| 1. |
- Alkner, Björn, 1968-, et al.
(author)
-
Effect of postoperative pneumatic compression after volar plate fixation of distal radial fractures: a randomized controlled trial
- 2018
-
In: Journal of Hand Surgery, European Volume. - : SAGE PUBLICATIONS LTD. - 1753-1934 .- 2043-6289. ; 43:8, s. 825-831
-
Journal article (peer-reviewed)abstract
- We investigated the difference between postoperative rehabilitation with or without adjunctive intermittent pneumatic compression therapy following distal radial fracture treated with volar plating. A total of 115 patients were randomized to a control or to an experimental group. After 4 weeks of immobilization the experimental group received intermittent pneumatic compression therapy in addition to conventional postoperative rehabilitation. Primary outcome up to 1 year postoperatively was assessed using the Canadian Occupational Performance Measure. No significant differences between groups were found. There were no clinically relevant differences regarding the secondary outcome measures swelling, strength, pain and flexibility. We conclude that postoperative intermittent pneumatic compression treatment had no major benefits. The results of the present study do not support general use of intermittent pneumatic compression initiated 4 weeks following volar plating surgery for distal radial fracture. Level of evidence: I
|
|
| 2. |
- Andersdotter Sandström, Anna, et al.
(author)
-
Patients with stress-induced exhaustion disorder and their experiences of physical activity prescription in a group context
- 2023
-
In: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 16:1
-
Journal article (peer-reviewed)abstract
- Background: Physical activity is a useful means to improve symptoms and memory performance to some extent in individuals with stress-induced exhaustion disorder. Individuals in this group commonly do not need to reach the recommended levels of physical activity. Developing methods to support physical activity as a lasting behaviour is important.Objective: The aim of the study was to explore the processes involved when using physical activity prescription as part of rehabilitation in a group context for individuals with stress-induced exhaustion disorder.Method: A total of 27 individuals with stress-induced exhaustion disorder participated in six focus groups. The informants underwent a multimodal intervention including prescription of physical activity. The physical activity prescription had a cognitive behaviour approach and included information about physical activity, home assignments and goal setting. The data was analysed with grounded theory method using constant comparison.Results: The analysis of the data was developed into the core category ‘trying to integrate physical activity into daily life in a sustainable way’, and three categories: ‘acceptance of being good enough’, ‘learning physical activity by doing’ and ‘advocation for physical activity in rehabilitation’. The informants identified that during the physical activity prescription sessions they learned what physical activity was, what was ‘good enough’ in terms of dose and intensity of physical activity, and how to listen to the body’s signals. These insights, in combination with performing physical activity during home assignments and reflecting with peers, helped them incorporate physical activity in a new and sustainable way. A need for more customised physical activity with the ability to adjust to individual circumstances was requested.Conclusion: Prescription of physical activity in a group context may be a useful method of managing and adjusting physical activity in a sustainable way for individuals with stress-induced exhaustion disorder. However, identifying people who need more tailored support is important.
|
|
| 3. |
- Aronsson, Ingela, et al.
(author)
-
“Recovery activities are needed every step of the way”—exploring the process of long-term recovery in people previously diagnosed with exhaustion disorder
- 2024
-
In: BMC Psychology. - : Springer Nature. - 2050-7283. ; 12
-
Journal article (peer-reviewed)abstract
- Background: Sick-leave rates are high due to stress-related illnesses, but little is still known about the process of recovery from these conditions. The aim of this study was to explore the experiences of the recovery process, 6 to 10 years after treatment in people previously diagnosed with exhaustion disorder (ED), focusing on facilitators and barriers for the process of recovery from ED, and recovery activities experienced as helpful during the recovery process.Method: Thirty-eight participants (average age: 52 years, 32 females) previously diagnosed with ED were interviewed with semi-structured interviews 6–10 years after undergoing treatment. The interviews were analyzed with thematic analysis.Results: Three themes resulted from the analysis. The first theme, “A long and rocky road”, summarizes the fluctuating path to feeling better and emphasizes barriers and facilitators that affected the process of recovery, with a focus on external life events and the participants’ own behaviors. Facilitators were changing workplace, receiving support, a reduction in stressors, and changed behaviors. Barriers were a poor work environment, caregiver responsibilities, negative life events and lack of support. The second theme “Recovery activities are needed every step of the way” describes how both the need for recovery activities and the types of activities experienced as helpful changed during the recovery process, from low-effort recovery activities for long periods of time to shorter and more active recovery activities. Recovery activities were described as important for self-care but hard to prioritize in everyday life. The last theme, “Reorienting to a new place”, captures the struggle to cope with the remaining impact of ED, and how internal facilitators in terms of understanding and acceptance were important to reorient and adjust to a new way of functioning.Conclusions: Recovering from ED is a long and ongoing process where recovery activities are needed every step of the way. Our results highlight the importance of supporting personal recovery and long-term behavioral change, addressing individual stressors that may perpetuate the condition, and adjusting recovery activities according to where the person is in the recovery process.Trial registration: ClinicalTrials.gov: NCT0073772. Registered on March 8, 2017. This study was pre-registered on Open Science Framework (osf.io).
|
|
| 4. |
- Eskilsson, Therese, et al.
(author)
-
Aerobic training for improved memory in patients with stress-related exhaustion : a randomized controlled trial
- 2017
-
In: BMC Psychiatry. - : BioMed Central. - 1471-244X. ; 17:1
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Patients with stress-related exhaustion suffer from cognitive impairments, which often remain after psychological treatment or work place interventions. It is important to find effective treatments that can address this problem. Therefore, the aim of this study was to investigate the effects on cognitive performance and psychological variables of a 12-week aerobic training program performed at a moderate-vigorous intensity for patients with exhaustion disorder who participated in a multimodal rehabilitation program.METHODS: In this open-label, parallel, randomized and controlled trial, 88 patients diagnosed with exhaustion disorder participated in a 24-week multimodal rehabilitation program. After 12 weeks in the program the patients were randomized to either a 12-week aerobic training intervention or to a control group with no additional training. Primary outcome measure was cognitive function, and secondary outcome measures were psychological health variables and aerobic capacity.RESULTS: In total, 51% patients in the aerobic training group and 78% patients in the control group completed the intervention period. The aerobic training group significantly improved in maximal oxygen uptake and episodic memory performance. No additional improvement in burnout, depression or anxiety was observed in the aerobic group compared with controls.CONCLUSION: Aerobic training at a moderate-vigorous intensity within a multimodal rehabilitation program for patients with exhaustion disorder facilitated episodic memory. A future challenge would be the clinical implementation of aerobic training and methods to increase feasibility in this patient group.TRIAL REGISTRATION: ClinicalTrials.gov: NCT03073772 . Retrospectively registered 21 February 2017.
|
|
| 5. |
|
|
| 6. |
- Eskilsson, Therese, 1970-, et al.
(author)
-
Enhanced Capacity to Act : Managers' Perspectives When Participating in a Dialogue-Based Workplace Intervention for Employee Return to Work
- 2021
-
In: Journal of occupational rehabilitation. - : Springer. - 1053-0487 .- 1573-3688. ; 31:2, s. 263-274
-
Journal article (peer-reviewed)abstract
- Purpose: To explore if and how a dialogue-based workplace intervention with a convergence dialogue meeting can support a return to work process from the managers' perspective.Methods: Individual interviews were conducted with 16 managers (10 women and 6 men) who had an employee on sick leave because of stress-induced exhaustion disorder. The manager and employee participated in a dialogue-based workplace intervention with a convergence dialogue meeting that was guided by a healthcare rehabilitation coordinator. The intervention aimed to facilitate dialogue and find concrete solutions to enable return to work. The interviews were analyzed by the Grounded Theory method.Results: A theoretical model was developed with the core category enhancing managerial capacity to act in a complex return to work process,where the managers strengthened their agential capacity in three levels (categories). These levels werebuilding competence, making adjustments, andsharing responsibilitywith the employee. The managers also learned to navigate in multiple systems and by balancing demands, control and support for the employee and themselves. An added value was that the managers began to take preventive measures with other employees. When sick leave was caused only by personal or social issues (not work), workplace actions or interventions were difficult to find.Conclusions: From the managers' perspective, dialogue-based workplace interventions with a convergence dialogue meeting and support from a rehabilitation coordinator can strengthen managerial competence and capacity to act in a complex return to work process.
|
|
| 7. |
- Eskilsson, Therese, 1970-, et al.
(author)
-
Hopeful struggling for health : Experiences of participating in computerized cognitive training and aerobic training for persons with stress-related exhaustion disorder
- 2020
-
In: Scandinavian Journal of Psychology. - : Wiley-Blackwell. - 0036-5564 .- 1467-9450. ; 61:3, s. 361-68
-
Journal article (peer-reviewed)abstract
- It is important to understand how people with exhaustion disorder (ED) perceive interventions aiming to facilitate cognitive functioning. Therefore, the overall aim of this study was to explore experiences from persons with ED after participating in a 12-week intervention of either computerized cognitive training or aerobic training. Both interventions were performed in addition to a multimodal rehabilitation programme. Thirteen participants, 11 women and 2 men, were interviewed about pros and cons with participating in the training. The interviews were analysed with Qualitative Content Analysis. The analyses resulted in the theme hopeful struggling for health and the categories support, motivation and sensations. It was hard work recovering from ED. Support from others who are in the same situation, family members, and technology and routines for the training were strongly emphasized as beneficial for recovery. Timing, i.e., matching activities to the rehabilitation programme, getting feedback and perceiving joy in the training were important for motivation. Participants in both interventions experienced positive sensations with improved memory performance, everyday life functioning and increased faith in the prospect of recovery. However, it is important to consider various aspects of support and motivation in both computerized cognitive training and aerobic training to enable participants to pursue their participation.
|
|
| 8. |
|
|
| 9. |
- Eskilsson, Therese, 1970-, et al.
(author)
-
Symptoms, work situation and work functioning 10 years after rehabilitation of stress-induced exhaustion disorder
- 2024
-
In: BMC Psychiatry. - : BioMed Central (BMC). - 1471-244X. ; 24:1
-
Journal article (peer-reviewed)abstract
- Background: Stress-induced exhaustion disorder (SED) is the most common reason for long-term sick leave in Sweden and the recovery process may be long and troublesome. This study explores the symptoms of burnout, depression and anxiety among patients with SED 10 years after termination of a multimodal rehabilitation program. Another aim of the study was to investigate work situation, work functioning, and any remaining exhaustion and sleeping disorders among those who were gainfully employed at the 10-year follow-up.Methods: This longitudinal study included 107 patients (91 women and 16 men), who had been diagnosed with SED 10 years prior to the study. After establishing the diagnosis they all underwent and completed an multimodal rehabilitation program. Data on symptoms of burnout, anxiety and depression were collected before and after the multimodal rehabilitation program, and at follow-ups after additional 1 year and an additional 10 years. At the 10-year follow-up, work situation, work functioning, and symptoms of exhaustion and sleep disorders were assessed in those who were gainfully employed (89 patients).Results: Symptoms of burnout, anxiety, and depression remained stable from the 1- to the 10-year follow-up after completed rehabilitation. Among participants who were gainfully employed, 73% had changed workplaces, and 31.5% had reduced their working hours. Common reasons for these changes were lack of energy or because they had chosen to prioritise their lives differently. Work functioning was rated as moderate, one third self-reported SED to some extent, and one fifth reported moderate-to-severe insomnia.Conclusion: A relatively large proportion of former patients with SED have residual health problems 10 years after rehabilitation and some have not been able to return to full-time work. Preventive and early rehabilitative interventions with adjustments and measures at the organisational level are probably needed to achieve a more sustainable working life.
|
|
| 10. |
-
Insatser i vården vid långtidssjukskrivning : En systematisk översikt och utvärdering av medicinska, hälsoekonomiska och etiska aspekter
- 2023
-
Reports (peer-reviewed)abstract
- SlutsatserVid psykisk och muskuloskeletal sjukdomUnimodala insatser, multimodala insatser och insatser som involverar arbetsplatskontakt eller koordinering mot arbetsplats har möjligen positiv effekt på återgång i arbete på kort sikt (upp till 12 månader) för personer sjukskrivna på grund av psykisk eller muskuloskeletal sjukdom (låg tillförlitlighet)3. Det går inte att bedöma effektens storlek.Det går inte att bedöma effekten på återgång i arbete av insatser som riktar sig till vårdgivare2.Det går inte att bedöma effekten på återgång i arbete på längre sikt för någon typ av insats.Effekterna på hälsa och funktion går inte att bedöma för någon typ av insats, varken på kort eller lång sikt4.2. Med vårdgivare avses den organisation som bedriver hälso- och sjukvård på en övergripande nivå, inte den enskilda läkaren. De insatser som studerats som riktas till vårdgivare kan förutom till vårdgivaren dock även vara riktade till behandlande personal.3. För noggrannare beskrivning av vilka populationer som slutsatsen gäller, se Tabell 1.4. Slutsatserna gäller för insatser som syftar till att underlätta återgång i arbete.Vid bröstcancerDet går inte att bedöma insatsernas effekt på återgång i arbete eller hälsa och funktion för personer sjukskrivna på grund av bröstcancer5.5. Slutsatserna gäller för insatser som syftar till att underlätta återgång i arbete och inkluderar inte medicinska insatser som har kurativt syfte.KommentarMajoriteten av de inkluderade studierna uppvisar inga statistiskt säkerställda effekter, men resultat från flera studier talar för att vissa insatser kan ha effekter som är betydelsefulla för patienter och samhälle. Det går inte att dra slutsatser om specifika insatser eller om vilka komponenter i insatserna som fungerar. Framtida forskning kan bidra med kunskap genom att replikera studier som uppvisat positiva resultat.Det är önskvärt att forskning om insatser som syftar till att främja återgång i arbete i möjligaste mån använder standardiserade mät- och analysmetoder och att forskare utvärderar ett begränsat antal prioriterade utfallsmått på ett vis som gör att dessa kan inkluderas i metaanalyser.De studier som ligger till grund för slutsatserna i denna rapport är i huvudsak genomförda i Nederländerna, Norge, Sverige och Danmark. Projektgruppen bedömer att resultatens överförbarhet till svenska förhållanden är god. Samtidigt kan arbetsmarknad, sjukförsäkringslagstiftning och hälso- och sjukvårdens organisation och arbetssätt ha betydelse för hur insatser genomförs och vilka effekter de har, och dessa faktorer kan dessutom förändras över tid.Ett krav för att en studie skulle inkluderas var att den undersökte insatsens effekt på återgång i arbete. I vissa fall har författarna även undersökt insatsens effekter på hälsa och funktion. Slutsatsen från denna rapport är att det inte går att bedöma insatsernas effekt på hälsa och funktion. Detta ska dock inte tolkas som att det är säkerställt att insatserna saknar effekt på dessa utfall, utan att det skulle behövas ytterligare, välgjorda studier för att kunna bedöma effekten. De sammanvägda resultaten ger inget stöd för att metoderna har negativa effekter, vare sig på återgång i arbete eller hälsa och funktion.Det är svårt att dra slutsatser om kostnadseffektivitet för de olika insatskategorierna som definierats i projektet. Hälsoekonomiska studier har bara identifierats för ett mindre antal av de specifika insatser som omfattas av utvärderingen, och det är oklart om dessa insatser är representativa för kategorierna som helhet. En hälsoekonomisk analys som genomförts i projektet visar att det räcker med en förhållandevis liten effekt på arbetsåtergång för att en insats ska bli kostnadsbesparande i ett samhällsekonomiskt perspektiv.I statistik över långtidssjukskrivning finns ofta könsskillnader. I de inkluderade studierna rapporterades endast undantagsvis separata resultat för kvinnor och män. De inkluderade studierna har inte redovisat effekter utifrån olika yrken eller arbetsmiljöer.Det identifierades inga studier som undersökt insatser till personer sjukskrivna på grund av bipolär sjukdom eller till följd av postinfektiöst tillstånd, inklusive postcovid.Den etiska analysen visar att insatser i vården vid långtidssjukskrivning berör etiska värden som jämlikhet, rättvisa, autonomi och integritet samt kan påverka tredje part vilket ställer höga krav på hur insatser planeras och genomförs i praktiken.
|
|
| 11. |
- Malmberg Gavelin, Hanna, 1982-, et al.
(author)
-
Mental fatigue in stress-related exhaustion disorder : Structural brain correlates, clinical characteristics and relations with cognitive functioning
- 2020
-
In: NeuroImage. - : Elsevier. - 2213-1582. ; 27
-
Journal article (peer-reviewed)abstract
- Emerging evidence suggests that mental fatigue is a central component of the cognitive and clinical characteristics of stress-related exhaustion disorder (ED). Yet, the underlying mechanisms of mental fatigue in this patient group are poorly understood. The aim of this study was to investigate cortical and subcortical structural neural correlates of mental fatigue in patients with ED, and to explore the association between mental fatigue and cognitive functioning. Fifty-five patients with clinical ED diagnosis underwent magnetic resonance imaging. Mental fatigue was assessed using the Concentration subscale from the Checklist Individual Strength. Patients with high levels of mental fatigue (n = 30) had smaller caudate and putamen volumes compared to patients with low-moderate levels of mental fatigue (n = 25). No statistically significant differences in cortical thickness were observed between the groups. Mediation analysis showed that mental fatigue mediated the relationship between caudate volume and working memory; specifically, smaller caudate volume was associated with higher level of mental fatigue and mental fatigue was positively associated with working memory performance. Our findings demonstrate that the structural integrity of the striatum is of relevance for the subjective perception of mental fatigue in ED, while also highlighting the complex relationship between mental fatigue, cognitive performance and its neural underpinnings.
|
|
| 12. |
- Malmberg Gavelin, Hanna, et al.
(author)
-
Neural activation in stress-related exhaustion : cross-sectional observations and interventional effects
- 2017
-
In: Psychiatry Research. - Clare : Elsevier. - 0925-4927 .- 1872-7506 .- 0165-1781 .- 1872-7123. ; 269, s. 17-25
-
Journal article (peer-reviewed)abstract
- The primary purpose of this study was to investigate the association between burnout and neural activation during working memory processing in patients with stress-related exhaustion. Additionally, we investigated the neural effects of cognitive training as part of stress rehabilitation. Fifty-five patients with clinical diagnosis of exhaustion disorder were administered the n-back task during fMRI scanning at baseline. Ten patients completed a 12-week cognitive training intervention, as an addition to stress rehabilitation. Eleven patients served as a treatment-as-usual control group. At baseline, burnout level was positively associated with neural activation in the rostral prefrontal cortex, the posterior parietal cortex and the striatum, primarily in the 2-back condition. Following stress rehabilitation, the striatal activity decreased as a function of improved levels of burnout. No significant association between burnout level and working memory performance was found, however, our findings indicate that frontostriatal neural responses related to working memory were modulated by burnout severity. We suggest that patients with high levels of burnout need to recruit additional cognitive resources to uphold task performance. Following cognitive training, increased neural activation was observed during 3-back in working memory-related regions, including the striatum, however, low sample size limits any firm conclusions.
|
|
| 13. |
- Malmberg Gavelin, Hanna, et al.
(author)
-
Rehabilitation for improved cognition in patients with stress-related exhaustion disorder : RECO – a randomized clinical trial
- 2018
-
In: Stress. - : Taylor & Francis. - 1025-3890 .- 1607-8888. ; 21:4, s. 279-291
-
Journal article (peer-reviewed)abstract
- Stress-related exhaustion has been associated with selective and enduring cognitive impairments. However, little is known about how to address cognitive deficits in stress rehabilitation and how this influences stress recovery over time. The aim of this open-label, parallel randomized controlled trial (ClinicalTrials.gov: NCT03073772) was to investigate the long-term effects of 12 weeks cognitive or aerobic training on cognitive function, psychological health, and work ability for patients diagnosed with exhaustion disorder (ED). One-hundred-and-thirty-two patients (111 women) participating in multimodal stress rehabilitation were randomized to receive additional cognitive training (n = 44), additional aerobic training (n = 47), or no additional training (n = 41). Treatment effects were assessed before, immediately after and one-year post intervention. The primary outcome was global cognitive function. Secondary outcomes included domain-specific cognition, self-reported burnout, depression, anxiety, fatigue and work ability, aerobic capacity, and sick-leave levels. Intention-to-treat analysis revealed a small but lasting improvement in global cognitive functioning for the cognitive training group, paralleled by a large improvement on a trained updating task. The aerobic training group showed improvements in aerobic capacity and episodic memory immediately after training, but no long-term benefits. General improvements in psychological health and work ability were observed, with no difference between interventional groups. Our findings suggest that cognitive training may be a viable method to address cognitive impairments for patients with ED, whereas the effects of aerobic exercise on cognition may be more limited when performed during a restricted time period. The implications for clinical practice in supporting patients with ED to adhere to treatment are discussed
|
|
| 14. |
|
|
| 15. |
- Nelson, Andreas, et al.
(author)
-
Subjective cognitive complaints and its associations to response inhibition and neural activation in patients with stress-related exhaustion disorder
- 2023
-
In: Stress. - : Taylor & Francis. - 1025-3890 .- 1607-8888. ; 26:1
-
Journal article (peer-reviewed)abstract
- Stress-related exhaustion is associated with cognitive deficits, measured subjectively using questionnaires targeting everyday slips and failures or more objectively as performance on cognitive tests. Yet, only weak associations between subjective and objective cognitive measures in this group has been presented, theorized to reflect recruitment of compensational resources during cognitive testing. This explorative study investigated how subjectively reported symptoms of cognitive functioning and burnout levels relate to performance as well as neural activation during a response inhibition task. To this end, 56 patients diagnosed with stress-related exhaustion disorder (ED; ICD-10 code F43.8A) completed functional magnetic resonance imaging (fMRI) using a Flanker paradigm. In order to investigate associations between neural activity and subjective cognitive complaints (SCCs) and burnout, respectively, scores on the Prospective and Retrospective Memory Questionnaire (PRMQ) and the Shirom-Melamed Burnout Questionnaire (SMBQ) were added as covariates of interest to a general linear model at the whole-brain level. In agreement with previous research, the results showed that SCCs and burnout levels were largely unrelated to task performance. Moreover, we did not see any correlations between these self-report measures and altered neural activity in frontal brain regions. Instead, we observed an association between the PRMQ and increased neural activity in an occipitally situated cluster. We propose that this finding may reflect compensational processes at the level of basic visual attention which could go unnoticed in cognitive testing but still be reflected in the experience of deficits in everyday cognitive functioning.
|
|
| 16. |
- Nelson, Andreas, et al.
(author)
-
Subjective cognitive complaints in patients with stress-related exhaustion disorder : a cross sectional study
- 2021
-
In: BMC Psychology. - : Springer Nature. - 2050-7283. ; 9:1
-
Journal article (peer-reviewed)abstract
- Background Stress-related exhaustion is associated with cognitive impairment as measured by both subjective cognitive complaints (SCCs) and objective cognitive test performance. This study aimed to examine how patients diagnosed with exhaustion disorder differ from healthy control participants in regard to levels and type of SCCs, and if SCCs are associated with cognitive test performance and psychological distress.Methods We compared a group of patients with stress-related exhaustion disorder (n = 103, female = 88) with matched healthy controls (n = 58, female = 47) cross-sectionally, concerning the type and magnitude of self-reported SCCs. We furthermore explored the association between SCCs and cognitive test performance as well as with self-reported depression, anxiety and burnout levels, in the patient and the control group, respectively.Results Patients reported considerably more cognitive failures and were more likely than controls to express memory failures in situations providing few external cues and reminders in the environment. In both groups, SCCs were associated with demographic and psychological factors, and not with cognitive test performance.Conclusion Our findings underline the high burden of cognitive problems experienced by patients with exhaustion disorder, particularly in executively demanding tasks without external cognitive support. From a clinical perspective, SCCs and objective cognitive test performance may measure different aspects of cognitive functioning, and external cognitive aids could be of value in stress rehabilitation.
|
|
| 17. |
- Norström, Fredrik, et al.
(author)
-
Healthcare utilisation among patients with stress-induced exhaustion disorder treated with a multimodal rehabilitation programme : a longitudinal observational study
- 2022
-
In: BMC Psychiatry. - : BioMed Central (BMC). - 1471-244X. ; 22:1
-
Journal article (peer-reviewed)abstract
- Background: Stress-induced exhaustion disorder is a major challenge in Swedish working life. Despite its increase in prevalence, there is still limited knowledge about the effectiveness of different rehabilitation methods. In this study, we aim to describe the healthcare utilisation for patients with stress-induced exhaustion disorder before, during and after a multi-modal rehabilitation (MMR) programme, as well as the health-related quality of life, work ability, sick leave level and psychological measures, and their possible relations.Methods: In this longitudinal observational study, 53 patients who were part of an MMR programme at the Stress Rehabilitation Clinic participated with survey data, and among them 43 also contributed with healthcare data. Data were collected from one year before start of MMR to one year after the end of it. The patients also answered a questionnaire at the start of, end of and at a one-year follow-up of the MMR, which included questions about health-related quality of life, work ability, clinical burnout, sick leave level, anxiety and depression.Results: There was a statistically significant increase in healthcare consumption during MMR, if including visits to the Stress Rehabilitation Clinic, while it decreased if excluding such visits, when comparing with before and after MMR. During the follow-up period there was a non-statistically significant (p=0.11), but still rather large difference (15.4 compared with 12.0 visits per patient), in healthcare consumption in comparison with the period before MMR, when excluding follow-up visits at the Stress Rehabilitation Clinic. Health-related quality of life was rated as poor before MMR (mean 0.59). There was a statistically significant improvement, but values were still below normal at the end of follow-up (mean 0.70). In addition, the level of sick leave, the work ability and signs of clinical burnout improved statistically significantly after MMR, but were not fully normalised at the end of follow-up. Individual healthcare consumption was related to residual health problems.Conclusions: Patients with stress-induced exhaustion disorder have not reduced their healthcare consumption notably after MMR, and residual health problems remain for some patients. More studies are needed for a deeper understanding of the individual effectiveness of MMR, and also of its cost-effectiveness.
|
|
| 18. |
- Stenberg, Gunilla, Med dr, 1968-, et al.
(author)
-
Gender matters in physiotherapy
- 2022
-
In: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 38:13, s. 2316-2329
-
Journal article (peer-reviewed)abstract
- The World Health Organization states that gender has implications for health across the course of a person's life in terms of norms, roles and relations. It also has implications in rehabilitation. In this article, we argue the need of gender perspectives in the field of physiotherapy; gender matters and makes a difference in health and rehabilitation. We highlight a number of central areas where gender may be significant and give concrete examples of social gender aspects in physiotherapy practice and in diverse patient groups. We also discuss why it can be important to consider gender from an organizational perspective and how sociocultural norms and ideals relating to body, exercise and health are gendered. Further we present useful gender theories and conceptual frameworks. Finally, we outline future directions in terms of gender-sensitive intervention, physiotherapy education and a gendered application of the ICF model. We want to challenge physiotherapists and physiotherapy students to broaden knowledge and awareness of how gender may impact on physiotherapy, and how gender theory can serve as an analytical lens for a useful perspective on the development of clinical practice, education and research within physiotherapy.
|
|
| 19. |
- Strömbäck, Maria, 1965-, et al.
(author)
-
Restoring confidence in return to work : A qualitative study of the experiences of persons with exhaustion disorder after a dialogue-based workplace intervention
- 2020
-
In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 15:7
-
Journal article (peer-reviewed)abstract
- Background: Stress-induced exhaustion disorder (SED) is a primary cause for sickness absence among persons with mental health disorders in Sweden. Interventions involving the workplace, and supporting communication between the employee and the supervisor, are proposed to facilitate return to work (RTW). The aim of this study was to explore experiences of persons with SED who participated in a dialogue-based workplace intervention with a convergence dialogue meeting performed by a rehabilitation coordinator.Methods: A qualitative design based on group interviews with 15 persons with SED who participated in a 24-week multimodal rehabilitation program was used. The interviews were analyzed with the methodology of grounded theory.Results: The analysis resulted in a theoretical model where the core category, restoring confidence on common ground, represented a health promoting process that included three phases: emotional entrance, supportive guidance, and empowering change. The health promoting process was represented in participant experiences of personal progress and safety in RTW.Conclusions: The intervention built on a health-promoting pedagogy, supported by continuous guidance from a rehabilitation coordinator and structured convergence dialogue meetings that enhanced common communication and collaboration with the supervisor and others involved in the RTW process. The intervention balanced relationships, transferred knowledge, and changed attitudes about SED among supervisors and colleagues in the workplace. The inclusion of a rehabilitation coordinator in the intervention was beneficial by enhancing RTW and bridging the gaps between healthcare, the workplace, and other organizational structures. In addition, the intervention contributed to a positive re-orientation towards successful RTW instead of an endpoint of employment. In a prolonged process, a dialogue-based workplace intervention with convergence dialogue meetings and a rehabilitation coordinator may support sustainable RTW for persons with SED.
|
|
| 20. |
- Wahlström, Viktoria, et al.
(author)
-
Effects of a multicomponent physical activity promoting program on sedentary behavior, physical activity and body measures : a longitudinal study in different office types
- 2019
-
In: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health (NOROSH). - 0355-3140 .- 1795-990X. ; 45:5, s. 493-504
-
Journal article (peer-reviewed)abstract
- Objectives: The aim of this study was to investigate effects of a multicomponent program promoting physical activity on sedentary behavior, physical activity, and body measures, when relocating from cell offices to either a flex or cell office.Methods: The Active Office Design (AOD) study is a longitudinal non-randomized controlled study performed in a municipality in northern Sweden. A subsample of 86 participants were randomly recruited from the AOD study to objectively measure sedentary behavior and physical activity, using ActivPAL and ActiGraph, before and after relocation to the two different office types. The multicomponent program promoting physical activity was performed in both offices. Data were analyzed using linear mixed models.Results: Eighteen months after relocation, the total number of steps per work day increased by 21% in the flex office and 3% in the cell office group, compared to baseline. Moderate and vigorous physical activity (MVPA) during work hours increased by 42% in the flex office group and 19% in the cell office group. No changes were seen regarding sitting time at work. Small additive effects for walking and MVPA were seen for both groups during non-work time. Weight increased in the flex office group.Conclusions: This long-term study shows that a multicomponent workplace intervention can lead to increased walking time, steps, and MVPA in a flex compared to a cell office. Small additive increases of physical activity were seen during non-work time in both groups. More long-term controlled studies are needed to confirm these results.
|
|
| 21. |
- Wahlström, Viktoria, et al.
(author)
-
Physical work environment in an activity-based flex office : a longitudinal case study
- 2024
-
In: International Archives of Occupational and Environmental Health. - : Springer Science+Business Media B.V.. - 0340-0131 .- 1432-1246.
-
Journal article (peer-reviewed)abstract
- Objective: This study aimed to investigate and explore Occupational Health and Safety (OHS) management, office ergonomics, and musculoskeletal symptoms in a group of office workers relocating from cell offices to activity-based flex offices (AFOs).Methods: The analysis was based on qualitative interview data with 77 employees and longitudinal questionnaire data from 152 employees.Results: Results indicate that there was a need to clarify roles and processes related to the management of OHS. Self-rated sit comfort, working posture, and availability of daylight deteriorated and symptoms in neck and shoulders increased after the relocation and seemed to be influenced by many factors, such as difficulties adjusting the workstations, the availability of suitable workplaces, and age, sex, and individual needs.Conclusion: Research on the long-term effects of physical work environments and management of (OHS) issues after implementing activity-based flex offices is sparse. This study demonstrates the importance of planning and organising OHS issue management when implementing an AFO, and to carefully implement office ergonomics among office workers.
|
|
