| 1. |
- Nilsson, Kerstin, et al.
(författare)
-
54 forskare: Inte alla klarar höjd pensions-ålder
- 2017
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Ingår i: Svenska Dagbladet, Stockholm. - 1101-2412.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Ett hållbart och acceptabelt pensionssystem måste utformas utifrån personliga förutsättningar och förhållanden i arbetslivet, så att fler klarar att arbeta i högre ålder. Att enbart genom ekonomiska åtgärder höja pensionsåldern är inte långsiktigt hållbart, skriver 54 forskare.DEBATT | PENSIONForskning visar att cirka var fjärde har en diagnos eller skada orsakad av sitt arbete. Detta gör arbetsorsakad sjukdom och skada till ett betydelsefullt folkhälsoproblem. Att då enbart genom ekonomiska åtgärder höja pensionsåldern för samtliga (yrkes)grupper utifrån deras kronologiska ålder är inte långsiktigt hållbart när individers biologiska ålder är så olika bland annat till följd av arbetslivet. Detta är en demokratifråga. Forskning om äldre i arbetslivet och hållbart arbete visar att man då främst flyttar individer från pensionssystemet till sjukförsäkringssystemet och ökar klyftorna i samhället.Debatt Det här är en argumenterande text med syfte att påverka. Åsikterna som uttrycks är skribentens egna.Vi är 54 forskare som nu gemensamt har skrivit denna debattartikel. Anledningen är att vi är oroade över att cirka var fjärde blir sjuk av sitt arbete samtidigt som man i det förslag som ligger om att senarelägga ålderspensionen i princip utgår ifrån att arbetskraftsdeltagande enbart styrs av ekonomin. Vi vill trycka på betydelsen av åtgärder i arbetslivet för att komma tillrätta med ohälsan, det vill säga inte enbart ekonomiska restriktioner som tvingar folk som inte kan, vill och orkar att stanna kvar i arbetslivet till en högre kronologisk ålder.Pensionssystemet bygger på att vi ska arbeta en viss del av våra liv för att förtjäna möjligheter till pension. Vi bör dock inte enbart utgå ifrån antalet år sedan en person föddes, då korttidsutbildade generellt träder in på arbetsmarknaden tidigare än långtidsutbildade. De har alltså varit en del av arbetskraften från en yngre ålder. Människor med kortare utbildning har oftare ett arbete som innebär påfrestningar som kan inverka negativt på hälsotillståndet och som till och med kan påskynda det biologiska åldrandet. Dessutom lever korttidsutbildade generellt sett inte lika länge som långtidsutbildade, vilket delvis även avspeglar skilda livs- och arbetsvillkor.Den svenska sjukförsäkringsreformen 2008 avsåg att få tillbaka människor i arbete. Men studien fann att den faktiskt bidrog till att fler gick i tidig ålderspension av dem som var i åldern 55–64 år. Ökningen var störst bland korttidsutbildade. Mer än 5 procent fler gick i tidig ålderspension då det blev svårare att få sjukpenning och sjukersättning. Vi kan notera att det är vanligare att manliga chefer tar ut tidig ålderspension, jämfört med kvinnliga maskinskötare inom tillverkningsindustrin. I vissa yrken är det dessutom vanligare att människor, trots pension, både orkar och faktiskt ges möjlighet att arbeta vidare om de har en specialkompetens som efterfrågas. Om vi endast kombinerar ekonomiska morötter med piskor finns en stor risk att vi ökar klyftan mellan grupper som både kan och vill fortsätta att yrkesarbeta och personer som av olika skäl inte längre kan eller orkar.Ta nytta av den forskning som vi har tagit fram. Ett hållbart och acceptabelt pensionssystem måste utformas utifrån personliga förutsättningar och förhållanden i arbetslivet. Ett hållbart arbetsliv för allt fler i vår åldrande befolkning fordrar att vi samtidigt beaktar faktorer som relaterar till biologisk/kroppslig ålder, mental/kognitiv ålder samt social ålder/livsloppsfas och våra attityder som är kopplade till ålder. Vi måste ta större hänsyn till olika förutsättningar och varierande funktionsförmåga och utifrån detta anpassa de åtgärder som gör att arbetslivet blir möjligt och hållbart för allt fler även i högre ålder.”Morötter” är viktigare för en god arbetshälsa och hög produktivitet än en piska i form av oron för en dålig ekonomi.Forskning visar att pedagogik som bygger på ”morötter” oftast är betydligt bättre än ”piskor” för att nå framgångsrika och långsiktiga mål. ”Morötter” i samhället, för organisationer, företag och individer är därför viktiga för god arbetshälsa och fortsatt produktivitet och kan bidra till ett längre arbetsliv även för grupper som tidigare inte ens klarat av att arbeta fram till pensionsåldern. Genom forskning inom området har bland annat swage-modellen utarbetats. Detta är ett verktyg som visar på komplexiteten i ett hållbart arbetsliv och tillsammans med systematiskt arbetsmiljöarbete, handlingsplaner och åtgärder syftar till ett mer hållbart arbetsliv. Morötter är enligt forskningen i detta sammanhang åtgärder för en god fysisk och mental arbetsmiljö, avpassad arbetsbelastning, stödjande teknik, att man kan anpassa arbetstakten, alternativa arbetstidsmodeller vid behov. Det är viktigt att man känner sig trygg och förväntas och tillåts vara delaktig, att man blir sedd av chefen och arbetskamraterna. Att de egna arbetsuppgifterna upplevs som meningsfulla och behövda av andra skapar självförverkligande och tillfredsställelse i arbetet. Att man känner att ens arbetsuppgifter och man själv är viktig för organisationen och företaget. Att man trots högre ålder inkluderas i olika nysatsningar och får tillgång till kompetensutveckling och inte blir åsidosatt eller åldersdiskriminerad. Utvärderingar visar att de äldre medarbetarna som fick några av dessa anpassningar och möjligheter var mer effektiva, utvilade, stimulerade när de var på arbetet samtidigt som sjukfrånvaron minskade. Vilket i sin tur bidrar till ett längre arbetsliv för grupper som tidigare inte klarat av att arbeta fram till pensionsåldern. I organisationer som bygger på en deltagar- och lärandekultur rustas de anställda för att klara omställningar, nya arbetsuppgifter och vid behov även yrkesbyten.Med en åldrande befolkning där allt fler lever allt längre behöver vi arbeta till en högre ålder i framtiden för att pensionssystemet ska hålla. Men ”morötter” är viktigare för en god arbetshälsa och hög produktivitet än en piska i form av oron för en dålig ekonomi. Det kräver också att vi ändrar våra attityder och förhållningssätt till äldre på arbetsmarknaden, vilket vi bäst gör genom att organisationer och företag får incitament till och erbjuder mer individanpassade arbetsvillkor, särskilt för personer i högre ålder. Låt oss därför använda den framtagna kunskapen i praktiken för att göra arbetslivet friskt och hållbart för alla åldrar.
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| 2. |
- Nilsson, Kerstin, et al.
(författare)
-
Vi är oroade över senare ålderspension
- 2017
-
Ingår i: Dagens Samhälle. - 1652-6511.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Var fjärde person blir i dag sjuk till följd av sitt arbete. Att höja pensionsåldern för alla yrkesgrupper, utan konkreta åtgärder för att minska ohälsan, är därför problematiskt och mycket oroande. Det är, enligt forskarna, inte långsiktigt samhällsekonomiskt lönsamt att utan andra åtgärder höja pensionsåldern för alla. Vi – 54 forskare – är mycket oroade över konsekvenserna av att, som föreslagits, senarelägga ålderspensionen.Förslaget utgår i princip från arbetskraftsdeltagande i princip enbart styrs av ekonomin, medan forskningen visar att det bara är en av flera faktorer som styr hur länge och hur mycket människor väljer att arbeta.Det här sättet att lösa problemet med en åldrande befolkning och ett sviktande pensionssystem är inte samhällsekonomiskt lönsamt på lång sikt, utan riskerar bara att flytta runt folk mellan olika ersättningssystem. Pensionssystemet bygger på att vi ska arbeta en viss del av våra liv för att tjäna in vår pension. Vi bör dock inte enbart utgå ifrån ålder eller antalet år sedan en person föddes då korttidsutbildade generellt träder in på arbetsmarknaden tidigare än långtidsutbildade. De med kortare utbildningstid har alltså varit en del av arbetskraften från en yngre ålder. Människor med kortare utbildning har också oftare ett arbete som innebär påfrestningar som kan inverka negativt på hälsotillståndet och som till och med kan påskynda det biologiska åldrandet. Dessutom lever korttidsutbildade generellt sett inte lika länge som långtidsutbildade, vilket delvis även avspeglar skilda livs- och arbetsvillkor.Ta nytta av den forskning som vi har tagit fram. Ekonomin är självklart viktigt för att vi ska vilja arbeta, men den är som sagt enbart en av flera faktorer med betydelse vårt arbetsliv.Hälsotillståndet, både det fysiska och det mentala, har en avgörande betydelse för hur länge och hur mycket vi orkar arbeta. Ett fysiskt och mentalt belastande arbete är en stark riskfaktor för en nedsatt hälsa i slutet av arbetslivet. Arbetstid, arbetstakt och möjlighet till återhämtning spelar en allt större roll ju äldre vi blir. Andra aspekter är arbetsinnehåll, hur meningsfulla och stimulerande arbetsuppgifterna är, balansen mellan arbete och familjesituation och fritidsaktiviteter. Organisationskultur, ledarskapet, stöd i arbetet och kompetens har stor betydelse för om vi ska kunna och vilja arbeta till en högre ålder. Vi måste ta större hänsyn till olika förutsättningar och varierande funktionsförmåga och utifrån detta anpassa de åtgärder som gör att arbetslivet blir möjligt och hållbart för allt fler även i högre ålder.Ett hållbart och acceptabelt pensionssystem måste därför utformas utifrån personliga förutsättningar och förhållanden i arbetslivet. Ett hållbart arbetsliv för allt fler i vår åldrande befolkning fordrar att vi samtidigt beaktar faktorer som relaterar till biologisk/kroppslig ålder, mental/kognitiv ålder samt social ålder/livsloppsfas samt de attityder som är kopplade till ålder.
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| 3. |
- Gyllensten, Kristina, 1977, et al.
(författare)
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Older assistant nurses’ motivation for a full or extended working life
- 2019
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Ingår i: Ageing and Society. - 0144-686X .- 1469-1779. ; 39:12, s. 2699-2713
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore older workers’ motivation for a full or extended working life. With particular focus on assistant nurses aged 55–64 years, working in the elderly care sector. Focus group interviews were conducted with five different groups of assistant nurses. Inductive thematic analysis was used to analyse the interviews and five main themes were developed from the data: ‘Organisational issues’, ‘Health-related problems’, ‘Private issues’, ‘Meaningfulness and appreciation’ and ‘Social support’. Several of the main themes concerned problems with too high work demands of the assistant nurses. These findings suggest that it is important to improve the working conditions of assistant nurses in order to create a more sustainable working life. Increasing the number of staff and improving recovery opportunities and work–life balance could be important steps to improving the working conditions for this group. Finally, upgrading the competency and professionalism of assistant nurses could help to increase the motivation for a full or extended working life.
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| 4. |
- Archer, Trevor, 1949, et al.
(författare)
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Internet-video Gaming: Symptoms, Epidemiology, Neurophysiology and Interventional Aspects.
- 2017
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Ingår i: Journal of Child and Adolescent Behavior. - : OMICS Publishing Group. - 2375-4494. ; 5:3
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Forskningsöversikt (refereegranskat)abstract
- Excessive perseverance with video-internet game usage, or alternatively Internet Gaming Disorder, presents a condition that, despite the potential utility of the underlying technology, augurs an assemblage of poor health and well-being, psychiatric liability and psychosocial perturbation with concomitant regional brain disturbance accompanied by incremental and inexorable prerequisites for appropriate interventions and eventual prevention. The tendency within the pathological expressions of disorder is for vulnerability to reside among the young, e.g., adolescents, rather than the older adults, over gender. Symptom-profiles of the condition incorporate varied, allconsuming and protracted problems ranging from cognitive-affective dysfunctions to biopsychological abnormalities such as sleep disturbances and fatigue. Escalating prevalence and epidemiological entanglement describe a putative framework of loneliness, introversion, neuroticism and impulsivity interspersed with expressions of depression, anxiety, sensation seeking, anger, a singular lack of assertiveness and the hazardous indications of ADHD propensity. Neurophysiological, brain regional and biomarker modifications underlying disorder pathophysiology appear more-or-less attuned to the symptomatic expressions of both diagnosed patients and those found to use excessive gaming, unconstrained from age-level: child, adolescent or young adult. Interventional strategies have centered upon the distinction of individual symptom-profiles, the description of withdrawal symptoms and related tolerance and the administration of coping strategies and resourceful behaviors, as for example implied by the “Craving Behavioral intervention”.
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| 5. |
- Arntén, Anne-Christine Andersson, et al.
(författare)
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Two Methods of Policing: Will the Resources of the Police Officers and the Local Communities be Spiraling Upwards or Downwards?
- 2019
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Ingår i: Journal of Forensic Science & Criminal Investigation. - 2476-1311. ; 11:3, s. 1-5
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Tidskriftsartikel (refereegranskat)abstract
- From the viewpoint of Swedish vulnerable areas this article focusing on the potential consequences of two methods of policing (Zero-tolerance and boundary-relation) from the perspective of factors connected with officers’ health, professional work performance, and the effect on the resources of the local community such as work against crime. The authors put forward different patterns of loss of resources that result from officers stressful and traumatic experiences. The article further discuss the effects on society connected to signs of loss of resources in the areas of health, such as cynicism, and performance. The two methods of policing play very different parts in whether resources will be lost or gained when the officers approach the local community. Reflecting the principles of Sir Robert Peel wherein the good relations between the police and the public is emphasized as the basis of effective policing.
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| 6. |
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| 7. |
- Brink, Eva, 1952, et al.
(författare)
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Constructing grounded theory : A practical guide through qualitative analysis
- 2006
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - Järfälla : CoAction Publishing. - 1748-2623 .- 1748-2631. ; 1:3, s. 188-192
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Recension (refereegranskat)abstract
- BOOK REVIEW: Constructing grounded theory. A practical guide through qualitative analysis Kathy Charmaz, 2006, 208 pp. London: Sage. ISBN 2005928035
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| 8. |
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| 9. |
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| 10. |
- Johansson, Maria E I, 1961, et al.
(författare)
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) Autistic spectrum disorders in Mobius sequence: a comprehensive study of 25 individuals
- 2001
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Ingår i: Developmental Medicine and Child Neurology. - : Wiley. - 0012-1622 .- 1469-8749. ; 43:5, s. 338-345
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of autistic disorder was analysed in 25 individuals with Möbius sequence, a disorder with brain-stem dysfunction. The sample consisted of 18 males and seven females (20 participants were aged 2 to 22 years, and five were aged 1, 19 and 23 months, and 55 years old). Participants were recruited after a nationwide call and were part of a multidisciplinary study of individuals with Möbius sequence. They were given a meticulous neuropsychiatric examination including standardized autism diagnostic interviews. Ten individuals had an autistic spectrum disorder. Six of these met all diagnostic criteria for autism. In 23 individuals cognitive development could be assessed. Eight of those 23 patients had clear learning disability and six individuals were functioning in the normal but subaverage range. Autistic spectrum disorder and learning disability occurred in more than a third of the examined patients. Considering the hospital-based nature of the sample, these findings may be overestimates. Nevertheless, awareness of this coexistence is important in the diagnosis and habilitation care of children with Möbius sequence. Moreover, the results provide further support for the notion of a subgroup of autistic spectrum disorders being caused by first trimester brain-stem damage.
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| 11. |
- Lange, Elvira, et al.
(författare)
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Physiological Adaptation in Women Presenting Fibromyalgia: Comparison with Healthy Controls
- 2017
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Ingår i: Clinical and Experimental Psychology. - : OMICS Publishing Group. - 2471-2701. ; 1:3
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare the heart rate variability (HRV) before and after a sub-maximal exercise test in women with fibromyalgia (FM) and to compare the result to matched controls. Additionally, to compare heart rate (HR) before, during and after the sub-maximal exercise test. Methods: Twenty-four women with FM and 26 controls performed a sub-maximal exercise test. HRV was registered for 5 minutes at rest before and after the exercise test. HR was registered at baseline, during the exercise test and at recovery. Results: The HRV of the healthy group was statistically different from the exercise test but the women with FM showed no such difference. HR was significantly higher among the women with FM than in the healthy group at baseline and up to 75W but lower at peak (138/152 bpm, p<0.008). In women with FM HR during exercise (HR2) was predicted by heart rate recovery (HRR20) and physical exertion (RPE2). HRR20 and RPE2 accounted for 0.465 of the variance (p=0.006) in HR2. In healthy women HR2 correlated with HRR20 and negatively with physical activity (PhA). In the reference group HRR20 and PhA accounted for 0.448 (p=0.002) of the variance HR. Conclusion:The HRV in women with FM show less adjustment of the ANS while not being significantly affected by submaximal exercise as healthy women. In healthy women heart rate during the test was negatively related to PhA. In women with FM exertion seems to replace an effect from exercise on physiological adaptation. FM may entail imperceptible extraction of power from PhA while under load. Links to FM pain will be discussed. Women with FM seem to rate exertion “Very hard” on lower workload and HR than healthy women. The physiotherapeutic methodology for measuring HRV with basic HR monitors should be improved before it can be recommended for clinical use.
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| 12. |
- Miller, Marilyn, T, et al.
(författare)
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The puzzle of autism: an ophthalmologic contribution.
- 1998
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Ingår i: Transactions of the American Ophthalmological Society. - 0065-9533. ; 96
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Tidskriftsartikel (refereegranskat)abstract
- A previous study of 86 thalidomide-affected subjects with ophthalmic manifestations revealed the unexpected finding of autism in 4 of the 5 severely retarded individuals. The subjects had anomalies associated with an early gestational effect of thalidomide, including facial nerve palsy and incomitant strabismus. Because autism has been observed in a few cases of Möbius sequence (Möbius syndrome), a condition characterized by involvement of the sixth and seventh cranial nerves, the similarity to early thalidomide embryopathy suggested a relation between cranial nerve involvement and autism. The present study was undertaken to further evaluate the association of autism with patients manifesting findings of Möbius syndrome.
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| 13. |
- Strömland, Kerstin, 1934, et al.
(författare)
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Mobius sequence--a Swedish multidiscipline study.
- 2002
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Ingår i: European Journal of Pediatric Neurology. - : Elsevier BV. - 1090-3798. ; 6:1, s. 35-45
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Tidskriftsartikel (refereegranskat)abstract
- Möbius sequence/syndrome is a rare disorder characterized by congenital palsy of the 6th and 7th cranial nerves. Other cranial nerves may be affected, skeletal and orofacial anomalies and mental retardation occur. The aims were to determine the frequency of associated clinical characteristics and to identify any pregnancy or environmental factors in patients with Möbius sequence. A prospective study of 25 Swedes with apparent involvement of the 6th and 7th cranial nerves was performed and 25 patients, 1 month to 55 years old, were examined. Obvious associated systemic anomalies observed included: limb malformations (10), Poland anomaly (2), hypodontia (7), microglossia (6), cleft palate (4), hearing impairment (5) and external ear malformation (1). Pronounced functional abnormalities were observed involving facial expression (16), speech (13), eating and swallowing (12) and difficulty in sucking in infancy (11). Six patients had an autistic syndrome, one an autistic-like condition, and mental retardation was found in all these patients. No common aetiological cause was found but their mothers' pregnancy histories revealed a history of benzodiazepines (1), bleeding during pregnancy (8), spontaneous abortion (7) and chorion villus sampling in the second month of pregnancy (1). In conclusion, many patients had multiple problems with eating and communication resulting from facial palsy, cleft palate and tongue anomalies. Autism and mental retardation was diagnosed in one-third of the patients. Awareness of the wide spectrum of manifestations in Möbius sequence will assist in identification of the associated malformations and functional problems that are often seen and result in better care of the children.
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| 14. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Blood pressure in women presenting fibromyalgia as a function of Pain and Avoidance disparities.
- 2017
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Ingår i: Journal of Psychology and Cognition. ; 2:3, s. 223-30
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the relationships between dimensions of PTSD and clinical everyday pain, physiological adaptation to a sub maximal test, i.e. moderate intensity exercise in terms of systolic blood pressure (SBPR) in women with fibromyalgia (FM), and to compare the result to a gender- and age-matched healthy control group. Materials and method: Twenty-two women presenting FM and twenty-six healthy women were education- and age-matched. All the women completed questionnaires regarding background, Impact of Event Scale-Revised (IES-R) and the short form health related quality of life instrument SF 36. All the women performed a stepwise load increment submaximal exercise test on a cycle ergometer to the severe perceived exertion level. Systolic blood pressure (SBPR) pressure was recorded before, during and after the test. Results: In comparison to healthy women, the women presenting FM showed higher IES-R values of intrusion, avoidance and hypertension and a tripled impact from clinical pain over 4 weeks. During recovery from the test, the successive decrease in SBPR was smaller in women presenting FM. In both groups the SBPR domain and IES-R domain presented intra correlation. In FM, a correlative link concerned avoidance and SBPR from baseline and through the test. In parallel, hypertension was correlatively linked to SBPR during recovery from the test. Clinical pain correlated with blunted SBPR responses through the test and also during recovery from the test. Conclusion: Both FM and PTSD are known to mirror suboptimal resources in dimensions such as avoidance, hyper-arousal and different ANS regulatory resources. This situation may be manifested by an interplay avoidance and hypertension and SBPR where in turn, both a vigorous a SBPR response and vigorous SBPR recovery after the test relates to less clinical pain. Further examinations regarding this blunted dynamic and clinical pain together may unfold the role of various agents on resting values and response versus recovery, respectively.
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| 15. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Career Crafting: Working during the Ages of 69-75 Years
- 2016
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Ingår i: Journal of Business and Economics. - 2155-7950. ; 7:8, s. 1334-1345
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to examine successful participation in working life in the ages of 69-75 years. A further aim was to elucidate socioeconomic and psychological processes surrounding successful participation. Focus groups were used to collect the data, and seven different focus groups met in four different towns in the western region of Sweden. Each group consisted of five to eight participants, and the groups met two to four times each to allow the participants to develop recollections and reflections on the topic. The interviews were transcribed verbatim and analyzed using inductive thematic analysis. It was found that from middle age onwards the participants transformed their working lives and created their ideal professional situations. This process took place in a context of embracing social support and large psychological resources. These findings suggest structural facilitation of career crafting in work life and working conditions that can reinforce psychological resources such as positive affect and continuous learning throughout one’s working life.
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| 16. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Exercise Induced Autonomic Disengagement and Pain in Women Presenting FM and Healthy Women: Analgesia and Blood Pressure
- 2017
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Ingår i: Clinical and Experimental Psychology. - : OMICS Publishing Group. - 2471-2701. ; 3:3
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the present analysis was to examine physiological adaptation to a sub-maximal test by measuring blood pressure (BPR) from the perspective of the fibromyalgia (FM) pain experience. Method: Twenty-four women presenting FM and twenty-six healthy women were education- and age-matched. In their homes, all women completed questionnaires regarding background and health related quality of life (SF-36). All the women performed a stepwise load increment submaximal exercise test on a cycle ergometer to the severe perceived exertion level. Blood pressure was recorded before, during and after the test. Result: Women presenting FM showed higher baseline resting systolic BPR (SBPR) and diastolic BPR (DBPR) with higher SBPR and DBPR during the recovery phase. In both groups SBPR and DBPR were correlated at base line. Women presenting FM contrasted to healthy women by BPR measures more frequently correlating during workload. In women with FM the correlative relationship between the SBPR and DBPR during recovery was pronouncedly higher. Clinical pain correlated four times more often with BPR measures in the FM study group as compared to the group of controls. In FM higher clinical pain was linked to lower BPR. Conclusion: In the context of the FM condition, the tests depict a physiologically perseverative pattern concerning SBPR and SBPR measurements. This pattern was pronounced during recovery. A higher level of clinical pain BP corresponded to lower SBPR and SBPR before and after the test confirming an inverse relationship between blood pressure and pain sensitivity in the condition of FM. Parallel, in FM the analgesic effect from BPR was insufficient due to lowered pain thresholds. Pain thresholds linked to dysregulated sympathetic and parasympathetic functions together with psychological functioning and higher levels of brain functioning need further examination.
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| 17. |
- Wentz, Kerstin, 1958
(författare)
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Fibromyalgia and self-regulatory patterns : development, maintenance or recovery in women
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims: The overall aim of this thesis was to elucidate psychological processes and development, maintenance or recovery related to fibromyalgia based on in depth interviews. In a next step women with fibromyalgia, women without long-lasting pain and women with long-lasting pain were compared using psychometric instruments selected or developed based on qualitative results. Methods: Twenty-one women with fibromyalgia and 8 women recovered were interviewed. Their narrations were analysed using Grounded Theory. Tentative theory was built. The I Myself Scale (IMS) was constructed to mirror self-regulation prior to onset of symptoms and complemented with an instrument on current self-regulation: Structural Analysis of Social Behaviour (SASB) and SF-36 mirroring health related quality of life, regarding the two pain groups. The groups were compared using analysis of variance, principal components analysis paired with discriminant analysis and profile analysis. Results: Analyses of the interviews resulted in core concepts of an “unprotected self” (current fibromyalgia) or a “strong but not enough to be weak” self (recovery). Data patterns indicated that the women as children were unprotected in relation to stimuli and affects. Relationships with the parents were characterised by strain and low levels of support. The recovery group had as children simultaneously been able to develop obvious competence and capability to receive help. Psychological vulnerability was in adult life compensated for through pronounced helpfulness and dissociation/repression including intense activity. An increase in mental load such as localised pain or psychosocial crisis preceded onset of fibromyalgia accompanied by impaired cognitive functioning. The state of fibromyalgia meant maintained high levels of mental load such as difficulties of the selfstructures, impaired cognitive functioning and somatic symptoms. The recovery group experienced substantial social support and often used mastering strategies to ease symptoms. A decrease in strain as improved life conditions and cease of overexertion preceded recovery. Health was thereafter maintained through careful management as seeking low levels of strain and pacing of activity. Recovery ‘on parole’ also meant personal growth and use of efficacious defences. Psychometrical testing confirmed qualitative data patterns of self-regulation connected to fibromyalgia. Impaired selfreference/ understanding of health needs and others not being asked for help and advice was reported before onset of symptoms. Dissociation or repression including intense activity and self-loading were also employed. SASB and SF-36 indicated that women with fibromyalgia experienced higher levels of mental “load” than the other pain group. Conclusion: Qualitative data indicated that life prior to onset of fibromyalgia and current fibromyalgia held qualities of impaired self-regulation in relation to mental and physical load. The state of recovery relied on improved self-regulation allowed by conditions of life. Quantitative data patterns confirmed qualitative results on impaired self-protection before onset of fibromyalgia and a specifically high level of mental load during the state of fibromyalgia. Psychological disregulation is discussed and hypothesised to cause but also later in the process parallel alterations in somatic homeostatic functions. Recovery could mean that biological regulation regarding strain is replaced with more of “psycho-social” regulation as careful pacing of work. Implications for treatment are suggested.
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| 18. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Fibromyalgia as a Variant of High-performing PTSD: Negative affect, Emotional integrity counter play and functional impairment.
- 2017
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Ingår i: Journal of Neuropsychology & Stress Management. ; 2, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the present analysis was to examine psychological functioning and functional impairment in fibromyalgia (FM) based on three dimensions of post traumatic stress disorder (PTSD), positive and negative affect adjective scales (PANAS), Health related quality of life (SF-36) scales concerning pain, vitality and impairment from emotional and physical and causes together with the Work Ability Index (WAI) and to compare the results to healthy women. Materials and method: Twenty-two women presenting FM and twenty-six healthy women were education-and age-matched. All the women completed questionnaires regarding background, Impact of Event Scale-Revised (IES-R) and health related quality of life (SF-36), Negative and Positive Affect Scale (PANAS) and the single item Work ability index (WAI). Result: In comparison to healthy women, women presenting FM showed higher IES-R values of intrusion, avoidance and hypertension and lower values regarding PA and higher values regarding NA. Role emotional (RE), role physical (RP) and vitality (VT) showed lower values respectively and bodily pain (BP) showed more pain during 4 weeks in women presenting FM and WAI showed a higher value in healthy women (all these p values p ≤ 0.001). Intrusion, avoidance and hypertension correlated but were inversely related to health relates quality of life in terms of RE in FM. Only intrusion and hypertension were associated with NA while avoidance showed a positive association to WAI in FM where also the PA and the NA values were correlated unlike in healthy women. BP was related to VT but unrelated to all other measurements in FM. Conclusion: The absence of links between BP and the other measurements may imply a somewhat non psychological nature of clinical FM pain. Lower PA values and higher NA values added by high levels of PTSD like symptomatology induces severe psychological strain in FM. Avoidance relates positively to WAI but negatively to RE which suggests a pattern of alarming emergency functioning. The result and other research on relentless activity in FM may term FM a variant of high performance PTSD. An investment in areas of psychological resources that need to be filled in in FM may open up for a more resourceful physiological regulation of pain and global self-regulation of e.g. RE, RP.
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| 19. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Need for recovery in relation to effort from work and health in four occupations
- 2020
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246.
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Tidskriftsartikel (refereegranskat)abstract
- Objective To examine three levels of need for recovery (NFR) after work in relation to effort from work demands, demand compensatory strategies, effort-moderating or -reversing resources, and health including health behaviors. A further purpose was to examine occupational characteristics determining NFR. Methods 5000 engineers, carpenters, nurses, and home care nurses were invited to participate. NFR k-means clusters were calculated from 1289 participants. The effect from three levels of NFR regarding demands, compensatory strategies, resources at work, health, and health behaviors was examined using analysis of variance (ANOVA) and post hoc analysis. Prevalence ratios (PRs) of suboptimal health for three levels of NFR were calculated using Poisson regression. Linear stepwise multiple regression predictors explaining NFR were examined also occupation wise. Results NFR centroids at 5.8/33, 13.1/33, and 21.0/33 points were identified. ANOVA showed corresponding effects from NFR levels on work demands and compensatory strategies. The inversed proportion concerned levels of resources at work. Only the low NFR cluster negated regular health effects. The other two cluster groups also repeatedly worked while ill and presented PRs concerning health effects from 1.9 to 3.9 when compared to the low NFR group. Making good quality work, recovery opportunities, and thinking of work when off work were the most important predictors of NFR among 1289 participants with also occupation-wise interpretable profiles. Conclusions Three levels of NFR meant corresponding levels of work demands, work-demand compensatory strategies, and unfavorable health behaviors. An inversed proportion of resources related to the same levels of NFR. Low NFR meant no regular health effects which could guide limit values regarding salutary NFR. Important predictors of NFR were resources making a good quality work, recovery opportunities, and reversely effort from rumination when off work. Occupation-wise predictors could guide interventions.
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| 20. |
- Wentz, Kerstin, 1958, et al.
(författare)
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On parole : The natural history of recovery from fibromyalgia in women: A grounded theory study
- 2012
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Ingår i: Journal of Pain Management. - Hauppauge, NY : Nova Science Publishers, Inc.. - 1939-5914. ; 5:2, s. 177-194
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Tidskriftsartikel (refereegranskat)abstract
- Full remission of fibromyalgia symptoms is unusual and this course is unknown. The aim of this study was to elucidate psychological functioning and psychosocial processes expressed by women originally diagnosed with fibromyalgia and presently recovered. Eight women, earlier diagnosed with fibromyalgia but presently subjectively and objectively recovered, were interviewed in-depth. The interviews were analysed in line with Grounded Theory. Result: The women were as children exposed to high levels of mental load. Adult psychological functioning, prior to the onset of fibromyalgia, was characterised by insufficient definition of self and dissociation; psychological strengths were used to cover up or desert psychological ’weaknesses’ as negative effects. Later in process an increase in mental load was accompanied by development of fibromyalgia symptoms. The phase of fibromyalgia held three dimensions; a maintained high level of load, mastering strategies as seeking alternative treatment and use of support from others. The stage of recovery or remission was reached proceeded by a pronounced decrease in mental load as improved life conditions or cease of overexertion of body and mind. The stage of conditional recovery was mirrored by the core concept ’on parole -strengthened enough to be weak’. At this stage of process, absence of symptoms was secured by personal growth and less dissociative functioning including careful management of health needs as pacing of activity. Conclusions: Recovery from fibromyalgia seems to be a recovery on parole. Recovery appears to rely on improved self-regulation including less dissociative psychological functioning and ways of living allowed by prosperous conditions of life. © Nova Science Publishers, Inc.
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| 21. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Pain and physiological adaptation in women presenting fibromyalgia
- 2016
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Ingår i: Journal of Pain Management and Therapy. ; 1:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the present analysis was to examine physiological adaptation to a sub-maximal test by measuring heart rate (HR) and heart rate variability (HRV) from the perspective of the fibromyalgia (FM) pain experience. Method: Twenty-five women presenting FM and healthy women were education- and age-matched. In their homes, all women completed questionnaires regarding health related quality of life and physical activity. All the women performed a stepwise load increment submaximal exercise test on a cycle ergometer to the severe perceived exertion level. HR and HRV were recorded before, during and after the test. Current pain was recorded before and after the test upon the FM women. Result: Correlational analysis over all the pain ratings and adaptation measures of HR and HRV showed that higher HR on two or three levels of workload were linked to greater clinical pain in women presenting FM. Pain at baseline related to clinical everyday pain. Both these pain measures correlated with the intersection between HR and workload and pain after the test. Reactivity through increase in pain from the test did not relate to everyday pain or baseline pain. Pain reactivity instead related to more adaptive HRV from the test, similar to the HRV adaptation of healthy women. In FM, the pain measures were neither related to HR at baseline, maximal workload during the test nor to physical exertion during the test. Conclusion: FM implies everyday clinical pain that is related to the intersection between HR and workload. In contrast to clinical pain, pain reactivity from the test related to a more physiologically adaptive pattern in terms of HRV. Clinical pain and pain reactivity seem to mobilize separate physiological processes via separate mechanisms.
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| 22. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Psychological functioning in women with fibromyalgia: a grounded theory study.
- 2004
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Ingår i: Health care for women international. - : Informa UK Limited. - 0739-9332 .- 1096-4665. ; 25:8, s. 702-29
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to elucidate psychological functioning and psychological processes in women with fibromyalgia. Twenty-one females with fibromyalgia (aged 26-72 years) were interviewed in-depth. The interviews were analysed in line with grounded theory. A core concept, "unprotected self," mirroring childhood conditions and adult psychological functioning, was identified. Intense activity or hypomanic helpfulness often was used as self-regulation in adult life. Later an increased exposure to mental load is accompanied by reduction of cognitive functioning and generalised pain. The phase of persistence of fibromyalgia is marked by reduction of cognitive functions, unprotected psychological functioning, and increased mental load as from crisis and somatic symptoms.
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| 23. |
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| 24. |
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| 25. |
- Wentz, Kerstin, 1958
(författare)
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Symptom fluctuation in fibromyalgia. Environmental, psychological and psychobiological influences.
- 2013
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Fibromyalgia is a syndrome of widespread pain characterized by symptom fluctuations. Analysing these is a basis for learning the nature of the syndrome itself. The book covers development, quantitative patterns, psychobiology, life with fibromyalgia, biomarkers, gaps in pain, environmental factors, affect and defense measures related to mental load and influences on recovery. A focus is on dissociation and environmental influences on maintenance.
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| 26. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Women Developing and Maintaining Fibromyalgia: Qualitatively and Quantitatively Appearing Dissociative and Self-Loading Psychological Patterns
- 2008
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Ingår i: In F. Hu (Ed). Pain Research Progress:Migraine, Fibromyalgia and related pain. - New York : Nova Publishers. ; , s. 71-111
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Aims: The overall aim of this study was to describe psychological functioning in women developing and maintaining fibromyalgia. A further aim was to test if women with fibromyalgia and women with organically explained long-lasting pain differed on selected psychometrical instruments. In this study creation, selection and use of inventories were based on theoretical formulations from in depth interviews with 21 women diagnosed with fibromyalgia. These formulations included difficulties handling affects and stimulation in adult life before onset of fibromyalgia. Psychological vulnerability was compensated for through pronounced helpfulness and dissociation/repression including intense activity. The state of fibromyalgia meant continued high levels of mental load such as difficulties due to the self-structure, impaired cognitive functioning and somatic symptoms. Methods: From previously naturalistically generated theory the I Myself Scale (IMS) was constructed to mirror self-regulation in adult life prior to onset of fibromyalgia symptoms. The IMS was complemented with an instrument on current self-regulation: Structural Analysis of Social Behaviour (SASB). The result of the psychometrical testing was elucidated by a determination of sample characteristics regarding physical functioning, bodily pain and other dimensions of health related quality of life. A standardized instrument, SF-36 was employed. The groups were compared using analysis of variance, principal components analysis paired with discriminant analysis and profile analysis. Results: Psychometrical testing confirmed qualitative data patterns of self-regulation connected to development and maintenance of fibromyalgia. Prior to onset of symptoms women with fibromyalgia showed contrasting self-regulatory measures as a pattern of impaired self-reference/understanding of health needs. Strategies of dissociation or repression including intense activity and self-loading were used to avoid mental pain. Others were urgent objects of help and assistance but were not asked for help and advice. SF-36 indicated that the two groups experienced similar quality of life in the physical dimension but less psychological well being on behalf of the fibromyalgia group. The result from SASB showed that women with fibromyalgia experienced a higher level of mental “load” than the other pain group. Conclusion: Qualitative data indicated that life prior to onset of fibromyalgia and current fibromyalgia held qualities of impaired self-regulation in relation to mental load. Quantitative data patterns confirmed qualitative results on impaired self-protection before onset of fibromyalgia and a specifically high level of mental load during the state of fibromyalgia. Based on the result, relationships between self-regulation, development and maintenance of mental overload and generalized pain are discussed. Aspects of psychological and psychosomatic disregulation are discussed and hypothesized to cause but also later in the process to parallel alterations in somatic homeostatic functions. Consequences for treatment are suggested.
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| 27. |
- Wentz, Kerstin, 1958
(författare)
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Women With Fibromyalgia: Distress Avoidance Interferes with Gaps in Pain
- 2012
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Ingår i: Journal of Pain Management. - 1939-5914. ; 5:3, s. 245-259
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Tidskriftsartikel (refereegranskat)abstract
- The aetiology and the mechanisms involved in fibromyalgia pain are insufficiently understood. Pain intensity varies with stress. The pain itself is continuous during waking hours for the majority affected. For one in three the pain is interrupted by breaks. The lengths of these pain-gaps vary substantially. Aim: The study aim was to explore initiation, maintenance and termination of these breaks. Method: Twenty-four women with fibromyalgia pain-gaps were interviewed in depth. The interviews were analysed inductively using Grounded Theory. Result: A dominating quality of dissociation keeping distress out of sight meant that psychological vulnerability was dealt with through habitual use of avoidance including incoherence, overemphasis on positive affect and an over-active/health jeopardizing approach. A state of permanent crisis and not accepting fibromyalgia was identified. The disease was unmapped and unmanaged. Unplanned gaps in pain ‘happened’ during happiness/absence from stress, physical conditions of warmth or paced exercise or absorption during joyous events. The pain-gaps were lost during reversed conditions as intense activity or emotional stress. A subgroup of informants had ceased to dissociate. The disease became recognized/managed. Pain-gaps were planned, promoted, preserved and lengthened. Discussion: Careful crisis intervention in treatment of fibromyalgia seems to be an important measure. Automatic forms of dissociation could thereby pass. Regarding aetiology and mechanism in fibromyalgia pain the effect of efforts at dissociating unwanted mental content needs to be investigated further. Suppression and recoil relapse that creates permanent suppression and relapse engendering chronic stress might exert an explanatory power regarding both the development and maintenance of fibromyalgia. Keywords: Fibromyalgia dissociation crisis acceptance rehabilitation aetiology
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| 28. |
- Wentz, Kerstin, 1958, et al.
(författare)
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Work Load and Heart Rate in Fibromyalgia: The Hub within “Pain Gaps” and Clinical Pain.
- 2017
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Ingår i: Journal of Chronic Diseases and Management. - 2573-1300. ; 2:1
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Tidskriftsartikel (refereegranskat)abstract
- Unlike recovery from fibromyalgia (FM), the phenomenon of short or long lasting pain free episodes or ‘gaps’ in FM pain occurs in one third of the patients. Parallel the characteristics of physiological adaptation to workload of this sub-group of patients with FM remain unknown. A physiological adaptation examination that included a stepwise load increment submaximal exercise test concerned women presenting FM with chronic pain, women presenting FM with gaps in pain and healthy volunteers. Measurements from the test were compared using a between-groups analysis of variance showing that gaps in clinical pain were contingent upon heart rate (HR) at different levels of workload. Women with gaps in FM pain were older than women with FM without pain free episodes. Gaps in FM pain are discussed from the perspective of
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