| 26. |
- Haglund, Emma, 1970-, et al.
(author)
-
Dynamic joint stability measured as gait symmetry in people with symptomatic knee osteoarthritis
- 2019
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In: Annals of the Rheumatic Diseases. - London, UK : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 78:Suppl. 2, s. -1458
-
Journal article (peer-reviewed)abstract
- Background: Modern strategies for knee osteoarthritis (OA) treatment and prevention includes early detection and analyses about pain, gait and lower extremity muscle function including both strength and stability. The very first sign of knee OA is pain or perceived knee instability, often experienced during weight bearing activities e.g. walking. Increased muscle strength will provide dynamic joint stability, reduce pain, and disability. Specific measures of gait symmetry (GS) can be assessed objectively by using accelerometers, which potentially is a feasible method when evaluating early symptoms of symptomatic knee OA.Objectives: The aim was to study if symptoms of early knee pain affected gait symmetry, and the association between lower extremity muscles function and gait symmetry in patients with symptomatic knee OA.Methods: Thirty-five participants (mean age 52 SD 9 years, 66% women) with uni- or bilateral symptomatic knee OA, and without signs of an inflammatory rheumatic disease or knee trauma were included. Pain was assessed by a numeric rating scale (NRS, range 0-10 best to worse), tests of lower extremity muscle function with the maximum number of one leg rises. Dynamic stability was measured as GS by using wearable inertial sensors (PXNordic senseneering platform), during the 6 min walking test to obtain spatio-temporal gait parameters. GS was computed based on stride time (temporal symmetry, TS) and stride length (spatial symmetry, SS). Stride length was normalized by height. Kruskal-Wallis and Spearman’s correlation coefficient were used for analyses.Results: Reports of knee pain did not differ between gender (women 4.7, SD 2.4 vs. men 3.9, SD 2.4, p= 0.362), neither did one leg rises or gait symmetry. Participants who reported unilateral knee pain (left/right side n=9/13), had a shorter stride length on the painful side. The mean difference in stride length was 0.7% of the subject’s height (SD 1.3). Participants with unilateral pain also presented less SS gait than those who reported bilateral pain (p=0.005). The higher number of one-leg rises performed, the better TS was observed. We found a significant relationship between TS and one-leg rise for the right r s =-0.39, p=0.006, and left r s =-0.40, p=0.004 left side). No significant relationship was observed between SS and one-leg rises.Conclusion: Our results is in line with earlier findings stating that knee pain affects GS negatively and that lower extremity muscle function is an important feature for symmetry and dynamic joint stability in patients with symptomatic knee OA. We also found that pain in one leg was related to impaired GS. Bilateral knee pain was however more symmetrical and will need healthy controls for comparison to better understand the negative impact of symptomatic knee OA.
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| 27. |
- Harris, Ulrika, et al.
(author)
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Parents’ Experiences of Direct and Indirect Implications of Sleep Quality on the Health of Children with ADHD : A Qualitative Study
- 2022
-
In: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 19:22
-
Journal article (peer-reviewed)abstract
- Sleep problems represent a significant challenge for children with ADHD. However, lack of knowledge about how sleep affects children with ADHD in terms of their health and everyday life prevents the development and implementation of interventions to promote sleep. The aim of this study was to explore parents’ experiences of direct and indirect implications of sleep quality onthe health of children with ADHD. The study used an abductive qualitative design, with Tengland’s two-dimensional theory of health as a deductive analysis framework. Semi-structured interviews were conducted with 21 parents of children aged 6–13 with ADHD and sleep problems. The parents experienced that sleep influenced their children’s abilities to control emotional behaviour relatedto ADHD and to manage everyday life. Sleep also had an impact on the children’s well-being,in relation to both vitality and self-esteem. In conclusion, the results show important direct and indirect implications of sleep quality on the health of children with ADHD. This implies a need forgreater focus on sleep, to target both abilities and well-being in promoting health among childrenwith ADHD. © 2022 by the authors
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| 28. |
- Hettiarachchi, Pasan, et al.
(author)
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Validity of a Non-Proprietary Algorithm for Identifying Lying Down Using Raw Data from Thigh-Worn Triaxial Accelerometers
- 2021
-
In: Sensors. - Basel : MDPI. - 1424-8220. ; 21:3
-
Journal article (peer-reviewed)abstract
- Body postural allocation during daily life is important for health, and can be assessed with thigh-worn accelerometers. An algorithm based on sedentary bouts from the proprietary ActivePAL software can detect lying down from a single thigh-worn accelerometer using rotations of the thigh. However, it is not usable across brands of accelerometers. This algorithm has the potential to be refined. Aim: To refine and assess the validity of an algorithm to detect lying down from raw data of thigh-worn accelerometers. Axivity-AX3 accelerometers were placed on the thigh and upper back (reference) on adults in a development dataset (n = 50) and a validation dataset (n = 47) for 7 days. Sedentary time from the open Acti4-algorithm was used as input to the algorithm. In addition to the thigh-rotation criterion in the existing algorithm, two criteria based on standard deviation of acceleration and a time duration criterion of sedentary bouts were added. The mean difference (95% agreement-limits) between the total identified lying time/day, between the refined algorithm and the reference was +2.9 (-135,141) min in the development dataset and +6.5 (-145,159) min in the validation dataset. The refined algorithm can be used to estimate lying time in studies using different accelerometer brands. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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| 29. |
- Karltun, Johan, 1954-, et al.
(author)
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Deboners’ stress in alternatively organized work
- 2011
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In: Human Factors in Organisational Design and Management - X. - Grahamstown, South Africa : Rhodes University.
-
Conference paper (peer-reviewed)abstract
- The high reported rates of work related musculoskeletal disorders (WMSD)and accidents among butchers and deboners in Sweden have resulted in several initiativesto reduce these. In this study, eight deboners working every second week at a pace lineand every second week at single tables, were examined concerning physical work load(heart rate) and feelings of stress and energy (stress-energy formula and interviews). Ther esults show that the physical work load was highest at single tables but that feelings of stress and musculoskeletal strain were highest at the pace line. The reasons for this are discussed.
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| 30. |
- Larsson, Ingrid, 1968-, et al.
(author)
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Parents’ Experiences of Weighted Blankets’ Impact on Children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Sleep Problems—A Qualitative Study
- 2021
-
In: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 18:24
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Journal article (peer-reviewed)abstract
- Sleep disturbances are common among children with attention-deficit/hyperactivity disorder (ADHD). While pharmacological treatment has increased dramatically, parents often prefer non-pharmacological interventions. Research on experiences of weighted blankets and their effect in sleep improvement is scarce. The aim of this study was to explore parents’ experiences of weighted blankets for children with ADHD and sleep problems, and the impact on their children’s sleep. The explorative design was based on qualitative content analysis. Interviews were conducted with a purposeful sample of 24 parents of children with ADHD and sleep problems, after completing a sleep intervention with weighted blankets for 16 weeks. Parents reported that children sleeping with weighted blankets: (1) achieved satisfactory sleep, including improved sleep onset latency, sleep continuity, and sleep routines; (2) achieved overall well-being, including improved relaxation and reduced anxiety; and (3) mastered everyday life, including improved balance in life, family function, and participation in school and leisure activities. This study brings forward novel aspects of the effects of improved sleep among children with ADHD. The findings contribute to the understanding of potential positive effects of an intervention with weighted blankets critical for clinical practice to improve sleep, well-being, and everyday life of children with ADHD and their families. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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| 31. |
- Larsson, Ingrid, 1968-, et al.
(author)
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SLEEP : intervention with weighted blankets for children with attention deficit hyperactivity disorder (ADHD) and sleep problems
- 2022
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In: BMJ Open. - London : BMJ Publishing Group Ltd. - 2044-6055. ; 12:1
-
Journal article (peer-reviewed)abstract
- INTRODUCTION AND OBJECTIVES: Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of sleep problems. Weighted blankets are one possible non-pharmacological intervention for these problems in this group of children. However, the effectiveness of weighted blankets is insufficiently investigated. This study aims to investigate the effectiveness of weighted blankets in terms of sleep, health-related outcomes and cost-effectiveness as well as to explore children's and parents' experiences of a sleep intervention with weighted blankets.METHODS AND ANALYSIS: This study is a randomised placebo-controlled crossover trial comparing the effect of weighted fibre blankets (active) with fibre blankets without weight (control). Children aged 6-13 years, recently diagnosed with uncomplicated ADHD with verified sleep problems, were included in the study. The study period is 4 weeks for each condition, respectively, and then an 8-week follow-up. A total of 100 children diagnosed with ADHD and sleep problems will enter the study. The primary outcomes are sleep and cost per quality-adjusted life years. The secondary outcomes are health-related quality of life, ADHD symptoms, psychological distress and anxiety. Interviews with a subsample of the participating children and parents will be conducted for exploring the experiences of the intervention.ETHICS AND DISSEMINATION: Ethical approval of the trial has been obtained from the Swedish Ethical Review Authority (number 2019--2158) and conforms to the principles outlined in the Declaration of Helsinki (WMA, 2013). Results will be reported as presentations at peer-review conferences, in articles in peer-review journals and meetings with healthcare providers.TRIAL REGISTRATION NUMBER: NCT04180189. © Author(s) (or their employer(s)) 2022.
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| 32. |
- Larsson, Ingrid, et al.
(author)
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SLEEP : Intervention with weighted blankets for children with attention deficit hyperactivity disorder (ADHD) and sleep problems: Study protocol for a randomised control trial
- 2022
-
In: BMJ Open. - : BMJ. - 2044-6055. ; 12:1
-
Journal article (peer-reviewed)abstract
- Introduction and objectives Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of sleep problems. Weighted blankets are one possible non-pharmacological intervention for these problems in this group of children. However, the effectiveness of weighted blankets is insufficiently investigated. This study aims to investigate the effectiveness of weighted blankets in terms of sleep, health-related outcomes and cost-effectiveness as well as to explore children's and parents' experiences of a sleep intervention with weighted blankets. Methods and analysis This study is a randomised placebo-controlled crossover trial comparing the effect of weighted fibre blankets (active) with fibre blankets without weight (control). Children aged 6-13 years, recently diagnosed with uncomplicated ADHD with verified sleep problems, were included in the study. The study period is 4 weeks for each condition, respectively, and then an 8-week follow-up. A total of 100 children diagnosed with ADHD and sleep problems will enter the study. The primary outcomes are sleep and cost per quality-adjusted life years. The secondary outcomes are health-related quality of life, ADHD symptoms, psychological distress and anxiety. Interviews with a subsample of the participating children and parents will be conducted for exploring the experiences of the intervention. Ethics and dissemination Ethical approval of the trial has been obtained from the Swedish Ethical Review Authority (number 2019 - 2158) and conforms to the principles outlined in the Declaration of Helsinki (WMA, 2013). Results will be reported as presentations at peer-review conferences, in articles in peer-review journals and meetings with healthcare providers. Trial registration number NCT04180189.
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| 33. |
- Larsson, Ingrid, 1968-, et al.
(author)
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Sleep interventions for children with attention deficit hyperactivity disorder (ADHD) : A systematic literature review
- 2023
-
In: Sleep Medicine. - Amsterdam : Elsevier. - 1389-9457 .- 1878-5506. ; 102, s. 64-75
-
Research review (peer-reviewed)abstract
- Objective/background: Healthy sleep is particularly important for children with attention deficit hyperactivity disorder (ADHD), as sleep disturbances might aggravate disease symptoms. This review aims to synthesize and report evidence on the effectiveness of sleep interventions in increasing sleep, quality of life (QoL), and ADHD symptoms among children with ADHD. Patients/methods: The systematic literature review follows the Cochrane Collaboration methodology recommendations for literature reviews. Four databases were used based on the population, intervention, control and outcome (PICO) framework. Controlled trials with minimum 20 children in each group, aged 6–18, and published from 2005 and onwards were included. Results from the studies were reported in forest plots and three of the seven review outcomes were synthesized in meta-analyses. Results: The search identified 7710 records; of which 4808 abstracts were screened. After fulltext-screening of 99 papers, eight papers from five studies were included. The studies included behavioral sleep interventions and pharmacological interventions using melatonin and eszopiclone. For six of the seven outcomes, the effect sizes were small to moderate and the certainty of the evidence was low. For one outcome, sleep disturbances, the effect size was a moderate −0.49 standardized mean differences (95% confidence interval −0.65;-0.33), with a moderate certainty of evidence for the behavioral interventions for children aged 5–13 years with ADHD. Conclusions: This review identified few and heterogeneous studies. A moderate certainty of evidence for a moderate effect size was only obtained for sleep disturbances from the behavioral interventions. A low certainty of the evidence for a moderate effect size was found for the total sleep time from the pharmacological intervention using melatonin and one behavioral intervention, which indicates that these sleep interventions impact sleep quantity and quality among children with ADHD. © 2022 The Authors
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| 34. |
- Lindholm, Annelie, 1975-, et al.
(author)
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Sex Differences in Children with Uncomplicated Attention Deficit/Hyperactivity Disorder and Sleep Problems
- 2024
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In: Children. - Basel : MDPI. - 2227-9067. ; 11:6
-
Journal article (peer-reviewed)abstract
- Background: Approximately 7.6% of children are diagnosed with attention deficit/hyperactivity disorder (ADHD), and sleep impairments affect 25–85%. There is a noticeable lack of research on girls and sex differences. The aim of this study was to examine sex differences in children with uncomplicated ADHD and sleep problems. Methods: Cross-sectional baseline data were retrieved from a randomized controlled trial with weighted blankets (55 boys and 41 girls, 6–14 years) on a cohort recently diagnosed with uncomplicated ADHD and sleep problems. Differences between boys and girls in ADHD symptoms, objectively and subjectively measured sleep, anxiety, and functioning were examined via parent- or self-reported validated instruments. Results: Girls reported significantly lower (worse) satisfaction with well-being, life overall, and school, but not for family. Parents reported more sleep anxiety and night-time wakings among boys, but no sex differences in other measures and also not in self-reported measures or objective sleep measures. Children who reported worry, sadness, or unhappiness had more sleep problems. Conclusions: Boys with ADHD and sleep problems may need support with sleep-related anxiety and night-time wakings, while girls may require support with overall functioning. Additionally, children who express feelings of worry, sadness, or unhappiness alongside their ADHD symptoms should have attention given to their sleep. © 2024 by the authors. Licensee MDPI, Basel, Switzerland.
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| 35. |
- Lönn, Maria, Doktorand, 1981-, et al.
(author)
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Changed sleep according to weighted blanket adherence in a 16-week sleep intervention among children with attention-deficit/hyperactivity disorder
- 2024
-
In: Journal of Clinical Sleep Medicine (JCSM). - Darien : The American Academy of Sleep Medicine. - 1550-9389 .- 1550-9397.
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Journal article (peer-reviewed)abstract
- Study objectives: To examine differences in sample characteristics and longitudinal sleep outcomes according to weighted blanket adherence.Methods: Children with attention-deficit/hyperactivity disorder (ADHD) (n =94), mean age 9.0 (sd 2.2, range 6-14) participated in a 16-week sleep intervention with weighted blankets (WB). Children were classified as WB adherent (use of WB ≥ 4 nights/week) or non-adherent (use of WB ≤ 3 nights/week). Changes in objectively measured sleep by actigraphy, parent-reported sleep problems (Children's Sleep Habits Questionnaire (CSHQ)) and child-reported Insomnia Severity Index (ISI) were evaluated according to adherence with mixed effect models. Gender, age, and ADHD subtype were examined as potential moderators.Results: Children adherent to WBs (48/94) showed an early response in sleep outcomes and an acceptance of the WB after four weeks of use as well as a decrease in parent- (CSHQ) (-5.73, P = .000) and child-reported sleep problems (ISI) (-4.29, P = .005) after 16 weeks. The improvement in sleep was larger among WB adherent vs. non-adherent (between-group difference: CSHQ: -2.09, P = .038; ISI: -2.58, P =.007). Total sleep time was stable for children adherent to WB but decreased for non-adherent (between-group difference: +16.90, P = .019).Conclusions: An early response in sleep and acceptance of the WB predicted later adherence to WBs. Improvements in sleep were more likely among WB adherents vs. non-adherents. Children with ADHD may thus benefit from using WBs to handle their sleep problems.© 2024 American Academy of Sleep Medicine
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| 36. |
- Lönn, Maria, Doktorand, 1981-, et al.
(author)
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Experiences of Using Weighted Blankets among Children with ADHD and Sleeping Difficulties
- 2023
-
In: Occupational Therapy International. - Oxford : John Wiley & Sons. - 0966-7903 .- 1557-0703. ; 2023, s. 1-12
-
Journal article (peer-reviewed)abstract
- Introduction. Sleeping difficulties are common in children with attention deficit hyperactivity disorder (ADHD). A sleep intervention with weighted blankets was designed to increase current understanding of using weighted blankets to target children’s individual needs in connection with sleep and daytime functioning. Aim. To explore how children with ADHD and sleeping difficulties experience the use of weighted blankets. Methods. An explorative qualitative design in which 26 children with ADHD and sleeping difficulties, 6-15 years old, were interviewed about a sleep intervention with weighted blankets. Four categories emerged from qualitative content analysis. Results. Children’s experiences revealed that the use of weighted blankets 1) requires a commitment, by adjusting according to needs and preferences and adapting to the environment; 2) improves emotional regulation by feeling calm and feeling safe; 3) changes sleeping patterns by creating new routines for sleep and improving sleep quality; and 4) promotes everyday participation by promoting daily function and balancing activity and sleep. Conclusions. Using weighted blankets promoted children’s management of daily life with ADHD and sleeping difficulties. Occupational therapists can improve the assessment and delivery of weighted blankets tailored to individual needs based on increased knowledge from the children themselves. Copyright © 2023 Maria Lönn et al.
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| 37. |
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| 38. |
- Lönn, Maria, Doktorand, 1981-, et al.
(author)
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The efficacy of weighted blankets for sleep in children with attention-deficit/hyperactivity disorder—A randomized controlled crossover trial
- 2024
-
In: Journal of Sleep Research. - Chichester : Wiley-Blackwell Publishing Inc.. - 0962-1105 .- 1365-2869.
-
Journal article (peer-reviewed)abstract
- Weighted blankets are a non-pharmacological intervention for treating sleep and anxiety problems in children with attention-deficit/hyperactivity disorder. However, research on the efficacy of weighted blankets is sparse. The aim of this randomized controlled trial with a crossover design (4 + 4 weeks) was to evaluate the efficacy of weighted blankets on sleep among children with attention-deficit/hyperactivity disorder and sleeping problems. Children diagnosed with uncomplicated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition attention-deficit/hyperactivity disorder with verified sleep problems were randomized to start with either a weighted blanket or a lighter control blanket. Data collection was performed at weeks 0, 4 and 8 using actigraphy, questionnaires and a daily sleep diary. T-tests were used to evaluate efficacy. The study included 94 children with attention-deficit/hyperactivity disorder (mean age 9.0 [sd 2.2] years; 54 [57.4%] boys). Weighted blankets had a significant effect on total sleep time (mean diff. 7.72 min, p = 0.027, Cohen's d = 0.24), sleep efficiency (mean diff. 0.82%, p = 0.038, Cohen's d = 0.23) and wake after sleep onset (mean diff. −2.79 min, p = 0.015, Cohen's d = −0.27), but not on sleep-onset latency (p = 0.432). According to our exploratory subgroup analyses, weighted blankets may be especially beneficial for improving total sleep time in children aged 11–14 years (Cohen's d = 0.53, p = 0.009) and in children with the inattentive attention-deficit/hyperactivity disorder subtype (Cohen's d = 0.58, p = 0.016). Our results suggest that weighted blankets may improve children's sleep and could be used as an alternative to pharmacological sleep interventions. © 2023 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.
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| 39. |
- Lönn, Maria, Doktorand, 1981-
(author)
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Weighted blankets as a sleep intervention for children with ADHD
- 2024
-
Doctoral thesis (other academic/artistic)abstract
- BAKGRUND: Healthy sleep practices for children should be promoted as an essential part of a healthy lifestyle, with important implications for the entire family. Unhealthy sleep patterns and sleep-related problems disrupt everyday life and functioning. Sleep problems are common among children, especially those with attention deficit hyperactivity disorder (ADHD). Weighted blankets are one type of non-pharmacological intervention that has been used in health-care settings, such as occupational therapy practice. However, evidence is scarce and knowledge is lacking concerning the effects of weighted blankets on sleep and their potential benefits. Given the challenges children with ADHD face in sleep problems and emotional and behavioural regulation, weighted blankets could be a particular relevant intervention. The SLEEP project was thus designed to increase current evidence and knowledge about the use of weighted blankets as a sleep intervention for children with ADHD. AIM: The overall aim of this thesis was to investigate the impact of weighted blankets on the sleep health of children with ADHD and sleep problems.METHODS: A crossover randomised controlled trial (Study I) was conducted that included 94 children with ADHD, 6-14 years old. Children were randomly assigned to four weeks of a weighted blanket or four weeks of a lighter control blanket, followed by the other intervention. Data was collected with actigraphy (primary outcome), child- and parent-questionnaires and a daily sleep diary. The efficacy of weighted blankets was analysed with a paired t-test. An experimental longitudinal study (Study II) was carried out that involved the same 94 children, who were followed for 16 weeks. Weighted blanket-adherent vs non-adherent children were compared based on sample characteristics and changed sleep outcomes. The data collected at baseline, at 4 weeks, 8 weeks and at 16-week follow-up were analysed with mixed effect models. Weighted blanket-adherent children were further examined longitudinally (Study III) and compared from baseline to the 16-week follow-up. Parents’ ratings of children’s sleep problems were analysed using paired t-test and McNemar’s test. Furthermore, a qualitative study (Study IV) was performed in which a purposive sample of 26 children participated in individual interviews. A qualitative content analysis was performed to analyse the data.RESULTS: In Study I, weighted blankets were found to be more efficacious than the lighter control blankets, according to objectively measured sleep (increased total sleep time, increased sleep efficiency and decreased wake after sleep onset). Older children, 11-14 years old, and children with an inattentive ADHD subtype slept longer and more effectively with the weighted blanket. In Study II, weighted blanket-adherent children showed improvement, with fewer sleep problems, compared to non-adherent children. Weighted blanket-adherent children also showed a stable total sleep time compared to non-adherent children, who displayed a decrease in their total sleep time during the 16-week sleep intervention. This association was shown for the older children aged 11-14, but not for the younger children aged 6-10. Furthermore, in Study III, the parents of the Weighted blanket-adherent children reported fewer episodes of night wakings, sleep onset delay, sleep duration difficulties and daytime sleepiness. Bedtime resistance and daytime sleepiness were considered the most problematic domains at baseline, and these also showed the greatest change, according to parents’ experiences of children’s problematic sleep. In Study IV, children described that using WBs requires a commitment, improves emotional regulation, changes sleeping patterns and promotes everyday participation.CONCLUSION: The overall results of this thesis indicate that children with ADHD and sleep problems benefit from using weighted blankets. Weighted blankets could thus be an efficient sleep intervention and an important complement to standard treatment for children with ADHD and sleep problems. More research is needed to establish the effectiveness of weighted blankets in different subgroups and settings.
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| 40. |
- Malmborg, Julia S., PhD, 1988-, et al.
(author)
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Parents' health experiences after their child with ADHD and sleep problems underwent a sleep intervention with a weighted blanket
- 2023
-
Conference paper (peer-reviewed)abstract
- Background: Being a parent of a child with attention deficit hyperactivity disorder (ADHD) and sleep problems can be challenging and stressful. Weighted blankets have the potential to improve sleep and health in these children, but less is known about the potential effects the child's use of a weighted blanket may have on parents' health.Purpose of the study: To explore parents' health experiences after their child with ADHD and sleep problems underwent a sleep intervention with a weighted blanket.Methods: This study is a part of a randomized, controlled crossover trial with a 16-week sleep intervention with weighted blankets for children with ADHD and sleep problems. A total of 24 parents of children who preferred sleeping with a weighted blanket were interviewed about how the sleep intervention influenced their health. An inductive qualitative content analysis resulted in seven subcategories and two categories.Findings: Children's sleep with weighted blankets influenced parents experienced health in terms of 1) coping with everyday life, including finding harmony, nurturing family relationships, and maintaining a sustainable structure, and 2) feeling well-being, including being well rested, sustaining energy, reaching calm, and achieving meaningful leisure time.Conclusion: A sleep intervention with weighted blankets in children with ADHD and sleep problems influenced parents' health positively by improving management of life and well-being. For parents who struggle to meet the everyday challenges of their child's ADHD, this sleep intervention may contribute to a sustainable health.
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| 41. |
- Svensson, Miriam, et al.
(author)
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Women’s experience of the journey to chronic widespread pain – a qualitative study
- 2019
-
In: Annals of the Rheumatic Diseases. - London, UK : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 78:Suppl 2, s. 657-657
-
Journal article (peer-reviewed)abstract
- Background: Chronic widespread pain (CWP) is a major burden to both the person and the community. Non-tumor chronic pain is one of the most common causes for long-term sickness absence in Sweden. The prevalence of CWP in the general population is approximately 10%, and the condition is almost twice as prevalent in women, than in men. Increased understanding of how women with CWP describe triggering factors of pain and pain progress would be of importance when preventing poor pain prognosis, and when customizing the treatment strategy in a setting with person-centered care.Objectives: To explore experiences of factors influencing the progress and severity of pain among women who have developed CWP within the last 21 years.Methods: This is a descriptive study, using a qualitative content analysis with an abductive approach 1 . Nineteen women reporting CWP in a survey 2016, between 45-67 (median 57) years of age, who had not reported CWP in a survey 1995, participated in the study. Data were collected through individual interviews with open-ended questions: “Can you describe how your CWP has developed the last 20 years?”, “How did your CWP change over time?” and “Have you experienced any important events that have influenced the development of your CWP?” Data were analyzed through a manifest qualitative content analysis and six categories emerged.Results: The women described their journey to CWP in terms of triggering, aggravating and consolidating factors. Six different categories emerged; physical strain, emotional strain, social strain, work-related strain, biological strain and environmental strain. Physical strain included strenuous physical activities in leisure time, having muscle tension, inactivity or sleeping problems. Emotional strain included being depressed, worried and stressed, as well as neglecting the pain. Social strain included to prioritize other people before oneself and to meet distrust from the social surroundings. Work-related strain included heavy, monotonous and stressful work but also sedentary work. Biological strain referred to heredity, age and infections. Environmental strain meant that the climate or weather aggravated the pain.Conclusion: The women in the study described how their journey to CWP was influenced by both external and internal strains. The six categories representing different types of strains were recurrent in a context describing triggering, aggravating and consolidating factors. This highlights the complexity of individual pain progress and argues for the importance of person-centred care approaches and rehabilitation programs. The fact that women with CWP feel mistrust from healthcare professionals indicates that the current care approach needs to be changed.
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| 42. |
- Svensson, Miriam, et al.
(author)
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Women's experiences of the journey to chronic widespread pain : a qualitative study
- 2020
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In: BMC Musculoskeletal Disorders. - London : BioMed Central. - 1471-2474. ; 21:1, s. 1-10
-
Journal article (peer-reviewed)abstract
- Background Chronic widespread pain (CWP) is a musculoskeletal disorder that affects approximately 10% of the population. It is more common in women than in men. It is important to understand how CWP develops and how it is maintained in order to prevent poor pain prognosis. Long term studies have shown that a mere part improves over time or fluctuates in their CWP condition. Female gender is one of the factors associated with persistence of CWP, suggesting men and women may experience their journey to CWP differently. The aim of the study was to explore women's experiences of the journey to CWP. Methods 19 women between 45 and 67 years of age who had not reported CWP in the EPIPAIN survey in 1995, but reported CWP in 2016, participated in the study. Data was collected through individual interviews, where open-ended questions were used to explore the women's experiences of their pain journey. The interviews were analyzed with a manifest qualitative content analysis. Results The women described their journey to CWP in terms of triggering, aggravating, and consolidating factors, from which three different categories emerged.Experiencing that environmental circumstances affect the pain journeyrefers to factors outside the women's immediate control, which appeared as unmanageable work-related demands, lack of social support, unfavorable physical environments, and traumatic events.Experiencing that lifestyle affects the pain journeyrefers to events that are consciously or unconsciously carried out by the women, including different levels of physical efforts and unfavorable behaviors.Experiencing that personal attributes affect the pain journeyrefers to the women's characteristics in terms of an anxious state of mind and adverse biological impact. Conclusions The women experienced that environmental circumstances, lifestyle, and personal attributes affected their CWP. How these adversities influenced the pain journey varied among the women. These findings show that women are conscious of the complexity of the condition and can describe the broad context of their pain journey. This study confirms the complexity of pain progress and highlights the individual's awareness of this complexity, which is important to consider when introducing interventions, and when expecting compliance to interventions.
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| 43. |
- Törnblom, Margareta, et al.
(author)
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Development of radiographic knee osteoarthritis and the associations to radiographic changes and baseline variables in individuals with knee pain : a 2-year longitudinal study
- 2024
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In: BMJ Open. - London : BMJ Publishing Group Ltd. - 2044-6055. ; 14:3
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Journal article (peer-reviewed)abstract
- Objectives: The aim was to study the development of radiographic knee osteoarthritis (RKOA) in individuals with knee pain over 2 years, and the associations between radiographic changes and baseline variables.Design: Longitudinal cohort study.Participants and setting: This study is part of the Halland Osteoarthritis cohort. The included 178 individuals, aged 30-67, had knee pain, without cruciate ligament injury or radiographic findings and 67% were women. The presence of RKOA was defined as Ahlbäck score of ≥1 in ≥1 knee. (Ahlbäck grade 1: joint space narrowing in the tibiofemoral joint <3 mm). Diagnosis of clinical KOA was based on the clinical guideline from the National Institute for Health and Care Excellence (NICE). Knee injury and Osteoarthritis Outcome Score (KOOS), pain intensity, physical function, body mass index (BMI) and visceral fat area (VFA) were measured. Associations to RKOA were analysed with logistic regression (OR).Results: In all, 13.8% (n=24) developed RKOA in 2 years whereof all had clinical KOA at baseline, as defined by NICE. Deterioration to RKOA was significantly associated with higher BMI, OR 1.119 (95% CI 1.024 to 1.223; p=0.013), and VFA, 1.008 (95% CI 1.000 to 1.016; p=0.049), worse knee pain intensity, 1.238 (95% CI 1.028 to 1.490; p=0.024), worse scores for KOOS Pain, 0.964 (95% CI 0.937 to 0.992; p=0.013) and KOOS Symptoms, 0.967 (95% CI 0.939 to 0.996; p=0.027), KOOS Activities of daily living 0.965 (95% CI 0.935 to 0.996; p=0.026) and KOOS Quality of Life 0.973 (95% CI 0.947 to 0.999; p=0.044), at baseline.Conclusions: One out of seven individuals with clinical KOA developed RKOA in only 2 years. Baseline variables associated with RKOA after 2 years may possibly be detected early by using the NICE guideline, assessment of obesity and self-reported data of symptoms to support first-line treatment: education, exercise and weight control. © Author(s) (or their employer(s)) 2024.
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| 45. |
- Törnblom, M., et al.
(author)
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Prevalence of Early Symptomatic Knee Osteoarthritis According to Three Clinical Classification Criteria
- 2021
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In: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 80, s. 1330-1330
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Journal article (peer-reviewed)abstract
- Knee osteoarthritis (KOA) is a heterogeneous disease. Different classification criteria for symptomatic KOA (SKOA) have been proposed. Determining the prevalence and comparing the different criteria of SKOA in patients with knee pain will serve as a base when studying the predictive ability of these criteria in a longer perspective.Objectives:To study the prevalence of SKOA in individuals with knee pain according to three different classification criteria: the American College of Rheumatology (ACR), (1), the European League Against Rheumatism (EULAR)(2), and the National Institute for Health and Care Excellence (NICE) (3).Methods:Baseline data from an ongoing longitudinal study (HALLOA) including 296 individuals with knee pain, recruited by advertisement, were analysed. The individuals were categorized according to the classification criteria of SKOA (ACR, EULAR and NICE) based on age, clinical examination (crepitation), and self-reported data from KOOS (pain, symptoms, ADL, and sport/recreation), and dichotomized as fulfilling the criteria (SKOA) or not (no SKOA). BMI was measured (kg/m2). Radiographic KOA (RKOA) was assessed according to Ahlbäck criteria (1-5), defined as RKOA with grade 1 or more in at least one knee. Prevalence was calculated (frequencies, %) for each criterion, and Chi-Square test or the Independent-Samples t-test were used for comparisons between individuals fulfilling SKOA or not.Results:The mean age was 52 (min-max 24-73) years, 70% were women and 22% were classified with RKOA. The prevalence of SKOA according to each criterion was 57% (ACR), 51% (EULAR) and 73% (NICE) respectively. In total, 48% had SKOA according to all three criteria and whereof 32% had RKOA, compared to 10% RKOA among individuals with no SKOA. Regardless of the criterion, significantly more individuals classified with SKOA also had RKOA compared to individuals with no SKOA, p<0.001. Those classified as SKOA were significantly older and had higher BMI compared with no SKOA (Table 1).Conclusion:Approximately 50-70% of the individuals with knee pain were classified as having SKOA, where EULAR criteria had the lowest prevalence. A better understanding of early knee pain classification according to different clinical criteria is essential for the ability to capture and follow the long-term prognosis of early SKOA. Further longitudinal studies are needed.References:[1]Altman R et al. Arthritis Rheum. 1986;29(8):1039-49.[2]Zhang W et al. Ann Rheum Dis. 2010;69(3):483-9.[3]Health NIf, Excellence C. UK: National Institute for Clinical Excellence. 2014.Table 1.Comparisons between the ACR, EULAR and NICE criteria of symptomatic knee osteoarthritis, stratified for symptomatic knee osteoarthritis or notACREULARNICETotalOANo OAP-valueOANo OAP-valueOANo OAP-valueN(%)296 (100)170 (57.4)98 (33.1)152 (51.4)114 (38.5)215 (72.6)58 (19.6)Age(Y), Mean (SD)51.6 (8.7)53.3 (7.0)49.0 (10.3)<0.00154.5 (5.1)48.1 (10.8)<0.00154.7 (4.9)40.5 (9.8)<0.001Gender, female (%)208 (70.3)121 (71.2)66 (67.3)0.511108 (58.4)77 (67.5)0.538154 (71.6)36 (62.1)0.160BMI(kg/m2), Mean (SD)26.4 (4.6)26.5 (4.5)25.8 (4.3)0.17926.9 (4.5)25.4 (4.2)0.00526.7 (4.5)24.8 (3.8)0.004RKOA, n (%)64 (21.6) 45 (26.5)12 (12.2)0.00347 (30.9)10 (8.7)<0.00158 (27.0)1 (1.7)<0.001Independent-samples t-test and Chi-2-test. Bold=Significant correlation (p≤0.05). OA = Osteoarthritis. ACR = American College of Rheumatology. EULAR = the European League Against Rheumatism. NICE = the National Institute of Care and Excellence. BMI = Body Mass Index. RKOA = Radiographic Knee Osteoarthritis (Ahlbäck, with grade ≥1 in ≥1 knee).Disclosure of Interests:None declared.
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| 46. |
- Westergården, Malin, et al.
(author)
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Living every-day life in the shadow of pain or live every-day life with the pain in the shadow – A constant balancing
- 2019
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In: Annals of the Rheumatic Diseases. - London, UK : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 78:Suppl 2, s. 1063-1064
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Journal article (peer-reviewed)abstract
- Background: Approximately 10% of the population report chronic widespread pain (CWP), the condition is more common in women than in men. Long-term pain is a public health problem. For most women, the pain interferes with many aspects of every-day life and implies large consequences. Thus, knowledge about how to facilitate life for these women is important.Objectives: To explore women’s experiences of how CWP influence their daily lifeMethods: The study has a latent qualitative content analysis design 1 . Individual interviews were conducted in 19 women 45-67 of age, who had reported CWP in a survey 2016. CWP was defined according to the 1990 ACR criteria for fibromyalgia. Pain that had lasted for more than three months, during the last 12 months, was considered chronic. A latent qualitative content analysis was used to analyze the main questions “Can you describe your experiences of living with CWP?” and “How do the CWP influence your life today?” The interviews were recorded, transcribed verbatim and coded into eight subcategories and three categories; represent the manifest content, and a latent theme exploring the interpreted content of women’s experiences of how CWP influence their every-day life.Results: The interviewed women expressed a life with CWP as “Living every-day life in the shadow of pain or live every-day life with the pain in the shadow” including three categories; the experience of alienation, limitations and plasticity. 1) The experiences of alienation appeared in the subcategories; suspicion and loneliness. Suspicion meant a feeling of not be taken seriously by healthcare and authorities and loneliness meant not being able to participate in social contexts. 2) The experiences of limitations in daily life includes the subcategories; barriers, stress, and dependence of other people. Barriers meant that fatigue limits the activities in every-day life, stress that constitutes limitations in life and dependence on other people’ support. 3) The experiences of plasticity referred to the subcategories resignation, adjustment and resistance. Resignation meant refraining from activities that could affect the pain, such as gardening, walking and dancing. Adjustment were manifested by making the best of the situation, and resistance meant to resist letting the pain set the terms, to give the pain a fight.Conclusion: Women with CWP have to deal with their physical, mental, social and spiritual environment in every-day life. They express a constant balancing in their life between mastering the pain in order to continue living as normal, and allowing the pain to set the terms, i.e. living every-day life in the shadow of pain or live every-day life with the pain in the shadow. Healthcare professionals may consider supporting the patients in finding their individual counterweight to manage life in order to reach better treatment outcome. © Westergården, Aili & Larsson 2019. No commercial re-use. See rights and permissions. Published by BMJ.
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- Westergården, Malin, et al.
(author)
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"Moving between living in the shadow of pain and living a life with the pain in the shadows" - women's experiences of daily life with chronic widespread pain : a qualitative study
- 2021
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In: International Journal of Qualitative Studies on Health and Well-being. - Abingdon : Informa UK Limited. - 1748-2631 .- 1748-2623. ; 16
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Journal article (peer-reviewed)abstract
- Purpose: Long-term pain is a public health problem but few studies have focused on experiences among women with CWP. This study aimed to explore women's experiences of the impact of CWP on daily life.Method: The participants were 19 women between 45-67 years old, who had developed CWP between 1995 and 2016. Individual interviews were conducted and analysed with qualitative content analysis.Results: Daily life with CWP was expressed in the main theme "Moving between living in the shadow of pain or living a life with the pain in the shadows" including three themes and eight subthemes; 1) living with invisible challenges by feeling neglected as a person and feeling lonely among other people; 2) struggling with limitations by moving between ability and inability, stress and worries, and being dependent on others; and 3) encountering daily life with varying degrees of flexibility by standing still and giving up, moving back and forth by adapting and striving forward with resistance. Conclusions: Women experienced different ways of how CWP influenced their daily life with challenges, limitations, and flexibility. Daily life with CWP entails moving between living in the shadow of pain and living a life with the pain in the shadows.
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