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- Andersson, H. Ingemar, 1950-, et al.
(author)
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Characteristics of subjects with chronic pain, in relation to local and widespread pain report : a prospective study of symptoms, clinical findings and blood tests in subgroups of a geographically defined population
- 1996
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In: Scandinavian Journal of Rheumatology. - 0300-9742 .- 1502-7732. ; 25:3, s. 146-154
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Journal article (peer-reviewed)abstract
- The relation between reported chronic pain and clinical findings was studied by comparing survey data six months before and eighteen months after a clinical examination. Studied individuals (n = 165) were randomly selected from subsamples of an initial survey (n = 1806) to a general population. Among individuals reporting chronic pain 85% were assessed to have chronic pain at the examination. Diagnoses were found in 22% of examined pain individuals. Myofascial pain syndrome and myalgia were the most common findings. Compared with located neck-shoulder pain, widespread pain had a greater impact on the individual, a worse prognosis regarding pain duration and working capacity, and revealed a raised serum urate level of unclear significance. Although no specific cause of pain is found in individuals with widespread pain it is important to identify and treat this group due to the great effects on functional capacity and the worse prognosis.
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- Andersson, H. Ingemar, 1950-
(author)
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Chronic pain : epidemiological studies in a general population
- 1998
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Doctoral thesis (other academic/artistic)abstract
- The aim was to study the epidemiology of chronic pain (> 3 months duration) and factors associated to pain prevalence, prognosis, health care and medication in a general population. A cross-sectional mailed survey to a random population sample (n = 1806) was followed by a clinical examination and a prospective study of three selected groups. Pain related diagnoses from primary health care was monitored and compared with pain prevalence. The most important findings were: - a high total prevalence of chronic pain, 55.2%, without gender difference but varying by age and socioeconomic level. About one fourth (12.8%) reported high pain intensity and functional impairments. Women experienced pain at more locations and with higher intensity. - in a multivariate analysis increasing age, female gender, low education, high work strain, depression and insomnia were associated with chronic pain. - widespread pain showed a worse 2- year prognosis compared with neck shoulder pain. - musculoskeletal location of pain dominated, myalgia and myofascial pain being the most common symptom descriptions. - co-morbidity with chronic pain was common. More hypertensives and an increased level of serum uric acid associated to widepread pain indicated possible metabolic connections to pain. - smoking (current and previous) was associated with low-back and widespread pain. - chronic pain had a substantial influence of primary health care-seeking and medication; high pain intensity being the most important predictor of care and medication. - pain related diagnoses in primary health care increased between 1987 and 1996. Chronic pain, mainly with musculoskeletal location, is a community health problem. A multi-factorial approach in prevention and treatment on the basis of present knowledge is necessary.
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3. |
- Andersson, H. Ingemar, 1950-, et al.
(author)
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Widespread musculoskeletal chronic pain associated with smoking : an epidemiological study in a general rural population
- 1998
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In: Scandinavian Journal of Rehabilitation Medicine. - 0036-5505 .- 1940-2228. ; 30:3, s. 185-191
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Journal article (peer-reviewed)abstract
- Data on smoking and pain symptoms from a random sample (n = 1806) of a general population were used to evaluate the association between chronic pain at various locations and smoking. In both genders current smoking was associated with reports of increased pain in low back, neck and with multiple locations. In a multiple logistic regression analysis current smoking was associated with an increase in widespread chronic musculoskeletal pain (OR 1.60, CI 1.04-2.46, in relation to non-smokers) and chronic low back pain (OR 1.58, CI 1.13-2.20, in relation to non-smokers). A dose-response relationship was found between the daily cigarette consumption and the prevalence of chronic low back pain. Smoking is associated not only with low back pain but also with chronic widespread musculoskeletal pain. No conclusive decrease in pain prevalence was found after quitting smoking. Further studies are necessary to elucidate an aetiologic relationship between smoking and chronic pain.
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4. |
- Edén, Lena, et al.
(author)
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Quality of life among early retirees
- 1999
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In: Experimental Aging Research, 25(4). ; , s. 471-475
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Conference paper (peer-reviewed)abstract
- Explanatory variables concerning poor quality of life (QL) were established among disability pensioners with musculoskeletal disorders and a control group. In both groups health status, leisure time activities, and social network were important for QL. Among the retirees immigration, employment before retirement and a negative attitude to the disability pension were related to poor QL.
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6. |
- Berg, Agneta, 1950-, et al.
(author)
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Effects from systematic clinical supervision on psychiatric nurses' sense of coherence, creativity, work related strain and job satisfaction : a pre-post design
- 1999
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In: Journal of Psychiatric and Mental Health Nursing. - 1351-0126 .- 1365-2850. ; 6:5, s. 371-381
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Journal article (peer-reviewed)abstract
- There are few investigations of the type and the outcome of interventions aimed at supporting nurses caring for psychiatric patients. Therefore a prepost–test design study was used in which 22 psychiatric nurses, on a general psychiatric ward were examined before, during and after one year of systematic clinical supervision combined with supervised documented, planned, individualized care. The methods used were the Sense of Coherence scale (SOC), the Creative Climate Questionnaire (CCQ), the Work-Related Strain Inventory and 34 statements from the Satisfaction with Nursing Care and Work Questionnaire (SNCW). In addition 14 statements were developed to evaluate the nurses' view of the effects from clinical supervision. The baseline values for the CCQ indicated a stagnant organization and a high score in the conflict dimension indicated personal and emotional tensions within the organization. The intervention led to a significantly increased creative and innovative climate in the dimensions for trust, idea time and reduced conflicts. However, the organizational climate remained stagnant. The nurses' view of the effects from clinical supervision also increased significantly. There were no significant changes in the nurses' SNCW, WRSI or SOC score. The result of the correlation analysis indicated that a strong sense of coherence was related to low work-related strain but not to unsatisfactory working conditions/milieu. The results gave some support to the idea that systematic clinical supervision and supervised nursing care plans constitute one type of support strategy that improves creativity and the organizational climate. It may, not, however, buffer for interpersonal problems. Further research is required to explore the need for and effects of various support systems depending on the circumstances in the organization.
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7. |
- Berg, Agneta, 1950-, et al.
(author)
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Nurses' reflections about dementia care, the patients, the care and themselves in their daily caregiving
- 1998
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In: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 35:5, s. 271-282
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Journal article (peer-reviewed)abstract
- In this study the aim was, through interviews, to disclose 13 nurses personal knowledge about the patients, themselves, and care provision, using a phenomenological-hermeneutic analysing method. Caring for people with severe dementia meant an intertwined life world emanating from making and doing together and the delicate interpretative work that the care provision required. The intertwined life world consisted of the interaction between the nurses and the patients separate lives, their common life and the environment, culminating in mutual dependency. Making together signifies the relationship being based on the nurses knowledge and skills as nurses i.e. the task they had to perform. Doing together signifies the relationship being based on the oneness of the nurses and the patients with severe dementia as ordinary human beings. The delicate interpretation process required, to adapt care to the individual patient, was based on knowledge about the patients personality, life history and disease progression in combination with the nurses interpretation of the current situation. The nurses searched for meaning and that, in turn, meant that the patients inner world was determined by the nurses and thus the patient was seen as being in their hands. It seems important to further understand the human aspects of both the nurse and the patient and to examine this dynamic, ongoing, vulnerable interpretation process, critically, in order to achieve high quality nursing care for the patients with severe dementia, and an experience of well-being in nurses everyday working lives.
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8. |
- Björklund, Margereth, 1950-, et al.
(author)
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Cancer patients' experiences of nurses' behaviour and health promotion activities : a critical incident analysis
- 1999
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In: European Journal of Cancer Care. - Oxford : Blackwell Publishing. - 0961-5423 .- 1365-2354. ; 8:4, s. 204-212
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Journal article (peer-reviewed)abstract
- Patients with head and neck cancer report several disease- and health-related problems before, during and a long time after completed treatment. Nurses have an important role in educating/supporting these patients about/through the disease and treatment so that they can attain well-being. This study describes the cancer patients' experiences of nurses' behaviour in terms of critical incidents after nurses had given them care to promote health. The study had a qualitative, descriptive design and the method used was the critical incident technique. Twenty-one informants from the Nordic countries diagnosed with head and neck cancer were strategically selected. It was explained to the informants what a critical incident implies before the interviews took place; this was defined as a major event of great importance, an incident, which the informants still remember, due to its great importance for the outcome of their health and well-being. The nurses' behaviour was examined, and critical incidents were involved in 208 cases-150 positive and 58 negative ones-the number of incidents varying between three and 20 per informant. The nurses' health promotion activities or lack of such activities based on the patients' disease, treatment and symptoms, consisted of informing and instructing the patients as well as enabling their participation. Personal consideration and the nurses' cognisance, knowledge, competence, solicitude, demeanour and statements of understanding were found to be important. Continuous health promotion nursing interventions were of considerable value for the majority of this group of cancer patients. Oncology nurses could reconfirm and update the care of head and neck cancer patients by including health promotion activities in individual care plans. By more frequent use of health promotion models, such as the empowerment model, the nurses could identify and focus on those individuals who needed to alter their life-style as well as tailor their approach towards these patient by setting goals for well-being and a healthy life-style.
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9. |
- Blomqvist, Kerstin, 1953-, et al.
(author)
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Pain in older adults living in sheltered accommodation : agreement between assessments by older adults and staff
- 1999
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In: Journal of Clinical Nursing. - 0962-1067 .- 1365-2702. ; 8:2, s. 159-169
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Journal article (peer-reviewed)abstract
- This study aimed to investigate the presence of pain, pain duration, localization(s), intensity, type and pharmacological treatment among older adults living in sheltered accommodation or receiving rehabilitation, as well as the agreement between pain assessments performed by staff and the older adults. Twenty-nine randomly selected older adults (65+ years) and the staff who looked after them participated in a structured interview based on standardized measures for pain assessment and physical, intellectual and communicative functions. Pain was found to be common, with a majority of participants experiencing it every day or all of the time. Nine out of 22 of the older adults in pain had no pain relief drugs at all. Agreement between assessments by the older adults and the staff was no higher than moderate and in general pain levels were underestimated. The findings indicate that older adults were at risk of undetected and untreated pain and the risk was even higher for those with speech difficulties. The provision of good nursing care for older adults in sheltered accommodation requires systematic routines for frequent pain assessments.
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10. |
- Jakobsson, Liselotte, 1953-, et al.
(author)
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Experiences of daily life and life quality in men with prostate cancer : an explorative study. Part I
- 1997
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In: European Journal of Cancer Care. - 0961-5423 .- 1365-2354. ; 6:2, s. 108-116
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Journal article (peer-reviewed)abstract
- Eleven men with prostate cancer were randomly chosen and interviewed during an in-patient period at a southern Swedish hospital. The interview focused on functional health status in relation to daily life and life quality. In addition the sense of coherence scale was used, as well as the European Organization or Research and Treatment of Cancer (EORTC) QLQ C-30 questionnaire. The interview findings were analysed from a phenomenological-hermeneutic perspective and interpreted within the concept of transition. The entry to transition was marked by the men when experiencing an altered life continuum in terms of physical and existential fatigue, pain, micturition problems and an altered sex life. The passage phase was marked by descriptions of a new lifestyle where hope was a central internal resource, creating a positive illusion of life in order to endure. Their external resources were wives and family who supported physically (household matters, gardening) and psychologically (comfort, encouragement). The exit phase meant continuously adapting to a new life style, living with a slowly deteriorating functional health status, a new sense of dependency on others, daily life routine broken by in-patient hospital periods and contacts with primary health care. Thus the findings pointed more at continously facing new passages than a stable exit, i.e. an ongoing transition. The areas of life imbalance described may serve as a basis for care assessment and intervention as well as supplying support of the transitional process.
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