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| 2. |
- Lager, Susanne, et al.
(författare)
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Alcohol consumption habits and associations with anxiety or depressive symptoms postpartum in women with high socioeconomic status in Sweden.
- 2022
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Ingår i: Archives of Women's Mental Health. - : Springer Nature. - 1434-1816 .- 1435-1102.
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Tidskriftsartikel (refereegranskat)abstract
- Postpar tum depression and anxiety are common among new mothers. It is well-established that in the general population alcohol use is associated with depression and anxiety. Linking alcohol consumption to symptoms of postpartum depression (PPDS) or postpartum anxiety (PPAS) is presently less established. This study aims to determine if alcohol consumption pre-pregnancy, 6 weeks postpartum, 6 months postpartum, or changes in alcohol consumption are associated with PPDS or PPAS. Longitudinal data on 3849 women from a Swedish perinatal cohort were analyzed using logistic regression analyses for associations between alcohol consumption and symptoms of anxiety or depression, as assessed with the Edinburgh Postnatal Depression Scale. There was no association between pre-pregnancy drinking habits and PPDS (p = 0.588, n = 2479) or PPAS (p = 0.942; n = 2449) at 6 weeks postpartum. Similarly, no associations were observed between concurrent drinking habits at 6 weeks postpartum and PPAS (p = 0.070, n = 3626), 6 months postpartum and PPDS (0.647, n = 3461) or PPAS (p = 0.700, n = 3431). However, there was an association between drinking habits at 6 weeks postpartum and concurrent PPDS (p = 0.047, n = 3659). In conclusion, robust associations were not found between postpartum alcohol consumption and mood symptoms. This lack of association between poor mental health and risk behaviors in new mothers could be interpreted as a result of long-term policy work and high participation in Swedish maternity care. Future studies need to address these research questions in more diverse socio-cultural contexts.
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| 3. |
- Landgren, Ellen, et al.
(författare)
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“Mastering a New Life Situation” – Patients’ Preferences of Treatment Outcomes in Early Rheumatoid Arthritis – A Longitudinal Qualitative Study
- 2020
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Ingår i: Patient Preference and Adherence. - : Dove Medical Press Ltd.. - 1177-889X. ; 14, s. 1421-1433
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore patients’ preferred treatment outcomes during their first two years with rheumatoid arthritis (RA). Patients and Methods: A qualitative, longitudinal, multicenter study with interviews at two time points was performed in Sweden. Individual interviews were conducted at time point 1 with 31 patients with RA, defined as disease duration of ≤1 year and treatment for 3–7 months. Seven focus group interviews and five individual interviews were conducted at time point 2 with 22 patients 12–20 months after treatment initiation. The interviews were analyzed using the Qualitative Analysis Guide of Leuven. A core category with four related concepts emerged. Results: The core finding of patient-preferred treatment outcomes was “mastering a new life situation”. Patients preferred to experience control of the disease by controlling the symptoms and by experiencing absence of disease. To experience autonomy by regaining former activity level, experiencing independence, and being empowered was another preferred outcome. Patients preferred to regain identity through being able to participate, experience well-being, and regain former self-image. To experience joy in everyday life through vitality and believing in the future was another preferred outcome. Patients’ preferences developed over time from the acute phase of controlling the symptoms and wanting to return to the life they lived prior to diagnosis, to a more preventive way of self-management and empower-ment to master the new life situation. Conclusion: The patients’ preferred treatment outcomes during the first two years with RA were to master their new life situation and changed from a preference to return to a life lived prior disease onset, to a preference of living with quality of life, despite RA. This study increases the understanding of patients’ preferred treatment outcomes in the early disease course and can be a foundation for tailoring interventions to be more person-centered and to improve long-term treatment outcomes. © 2020 Landgren et al.
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| 4. |
- Landgren, E., et al.
(författare)
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Patients' Perceptions of Person-Centred Care in Early RA : A Qualitative Study
- 2021
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 80:Suppl. 1, s. 1024-1024
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Tidskriftsartikel (refereegranskat)abstract
- Data on patients’ experience can identify strengths and weaknesses with given care, why a person-centred care will improve health care quality. In rheumatology care, most research on patient preferences for and experiences of RA care is performed in patients with established RA and less often in patients with early RA. In the early course of RA patients often struggle to manage their new life situation with a chronic disease and its treatment. Expectations and experiences of health care may change over time why it is important to understand how newly diagnosed patients perceive person-centred care.Objectives:To explore patients’ perceptions of person-centred care early in the RA disease course within the framework of person-centred care.Methods:In this qualitative study 31 patients with early RA from four rheumatology specialist outpatient clinics were interviewed. An abductive qualitative content analysis was conducted based on the framework of McCormack and McCance (2006, 2016). The four constructs; prerequisites, care environment, person-centred processes, and person-centred outcomes constituted the four categories in the deductive part of the study. An inductive analysis revealed eleven sub-categories exploring the content of person-centred care for patients with early RA.Results:For patients with early RA person-centred care was described as; 1. Prerequisites were to be treated with respect, to meet dedicated healthcare professionals, and to meet professional competence. 2. The care environment was to have access to a multidisciplinary team, to have access to health care, and a supportive organization. 3. Person-centred processes were to be listened to, to be supported, and to be involved in decision-making. 4. The person-centred outcomes were to be satisfied with received health care and to achieve optimal health.Conclusion:A true person-centred care is important to patients early in the RA disease course, supporting the relevance to implement person-centred approach at all stages in the health care system. This study contributes to information about how to further develop person-centredness in rheumatology care also early in the disease course.References:[1]McCormack, B., & McCance, T. V. (2006). Development of a framework for person-centred nursing. J Adv Nurs, 56(5), 472-479. doi:10.1111/j.1365-2648.2006.04042.x[2]McCormack, B., & McCance, T. V. (2016). Person-centred practice in nursing and health care: theory and practice (2nd edition ed.): John Wiley & Sons.Disclosure of Interests:None declared
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| 5. |
- Landgren, Ellen, et al.
(författare)
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Patients’ Perceptions of Person‐Centered Care in Early Rheumatoid Arthritis : A Qualitative Study
- 2021
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Ingår i: ACR Open Rheumatology. - Hoboken, NJ : John Wiley & Sons. - 2578-5745. ; 3:11, s. 788-795
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Most research on patient experiences of rheumatoid arthritis (RA) care is performed with patients who have established RA and less often with patients with early RA. Experiences of and expectations about health care may change over time, which is why the aim was to explore patients’ perceptions of person-centered care (PCC) early in the RA disease course.Methods: Thirty-one patients with early RA were interviewed in this qualitative study. An abductive qualitative content analysis was conducted based on the framework of McCormack and McCance (1,2). The four constructs, prerequisites, care environment, person-centered processes, and person-centered outcomes, constituted the four categories in the deductive part of the study. An inductive analysis generated 11 subcategories exploring the content of PCC.Results: For patients with early RA, PCC was described in terms of 1) prerequisites including being treated with respect, meeting dedicated health care professionals, and meeting professional competence; 2) care environment including having access to a multidisciplinary team, having access to health care, and encountering a supportive organization; 3) person-centered processes including being listened to, being supported, and being involved in decision-making; and 4) person-centered outcomes including being satisfied with received health care and achieving optimal health.Conclusion: Genuine PCC is important for patients early in the RA disease course, supporting the implementation of a person-centered approach during all stages in the health care system. This study contributes to information about how to further develop person-centeredness in rheumatology care. © 2021 The Authors.
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| 6. |
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| 7. |
- Larsson, Ingrid, 1968-, et al.
(författare)
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Patients’ experiences of living with RA after 1-2 years of DMARD treatment
- 2022
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Ingår i: Reumabulletinen. - Stockholm : Svensk reumatologisk förening. - 2000-2246 .- 2001-8061. ; 154:4, s. 66-67
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Tidskriftsartikel (refereegranskat)abstract
- Background: Rheumatoid arthritis (RA) is a disease with a great impact on all aspects of life. Living with RA affects patients’ health including physical, emotional, psychological, and social aspects. Patients with RA are treated with disease-modifying anti-rheumatic drugs (DMARDs) and monitored with tight control to achieve low disease activity or remission. Nevertheless, RA can be life-changing when the patients need long-term treatment to control the disease activity. The goal of treatment for patients with chronic diseases such as RA is to achieve optimal health and a life as normal as possible. It is therefore important to gain knowledge about how patients experience everyday life a short period after the initiation of DMARD treatment. Aim: To describe patients’ experiences of living with RA after 1-2 years of DMARD treatment.Methods: The study has a qualitative design with an inductive approach. Focus groups (n=17) and individual (n=5) interviews were conducted with 22 patients with RA. The participants consisted of 15 women and 7 men with a mean age of 57 years and a disease duration of 12-21 months. The participants were treated with conventional or biological DMARDS for 12-20 months. The main questions were: “Can you tell me how RA impacts your daily life?” “Which outcomes of your RA are important to you at this moment?“ The interviews were analyzed with qualitative content analysis and five categories with an overarching theme emerged (Table 1).Results: Patients’ experiences of living with RA after 1-2 years of DMARD treatment lead to new insights into life and were expressed as 1) Surrendering to disease limitations due to being restricted by pain, fatigue, and in function; 2) Adapting to disease limitations by adjusting one´s work balance and one’s social life; 3) Transitioning in self-identity due to disease limitations by not recognising oneself and experiencing a change of bodily appearance and mood; 4) Fighting disease limitations by experiencing joy through exercise, promoting health by exercise and dietary habits, and; 5) Feeling humility despite disease limitations by being grateful for the treatment and seizing the day.Conclusions: Despite the fact that patients have been living with RA and treated with DMARD for 1-2 years, they are still struggling to make everyday life work. Although patients adapt their lives to the new conditions, their lives are affected by symptoms such as fatigue, pain, stiffness, and side effects such as nausea, hair loss, and weight gain. However, patients highlight the positive effects of how exercise influences their health and how living with RA leads to new insights into life.
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| 8. |
- Lundberg, Stina, 1990-
(författare)
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Adolescent behavior : Links to early-life stress and alcohol in male and female rats
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Adolescence is an important developmental phase with large changes in behavior, physiology and neurobiology, which transform an individual from immature child to independent adult. Due to these changes, adolescence is a sensitive period for exposure to environmental factors such as stress and drug exposure; it is also a common age of onset for alcohol consumption as well as several psychiatric disorders. Despite these factors, less is known about this developmental period than regarding adult individuals. Behavior is regulated by the central nervous system and can be used as a lens to study these processes as well as for examination of associations between individual differences, early-life stress and alcohol. The aim of this thesis was to experimentally examine adolescent behavior and its links to early-life stress and alcohol in adolescent male and female rats. Different behavioral tests were used to profile adolescent animals together with animal models of early-life stress, voluntary alcohol consumption and alcohol exposure. In addition, stress responsiveness after early-life stress and the impact of alcohol exposure on endogenous opioid peptide levels as well as blood alcohol concentrations were examined. The adolescent behavioral profile in the multivariate concentric square field™ (MCSF) was characterized and validated against the elevated plus maze and open field tests. The main finding was subgroups based on individual variation that revealed three distinct behavioral types: Explorers, Shelter seekers and Main type animals. This pattern was replicated in an additional, independent cohort. Early-life stress, modelled by prolonged maternal separation, showed small effects on behavior in the MCSF and on social play behavior. However, an effect on stress responsiveness in males but not females subjected to prolonged maternal separation was discovered. Predisposition for high alcohol consumption did not have a shared behavioral profile among selectively bred rat lines. However, a subgroup of high drinking individuals in an outbred cohort showed behavioral similarities to one of the selectively bred lines. Alcohol exposure showed small, but sex-dependent, effects on behavior and endogenous opioid peptide levels. Together, these studies provide new information about adolescent behavior and associations to early-life stress and alcohol in males and females, relationships not extensively studied in adolescence.
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| 9. |
- Lundberg, Stina, 1990-, et al.
(författare)
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Behavioral profiling in early adolescence and early adulthood of male Wistar rats after short and prolonged maternal separation
- 2020
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Ingår i: Frontiers in Behavioral Neuroscience. - : Frontiers Media SA. - 1662-5153. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Early-life stress and its possible correlations to genes, environment, and later health outcomes can only be studied retrospectively in humans. Animal models enable the exploration of such connections with prospective, well-controlled study designs. However, with the recent awareness of replicability issues in preclinical research, the reproducibility of results from animal models has been highlighted. The present study aims to reproduce the behavioral effects of maternal separation (MS) previously observed in the multivariate concentric square fieldTM (MCSF) test. A second objective was to replicate the adolescent behavioral profiles previously described in the MCSF test. Male rats, subjected to short or prolonged MS or standard rearing, were subjected to behavioral testing in early adolescence and early adulthood. As seen in previous studies, the behavioral effects of MS in the MCSF were small at both tested time points. When tested in early adolescence, the animals exhibited a similar behavioral profile as previously seen, and the finding of adolescent behavioral types was also reproduced. The distribution of animals into the behavioral types was different than in the initial study, but in a manner consistent with developmental theories, as the current cohort was younger than the previous. Notably, the Shelter seeker behavioral type persisted through development, while the Explorer type did not. The lack of basal behavioral effect after MS is in line with the literature on this MS paradigm; the working hypothesis is that the prolonged MS gives rise to a phenotype predisposed to negative health outcomes but which is not apparent without additional provocation.
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| 10. |
- Van der Elst, Kristien, et al.
(författare)
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What do patients prefer? A multinational, longitudinal, qualitative study on patient-preferred treatment outcomes in early rheumatoid arthritis
- 2020
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Ingår i: RMD Open. - London : BMJ Publishing Group Ltd. - 2056-5933. ; 6:2
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To explore treatment outcomes preferred by patients with early rheumatoid arthritis (RA) and how these change throughout the early disease stage across three European countries.METHODS: A longitudinal, qualitative, multicentre study was conducted in Belgium, the Netherlands and Sweden. 80 patients with early RA were individually interviewed 3-9 months after treatment initiation and 51 of them participated again in either a focus group or an individual interview 12-21 months after treatment initiation. Data were first analysed by country, following the Qualitative Analysis Guide of Leuven (QUAGOL). Thereafter, a meta-synthesis, inspired by the principles of meta-ethnography and the QUAGOL, was performed, involving the local research teams.RESULTS: The meta-synthesis revealed 11 subthemes from which four main themes were identified: disease control, physical performance, self-accomplishment and well-being. 'A normal life despite RA' was an overarching patient-preferred outcome across countries. Belgian, Dutch and Swedish patients showed many similarities in terms of which outcomes they preferred throughout the early stage of RA. Some outcome preferences (eg, relief of fatigue and no side effects) developed differently over time across countries.CONCLUSIONS: This study on patient-preferred outcomes in early RA revealed that patients essentially want to live a normal life despite RA. Our findings help to understand what really matters to patients and provide specific insights into the early stage of RA, which should be addressed by clinicians of different disciplines from the start of treatment onwards. © Author(s) (or their employer(s)) 2020.
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