| 1. |
- Ahlstrand, Inger, et al.
(författare)
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Health-promoting factors among students in higher education within health care and social work : a cross-sectional analysis of baseline data in a multicentre longitudinal study
- 2022
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work.Methods: This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ).Results: Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC.Conclusions: Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.
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| 2. |
- Aili, Katarina, 1980-, et al.
(författare)
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Passive coping strategies but not physical function are associated with worse mental health, in women with chronic widespread pain – a mixed method study
- 2019
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Ingår i: Annals of the Rheumatic Diseases. - London, UK : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 78:Suppl 2, s. 2159-2159
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic widespread pain (CWP) is a common condition (approximately 10% prevalence), that affects women twice as often as men. There is a lack of knowledge in how different coping strategies relates to health status during CWP development in a general population.Objectives: To explore different ways of coping with CWP and to relate the different coping strategies to health-related factors, before and after developing CWP.Methods: A sequential explorative mixed methods study including 19 women 45-67 of age, who had reported CWP in a survey 2016, but not in 1995. Individual interviews were analysed with a phenomenographic approach, and resulted in four categories of coping strategies. These categories were further explored with regard to four dimensions of health status (physical function, bodily pain, vitality and mental health) as measured by SF-36 (0-100, a lower score indicates more disability) and sleep problems measured both in 1995, and 2016.Results: The qualitative analysis revealed four categories representing different coping strategies, where each woman was labelled by the most dominant category; the mastering woman, the persistent woman, the compliant woman and the conquered woman. The first two categories emerged as being active coping strategies, and the latter two as passive. Women with passive strategies reported significantly lower vitality (median 57.5 vs 75, p=0.007) and worse mental health (median 54 vs 93, p=0.021) in 1995, before they had developed CWP compared with those with active coping strategies. No differences were seen between the groups on physical function, bodily pain or sleep.In 2016, there were still a difference between the passive and active group regarding mental health (median 56 vs 80, p=0.022), but not for vitality (median 35 vs 40, p=0.707). No differences were seen between the groups on physical function or bodily pain. All eight women with passive strategies reported problems with sleep in 2016, as compared to 6 of the 11 women with active strategies (p=0.045).Conclusion: Women that reported CWP in 2016, but not in 1995, described both active and passive coping strategies. The qualitative findings were associated with differences in vitality and mental health already in 1995, before they had developed CWP. Further, those with passive coping strategies reported worse health with regard to mental health and sleep problems in 2016. Interestingly, the groups did not differ in bodily pain or physical function neither in 1995 nor in 2016, which implicates the importance for the clinician to take the typical coping strategy into consideration, when meeting these patients in clinical settings. © Aili, Bergman, Bremander, Haglund & Larsson 2019. No commercial re-use. See rights and permissions. Published by BMJ.
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| 3. |
- Aili, Katarina, et al.
(författare)
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Sleep problems and fatigue as a predictor for the onset of chronic widespread painover a 5- and 18-year perspective : a 20-year prospective study
- 2018
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 77, s. 87-87
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Tidskriftsartikel (refereegranskat)abstract
- Background: If localised pain represent one end of a pain spectra, with overall better general health, chronic widespread pain (CWP) and fibromyalgia represent the other end of the spectra with worse general health and more comorbidities with other somatic diseases and mental illness. Sleep problems and fatigue are common among individuals reporting CWP and previous research indicate that sleep problems may be an important predictor for pain prognosis.Objectives: The aim of this population-based study was to investigate if sleep problems and fatigue predict the onset of CWP 5 and 18 years later.Methods: In order to get more stable baseline classifications of CWP, a wash-out period was used, including only individuals who had not reported CWP (according to ACR 1990 criteria for fibromyalgia) at baseline (−98) and three years prior baseline (−95). In all, data from 1249 individuals entered the analyses for the 5 year follow-up (−03) and 791 entered for the 18 year follow-up (−16). Four parameters related to sleep (difficulties initiating sleep, maintaining sleep, early morning awakening and non-restorative sleep), and one parameter related to fatigue (SF-36 vitality scale) were investigated as predictors for CWP. Binary logistic regression analysis were used for analyses.Results: All investigated parameters predicted the onset of CWP five years later (problems with initiating sleep (OR 1.91; 1.16–3.14), maintaining sleep (OR 1.85; 1.14–3.01), early awakening (OR 2.0; 1.37–3.75), non-restorative sleep (OR 2.27; 1.37–3.75) and fatigue (OR 3.70; 1.76–7.84)) in a model adjusted for age, gender, socio-economy and mental health. All parameters except problems with early awakening predicted the onset of CWP also 18 years later. In all, 785 individuals did not report any of the sleeping problems at baseline (fatigue not included), 268 reported one of the problems, 167 two, 128 three and 117 subjects reported to have all four sleep problems. Reporting all four sleep problems was significantly associated with CWP at follow-up at both time points when adjusting for age, gender, socio economy and mental health (OR 4.00; 2.03–7.91 and OR 3.95; 1.90–8.20); adjusting for age, gender, socio economy and number of pain regions (OR 2.94; 1.48–5.82 and OR 2.65; 1.24–5.64) and in a model adjusting for age, gender, socio economy and pain severity (OR 2.97;1.53–5.76; and OR 3.02;1.47–6.21) for the 5 year and 18 year follow-up respectively, compared to not reporting any of the sleep problems at baseline.Conclusions: Both sleeping problems and fatigue predicts the onset of CWP 5- and 18 years later. The results highlight the importance of the assessment of sleep quality in the clinic.
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| 4. |
- Aili, Katarina, 1980-, et al.
(författare)
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Sleep problems and fatigue as predictors for the onset of chronic widespread pain over a 5-and 18-year perspective
- 2018
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Ingår i: Bmc Musculoskeletal Disorders. - London : Springer Science and Business Media LLC. - 1471-2474. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrevious research suggests that sleep problems may be an important predictor for chronic widespread pain (CWP). With this study we investigated both sleep problems and fatigue as predictors for the onset of CWP over a 5-year and an 18-year perspective in a population free from CWP at baseline.MethodsTo get a more stable classification of CWP, we used a wash-out period, including only individuals who had not reported CWP at baseline (1998) and three years prior baseline (1995). In all, data from 1249 individuals entered the analyses for the 5-year follow-up and 791 entered for the 18-year follow-up. Difficulties initiating sleep, maintaining sleep, early morning awakening, non-restorative sleep and fatigue were investigated as predictors separately and simultaneously in binary logistic regression analyses.ResultsThe results showed that problems with initiating sleep, maintaining sleep, early awakening and non-restorative sleep predicted the onset of CWP over a 5-year (OR 1.85 to OR 2.27) and 18-year (OR 1.54 to OR 2.25) perspective irrespective of mental health (assessed by SF-36) at baseline. Also fatigue predicted the onset of CWP over the two-time perspectives (OR 3.70 and OR 2.36 respectively) when adjusting for mental health. Overall the effect of the sleep problems and fatigue on new onset CWP (over a 5-year perspective) was somewhat attenuated when adjusting for pain at baseline but remained significant for problems with early awakening, non-restorative sleep and fatigue. Problems with maintaining sleep predicted CWP 18years later irrespective of mental health and number of pain regions (OR 1.72). Reporting simultaneous problems with all four aspects of sleep was associated with the onset of CWP over a five-year and 18-yearperspective, irrespective of age, gender, socio economy, mental health and pain at baseline. Sleep problems and fatigue predicted the onset of CWP five years later irrespective of each other.ConclusionSleep problems and fatigue were both important predictors for the onset of CWP over a five-year perspective. Sleep problems was a stronger predictor in a longer time-perspective. The results highlight the importance of the assessment of sleep quality and fatigue in the clinic.
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| 5. |
- Aili, Katarina, et al.
(författare)
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Women’s experiences of coping with chronic widespread pain – a qualitative study
- 2018
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 77, s. 1815-1815
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Tidskriftsartikel (refereegranskat)abstract
- Background: Approximately ten percent of the population report chronic widespread pain (CWP), the condition is more common among women than men. For most people, the pain interferes with many aspects of every-day life and implies large consequences. However, the group reporting CWP is heterogeneous and there is a need for better understanding of the different strategies used for coping with pain in every-day life.Objectives: The purpose of this study was to describe women’s experiences of how to cope with CWP.Methods: The study had a descriptive design with a qualitative content analysis approach. Individual interviews were conducted with 19 women, 31–66 of age, who had reported CWP in a survey 2016. CWP was defined according to the 1990 ACR criteria for fibromyalgia. To be considered chronic, the pain should have persisted for more than three months during the last 12 months. A manifest qualitative content analysis was used to analyze the main question “How do you cope with your chronic widespread pain?” The analysis resulted in four categories.Results: Women described their coping with CWP in four different ways; to take control, to continue as usual, to follow instructions and to rest. To take control meant to make deliberate decisions to handle everyday day life. It also meant to take care of oneself, to think positive and to exercise at an adequate level. To continue as usual meant not to listen to body signals and either to ignore or accept the pain. To follow instructions meant listening to the health professionals and following advices, but without taking any part of the responsibility for the treatment outcome. To rest meant to perceive an unreasonable need for recovery, to resign and let the pain set the terms for the daily living.Conclusions: Women expressed different ways of coping with CWP including both active and passive strategies. The coping strategies included two dimensions, where one ranged from actively taking control over the pain, to passively following instructions and the other from actively continue as usual by either accepting or ignoring the pain to passively rest and being mastered by pain.
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| 6. |
- Almgren, Johanna, et al.
(författare)
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Patients' Health Experiences of Post COVID-19 Condition – A Qualitative Study
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 19:21
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Tidskriftsartikel (refereegranskat)abstract
- Patients who suffer from long-term symptoms of COVID-19, described as post COVID-19 condition, are a new and large group of patients. There is a lack of knowledge concerning health experiences in this patient group. The aim of this study was to explore patients' health experiences of post COVID-19 condition. Data collection was performed through 14 semi-structured interviews. The qualitative content analysis resulted in six sub-categories, three categories, and an overall theme. Patients experienced symptoms of varying duration-ranging from 5-21 months. The results showed that patients' health experiences of post COVID-19 condition moved between uncertainty and new insights. This was shown by patients experiencing: (1) loss of abilities, including losing smell and taste and lacking energy, (2) loss of control, including being foreign to oneself and seeking answers, and (3) revaluation of life, including accepting the transformed body and prioritizing health. This study illustrates that patients living with post COVID-19 condition need to be treated with flexibility, based on each individual's unique challenges and experiences of the symptoms and the consequences for their health. © 2022 by the authors.
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| 7. |
- Andersson, M., et al.
(författare)
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Empowerment and Associations to Disease Activity and Pain in Patients with Rheumatoid Arthritis
- 2021
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 80:Supplement 1, s. 197-197
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Tidskriftsartikel (refereegranskat)abstract
- The WHO describes empowerment as a process in which patients can take control and make informed decisions about their life and health. Empowerment is important for patients with rheumatoid arthritis (RA) since most of the care is provided by the patients themselves.Objectives:The aim was to study levels of empowerment and associated variables in individuals with RA and to investigate longitudinal clinical data in patients with low and high empowerment.Methods:This study involved patients with RA from the BARFOT (Better Anti-Rheumatic PharmacOTherapy) cohort, who were recruited between 1992 and 2006 and included in the study at the time for diagnosis (n = 2,837) [1]. The patients were assessed according to a structured protocol at inclusion and after 3, 6, 12, 24, 60, 96, and 180 months. At each follow-up DAS28-3, HAQ and pain were assessed. In 2017, a postal survey was sent to all still living patients (n=1542), with a response rate of 69% (n = 1,065). The questionnaire included disease characteristics, questions about lifestyle habits and the Swedish Rheumatic Disease Empowerment Scale (SWE-RES-23) [2]. The 844 patients who answered the SWE-RES-23 made up the study cohort. Differences in empowerment between groups (lowest third [LE], SWE-RES-23 ≤3.48 vs. highest third [HE], SWE-RES-23 ≥4.04) were analysed with t-tests. Logistic regression analysis was used to study associations with LE vs. all others. Thirdly, differences between LE and HE were studied with longitudinal data (seven time points) of pain, HAQ and disease activity.Results:Responders were mean 65 (SD13) years old, disease duration 15.6 (3.9) years, and 74% were women. The LE group (n=282) were older and were more often women, and reported worse overall health compared with the HE group (n=270), Table 1.Table 1.Descriptives at questionnaire 2017, including all participants and comparisons between highest and lowest third of SWE-RES-23AllMean (sd)Low SWERES*Mean (sd)High SWERES*Mean (sd)p-valueN844282270Sex, women, %7478690.015Age65 (13)66 (13)63 (12)0.002Disease duration, year15.6 (3.9)15.7 (4.1)15.6 (3.8)0.917TJC28 (0-28)5 (6)6 (8)4 (5)<0.001SJC28 (0-28)3 (5)3 (4)3 (4)0.334PatGA (0-10)3 (2)4 (3)2 (2)<0.001Pain (0-10)3 (2)4 (3)3 (2)<0.001Fatigue (0-10)4 (3)5 (3)3 (3)<0.001HAQ (0-3)0.62 (0.61)0.81 (0.69)0.42 (0.51)<0.001EQ5D (0-1)0.70 (0.25)0.62 (0.29)0.79 (0.19)<0.001SWERES3.8 (0.7)3.1 (0.3)4.6 (0.3)<0.001*tricotomized data, lowest third vs. highest thirdRegarding lifestyle habits, there were no differences between the groups in smoking habits, diets, or drinking habits. Moderate physical activity for ≥150 min/week was reported by 27% in the LE group vs. 41% in the HE group, p<0.001. Vigorous physical activity ≥60 min/week was reported by 22% vs. 37% in the LE and the HE group respectively, p<0.001.In the logistic regression analysis (n=844), several factors were associated with LE: being a woman (OR 1.40, 95% CI 1.00-1.97), pain-related factors as higher tender joint count (OR 1.04, 95% CI 1.01-1.06), worse patient global assessment (OR 1.19, 95% CI 1.12-1.27), pain (OR 1.14, 95% CI 1.08-1.21), fatigue (OR 1.14, 95% CI 1.09-1.21), HAQ (OR 2.08, 95% CI 1.64-2.64) and EQ-5D (OR 0.16, 95% CI 0.09-0.28). There were also associations between moderate physical activity (<150 min/week) (OR 1.60, 95% CI 1.16-2.19) and vigorous (< 60min/week) (OR 1.50, 95% CI 1.07-2.10) and LE.Analysing longitudinal data, the LE group reported worse pain and HAQ at all timepoints, a worse DAS28-3 at year 2 and 8, and a worse ESR at 15 years follow-up compared with the HE group (p<0.05).Conclusion:In patients with RA, low empowerment is associated with worse all over health. Interventions aimed to improve empowerment may include mastering of pain, physical function, and improved physical activity.References:[1]Hafstrom I et al. Open Access Rheumatol 2019;11:207-17.[2]Arvidsson S et al. Musculoskeletal Care 2012;10:101-9.Figure 1.Panel showing mean DAS28-3 (A), ESR (B), VAS pain (C) and HAQ (D) over 15 years in the different groups.Disclosure of Interests:None declared.
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| 8. |
- Andersson, Maria L.E. 1968-, et al.
(författare)
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Reasons to stop drinking alcohol among patients with rheumatoid arthritis – a mixed method study
- 2016
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 75:Suppl 2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies of alcohol use in patients with rheumatoid arthritis are sparse and studies of why patients choose to stop drinking alcohol in particular.Objectives: The aim of the current study was twofold: first to identify patients with RA who stopped drinking alcohol and compare those to patients drinking alcohol, and second, to explore reasons to stop drinking alcohol.Methods: In 2010 a self-completion postal questionnaire was sent to all 2,102 prevalent patients in the Better anti-rheumatic farmacotherapy (BARFOT) study enquiring about disease severity, physical function (HAQ) and health related quality of life (EQ5D), pain, fatigue, patient global assessment (PatGA) and lifestyle factors e.g. alcohol. The questions assessing alcohol included the question “Have you stopped drinking alcohol?” and an open question “Why have you stopped drinking alcohol?” A mixed method design was used and 1512 patients had answered the alcohol questions and was included in the study of those 86 had stopped drinking alcohol. Seventy-one patients answered the open question and their answers were analyzed with qualitative content analysis (1).Results: Comparing patient with RA using alcohol or not, the patients who stopped drinking alcohol was older median age (min-max) 69 (36–90) vs. 66 (23–95), p=0.011, more men 42% vs. 29%, p=0.015, had worse physical function, median HAQ (min-max) 0.50 (0–3.00) vs. 1.00 (0–2.75), p<0.001, worse health related quality of life, median EQ5D (min-max), 0.69 (-0.59–1.00) vs. 0.76 (-0.02–1.00), p<0.001, worse self-perceived health, median PatGA (min-max) 5 (0–10) vs. 3 (0–10), <0.001, more pain, median (min-max) 5 (0–10) vs. 3 (0–10), p<0.001, and more fatigue median (min-max) 6 (0–10) vs 4 (0–10), p<0.001. There were no differences between the groups regarding disease duration, swollen and tender joints. The qualitative content analysis resulted in five categories describing the reasons for patient with RA to stop drinking alcohol: disease and treatment, health and wellbeing, work and family, faith and belief and dependences and abuse.Conclusions: Patients with RA who stopped drinking alcohol have a lower physical function, health related quality of life, self-perceived health and more pain and fatigue comparing to patients with RA drinking alcohol. The reasons to stop drinking alcohol were of different nature such as medical, physical, mental, social and spiritual
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| 9. |
- Bennett, Sarah E., et al.
(författare)
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Assessing acceptability and identifying barriers and facilitators to implementation of the EULAR recommendations for patient education in inflammatory arthritis : a mixed-methods study with rheumatology professionals in 23 European and Asian countries
- 2022
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 81:10, s. 1348-1357
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To disseminate and assess the level of acceptability and applicability of the European Alliance of Associations for Rheumatology (EULAR) recommendations for patient education among professionals in rheumatology across Europe and three Asian countries and identify potential barriers and facilitators to their application. Methods: A parallel convergent mixed-methods design with an inductive approach was used. A web-based survey, available in 20 different languages, was distributed to health professionals by non-probability sampling. The level of agreement and applicability of each recommendation was assessed by (0-10) rating scales. Barriers and facilitators to implementation were assessed using free-text responses. Quantitative data were analysed descriptively and qualitative data by content analysis and presented in 16 categories supported by quotes. Results: A total of 1159 completed the survey; 852 (73.5%) were women. Most of the professionals were nurses (n=487), rheumatologists (n=320), physiotherapists (n=158). For all recommendations, the level of agreement was high but applicability was lower. The four most common barriers to application were lack of time, lack of training in how to provide patient education, not having enough staff to perform this task and lack of evaluation tools. The most common facilitators were tailoring patient education to individual patients, using group education, linking patient education with diagnosis and treatment and inviting patients to provide feedback on patient education delivery.Conclusions: This project has disseminated the EULAR recommendations for patient education to health professionals across 23 countries. Potential barriers to their application were identified and some are amenable to change, namely training patient education providers and developing evaluation tools. © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
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| 10. |
- Bremander, Ann, 1957-, et al.
(författare)
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Cultural adaptation, validity, reliability and responsiveness of the Swedish version of the effective musculoskeletal consumer scale (EC-17)
- 2012
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Ingår i: Musculoskeletal Care. - Chichester : John Wiley & Sons. - 1478-2189 .- 1557-0681. ; 10:1, s. 43-50
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Endorsed by the Outcome MEasures in Rheumatoid Arthritis in Clinical Trials (OMERACT) group, The Effective Consumer Scale (EC-17) was developed in English for patients with musculoskeletal diseases to assess the skills and perceptions important for participating in and managing health care. The objective of this study was culturally to adapt the questionnaire into Swedish and to study its psychometric properties.METHODS: After translation of the questionnaire into Swedish, two different groups of outpatients from two specialist rheumatology departments participated in the study. Face validity was assessed, together with internal consistency, test-retest and responsiveness of the questionnaire. Construct validity was assessed using the Arthritis Self-Efficacy Scale (ASES), and responsiveness to a five day educational intervention was analysed using the standardized response mean (SRM).RESULTS: Analyses were based on 124 patients with inflammatory rheumatic diseases, of whom 50 attended the intervention. Data quality met the requirements, with missing values <5%, and floor and ceiling effects <15%. Item total correlations were all >0.4, ranging from 0.49 to 0.88. Cronbach's alpha was 0.93 and 0.95 for the two groups. The test-retest correlation (ICC₂.₁) was 0.94, and there was a significant improvement as a result of the intervention, with an SRM of 0.43. However, the questionnaire had a higher construct validity with the ASES subscale 'other symptoms' than hypothesized a priori (r(s) 0.75).CONCLUSION: The Swedish version of the EC-17 met the required recommendations for face validity, internal consistency, test-retest reliability and responsiveness. Its construct validity needs to be further established, and the questionnaire needs further testing in different groups of patients and in different interventions. © 2012 John Wiley & Sons, Ltd.
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