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Larsson, J., Dencker, M., Olsson, M. C. & Bremander, A. (2020). Development and application of a questionnaire to self-rate physical work demands for ground combat soldiers. Applied Ergonomics, 83, Article ID 103002.
Open this publication in new window or tab >>Development and application of a questionnaire to self-rate physical work demands for ground combat soldiers
2020 (English)In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 83, article id 103002Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim of the present study was to identify the most physically demanding work tasks for Swedish ground combat soldiers through the development and application of a questionnaire survey. This is the first in a series of studies aiming to describe the development process and validation of physical selection standards in the Swedish armed forces.

Methods: Based on procedural documentation, combat manuals and job analyses, a questionnaire was developed that defined and rated the perceived physical strain of 30 work tasks for ground combat soldiers. To assess validity, an expert focus group was used and psychometric analysis performed. The questionnaire was then distributed to 231 ground combat soldiers, of whom 165 responded (71%).

Results: The questionnaire was validated in three steps to achieve face and content validity, and internal consistency was acceptable (Chronbach's alpha ≥0.95). Of the 30 work tasks included in the survey, transport of wounded was rated as the most demanding task for both aerobic capacity and strength. Other highly demanding tasks for aerobic capacity included combat movement (low/high crawl), dismounted attack in close country, urban and rough terrain and carrying heavy loads. There were no gender differences for either aerobic or strength demands in the top five most challenging tasks based on proportions.

Conclusions: This study identified the most physically demanding tasks performed in the Swedish ground combat forces. Almost all the physically demanding tasks found in the present study contain elements of lifting and carrying, which require muscular strength and muscular endurance, with no gender differences. © 2019 Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
Oxford: Elsevier, 2020
Keywords
Ground combat soldiers, Work-demands, Physical demand, Aerobic capacity
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:hh:diva-40998 (URN)10.1016/j.apergo.2019.103002 (DOI)31747636 (PubMedID)2-s2.0-85074946049 (Scopus ID)
Funder
Swedish Armed Forces
Available from: 2019-11-20 Created: 2019-11-20 Last updated: 2019-11-21
Lindholm, A., Roswall, J., Alm, B., Almquist-Tangen, G., Bremander, A., Dahlgren, J., . . . Bergman, S. (2019). Body mass index classification misses to identify children with an elevated waist-to-height ratio at 5 years of age. Pediatric Research, 85(1), 30-32
Open this publication in new window or tab >>Body mass index classification misses to identify children with an elevated waist-to-height ratio at 5 years of age
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2019 (English)In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 85, no 1, p. 30-32Article in journal (Refereed) Published
Abstract [en]

Background:  Abdominal adiposity is an important risk factor in the metabolic syndrome. Since BMI does not reveal fat distribution, waist-to-height ratio (WHtR) has been suggested as a better measure of abdominal adiposity in children, but only a few studies cover the preschool population. The aim of the present study was to examine BMI and WHtR growth patterns and their association regarding their ability to identify children with an elevated WHtR at 5 years of age.

Methods: A population-based longitudinal birth cohort study of 1540 children, followed from 0 to 5 years with nine measurement points. The children were classified as having WHtR standard deviation scores (WHtRSDS) <1 or ≥1 at 5 years. Student’s t-tests and Chi-squared tests were used in the analyses.

Results: Association between BMISDS and WHtRSDS at 5 years showed that 55% of children with WHtRSDS ≥1 at 5 years had normal BMISDS (p < 0.001). Children with WHtRSDS ≥1 at 5 years had from an early age significantly higher mean BMISDS and WHtRSDS than children with values <1.

Conclusions: BMI classification misses every second child with WHtRSDS ≥1 at 5 years, suggesting that WHtR adds value in identifying children with abdominal adiposity who may need further investigation regarding cardiometabolic risk factors.

© 2018, International Pediatric Research Foundation, Inc.

Place, publisher, year, edition, pages
New York, NY: Nature Publishing Group, 2019
National Category
Pediatrics
Identifiers
urn:nbn:se:hh:diva-38474 (URN)10.1038/s41390-018-0188-4 (DOI)30287892 (PubMedID)2-s2.0-85054473136 (Scopus ID)
Projects
Halland Health and Growth Study
Available from: 2018-12-03 Created: 2018-12-03 Last updated: 2019-04-24Bibliographically approved
Larsson, J., Engberg, A., Turnstedt, M., Dencker, M., Bremander, A. & Olsson, M. C. (2019). Cardiovascular Effects of Load Carriage in Soldiers; A Pilot Study. In: Bunc, V. & Tsolakidis, E. (Ed.), Book of Abstracts of the 24th Annual Congress of the European College of Sport Science – 3rd - 6th July 2019, Prague – Czech Republic: . Paper presented at 24th Annual Congress of the European College of Sport Science, ECSS, Prague, Czech Republic, 3-6 July, 2019 (pp. 422-423). European College of Sport Science
Open this publication in new window or tab >>Cardiovascular Effects of Load Carriage in Soldiers; A Pilot Study
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2019 (English)In: Book of Abstracts of the 24th Annual Congress of the European College of Sport Science – 3rd - 6th July 2019, Prague – Czech Republic / [ed] Bunc, V. & Tsolakidis, E., European College of Sport Science , 2019, p. 422-423Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Introduction: Previous studies have shown that risk of physical fatigue increases if prolonged average work intensity exceeds 50% of oxygen uptake (VO2). In order to avoid persistent fatigue in a work setting, it is important to conduct suitable work capacity analyses. In physically demanding jobs where wearing protective gear and/or external load is mandatory, monitoring of cardiovascular demands through heart rate (HR) is one way to track the workers’ relative effort.  There are limited studies examining effects of load carrying on cardiovascular capacity where it appears that VO2peak differ when soldiers and firefighters are tested with work-related equipment/clothing compared to light clothing. The aim of this pilot study was to investigate effects of load (combat gear) on HR, VO2 and muscle oxygen saturation (SmO2) compared to no load in soldiers during a graded treadmill protocol.

Methods: Eight volunteer army soldiers (1 woman, 7 men) performed a graded treadmill test until exhaustion. All soldiers performed the test twice, once with light clothes and no load (NL) and once with added load, their personal combat gear (CG), with at least 48 h between sessions. The treadmill protocol stages included supine and standing positions, followed by marching speeds of 5.4 km/h and 8 km/h at 0 incline (all 5 min) immediately followed by a set marching speed of 8 km/h with a starting incline of 2 % increasing the incline 2 % every third minute until voluntary exhaustion. Measurements of HR, VO2 and SmO2 were collected continuously and the last 30 s of each stage were averaged and used for statistical analyses (paired t-tests).

Results: The mean added load for all soldiers with CG was 16.8 ± 1.1 kg. All soldiers completed at least 6 stages (range 6-11 stages) with both NL and CG, where time to exhaustion with NL was longer (19.1 ± 3.2 min) compared to CG (9.1 ± 2.9 min; p <0.01). Submaximal HR and VO2 were both significantly higher with CG compared to NL (at absolute intensities) at all marching speeds all soldiers completed (5.4 km/h 0 % grade - 8 km/h 4% grade; all p<0.05). For SmO2, marching with CG compared to NL resulted in increased muscle oxygen utilization, at submaximal stages 8 km/h 0% -4% grade (all p<0.05). For values at maximal effort the CG had a significantly lower VO2peak (3.7 ± 0.5 L/min) compared to NL (4.1 ± 0.6 L/min, p <0.01), whereas there was no difference in HRpeak or the lowest value of SmO2 between CG (193.1 ± 7.2 bpm; 42.4 ± 30.3%) and NL (195.4 ± 8.9 bpm; 47.0 ± 29.2%).

Conclusions: This pilot study suggests that assessment of aerobic capacity in soldiers should be conducted with combat gear to help determine their actual work capacity during combat and other load carrying tasks. These results suggest that if soldiers’ work performance is determined without added load it overestimates their aerobic capacity (VO2peak) in tasks wearing combat gear, which might lead to added fatigability and deleterious effect on performance.

Place, publisher, year, edition, pages
European College of Sport Science, 2019
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:hh:diva-40393 (URN)978-3-9818414-2-8 (ISBN)
Conference
24th Annual Congress of the European College of Sport Science, ECSS, Prague, Czech Republic, 3-6 July, 2019
Available from: 2019-08-13 Created: 2019-08-13 Last updated: 2019-08-14Bibliographically approved
Malm, K., Bergman, S., Bremander, A., Larsson, I. & Andersson, M. L. E. (2019). Discussions of lifestyle habits as an integral part of care management: a cross-sectional cohort study in patients with established rheumatoid arthritis in Sweden. Rheumatology Advances in Practice, 3(2), Article ID rkz039.
Open this publication in new window or tab >>Discussions of lifestyle habits as an integral part of care management: a cross-sectional cohort study in patients with established rheumatoid arthritis in Sweden
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2019 (English)In: Rheumatology Advances in Practice, E-ISSN 2514-1775, Vol. 3, no 2, article id rkz039Article in journal (Refereed) Published
Abstract [en]

Objectives: The primary aim was to determine whether patients with RA recalled having discussions concerning lifestyle habits during their health-care visits. The secondary aim was to study the association between patients' reported lifestyle and their wish to discuss it.

Methods: A postal questionnaire sent to 1542 eligible patients from the Better Anti-Rheumatic Pharmacotherapy (BARFOT) study included questions on lifestyle habits (physical activity, diet, smoking and alcohol), on whether these were discussed during health-care visits and on whether there was an interest in such discussions.

Results: A total of 1061 patients (68%) responded [mean age 67 (s.d. 13) years, 73% women]. Half of the patients (49%) recalled discussions on physical activity, and 23% recalled discussions about diet. Those who reported health-enhancing levels of physical activity were more likely to discuss physical activity with their health professionals. Likewise, patients who reported having a non-traditional mixed diet were more likely to discuss diet. Smoking was discussed with 25% of the patients, more often with current smokers than with non-smokers (32 vs 17%; P < 0.001). Alcohol was discussed with 17% of the patients. Of those patients who reported having hazardous drinking habits, 77% had not discussed alcohol use with any health professional.

Conclusion: Discussions about lifestyle were recalled by half of the patients with established RA. There is a need for improvement, because lifestyle habits may affect the long-term outcome in a chronic disease, such as RA. Patient education concerning lifestyle habits should be an integral part of care management and an interactive process. © Malm et al. 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology.

Place, publisher, year, edition, pages
Oxford: Oxford University Press, 2019
Keywords
rheumatoid arthritis, lifestyle, habits, physical activity, diet, smoking, alcohol, discussion
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hh:diva-40912 (URN)10.1093/rap/rkz039 (DOI)31701084 (PubMedID)
Funder
Swedish Rheumatism Association
Note

Other funders: County Council of Halland Research Fund & Norrbacka-Eugenia Foundation

Available from: 2019-11-12 Created: 2019-11-12 Last updated: 2019-11-27Bibliographically approved
Haglund, E., Pinheiro Sant'Anna, A., Andersson, M., Bremander, 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)
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, p. -1458Article 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)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: 2019-12-09Bibliographically approved
Van der Elst, K., Bremander, A., De Groef, A., Larsson, I., Mathijssen, E. G. .., Vriezekolk, J. E., . . . van Eijk-Hustings, Y. J. .. (2019). European Qualitative research project on Patient-preferred outcomes in Early Rheumatoid Arthritis (EQPERA): rationale, design and methods of a multinational, multicentre, multilingual, longitudinal qualitative study. BMJ Open, 9(3), Article ID e023606.
Open this publication in new window or tab >>European Qualitative research project on Patient-preferred outcomes in Early Rheumatoid Arthritis (EQPERA): rationale, design and methods of a multinational, multicentre, multilingual, longitudinal qualitative study
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 3, article id e023606Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Including the patient perspective is important to achieve optimal outcomes in the treatment of rheumatoid arthritis (RA). Ample qualitative studies exist on patient outcomes in RA. A Belgian study recently unravelled what matters most to patients throughout the overwhelming and rapidly evolving early stage of RA. The present study, European Qualitative research project on Patient-preferred outcomes in Early Rheumatoid Arthritis (EQPERA) was created to contribute to a more universal understanding of patient-preferred health and treatment outcomes by integrating the perspectives of patients with early RA from three European countries.

METHODS AND ANALYSIS: In EQPERA, a qualitative, explorative, longitudinal study will be implemented in The Netherlands and Sweden, parallel to the methods applied in the previously conducted Belgian study. In each country, a purposive sample of patients with early RA will be individually interviewed 3-6 months after start of the initial RA treatment and subsequently, the same participants will be invited to take part in a focus group 12-18 months after RA treatment initiation. Data collection and analysis will be independently conducted by the local research teams in their native language. A meta-analysis of the local findings will be performed to explore and describe similarities, differences and patterns across countries.

ETHICS AND DISSEMINATION: Ethics approval was granted by the responsible local ethics committees. EQPERA follows the recommendations of the Declaration of Helsinki. Two main papers are foreseen (apart from the data reporting on the local findings) for peer-reviewed publication.

© Author(s) (or their employer(s)) 2019.

Place, publisher, year, edition, pages
London, UK: BMJ Publishing Group Ltd, 2019
Keywords
longitudinal study, patient preference, qualitative research, rheumatoid arthritis
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-39485 (URN)10.1136/bmjopen-2018-023606 (DOI)000413181404498 ()30918031 (PubMedID)2-s2.0-85063639513 (Scopus ID)
Funder
Swedish Rheumatism AssociationRegion Skåne
Note

Funding: Bristol-Myers Squibb, Fonds voor Wetenschappelijk Reuma Onderzoek (fund for Scientific Rheumatism Research) (Belgium), & Southern Health Care Region (Sweden)

Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-11-29Bibliographically 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
Nilsdotter, A. K., Cöster, M. E., Bremander, A. & Cöster, M. C. (2019). Patient-reported outcome after hallux valgus surgery — a two year follow up. Foot and Ankle Surgery, 25(4), 478-481
Open this publication in new window or tab >>Patient-reported outcome after hallux valgus surgery — a two year follow up
2019 (English)In: Foot and Ankle Surgery, ISSN 1268-7731, E-ISSN 1460-9584, Vol. 25, no 4, p. 478-481Article in journal (Refereed) Published
Abstract [en]

Background: Patients with hallux valgus deformity may require surgery but prospective patient-reported data is scarce.

Methods: We evaluated 53 patients with a mean age of 55.3 years (SD 14.1, 50 women), who underwent surgery due to hallux valgus. They completed the PROMs SEFAS, EQ-5D and SF-36 before and 6, 12 and 24 months after surgery.

Results: All patient-reported outcomes improved at 6, 12 and 24 months compared with the preoperative status. The greatest improvement occurred at 6 months: SEFAS Δ 10.0 (95% confidence interval 7.8–12.2), EQ-5D Δ 0.22 (0.15–0.29), EQ-VAS Δ 8.4 (4.4–12.4), PF SF-36 Δ 22.0 (14.6–29.3) and BP SF-36 Δ 30.6 (23.1–38.1).

Conclusions: Hallux valgus surgery considerably reduced pain and improved function already within 6 months after surgery. The improvement between 6 and 24 months’ follow-up was minimal measured with PROMs.

Level of clinical evidence: III — prospective observational cohort study.

© 2018 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
London, UK: Elsevier, 2019
Keywords
Hallux valgus, Function, Pain, Patient-reported outcome, Prospective, SEFAS
National Category
Surgery
Identifiers
urn:nbn:se:hh:diva-40799 (URN)10.1016/j.fas.2018.02.015 (DOI)000479133400011 ()30321964 (PubMedID)2-s2.0-85044145387 (Scopus ID)
Note

Financial support was received from the Kalmar Regional Funds, Herman Järhardts stiftelse, Stiftelsen för Skobranschens utvecklingsfond, Kockska stiftelsen and Svenska Reumakirurgiska föreningen (SRK).

Available from: 2019-11-05 Created: 2019-11-05 Last updated: 2019-11-07Bibliographically approved
Landgren, E., Bremander, A., Lindqvist, E., Van der Elst, K. & Larsson, I. (2019). To regain one’s health” – patients’ preferencesof treatment outcomes in early rheumatoid arthritis – a qualitative study.. In: Annals of the Rheumatic Diseases: . Paper presented at Annual European Congress of Rheumatology EULAR. Madrid, Spain, 12-15 June 2019. , 78, Article ID A648.
Open this publication in new window or tab >>To regain one’s health” – patients’ preferencesof treatment outcomes in early rheumatoid arthritis – a qualitative study.
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2019 (English)In: Annals of the Rheumatic Diseases, 2019, Vol. 78, article id A648Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Background: Rheumatology care strives to identify and meet the needs of the patients, and to understand disease and treatment impact from the patients’ perspective. A better understanding of patients’ expectations from the treatment is needed to enable a patient centered approach in clinical practice and a shared-decision making as recommended in the EULAR treatment recommendations for rheumatoid arthritis (RA). Understanding of patients’ expectations in the early stage of the RA disease may facilitate adherence to treatment, patient independence and prevent unmet needs in the future.

Objectives: To explore patients’ preferred treatment outcomes in early rheumatoid arthritis (eRA).

Methods: A qualitative, explorative study. Individual interviews were conducted with 31 patients with eRA, defined as disease duration of ≤ 1 year and disease-modifying antirheumatic drugs (DMARDs) treatment for 3-6 months 1 . Interviews were analyzed using a constant comparison method according to the Qualitative Analysis Guide of Leuven (QUAGOL) and lasted in a core category and four related concepts.

Results: The patient-preferred treatment outcomes in eRA were described in the core category “to regain one’s health” and the four related concepts: to experience external control of the disease, to experience independence, to regain identity and to experience joy in everyday life. The patients expected to experience external control of the disease by the given treatment to regain one’s health. It was perceived as controlling the symptoms and as absence of disease. Independence was perceived as regaining former activity levels, experiencing autonomy and using active coping strategies. Patients wanted to regain identity through participation, empowerment and their self-image. Joy in everyday life was perceived as vitality and believing in the future.

Conclusion: Patients’ preferred treatment outcomes in eRA were to regain one’s health including both external and internal control. External control as disease control and independence as well as internal control as identity and joy in everyday life. The results from this study can assist healthcare professionals to better understand patients’ preferred treatment outcomes early in the disease process and to tailor the interventions accordingly to improve long term treatment outcome.

Keywords
Rheumatoid arthritis
National Category
Medical and Health Sciences Health Sciences
Identifiers
urn:nbn:se:hh:diva-40917 (URN)10.1136/annrheumdis-2019-eular.1408 (DOI)
Conference
Annual European Congress of Rheumatology EULAR. Madrid, Spain, 12-15 June 2019
Available from: 2019-11-12 Created: 2019-11-12 Last updated: 2019-11-12
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8081-579X

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