| 1. |
- Aust, Birgit, et al.
(författare)
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The Danish national return-to-work program - aims, content, and design of the process and effect evaluation
- 2012
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 38:2, s. 120-133
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Tidskriftsartikel (refereegranskat)abstract
- The Danish national return-to-work (RTW) program aims to improve the management of municipal sickness benefit in Denmark. A study is currently ongoing to evaluate the RTW program. The purpose of this article is to describe the study protocol. The program includes 21 municipalities encompassing approximately 19 500 working-age adults on long-term sickness absence, regardless of reason for sickness absence or employment status. It consists of three core elements: (i) establishment of multidisciplinary RTW teams, (ii) introduction of standardized workability assessments and sickness absence management procedures, and (iii) a comprehensive training course for the RTW teams. The effect evaluation is based on a parallel group randomized trial and a stratified cluster-controlled trial and focuses on register-based primary outcomes-duration of sickness absence and RTW and questionnaire-based secondary outcomes such as health and workability. The process evaluation utilizes questionnaires, interviews, and municipal data. The effect evaluation tests whether participants in the intervention have a (i) shorter duration of full-time sickness absence, (ii) longer time until recurrent long-term sickness absence, (iii) faster full RTW, (iv) more positive development in health, workability, pain, and sleep; it also tests whether the program is (v) cost-effective. The process evaluation investigates: (i) whether the expected target population is reached; (ii) if the program is implemented as intended; (iii) how the beneficiaries, the RTW teams, and the external stakeholders experience the program; and (iv) whether contextual factors influenced the implementation. The program has the potential to contribute markedly to lowering human and economic costs and increasing labor force supply. First results will be available in 2013. The trial registrations are ISRCTN43004323, and ISRCTN51445682.
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| 2. |
- Ektor-Andersen, John, et al.
(författare)
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Behaviour-focused pain coping: consistency and convergence to work capability of the swedish version of the chronic pain coping inventory.
- 2002
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Ingår i: Journal of Rehabilitation Medicine. - 1651-2081. ; 34:1, s. 33-39
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to study the psychometric properties of the Swedish version of the Chronic Pain Coping Inventory. The material consisted of a group of 100 subjects recruited from a large population study. Pain status and the absence of pain-related sick leave during the previous year conditioned inclusion. Another group comprised 160 patients on the long-term sick list and who had been referred to a multidisciplinary pain clinic for evaluation. The psychometric properties in terms of internal consistency of the scales were good or very good for all scales of behaviour-focused pain coping. Use of the strategies "Guarding", "Resting", "Asking for assistance", "Relaxation", "Task persistence", "Coping self-statements" and "Seeking social support" was significantly related to vocational capability. "Guarding". "Asking for assistance", "Relaxation", "Exercise and stretch" and "Coping self-statements" increased in parallel to increasing pain from localized to intermediate or widespread. No gender difference was found in cases reporting more pronounced pain.
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| 3. |
- Ektor-Andersen, John
(författare)
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CHRONIC MUSCULOSKELETAL PAIN. Population studies of pain-experience with special focus on the Total Body Pain and aspects of adaptation in a cognitive-behavior psychological frame of reference
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Musculoskeletal pain-related vocational dysfunction is a major public health problem. The solution is beyond the scope of biomedicine, but the problem could well be analyzed in the complementary, cognitive-behavior psychological frame of reference. In order to better prevent the development of pain-related dysfunction: The sociodemographic milieu of dysfunctional chronic pain patients was examined. The concept of pain, assessed by the Standardized Nordic Questionnaire (SNQ), was validated and the concept of Total Body Pain (TBP) de-fined and its epidemiology studied. In a prospective design, short- and long-term sick leave as resulting from me-chanical exposure, psychosocial- workplace and spare time factors and subject’s pain load was studied. Adaptive and maladaptive behavioral coping strategies, tapped by the newly translated Swedish version of the Chronic Pain Coping Inventory (CPCI), were reported, studying two populations, comparable in terms of Pain Load but work-ing full-time and long-term sick listed respectively. It was concluded that: The concept of pain was well reflected in the SNQ. The concept of TBP equaled pain as-sessed by the SNQ considering relations to scores of Self-Rated Health (SRH) and Mental Distress. Independently of working status, SRH decreased with both increasing TBP-score and increasing pain in the Shoulder-Neck area. Women showed the same SRH levels independently of working status, whereas men scored their SRH better than women did when working full-time and worse, when they were out of full-time gainful work. The TBP should be under control in epidemiological studies of work-related musculoskeletal pain. Mechanical exposure, bad pos-tures, was the only workplace factor that independently predicted incident and recurrent short- and incident long-term sick leave. In addition, previous short-term sick leave was of importance, whereas low Self-Rated Health predicted long-term sick leave only. The overall pain load was of equal importance as other factors assessed, pre-dicting both short- and long-term sick leave and introduced no effect modification when analyzing long-term sick leave. Pain load and previous short-term sick leave confounded self-rated health considering short-tern sick leave. Assessed by the CPCI, adaptive and maladaptive coping-behavior, with high discriminative power, separated vo-cationally active subjects from subjects on long-term sick leave, with no gender difference.
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| 4. |
- Jorgensen, Marie Birk, et al.
(författare)
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A randomised controlled trial among cleaners-Effects on strength, balance and kinesiophobia
- 2011
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cleaners constitute a job group with poor health and low socioeconomic resources. Therefore, there is a great need for scientifically documented health promoting initiatives for cleaners. However, both workplace initiatives and high quality intervention studies are lacking. The aim of this study was to evaluate the effects of a 3-month workplace trial with interventions to improve physical or cognitive behavioural resources among cleaners. Methods: A cluster randomised controlled trial was conducted among 294 female cleaners from 9 workplaces. The participants were allocated to three groups: Physical coordination training (PCT, n = 95), Cognitive behavioural theory-based training (CBTr, n = 99) and Reference group (REF, n = 100). Interventions were conducted during work hours for an average of 1 hour/week. Muscle strength was measured by maximal voluntary contractions in trunk/extension, and shoulder abduction/elevation. Postural balance was measured on a force platform. Kinesiophobia was measured with Tampa Scale for Kinesiophobia. Test and questionnaires were completed at baseline and at 3-month follow-up and analyses followed the intention-to-treat (ITT) principle with last observation carried forward in case of missing data at follow-up. Reports and analyses are given on true observations as well. Results: ITT-analyses revealed that PCT improved strength of the trunk (p < .05) and postural balance (p < .05) compared to CBTr and REF. Based on true observations the strength and balance improvements corresponded to similar to 20% and similar to 16%, respectively. ITT-analyses showed that CBTr reduced kinesiophobia compared to PCT and REF (p < .05). Based on true observations, the improvement corresponded to a similar to 16% improvement. Conclusion: This workplace-based intervention study including PCT and CBTr among cleaners improved strength and postural balance from PCT, and kinesiophobia from CBTr. The improved strength, postural balance and kinesiophobia may improve the cleaners' tolerance for high physical work demands. Future studies should investigate the potential in the combination of PCT and CBTr in a workplace intervention.
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| 5. |
- Jorgensen, Marie B., et al.
(författare)
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Implementation of physical coordination training and cognitive behavioural training interventions at cleaning workplaces - secondary analyses of a randomised controlled trial
- 2012
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Ingår i: Ergonomics. - : Informa UK Limited. - 0014-0139 .- 1366-5847. ; 55:7, s. 762-772
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluates the implementation of physical coordination training (PCT) and cognitive behavioural training (CBTr) interventions in a randomised controlled trial at nine cleaners' workplaces. Female cleaners (n - 294) were randomised into a PCT, a CBTr or a reference (REF) group. Both 12-week interventions were performed in groups guided by an instructor. Records were kept on intervention dose (adherence) unanticipated events at the work place (context) and quality of intervention delivery (fidelity). Participant adherence was 37% in the PCT and 49% in the CBTr interventions. Optimal implementation was reached by only 6% in PCT and 42% in the CBTr. Analysis of the barriers to successful implementation indicated that the intervention process is sensitive to unanticipated events. In order to succeed in improving the health of high-risk populations such as cleaners and to correctly interpret intervention effects, more research on implementation is needed. Trial registration: ISRCTN96241850. Practitioner Summary: Both physical coordination training and cognitive behavioural training are potential effective workplace interventions among low educated job groups with high physical work demands. However, thorough consideration should be given to feasibility in the design of interventions. The optimal intervention should be tailored to closely match the implementation context and be robust and flexible to minimise susceptibility to changes in work organisation.
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| 6. |
- Kendler, Kenneth S., et al.
(författare)
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Risk factors for the development of opioid use disorder after first opioid prescription : a Swedish national study
- 2023
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Ingår i: Psychological Medicine. - 0033-2917. ; 53:13, s. 6223-6231
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Tidskriftsartikel (refereegranskat)abstract
- Background We need to better understand the frequency and predictors of opioid use disorder (OUD) after first opioid prescription (OP). Methods We followed 1 516 392 individuals from the Swedish population born 1980-2000, from 1 July 2007, until 31 Dec 2017. We examined putative risk predictors with univariable and multivariable Cox Models and the potential causal effects of predictors by propensity score and co-sibling analyses. Result Of the individuals in our cohort, 24.8% (375 404) received a first OP, of whom 3034 (0.90%) developed a subsequent first OUD. The hazard ratio (HR) (± 95% CIs) for OUD after OP equaled 7.10 (6.75-7.46), with a mean time to onset of 3.41 (2.39) years. The strongest putative risk factors for development of OUD after OP were prior psychiatric and substance use disorders, criminal behavior, parental divorce/death, poor school performance, current community deprivation, divorce, and male sex. Few predictors differed across sexes. OP renewal was associated with a HR of 3.66 (3.41-3.93) for OUD. Co-sibling and propensity score analyses suggested that at least a moderate proportion of the risk factor-OUD association was likely causal. A risk score to predict OUD after OP had an AUC of 0.85, where nearly 60% of cases scoring in the top decile. Conclusions In a general population sample, an OP represents a substantial risk factor for subsequent OUD. Many of the risk factors for OUD after OP can be readily assessed at the time of potential OP, permitting clinicians to evaluate the risk of iatrogenic OUD.
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