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Aili, K., Bergman, S. & Haglund, E. (2019). Adding information on widespread pain to the start back screening tool when identifying low back pain patients at increased risk for poor prognosis. Paper presented at Annual European Congress of Rheumatology (EULAR 2019), Madrid, Spain, June 12-15, 2019. Annals of the Rheumatic Diseases, 78(Suppl 2), 1457-1457
Open this publication in new window or tab >>Adding information on widespread pain to the start back screening tool when identifying low back pain patients at increased risk for poor prognosis
2019 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, no Suppl 2, p. 1457-1457Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
London, UK: BMJ Publishing Group Ltd, 2019
Keywords
low back pain, screening, primary care
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-40947 (URN)
Conference
Annual European Congress of Rheumatology (EULAR 2019), Madrid, Spain, June 12-15, 2019
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2019-11-15
Drab, B., Aili, K., Haglund, E. & Bergman, S. (2019). Chronic pain and sick leave in a 21-year follow up. Paper presented at Annual European Congress of Rheumatology (EULAR 2019), Madrid, Spain, June 12-15, 2019. Annals of the Rheumatic Diseases, 78(Suppl 2), 122-122
Open this publication in new window or tab >>Chronic pain and sick leave in a 21-year follow up
2019 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, no Suppl 2, p. 122-122Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Chronic musculoskeletal pain (CMP) is a common cause of disability and impaired quality of life. In Sweden, chronic pain and mental illness are major causes of sick leave. But sick leave itself is also proposed as a risk factor for prolonged sick leave and disability pension.

Objectives: To study CMP and sick leave as potential risk factors for long term sick leave or disability pension in a 21 year follow up of a general population cohort.

Methods: In a cohort study, with a baseline survey in 1995, 1466 individuals aged 20-67 years were followed for 3 years and 691 for 21 years, or up to the age of 67. CMP (>3 months duration) was reported on a pain mannequin. Sick leave and disability pension were self-reported. Mental health was measured by the mental health (MH) score of the SF-36 health status, and categorized into tertiaries (best, medium and worst). CMP, sick leave, and mental health at baseline, were studied as potential predictors for long term sick leave (disability pension or sick leave >3 months) at a 3 and 21 year follow up. Other potential predictors (socioeconomic group, education, and immigrant status) were introduced in multiple regression analyzes but did not add to the results and were removed from the final models, which were controlled for age and sex.

Results: CMP and mental health predicted long term sick leave at the 3 year follow up (OR 2.11, p=0.010 and OR 3.52, p<0.001). Mental health (OR 1.92, p=0.046), but not CMP (OR 0.77, p=0.409), was also a predictor at the 21 year follow up. Sick leave >3 months, irrespectively if due to pain or not, predicted long term sick leave both at the 3 and the 21 year follow up (Table). Sick leave for ≤3 months also predicted long term sick leave at both follow ups when due to pain (OR 2.70, p=0.008 and OR 2.78, p=0.012), but not when due to other causes (OR 1.52, p=0.212 and OR 1.17, p=0.606).

Conclusion: Sick leave and especially sick leave due to pain predicted long term sick leave up to 21 years later, independently of pain status or mental health at baseline. It is thus important to early identify individuals at risk and minimize sick leave by providing proper rehabilitation.

© Drab, Aili, Haglund & Bergman 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Place, publisher, year, edition, pages
London, UK: BMJ Publishing Group Ltd, 2019
Keywords
Chronic pain, Sickness absence
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-40944 (URN)10.1136/annrheumdis-2019-eular.2021 (DOI)000472207100311 ()
Conference
Annual European Congress of Rheumatology (EULAR 2019), Madrid, Spain, June 12-15, 2019
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2019-11-27Bibliographically approved
Haglund, E., Pinheiro Sant'Anna, A., Andersson, M., Bramander, A. & Aili, K. (2019). Dynamic joint stability measured as gait symmetry in people with symptomatic knee osteoarthritis. Paper presented at Annual European Congress of Rheumatology (EULAR 2019), Madrid, Spain, June 12-15, 2019. Annals of the Rheumatic Diseases, 78(Suppl. 2), Article ID A1458.
Open this publication in new window or tab >>Dynamic joint stability measured as gait symmetry in people with symptomatic knee osteoarthritis
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2019 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, no Suppl. 2, article id A1458Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
London, UK: BMJ Publishing Group Ltd, 2019
Keywords
Knee osteoarthritis, joint stability, objective measure
National Category
Physiotherapy
Identifiers
urn:nbn:se:hh:diva-40948 (URN)10.1136/annrheumdis-2019-eular.4648 (DOI)000472207104307 ()
Conference
Annual European Congress of Rheumatology (EULAR 2019), Madrid, Spain, June 12-15, 2019
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2019-11-25
Arvidsson, S., Aili, K. & Nygren, J. M. (2019). Health-Related Quality of Life among Young Adult Acute Lymphoblastic Leukemia Survivors in Sweden. In: : . Paper presented at 51th Congress of the International Society of Paediatric Oncology (SIOP 2019), Lyon, France, October 23-26, 2019.
Open this publication in new window or tab >>Health-Related Quality of Life among Young Adult Acute Lymphoblastic Leukemia Survivors in Sweden
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Keywords
ALL, health-related quality of life, survivors
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-40996 (URN)000488458003013 ()
Conference
51th Congress of the International Society of Paediatric Oncology (SIOP 2019), Lyon, France, October 23-26, 2019
Available from: 2019-11-20 Created: 2019-11-20 Last updated: 2019-11-20
Westergården, M., Aili, K. & Larsson, I. (2019). Living every-day life in the shadow of pain or live every-day life with the pain in the shadow – a constant balancing. In: Annals of the Rheumatic Diseases: . Paper presented at Annual European Congress of Rheumatology EULAR. , Article ID A1063.
Open this publication in new window or tab >>Living every-day life in the shadow of pain or live every-day life with the pain in the shadow – a constant balancing
2019 (English)In: Annals of the Rheumatic Diseases, 2019, article id A1063Conference paper, Poster (with or without abstract) (Refereed)
Keywords
Chronic widespread pain, health
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-40945 (URN)10.1136/annrheumdis-2019-eular.3692 (DOI)
Conference
Annual European Congress of Rheumatology EULAR
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2019-11-14
Westergården, M., Aili, K. & Larsson, I. (2019). Living every-day life in the shadow of pain or live every-day life with the pain in the shadow – A constant balancing. Paper presented at Annual European Congress of Rheumatology (EULAR), Madrid, Spain, June, 12-15, 2019. Annals of the Rheumatic Diseases, 78(Suppl 2), 1063-1064
Open this publication in new window or tab >>Living every-day life in the shadow of pain or live every-day life with the pain in the shadow – A constant balancing
2019 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, no Suppl 2, p. 1063-1064Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

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 life

Methods: 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.

Place, publisher, year, edition, pages
London, UK: BMJ Publishing Group Ltd, 2019
Keywords
Chronic Widespread Pain
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-40915 (URN)10.1136/annrheumdis-2019-eular.3692 (DOI)000472207103186 ()
Conference
Annual European Congress of Rheumatology (EULAR), Madrid, Spain, June, 12-15, 2019
Available from: 2019-11-12 Created: 2019-11-12 Last updated: 2019-12-06Bibliographically approved
Aili, K., Campbell, P., Michaleff, Z., Strauss, V., Jordan, K., Bremander, A., . . . Bergman, S. (2019). Long term trajectories of chronic widespread pain: a 21-year prospective cohort latent class analysis. Paper presented at Annual European Congress of Rheumatology (EULAR 2019), Madrid, Spain, June 12-15, 2019. Annals of the Rheumatic Diseases, 78(Suppl 2), 239-239
Open this publication in new window or tab >>Long term trajectories of chronic widespread pain: a 21-year prospective cohort latent class analysis
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2019 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, no Suppl 2, p. 239-239Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Chronic widespread pain (CWP) is common (population prevalence of approximately 10%) and has a significant impact on the individual, healthcare, and society. Currently little is known about the actual course of CWP over time, in particular the pathways to the development and maintenance of CWP. One useful way to understand these pathways is to identify common clusters of people who share pain trajectories. Such information is clinically useful to identify factors that predict development, persistence, and resolution of CWP.

Objectives: To identify different longitudinal pain trajectories over a period of 21 years.

Methods: A 21-year longitudinal open-population cohort of n=1858 adults (aged 20-74) who completed surveys relating to their pain status in at least three of the five time points 1995, 1998, 2003, 2007, and 2016. Pain status (presence of persistent pain) was ascertained from a report of painful regions (0-18) on a pain mannequin and categorised into: NCP (No chronic pain), CRP (Chronic regional pain) and CWP (chronic widespread pain). Latent Class Growth Analysis (LCGA) was carried out based on these categories. Participants were assigned to a trajectory cluster where the posterior probability was the highest. Model fit was assessed by statistical indices and clinical interpretations of clusters.

Results: LCGA identified five clusters describing different pathways of NCP, CRP and CWP over the 21 years. The cluster “Persistent NCP” was the most common pathway (n = 1052, 57%) representing those with no chronic pain over the whole time period. The “Persistent CRP or Migration from CRP to NCP” cluster included 411 individuals (22%) representing a group with stable or improving regional pain. In the groups who were shown to increase pain status, the “Migration from NCP to CRP or CWP” cluster included 92 individuals (5%), and there were 184 individuals (10%) in the cluster “Migration from CRP to CWP” representing a group with regional pain who developed CWP. The final cluster “Persistent CWP” included 119 individuals (6%) representing those with stable CWP throughout the time period. Figure 1 presents the mean number of pain sites over time by cluster.

Conclusion: This study showed that whilst half of adults report no chronic pain over 21 years, a substantial proportion develop CWP or have persistent CWP over this time period. Whilst a common trajectory was movement from chronic regional pain to no chronic pain, a pattern of improving CWP was not seen suggesting this is an uncommon trajectory. This is the first study to show long-term trajectories for CWP, and further work is now required to understand factors that may identify individuals at risk of worsening pain status and factors that might promote improvement. These identified pathways of chronic pain over a lifespan improve the understanding of long-term development of chronic pain and chronic widespread pain. © Aili et al. 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Place, publisher, year, edition, pages
London, UK: BMJ Publishing Group Ltd, 2019
Keywords
Chronic pain, public health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-40943 (URN)10.1136/annrheumdis-2019-eular.2993 (DOI)000472207100527 ()
Conference
Annual European Congress of Rheumatology (EULAR 2019), Madrid, Spain, June 12-15, 2019
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2019-11-27Bibliographically approved
Aili, K., Bergman, S., Bremander, A., Haglund, E. & Larsson, I. (2019). Passive coping strategies but not physical function are associated with worse mental health, in women with chronic widespread pain – a mixed method study. Paper presented at Annual European Congress of Rheumatology (EULAR 2019), Madrid, Spain, June 12-15, 2019. Annals of the Rheumatic Diseases, 78(Suppl 2), 2159-2159
Open this publication in new window or tab >>Passive coping strategies but not physical function are associated with worse mental health, in women with chronic widespread pain – a mixed method study
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2019 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, no Suppl 2, p. 2159-2159Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Chronic widespread pain (CWP) is a common condition (approximately 10% prevalence), that affects women twice as often as men. There is a lack of knowledge in how different coping strategies relates to health status during CWP development in a general population.

Objectives: To explore different ways of coping with CWP and to relate the different coping strategies to health-related factors, before and after developing CWP.

Methods: A sequential explorative mixed methods study including 19 women 45-67 of age, who had reported CWP in a survey 2016, but not in 1995. Individual interviews were analysed with a phenomenographic approach, and resulted in four categories of coping strategies. These categories were further explored with regard to four dimensions of health status (physical function, bodily pain, vitality and mental health) as measured by SF-36 (0-100, a lower score indicates more disability) and sleep problems measured both in 1995, and 2016.

Results: The qualitative analysis revealed four categories representing different coping strategies, where each woman was labelled by the most dominant category; the mastering woman, the persistent woman, the compliant woman and the conquered woman. The first two categories emerged as being active coping strategies, and the latter two as passive. Women with passive strategies reported significantly lower vitality (median 57.5 vs 75, p=0.007) and worse mental health (median 54 vs 93, p=0.021) in 1995, before they had developed CWP compared with those with active coping strategies. No differences were seen between the groups on physical function, bodily pain or sleep.

In 2016, there were still a difference between the passive and active group regarding mental health (median 56 vs 80, p=0.022), but not for vitality (median 35 vs 40, p=0.707). No differences were seen between the groups on physical function or bodily pain. All eight women with passive strategies reported problems with sleep in 2016, as compared to 6 of the 11 women with active strategies (p=0.045).

Conclusion: Women that reported CWP in 2016, but not in 1995, described both active and passive coping strategies. The qualitative findings were associated with differences in vitality and mental health already in 1995, before they had developed CWP. Further, those with passive coping strategies reported worse health with regard to mental health and sleep problems in 2016. Interestingly, the groups did not differ in bodily pain or physical function neither in 1995 nor in 2016, which implicates the importance for the clinician to take the typical coping strategy into consideration, when meeting these patients in clinical settings. © Aili, Bergman, Bremander, Haglund & Larsson 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Place, publisher, year, edition, pages
London, UK: BMJ Publishing Group Ltd, 2019
Keywords
Chronic widespread pain, health, mental health, coping
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-40949 (URN)10.1136/annrheumdis-2019-eular.5393 (DOI)
Conference
Annual European Congress of Rheumatology (EULAR 2019), Madrid, Spain, June 12-15, 2019
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2019-11-27Bibliographically approved
Aili, K., Bergman, S., Bremander, A., Haglund, E. & Larsson, I. (2019). Passive coping strategies but not physicalfunction are associated with worse mental health, in women with chronicwidespread pain– a mixed method study. In: Annual Annals of the Rheumatic Diseases: . Paper presented at Annual European Congress of Rheumatology EULAR. , Article ID A2159.
Open this publication in new window or tab >>Passive coping strategies but not physicalfunction are associated with worse mental health, in women with chronicwidespread pain– a mixed method study
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2019 (English)In: Annual Annals of the Rheumatic Diseases, 2019, article id A2159Conference paper, Published paper (Refereed)
Abstract [en]

Background: Chronic widespread pain (CWP) is a common condition (approximately 10% prevalence), that affects women twice as often as men. There is a lack of knowledge in how different coping strategies relates to health status during CWP development in a general population.

Objectives: To explore different ways of coping with CWP and to relate the different coping strategies to health-related factors, before and after developing CWP.

Methods: A sequential explorative mixed methods study including 19 women 45-67 of age, who had reported CWP in a survey 2016, but not in 1995. Individual interviews were analysed with a phenomenographic approach, and resulted in four categories of coping strategies. These categories were further explored with regard to four dimensions of health status (physical function, bodily pain, vitality and mental health) as measured by SF-36 (0-100, a lower score indicates more disability) and sleep problems measured both in 1995, and 2016.

Results: The qualitative analysis revealed four categories representing different coping strategies, where each woman was labelled by the most dominant category; the mastering woman, the persistent woman, the compliant woman and the conquered woman. The first two categories emerged as being active coping strategies, and the latter two as passive. Women with passive strategies reported significantly lower vitality (median 57.5 vs 75, p=0.007) and worse mental health (median 54 vs 93, p=0.021) in 1995, before they had developed CWP compared with those with active coping strategies. No differences were seen between the groups on physical function, bodily pain or sleep.

In 2016, there were still a difference between the passive and active group regarding mental health (median 56 vs 80, p=0.022), but not for vitality (median 35 vs 40, p=0.707). No differences were seen between the groups on physical function or bodily pain. All eight women with passive strategies reported problems with sleep in 2016, as compared to 6 of the 11 women with active strategies (p=0.045).

Conclusion: Women that reported CWP in 2016, but not in 1995, described both active and passive coping strategies. The qualitative findings were associated with differences in vitality and mental health already in 1995, before they had developed CWP. Further, those with passive coping strategies reported worse health with regard to mental health and sleep problems in 2016. Interestingly, the groups did not differ in bodily pain or physical function neither in 1995 nor in 2016, which implicates the importance for the clinician to take the typical coping strategy into consideration, when meeting these patients in clinical settings.

Keywords
chronic widespread pain
National Category
Health Sciences
Identifiers
urn:nbn:se:hh:diva-40913 (URN)10.1136/annrheumdis-2019-eular.5393 (DOI)
Conference
Annual European Congress of Rheumatology EULAR
Available from: 2019-11-12 Created: 2019-11-12 Last updated: 2019-11-12
Svensson, M., Larsson, I. & Aili, K. (2019). Women’s experience of the journey to chronic widespread pain – a qualitative study. In: Annals of the Rheumatic Diseases: . Paper presented at Annual European Congress of Rheumatology EULAR. , 78, Article ID A657.
Open this publication in new window or tab >>Women’s experience of the journey to chronic widespread pain – a qualitative study
2019 (English)In: Annals of the Rheumatic Diseases, 2019, Vol. 78, article id A657Conference paper, Poster (with or without abstract) (Refereed)
Keywords
Chronic widespread pain, health
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-40946 (URN)10.1136/annrheumdis-2019-eular.2298 (DOI)
Conference
Annual European Congress of Rheumatology EULAR
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2019-11-14
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-4260-7399

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