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| 2. |
- Andersson, Lena, 1965-, et al.
(författare)
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Associations between general self efficacy, barriers to care and self-reported mental illness—a population-based study
- 2010
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Ingår i: European Journal of Public Health. - Oxford : Oxford University Press. - 1101-1262 .- 1464-360X. ; 20:Suppl. 1, s. 69-69
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMental illness is an increasing health problem globally. However, many individuals do not seek health care although evidence-based care is available. Research has shown that self efficacy is associated with various health outcomes and it is of importance to investigate if it also is associated mental illness. Early detection promotes recovery and decreases suicide risk.AimThe aim of this study is to investigate whether low levels of self efficacy is associated with a higher degree of mental illness and whether level of self-efficacy influence health seeking behaviour.MethodsThis is a cross-sectional study based on data from the Health Assets study, with data collected in 2008 in West Sweden. The study population is a randomly selected population sample of 4027 individuals, aged 18–65 years. Data collection was done by a postal questionnaire and the response rate was 50.4%. Bi-and multivariate analyses were employed to investigate associations and results were stratified on sex, age, civil status, education and social support.ResultsA total number of 1361 (36%) out of 3811 individuals answered ‘Yes’ on the question ‘Have you ever felt so mentally ill that you had (felt a need) to seek care’. A total of 33% of the women answering yes were found in the lowest quartile of the general self efficacy scale, 20% in the highest quartile. Corresponding figures for men were 30 and 23% respectively. The most common reason stated for not seeking health care was a belief that the mental health problem would disappear by itself. Others reasons mentioned were beliefs that health care would not help, they did not know were to go or they felt ashamed for showing others they suffered from mental illness.ConclusionMental illness is a serious health problem and access to care needs to be improved. Health promotion should also include individual traits/characteristics such as self efficacy and health-seeking behaviour.
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| 3. |
- Andersson, Lena, 1965, et al.
(författare)
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General Self-efficacy and Its Relationship to Self-reported Mental Illness and Barriers to Care: A General Population Study
- 2014
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Ingår i: Community mental health journal. - : Springer Science and Business Media LLC. - 0010-3853 .- 1573-2789. ; 50:6, s. 721-728
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Tidskriftsartikel (refereegranskat)abstract
- Given the prevalence of mental illness worldwide, it is important to better understand the dynamics of mental health help-seeking behavior to improve access to care. The aim of this study was to investigate if general self-efficacy (GSE) was associated with self-reported mental illness and help-seeking behavior and barriers to care in a randomized population. This study utilized a mailed questionnaire completed by 3,981 persons aged 19-64 years who resided in Western Sweden. GSE was measured and logistic regression models calculated, controlling for various sociodemographic variables. Results showed that 25 % of men and 43 % of women reported a lifetime prevalence of mental illness that they felt could have benefitted from treatment. Of those, 37 % of the men and 27 % of the women reported barriers to care. Men and women with low GSE were more likely to suffer from mental illness compared with persons high in GSE, but GSE did not enhance help-seeking behavior or perceived barriers to care. The most prevalent barriers to care for both sexes were beliefs that the illness will pass by itself, doubt whether treatment works, lack of knowledge of where to go and feelings of shame. Overall, GSE scores did not differ among those who experienced various barriers to care with the exception of two barriers only among women.
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- Canivet, Catarina, et al.
(författare)
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Can high psychological job demands, low decision latitude, and high job strain predict disability pensions? A 12-year follow-up of middle-aged Swedish workers
- 2013
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Ingår i: International Archives of Occupational and Environmental Health. - Amsterdam : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 86:3, s. 307-319
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this study was to investigate whether job strain, psychological demands, and decision latitude are independent determinants of disability pension rates over a 12-year follow-up period. METHODS: We studied 3,181 men and 3,359 women, all middle-aged and working at least 30 h per week, recruited from the general population of Malmö, Sweden, in 1992. The participation rate was 41 %. Baseline data include sociodemographics, the Job Content Questionnaire, lifestyle, and health-related variables. Disability pension information was obtained through record linkage from the National Health Insurance Register. RESULTS: Nearly 20 % of the women and 15 % of the men were granted a disability pension during the follow-up period. The highest quartile of psychological job demands and the lowest quartile of decision latitude were associated with disability pensions when controlling for age, socioeconomic position, and health risk behaviours. In the final model, with adjustment also for health indicators and stress from outside the workplace, the hazard ratios for high strain jobs (i.e. high psychological demands in combination with low decision latitude) were 1.5 in men (95 % CI, 1.04-2.0) and 1.7 in women (95 % CI, 1.3-2.2). Stratifying for health at baseline showed that high strain tended to affect healthy but not unhealthy men, while this pattern was reversed in women. CONCLUSIONS: High psychological demands, low decision latitude, and job strain were all confirmed as independent risk factors for subsequent disability pensions. In order to increase chances of individuals remaining in the work force, interventions against these adverse psychosocial factors appear worthwhile.
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| 5. |
- Canivet, Catarina, et al.
(författare)
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Insomnia Symptoms, Sleep Duration, and Disability Pensions: a Prospective Study of Swedish Workers
- 2014
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Ingår i: International Journal of Behavioral Medicine. - : Springer Science and Business Media LLC. - 1070-5503 .- 1532-7558. ; 21:2, s. 319-328
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have found insomnia and long sleep duration to be independently associated with subsequent disability pension (DP). However, the issue of a possible gender-based pattern in this context has received little attention. This study aims to assess the impact of insomnia symptoms and sleep duration on the DP rates among Swedish women and men during a 12-year follow-up period. The participants, from the general population of Malmo, Sweden, were enrolled from 1992 to 1994 (n = 4,319; participation rate 41 %), aged 45-64, healthy, and employed a parts per thousand yen30 h per week. Baseline inquiry data concerning psychosocial circumstances and self-reported sleep habits were compared with official register-based DP rates. Five hundred and nine persons were granted a DP. Insomnia symptoms, affirmed by 33 % of the men and 41 % of the women, were associated with receiving a DP; the hazard ratios in the fully adjusted model were 1.4 for both men [95 % confidence interval (CI) 1.1, 1.9] and women (95 % CI 1.1, 1.7). The fully adjusted hazard ratio for women sleeping a parts per thousand yen9 h was 7.8 (95 % CI 3.7, 16.6) for DP due to a mental disorder. In the age-adjusted analyses, the sub-domain "difficulties falling asleep" was related to DP due to mental disorders in men and DP due to cardiovascular diseases in women. The findings suggest that preventing and treating insomnia symptoms could reduce DP and that disease mechanisms linking sleep disturbances to DP may differ by gender.
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| 6. |
- Canivet, Catarina, 1954-, et al.
(författare)
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Sleeping problems, sleep duration and the risk of disability pension : A prospective study of a Swedish general population
- 2012
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Ingår i: International Journal of Behavioral Medicine. - New York, NY : Springer. - 1070-5503 .- 1532-7558. ; 19:Suppl. 1, s. S107-S107
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Tidskriftsartikel (refereegranskat)abstract
- Several studies have found insomnia and long sleep duration to be independently associated with subsequent disability pension. However, the issue of a possible gender-based pattern in this context has received little attention. The aim of the present study was to assess the impact of different sleeping problems and sleep duration on the rate of disability pension during a 12-year follow-up period.The cohort was recruited by random invitations from the general population of Malmö, Sweden, aged 45–65 years in 1992; the participation rate was 41% (n=14,555). The participants in this study were the 2,254 men and 2,065 women who were healthy and working at least 30 hours per week at baseline. Baseline data included socio-demographic factors, lifestyle, body mass index, the Job Content Questionnaire, social support and participation, ‘stress outside work’, self-rated health and an instrument assessing sleep quality and duration. Information on disability pension was obtained through record linkage from the National Health Insurance Register.Disability pensions were granted to 9% of the men and 15% of the women during the follow-up period. Affirming moderate or very large problems with any of ‘initiating sleep’, ‘waking up during the night’, ‘waking up too early’, and ‘not feeling rested by sleep’ was defined as ‘problems with sleep’, and this was present in 33% of the women and 41% of the men. The age-adjusted hazard ratios for problems with sleep and subsequent disability pension were in men 1.8 (95% CI 1.4 to 2.4) and in women 1.6 (95% CI 1.3 to 2.0). In the full model, after adjustment for sleep duration and for potential confounders and/or mediators, these HRs decreased to 1.4 (95% CI 1.1 to 2.0) in men and 1.4 (95% CI 1.1 to 1.7) in women.Short sleep duration, i.e. ≤6 hours/night on weekdays, was associated with having problems with sleep, long sleep duration was not. Only two percent of the population slept ≥9 hours/night. In women, but not in men, long sleep duration was strongly associated with the subsequent granting of a disability pension; the HR was 2.8 (1.7 to 4.6). In conclusion, sleeping problems seem to be a significant risk-factor for disability pension in the middle-aged working population. There were also clear gender differences in the pattern regarding which type of sleeping problems that were most linked to disability pension.
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| 8. |
- Eriksson, Lena, 1971, et al.
(författare)
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Expertis, sjukskrivning och mötet mellan normal och post-normal vetenskap
- 2014
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Ingår i: Socialvetenskaplig tidskrift. - 1104-1420. ; :2, s. 70-84
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Tidskriftsartikel (refereegranskat)abstract
- Läkares erfarenheter av otillräcklighet vid sjukskrivning är ett uttryck för två problem: Formatet för det försäkringsmedicinska beslutsstödet begränsar vilka aspekter av sin expertkunskap läkare kan förmedla till Försäkringskassan, och man tvingas hantera ett kunskapsobjekt utanför sin etablerade expertis. Nuvarande strategier behandlar symtomen på ett kunskapsteoretiskt glapp, snarare än att höja expertisen kring arbetsförmåga.
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| 9. |
- Eriksson, Lena, et al.
(författare)
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Expertise and post-normal science in the development of the Swedish sickness certification decision-support tool
- 2012
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Ingår i: European Journal of Public Health. - Oxford : Oxford University Press. - 1101-1262 .- 1464-360X. ; 2:Suppl. 2, s. 98-98
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn Sweden, large variations were identified in sick-leave duration also in episodes with the same diagnoses. A decision support was developed to ensure more uniform assessment of sick leave. The present qualitative study aimed at examining the process of construction and development of the new decision support.MethodsQualitative analyses of data from interviews and documents were performed. Participants (n = 15) in in-depth interviews were medical and insurance experts from the Social Insurance Agency involved in the development of the decision-support. Interviews with the medical experts focused on how well their specific medical field of expertise fitted the format suggested for the decision support and how a ‘‘standard patient’’ looked like in their clinical everyday work. For both groups of interviewees, issues regarding assessment of work capacity were discussed. The documentary analysis was done reading investigations, memos, reports and minutes. Themes identified in the interviews were compared with the overall documentary analysis and constituted the basis for an epistemic analysis.ResultsThe analyses showed that the decision-support was developed under a tight schedule and with strict templates for its format. The decision support was built around diagnostic categories and a majority of the experts that were used were specialized in medicine. A difficulty in the process was according to participants to produce standardised medical assessments of how a particular illness was expected to affect patients’ work capacity rather than how the illness affected the patient. The evidential basis for such assessments was scant. Findings show that conditions that were not somatic or could not be ‘measured objectively’ proved extra problematic, since much of the assessment in these situations hinges on physicians’ experience-based expertise combined with their understanding of the circumstances of individual patients.ConclusionThe analysis indicates that ‘work capacity’ does not fall squarely within the remit of medical expertise, but is an example of ‘post-normal science’ that requires a broad range of experts from different fields both inside and outside of science coming together to pool their knowledge and build new expertise.
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