verksamheten gynnsam förändring. Det innebär att frågan om utvecklings- arbetets hållbarhet är en av de viktigaste frågorna. Det verktyg som utvecklats i projektet och som kommit att symbolisera det kollegiala arbetet på pilotskolan är KLÖS-hjulet. Frågan om hur KLÖS-hjulet 2.0 kan utvecklas och anpassas så att det verkligen blir ett flexibelt och användbart verktyg för att stötta det kollegiala lärandet är kanske den alla viktigaste konkreta frågan. Frågor som är besläktade med frågan om hållbarhet är de som syftar till att undersöka hur det kollegiala lärandet kan bli mer robust. Till dessa hör frågor om hur lärledarens roll kan förstärkas, hur verktyg som stöttar lärares observation och analys av den egna verksamheten kan designas, hur ansvar och engagemang på alla nivåer kan förstärkas och bli synligt samt hur arbetet med kollegialt lärande kan utvärderas. Vi har under projektets gång sett hur lärare behöver stöd i arbetet med att systematiskt identifiera behov i verksamheten för att sedan utforska möjligheter att utveckla och förändra praktiken. Medverkan från forskare som ställt frågor, problematiserat och belyst olika perspektiv har i flera fall varit avgörande för hur ett utvecklingsbehov har identifierats, avgränsats och formulerats som en undersökningsbar fråga. Det är av avgörande betydelse att utvecklingsarbetet inte står och faller med denna medverkan. Verksamheten måste själv ta fram strukturer för hur lärare och lärledare får ett tillfredsställande stöd i sitt utvecklingsarbete så att de har möjlighet att göra kollegialt lärande till en naturlig del av sitt arbete där de känner sig så bekanta med KLÖS-hjulet att de själva kan ställa de frågor som krävs. Således behöver många funktioner, både centralt och lokalt samverka för att vidareutveckla och stötta kollegialt lärande för att utveckla undervisningen i Örebro skolor.
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| 6. |
- Anskär, Eva, 1957-, et al.
(författare)
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Legitimacy of work tasks, psychosocial work environment, and time utilization among primary care staff in Sweden
- 2019
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Ingår i: Scandinavian Journal of Primary Health Care. - : Taylor & Francis. - 0281-3432 .- 1502-7724. ; 37:4, s. 476-483
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Primary care staff faces a complex work environment including a heavy administrative work load and perceive some work tasks as illegitimate. This study aimed to elucidate associations between the perceived legitimacy of work tasks, the psychosocial work environment, and the utilization of work time among Swedish primary care staff.Design and setting: The study was designed as a multicenter study involving all staff categories, i.e. registered nurses, primary care physicians, care administrators, nurse assistants and allied professionals, at eleven primary care centers in Sweden.Subjects: Participants completed the Bern Illegitimate Tasks Scale and the Copenhagen Psychosocial Questionnaire. They also recorded time spent on all work tasks, day by day during two separate weeks.Main outcome measures and results: More than a quarter (27%) of primary care physicians perceived a high proportion of unnecessary work tasks. After adjusting for profession, age and gender, the perception of having to perform unreasonable work tasks was positively associated with experiencing role conflicts and with the proportion of organization-related administration and service work tasks.Conclusion: Across all staff groups, the perception of unreasonable work tasks was more pronounced among staff with a high proportion of non-patient related administration. Also, the perception of having to perform a large amount of illegitimate work tasks affected the psychosocial work environment negatively, which might influence staffs perception of their professional roles. These results illuminate the importance of decision makers to thoroughly consider the distribution and allocation of non-patient related work tasks among staff in primary care.Key pointsWe observed an interaction between perception of having a large proportion of illegitimate work tasks and impaired psychosocial work environment. • More than a quarter of the primary care physicians perceived a high proportion of unnecessary work tasks.• Across all staff groups, performing unreasonable work tasks was associated with an experience of having role conflicts.• Across all staff groups, a perception of performing unreasonable work tasks was associated with the proportion of non-patient related administrative work tasks.
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| 7. |
- Anskär, Eva, 1957-
(författare)
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Time flies in primary care : a study on time utilisation and perceived psychosocial work environment
- 2019
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Time utilisation among primary care professionals has been affected by structural changes and reorganisation performed in Swedish primary care over several decades. The work situation is complex with a heavy administrative work load. The overall aim with this thesis was to describe time utilisation among staff in Swedish primary care and to investigate associations with perceived psychosocial work environment and legitimacy of work tasks.Methods: A multicentre, descriptive, cross-sectional study design was used including all staff categories in primary care i.e. registered nurses, primary care physicians, care administrators, nurse assistants and allied professionals (physiotherapists, occupational therapists, psychologists, counsellors, dieticians and chiropodists) at eleven primary care centres located in southeast Sweden. The data collection consisted of a questionnaire including a subjective estimate of workload, the Bern Illegitimate Tasks Scale (BITS) and the Copenhagen Psychosocial Questionnaire (COPSOQ). Also, a time study was performed, where the participants reported their work time based on three main categories; direct patient work tasks, indirect patient work tasks and other work tasks, each with a number of subcategories. The participants reported time spent on different work tasks, day by day during two separate weeks. Response rates were 75% for the questionnaire and 79% for the time study.Results: In paper I the time study revealed that health professionals at the primary care centres spent 37% of their work time with direct patient work tasks. All professions estimated a higher proportion of time spent directly with patients than they reported in the time study. Physicians scored highest on the psychosocial scales of quantitative demands, stress and role conflicts. The proportion of administrative work tasks was associated with role conflicts, the more administration the more role conflicts. Findings in paper II were that more than a quarter of physicians scored above the cut-off value for BITS regarding unnecessary work tasks, which was significantly more than the proportion observed in all other professions in the survey. Across all staff groups, a perception of having to perform illegitimate work tasks was associated with experiencing negative psychosocial work environment and with high proportion of administrative-related work tasks.Conclusions: Swedish primary care staff spend a limited proportion of their work time directly with patients and primary care physicians perceive the psychosocial work environment in negative terms to a greater extent than all other staff members. Allocation of work tasks has an influence on the perceived psychosocial work environment. The perception of having a large number of illegitimate work tasks affects the psychosocial work environment negatively, which might influence the perception the staff have of their professional roles. Perception of high proportion of unreasonable work tasks is associated with a high proportion of non-patient-related administration.This thesis illuminates the importance of decision makers thoroughly considering the distribution and allocation of non-patient related work tasks among staff in primary care, in order to achieve efficient use of personnel resources and favourable working conditions. Hopefully, the results of this study will contribute to further development of primary care so that medical competence will benefit patients as much as possible.
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| 8. |
- Borland, Maria, 1967, et al.
(författare)
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Effects of 3months of detraining following cardiac rehabilitation in patients with atrial fibrillation.
- 2022
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Ingår i: European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity. - : Springer Science and Business Media LLC. - 1813-7253. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Atrial fibrillation negatively impacts physical fitness and health-related quality of life. We recently showed that 3months of physiotherapist-led exercise-based cardiac rehabilitation improves physical fitness and muscle function in elderly patients with permanent atrial fibrillation and concomitant diseases. Little is, however, known about the consequences for physical fitness, physical activity level, and health-related quality of life after ending the rehabilitation period.Prospective 3months follow-up study of 38 patients out of 40 eligible (10 women) who, as part of a randomized controlled trial, had completed a 3months physiotherapist-led cardiac rehabilitation resulting in improved physical fitness,. In the current study, the participants were instructed to refrain from exercise for 3months after completion of the rehabilitation period. Primary outcome measure was physical fitness measured as highest achieved workload using an exercise tolerance test. Secondary outcome measures were muscle function (muscle endurance tests), physical activity level (questionnaire and accelerometer), and health-related quality of life, (Short Form-36), as in the preceding intervention study. We used the Wilcoxon Signed Rank test to analyse differences between the end of rehabilitation and at follow-up. The effect size was determined using Cohen's d .Exercise capacity and exercise time significantly decresead between end of rehabilitation and at follow-up (p<.0001 for both). A significant reduction in shoulder flexion repetitions (p=.006) was observed as well as reduced health-related quality of life in the Short Form-36 dimensions Physical Function (p=.042), Mental Health (p=.030), and Mental Component Score (p=.035). There were, however, no changes regarding objective and subjective physical activity measurements.In older patients with permanent atrial fibrillation, previously achieved improvements from physiotherapist-led exercise-based cardiac rehabilitation in physical fitness and muscle function were lost, and health-related quality of life was impaired after ending the rehabilitation period. A strategy for conserving improvements after a rehabilitation period is essential.
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| 9. |
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| 10. |
- Hass, Ursula, et al.
(författare)
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Assessment of computer-aided assistive technology: analysis of outcomes and costs
- 1997
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Ingår i: Augmentative and Alternative Communication. - : Informa UK Limited. - 0743-4618 .- 1477-3848. ; 3:2, s. 125-135
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Tidskriftsartikel (refereegranskat)abstract
- The objectives of this study were to identify and quantify outcomes related to implementation of computer-aided assistive technologies (CAAT) for individuals with communication disabilities and to analyze CAAT costs comprising the selected devices as well as the selection process. The study was designed as a pre/post, longitudinal study. Intermediate and global measures were used as outcome measures. Costs reflecting the resource consumption for the selected devices as well as the selection process were estimated. Individuals with communication disabilities who were referred to the regional CAAT centers were asked to participate in the study. Eighty-seven individuals were recruited. The study shows that usage of CAAT involves reasonable marginal costs for the selection process and equipment (on average SEK 14,800). Usage of CAAT diminishes disability and increases skills in handling computers. However, the outcomes are not entirely positive regarding handicap, health-related quality of life, and utility.Read More: http://informahealthcare.com/doi/abs/10.1080/07434619712331277928
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| 11. |
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| 12. |
- Ivarsson Westerberg, Anders, et al.
(författare)
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Papper, pengar & patienter : Primärvården i administrationssamhället
- 2021
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Hälso- och sjukvården i Sverige är en del av administrationssamhället. Det innebär att alltmer tid används till att göra det vi kallar administrativt arbete, som att redovisa, rapportera, kommunicera, mäta, granska och föra statistik.Personalen inom hälso- och sjukvården ägnar allt mindre av sin tid åt patienterna, människorna, och alltmer tid åt systemen och de krav som systemen ställer. Sammantaget leder detta till att vi får ut mindre vård för de pengar som satsas, eftersom de går åt till administrativt arbete.I den här boken diskuteras, utifrån studier av arbetstid och arbetsmiljö på vårdcentraler, hur den administrativa förändringen ser ut inom hälso- och sjukvården, vilka förklaringar som kan finnas till utvecklingen och vilka konsekvenserna är. Därav bokens titel: Papper, pengar och patienter: Primärvården i administrationssamhället.
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| 13. |
- Iversen, Kia Nøhr, et al.
(författare)
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A hypocaloric diet rich in high fiber rye foods causes greater reduction in body weight and body fat than a diet rich in refined wheat : A parallel randomized controlled trial in adults with overweight and obesity (the RyeWeight study)
- 2021
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Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983 .- 2405-4577. ; 45, s. 155-169
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: A high intake of whole grain foods is inversely associated with body mass index (BMI) and body fat in observational studies, but mixed results have been found in interventional studies. Among whole grains, rye is the richest source of dietary fiber and meals containing high-fiber rye foods have shown increased satiety up to 8 h, compared to meals containing refined wheat products. The aim of the study was to determine the effect of consuming high fiber rye products, compared to refined wheat products, on body weight and body fat loss in the context of an energy restricted diet.Methods: After a 2-week run-in period, 242 males and females with overweight or obesity (BMI 27-35 kg/m2), aged 30-70 years, were randomized (1:1) to consume high fiber rye products or refined wheat products for 12 weeks, while adhering to a hypocaloric diet. At week 0, week 6 and week 12 body weight and body composition (dual energy x-ray absorptiometry) was measured and fasting blood samples were collected. Subjective appetite was evaluated for 14 h at week 0, 6 and 12.Results: After 12 weeks the participants in the rye group had lost 1.08 kg body weight and 0.54% body fat more than the wheat group (95% confidence interval (CI): 0.36; 1.80, p < 0.01 and 0.05; 1.03, p = 0.03, respectively). C-reactive protein was 28% lower in the rye vs wheat group after 12 weeks of intervention (CI: 7; 53, p < 0.01). There were no consistent group differences on subjective appetite or on other cardiometabolic risk markers.Conclusion: Consumption of high fiber rye products as part of a hypocaloric diet for 12 weeks caused a greater weight loss and body fat loss, as well as reduction in C-reactive protein, compared to refined wheat. The difference in weight loss could not be linked to differences in appetite response
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| 14. |
- Lindegård Andersson, Agneta, 1955, et al.
(författare)
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Longitudinal associations between cardiorespiratory fitness and stress-related exhaustion, depression, anxiety and sleep disturbances.
- 2019
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Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- In the last few years, so-called "common mental disorders", including adjustment disorder and stress-related exhaustion, have outrivalled musculoskeletal disorders as being the leading cause of long-term sick leave in Sweden. Cardiorespiratory fitness level defined as "the maximal amount of physiological work that an individual can do as measured by oxygen consumption" has in many studies shown to reduce the risk of several life-style related diseases and moreover to improve mood, well-being and physical performance. The aim of the present study was to investigate, longitudinal associations between cardiorespiratory fitness and self-reported physical activity levels and the severity of symptoms connected to stress-related exhaustion, depression, anxiety, and sleep disturbances among women clinically diagnosed with stress-related exhaustion disorder (ED).The study was that of a longitudinal cohort study consisting of women (n=88) diagnosed with stress-related ED in a specialist clinic in Gothenburg, Sweden. Cardiorespiratory fitness was measured with the Åstrand indirect test of maximal oxygen uptake (VO2max) and subjective measures of physical activity levels were rated on 4-graded physical activity scale. To measure and follow symptoms of ED over time the SMBQ-questionnaire (Shirom Melamed Burnout Questionnaire) was used. The Hospital Anxiety and Depression Scale (HADS) was used to measure depression and anxiety. A proxy variable for capturing overall disturbed sleep used to measure sleep. Longitudinal associations for continuous outcome variables and the dichotomous variable sleep were analysed using mixed- effects regression models with random intercepts. Regression coefficients along with the 95% confidence interval (CI) are presented as measures of association. Both exposures and the outcome were measured simultaneously over six waves (T1-T6).The results showed statistically significant associations between level of fitness and reduced symptoms of stress-related exhaustion over time. Best improvements over time were seen in patients having a medium cardiorespiratory fitness level. No associations could be found between cardiorespiratory fitness level over time and anxiety, depression or sleep disturbances.Having medium cardiorespiratory fitness was positivity associated with a more sustained reduction in symptoms of ED overtime compared to those having low or high cardiorespiratory fitness levels. The clinical implication following this result is that an individual recommendation based on a medium level of physical activity in line with the recommendations from ACSM (American College of Sports Medicine) is preferable compared to recommendations including more vigorous physical activity in order to restore and sustainably reduce symptoms of exhaustion disorder over time.
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| 15. |
- Schmidt, Andrea, 1971-, et al.
(författare)
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Östgötars samhällskostnader för ohälsa fördelat på sjukdomsgrupper - 2006
- 2008
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport är den andra av två delarbeten (det tidigare publicerades i samma rapportserie 2004) som är ett resultat av ett samarbete mellan Centrum för utvärdering av medicinsk teknologi och Landstinget i Östergötland. Målet har varit att utveckla beslutsunderlaget för öppna horisontella prioriteringar inom landstinget i Östergötland genom att fördela alla kostnader för sjukdom och ohälsa på olika sjukdomsgrupper.Vi som har arbetat med denna rapport är Andrea Schmidt, hälsoekonom vid CMT, Institutionen för medicin och hälsa (IMH) samt Agneta Andersson, Fil Dr, forskare vid Socialmedicin och folkhälsovetenskap (IMH) samt FoU-handledare vid FoU-enheten för Närsjukvård vid Landstinget i Östergötland.Vi vill rikta ett stort tack till Lars Svensson, Rolf Wiklund samt Bengt Grip, KPP-gruppen vid Landstinget i Östergötland. Utan er hjälp och bistånd med data hade detta projekt inte varit genomförbart.Linköping 2007Andrea Schmidt Agneta Andersson
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| 16. |
- Sommarö, Susanna, et al.
(författare)
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A deviation too many? Healthcare professionals knowledge and attitudes concerning patients with intellectual disability disrupting norms regarding sexual orientation and/or gender identity
- 2020
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Ingår i: JARID. - : Wiley-Blackwell Publishing Inc.. - 1360-2322 .- 1468-3148. ; 33:6, s. 1199-1209
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPeople with intellectual disability (ID) have few role models for sexual expression and behaviour, and those who identify as LGBTQ experience dual marginalization. The aim of this study is to explore knowledge and attitudes concerning patients with both ID and norm‐breaking sexuality and/or gender identity among healthcare professionals in habilitation centres.MethodData were collected from four focus group interviews that included 19 healthcare professionals from child and adult teams at two Swedish habilitation centres. Data were analysed using thematic analysis.ResultsThree themes were identified as follows: heteronormative treatment in health care, barriers for inclusion and possibilities for inclusion.ConclusionsNorm‐breaking sexuality and gender identity are still relatively invisible in habilitation centres. People with ID are still predominately desexualized and perceptions regarding their sexuality are lagging behind the rest of society. Conditions that allow for more LGBTQ‐affirmative practice were described by the teams that have undergone LGBTQ training.
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| 17. |
- Strander, Björn, 1952, et al.
(författare)
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The performance of a new scoring system for colposcopy in detecting high-grade dysplasia in the uterine cervix
- 2005
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Ingår i: Acta Obstet Gynecol Scand. - : Wiley. - 0001-6349. ; 84:10, s. 1013-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To construct a simple scoring system for colposcopic examination that can facilitate education of colposcopists and increase the accuracy of evaluation. DESIGN: Prospective clinical study. SETTING AND POPULATION: Two hundred ninety-seven examinations of women referred for colposcopy in western Sweden. METHODS: Five variables were scored: acetowhiteness, margins and surface, vessels, lesion size, and iodine staining. Each variable could be assigned one of three ordered values. Multiple logistic regression was used in order to assess the ability of each single score to predict high-grade lesions (HGL) in histology (cone or biopsy). MAIN OUTCOME MEASURES: Histopathology. RESULTS: All five variables independently predicted for HGL. The analysis resulted in an 'ideal' weighted scoring system, which showed good sensitivity and specificity. Rounding off of each weight gave a more useful and simpler scoring system with values of 0, 1, or 2 without any significant change in performance. The possible total score was then 0-10. A score of > or =5 points identified all HGL and > or =8 points had a specificity of 90%. CONCLUSIONS: The scoring system safely identified a group of patients with low-grade lesions or normal findings, thus allowing 17% to be followed only by colposcopy or cytology. Furthermore, it could select women for see-and-treat with only 10% of cases having less than HGL. With this strategy, only approximately 50% of the cases would have needed biopsy in the evaluation.
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| 18. |
- Wahlström, Jens, 1972, et al.
(författare)
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Perceived muscular tension, emotional stress, psychological demands and physical load during VDU work.
- 2003
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Ingår i: International archives of occupational and environmental health. - 0340-0131. ; 76:8, s. 584-90
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES. The aim of this study was to investigate whether perceived muscular tension, psychological demands and emotional stress were associated with physical load or working technique during visual display unit (VDU) work. METHODS. Subjects (28 women and 29 men) from two different organisations volunteered to participate in the study. The study design was cross-sectional, and the data were assessed when the subjects performed their usual work tasks at their usual work place. Multivariate linear and logistic regression models were used to investigate possible associations. The different outcome variables were: median muscle activity and muscular rest in the trapezius muscle bilaterally, wrist movements and working technique. The different explanatory variables were: perceived muscular tension (binary), emotional stress (binary), psychological demands (binary), organisation (binary) and gender (binary). Age (continuous) and present musculoskeletal pain (binary) were also controlled for in the multivariate models. Electromyography (EMG) and electrogoniometers were used to assess the physical load, and the data collection time was 15 min. An ergonomic checklist was used to assess working technique, i.e. work with lifted shoulders. RESULTS. Subjects who perceived muscular tension at least a few times per week the month before the measurements were made worked with higher muscle activity [expressed as per cent of a reference voluntary electrical activity (% RVE)] in the trapezius muscle bilaterally (5% RVE, P=0.05). High emotional stress during the measurement was associated with higher muscle activity in the trapezius muscle on the side not operating the computer mouse (8% RVE, P=0.006). Subjects who reported high levels of emotional stress worked more often with lifted shoulders (odds ratio 6.0, 95% CI 1.2-28.9). However, when present musculoskeletal pain was included in the multivariate model the odds ratio for high emotional stress decreased to 4.5 (95% CI 0.9-23.2). CONCLUSIONS. Perceived muscular tension and emotional stress were associated with physical load, in terms of muscle activity in the trapezius muscles, during VDU work in ordinary occupational settings.
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