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- Holmgren, Kristina, 1955, et al.
(författare)
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Does early identification of work-related stress, combined with feedback at GP-consultation, prevent sick leave in the following 12 months? a randomized controlled trial in primary health care
- 2019
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 The Author(s). Background: Experiencing work-related stress constitutes an obvious risk for becoming sick-listed. In primary health care, no established method to early identify, advise and treat people with work-related stress exists. The aim was to evaluate if the use of the Work Stress Questionnaire (WSQ) brief intervention, including feedback from the general practitioner (GP), had an impact on the level of sickness absence. Method/design: In total 271 (intervention group, n = 132, control group, n = 139) non-sick-listed employed women and men, aged 18 to 64 years, who had mental and physical health complaints and sought care at primary health care centers participated in this two-armed randomized controlled trial. The main outcomes were the number of registered sick leave days and episodes, and time to first sick leave during the 12-months follow-up. The intervention included early identification of work-related stress by the WSQ, GP awareness supported by a brief training session, patients' self-reflection by WSQ completion, GP feedback at consultation, and initiation of preventive measures. Results: The mean days registered for the WSQ intervention group and the control group were 39 and 45 gross days respectively, and 31 and 39 net days respectively (ns). No statistical significant difference for the number of sick leave episodes or time to first day of sick leave episode were found between the groups. Conclusions: The WSQ brief intervention combined with feedback and suggestions of measures at patient-GP-consultation was not proven effective in preventing sick leave in the following 12 months compared to treatment as usual. More research is needed on methods to early identify, advise and treat people with work-related stress in primary health care, and on how and when GPs and other professionals in primary health care can be trained to understand this risk of sick leave due to work-related stress, on how to prevent it, and on how to advise and treat employees at risk. Trial registration: ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015.
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- Holmgren, Kristina, 1955, et al.
(författare)
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Early identification in primary health care of people at risk for sick leave due to work-related stress - Study protocol of a randomized controlled trial (RCT)
- 2016
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- © 2016 The Author(s).Background: Early identification of persons at risk of sickness absence due to work-related stress is a crucial problem for society in general, and primary health care in particular. Tho date, no established method to do this exists. This project's aim is to evaluate whether systematic early identification of work-related stress can prevent sickness absence. This paper presents the study design, procedure and outcome measurements, as well as allocation and baseline characteristics of the study population. Method/design: The study is a two-armed randomized controlled trial with follow-up at 3, 6 and 12 months. Non-sick-listed employed women and men, aged 18 to 64 years, who had mental and physical health complaints and sought care at primary health care centers (PHCC) were eligible to participate. At baseline work-related stress was measured by the Work Stress Questionnaire (WSQ), combined with feedback at consultation, at PHCC. The preventive intervention included early identification of work-related stress by the WSQ, GP training in the use of WSQ, GP feedback at consultation and finding suitable preventive measures. A process evaluation was used to explore how to facilitate future implementation and structural use of the WSQ at the PHCC. The primary outcome to compare the preventive sick leave intervention by the general practitioner (GP) versus treatment as usual is sick leave data obtained from the Swedish Social Insurance Agency register. Discussion: Early screening for sick leave due to work-related stress makes it possible not only to identify those at risk for sick leave, but also to put focus on the patient's specific work-related stress problems, which can be helpful in finding suitable preventive measures. This study investigates if use of the WSQ by GPs at PHCCs, combined with feedback at consultation, prevents future sickness absence. Trial registration: ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015
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- Janeslätt, Gunnel, 1952-, et al.
(författare)
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An Intervention using the Tool-kit ”Children – what does it involve?” and the Real-Care-Baby simulator among students with ID - a feasibility study
- 2019
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Ingår i: JARID. - : Wiley. - 1360-2322 .- 1468-3148. ; 32:2, s. 380-389
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Tidskriftsartikel (refereegranskat)abstract
- Background There is limited knowledge about how young people with intellectual disability (ID) can be facilitated in their process of deciding about parenthood. This study aimed to evaluate the feasibility of an upcoming trial to evaluate an intervention using the Toolkit ”Children – what does it involve?” and the “Real-Care-Baby” (RCB) simulator among students with ID. Methods Six students with ID participated in an intervention with eight educational sessions and a three-day caring-session with the RCB simulator. Data were collected with questionnaires and interviews. Results The study showed that it is possible to evaluate an intervention using these instruments among students with ID in order to provide them with further insights about parenthood. Conclusion It is feasible to evaluate the Toolkit and the RCB in a cluster-randomized study and that such a study could add to our knowledge about possible intervention strategies regarding reproduction and parenting among students with ID.
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- Landegren, Nils, et al.
(författare)
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Autoantibodies Targeting a Collecting Duct-Specific Water Channel in Tubulointerstitial Nephritis
- 2016
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Ingår i: Journal of the American Society of Nephrology: JASN. - 1533-3450 .- 1046-6673. ; 27:10, s. 3220-3228
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Tidskriftsartikel (refereegranskat)abstract
- Tubulointerstitial nephritis is a common cause of kidney failure and may have diverse etiologies. This form of nephritis is sometimes associated with autoimmune disease, but the role of autoimmune mechanisms in disease development is not well understood. Here, we present the cases of three patients with autoimmune polyendocrine syndrome type 1 who developed tubulointerstitial nephritis and ESRD in association with autoantibodies against kidney collecting duct cells. One of the patients developed autoantibodies targeting the collecting duct-specific water channel aquaporin 2, whereas autoantibodies of the two other patients reacted against the HOXB7 or NFAT5 transcription factors, which regulate the aquaporin 2 promoter. Our findings suggest that tubulointerstitial nephritis developed in these patients as a result of an autoimmune insult on the kidney collecting duct cells.
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- Wennberg, Birgitta, 1956-
(författare)
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Keeping track of time : Daily time management, participation, and time-related interventions for children, adolescents, and young adults with neurodevelopmental disorders
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to investigate daily time management (DTM) and time-related interventions aiming to enhance participation in everyday activities among school-age children and young adults with neurodevelopmental disorders.In study I, experiences of participation when using time assistive devices (TADs) in daily activities were investigated from the perspective of young adults (aged 17–37) with intellectual disabilities (ID) (n = 9), using semi structured interviews. In studies II and IV, a new multimodal time-related intervention consisting of psychoeducation, compensation with TADs and time-skills training, was investigated in children aged 9–15 with attention-deficit/hyperactivity disorder (ADHD). Study II was a randomized controlled trial (RCT) with an intervention group (n = 19) and a control group (n = 19). The aim of study III was to describe DTM, time processing ability (TPA) and self-rated autonomy in children aged 9–15 with ADHD (n = 47), compared to children with ID (n = 47) and typically developing (TD) children (n = 47). In study IV, occupational performance and satisfaction were evaluated (n = 27). In studies II, III and IV, a source for data collection included assessment, proxy report and self-reports.Using TADs (study I) increased participation in activities in all areas of daily life: self-care, activities at work or school and leisure time activities. A feeling of having more control led to health benefits. Participants described participation restrictions related to attitudes from their social network towards participation and attitudes towards the use of TADs from the individuals themselves. Study II showed that the children in the intervention group increased their TPA significantly more compared to the control group, mostly in terms of time orientation. The parents in the intervention group rated their children’s DTM as significantly more improved compared to the parents of the children in the control group. However, according to the children themselves, there was no statistically significant improvement in their DTM. The psychoeducation for parents and school staff did not increase children’s TPA and DTM on its own. The majority of parents and children (study IV) rated the children’s occupational performance and satisfaction significantly higher at follow-up than at baseline. In general, children rated their occupational performance and satisfaction higher than their parents did. Most goals decided by the children and their parents involved daily routines and time orientation. Study III showed that children with ADHD and children with ID had significantly lower TPA, DTM and autonomy compared to TD children. Children with ADHD showed higher levels of self-rated autonomy compared to children with ID, but the reverse was found in DTM. However, there was significant diversity among children with ADHD and children with ID, which was not explained by age. Some children had difficulties at every level of TPA, while others were skilled at every level. The level of self-rated autonomy followed the level of TPA.In conclusion, this thesis revealed that children with ADHD and ID have the same overall pattern of TPA but may have a delayed TPA, which affects their DTM and autonomy, and thereby also influences their participation in daily activities. The results show that a multimodal time-related intervention using TADs and time-skills training could increase TPA and DTM in children with ADHD aged 9–15 years with time deficits. Experiences from young adults with ID also show increased participation in daily activities and health benefits using TADs. It is recommended that TPA and DTM should be measured to identify difficulties in TPA and DTM in children with ADHD and to offer tailored time-related interventions in addition to medication.
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