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Vinblad, E., Svedberg, P., Nygren, J. M., Lönn, M., Olsson, E. & Larsson, I. (2019). Children and young people’s experiences of participation in pediatric rehabilitation: a qualitative study. Paper presented at 31st Annual Meeting of the European Academy of Childhood Disability Conference (EACD), Paris, France, May 23-25, 2019. Developmental Medicine & Child Neurology, 61(S2)
Open this publication in new window or tab >>Children and young people’s experiences of participation in pediatric rehabilitation: a qualitative study
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2019 (English)In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 61, no S2Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction: Creating a healthcare system of justice requires a child-centered care where children and young people, regardless of disability, are allowed to participate in their own rehabilitation. The aim of this study was to explore children and young people’s experiences of participation in pediatric rehabilitation.

Patients and methods: The study had a descriptive design with a qualitative content analysis approach. Interviews were conducted with 20 children (6-17 years old, 9 girls and 11 boys) and 8 young people (18-30 years old, 6 women and 2 men) with intellectual disabilities, physical disabilities or autism spectrum disorders.

Results: Three categories emerged that reflected children and young people’s experiences of participation in pediatric rehabilitation: to be included; to be empowered; and to feel supported. To be included meant that children and young people are respected, listened to and involved in shared decision-making. To be empowered comprised autonomy, responsibility and understanding as essential aspects for participation. To feel supported meant that children and young people described their parents as facilitators for enabling participation by supporting communication and being a bridge between child and professionals.

Conclusion: To increase participation, children need support in communication with the healthcare professionals in a way that they feel respected, empowered and able to be included in decisions concerning their own pediatric rehabilitation. This result constitutes an important step in the development of a forthcoming digital communication and decision tool, with the main objective to increase participation, for children with disabilities.

Place, publisher, year, edition, pages
Chichester: , 2019
Keywords
child, participation
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-39492 (URN)
Conference
31st Annual Meeting of the European Academy of Childhood Disability Conference (EACD), Paris, France, May 23-25, 2019
Note

Conference Poster

Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-09-30Bibliographically approved
Teleman, B., Karsson, C., Svedberg, P., Vinblad, E., Larsson, I. & Nygren, J. M. (2019). Co-construction of child personas in the development of a digital communication support system for increased participation in pediatric habilitation. Paper presented at 31st Annual Meeting of the European Academy of Childhood Disability (EACD), Paris, France, May 23-25, 2019. Developmental Medicine & Child Neurology, 61(S2), 17-17
Open this publication in new window or tab >>Co-construction of child personas in the development of a digital communication support system for increased participation in pediatric habilitation
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2019 (English)In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 61, no S2, p. 17-17Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction: Digital communication support systems have great potential to facilitate the provision of child-centered care where children and young people are allowed and enabled to participate in planning and decision-making in their own habilitation. The aim of this study was to co-construct child personas together with children and young adults from pediatric habilitation for the design of a digital communication support system.

Patients and methods: The child, parent and practitioner perspectives on goals, needs and behaviours in relation to participation in pediatric habilitation were characterized based on interviews with 20 children (6-17 years old) and 8 young people (18-30 years old) with intellectual disabilities, physical disabilities or autism spectrum disorders, 17 parents (aged 31-62 years) and 10 practitioners. Data were interpreted and explained together with children from the interviews (n=14) in two explorative design workshops and a validation workshop.

Results: We present findings and insights on how to co-construct child personas in the context of pediatric habilitation. The work resulted in three personas with different priorities that model the behaviors, attitudes, and goals of three user archetypes tailored for developing digital communication support systems in this particular use context.

Conclusion: By applying our progressive steps of data collection and analysis, we arrive at authentic child-personas that are now used to design and develop a digital communication support system for the particular goals, needs and behaviors of children in pediatric habilitation.

Place, publisher, year, edition, pages
Chichester: Wiley-Blackwell Publishing Inc., 2019
Keywords
Co-construction, digital communication tool, participation, personas
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-39493 (URN)10.1111/dmcn.14244 (DOI)
Conference
31st Annual Meeting of the European Academy of Childhood Disability (EACD), Paris, France, May 23-25, 2019
Note

Oral presentation 37

Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-10-02Bibliographically 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), 1-13, 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, p. 1-13, 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

Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-08-30
Holmqvist, G., Roxberg, Å., Larsson, I. & Lundqvist-Persson, C. (2019). Expressions of vitality affects and basic affects during art therapy and their meaning for inner change. International Journal of Art Therapy, 24(1), 30-39
Open this publication in new window or tab >>Expressions of vitality affects and basic affects during art therapy and their meaning for inner change
2019 (English)In: International Journal of Art Therapy, ISSN 1745-4832, Vol. 24, no 1, p. 30-39Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to describe the occurrence of vitality affects and basic affects and to shed light on their importance in terms of patients’ inner change through art therapy. In an earlier study, where 17 women were interviewed about inner change through art therapy, a secondary deductive content analysis of images and statements was performed exploring the presence of vitality affects and basic affects. Nine of the 17 interviews contained clear descriptions of vitality affects and basic affects in the intersubjective communication between the patient and the therapist; these affects were also mirrored in the patients’ painted images. Three cases are used to illustrate the result and how affects are related to inner change. These three cases differ from each other in that they describe vitality affects either; arising from the art therapist’s empathetic verbal or non-verbal response, from a particular experience in nature, or from the interpreted symbolic language of the image. The common denominator identified as uniting the three cases was the intersubjective communication with the therapist. This study indicates that image making in art therapy gives rise to vitality affects and basic affects that contribute to inner change. It also indicates the importance of having trust in both the method and the art therapist. © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

Place, publisher, year, edition, pages
Abingdon: Routledge, 2019
Keywords
Art therapy, vitality affects, basic affects, intersubjectivity, deductive content analysis
National Category
Other Medical Sciences Psychiatry
Identifiers
urn:nbn:se:hh:diva-35589 (URN)10.1080/17454832.2018.1480639 (DOI)2-s2.0-85049599402 (Scopus ID)
Note

As manuscript in thesis. Funding: This work was supported by FOU, Skaraborgs Hospital, Skövde [VGSKAS-663501], and Skaraborgs Institute for Research and Development, Skövde [09/1032].

Available from: 2017-11-29 Created: 2017-11-29 Last updated: 2019-02-28Bibliographically approved
Vinblad, E., Nygren, J. M., Karsson, C., Teleman, B., Svedberg, P. & Larsson, I. (2019). Parents’ expectations of a digital decision support tool for children with disabilities in pediatric rehabilitation – a qualitative study. In: 31st EACD Conference: . Paper presented at 31st EACD Conference, Paris, France, May 23-25, 2019.
Open this publication in new window or tab >>Parents’ expectations of a digital decision support tool for children with disabilities in pediatric rehabilitation – a qualitative study
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2019 (English)In: 31st EACD Conference, 2019Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Introduction: Children with disabilities usually have an extensive need for support from their parents in communication with healthcare professionals in pediatric rehabilitation. The aim of this study was to explore parents’ expectations of a digital communication and decision making tool for children with disabilities in pediatric rehabilitation.

Patients and methods: The study had a descriptive design with a qualitative content analysis approach. Interviews were conducted with 17 parents (aged 31-62 years, 13 mothers and 4 fathers) to children with intellectual disabilities, physical disabilities or autism spectrum disorders. Results: Three categories emerged reflecting parents’ expectation of how to increase participation in rehabilitation by using a digital communication and decision tool: 1) the children will become more confident with a higher self-esteem if they easily can express themselves and their inner thoughts 2) the children will respond more honestly without considering what their parents or healthcare professionals expect to hear 3) the children will become more independent if they have a possibility to be involved and understand decisions in their own rehabilitation.

Conclusion: The parents highlighted the importance of self-esteem as prerequisites to increase participation in rehabilitation for their children with disabilities, which they believed could be achieved by using a digital tool. A digital communication and decision making tool would strengthen the children’s voices in their own rehabilitation. This result constitutes therefore a basis in the development of a forthcoming digital communication and decision making tool, with the main objective to increase participation, for children with disabilities.

Keywords
Children, digital desicion support tool, parents, participation
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-39491 (URN)
Conference
31st EACD Conference, Paris, France, May 23-25, 2019
Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-09-24
Larsson, I., Nyman, C., Svedberg, P., Nygren, J. M. & Carlsson, I.-M. (2018). Children and young people’s participation in developing interventions in health and well-being: a scoping review. BMC Health Services Research, 18(507)
Open this publication in new window or tab >>Children and young people’s participation in developing interventions in health and well-being: a scoping review
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2018 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, no 507Article, review/survey (Refereed) Published
Abstract [en]

Background: Greater interest is being shown in participatory approaches, especially in research on interventions that concern children and young people'shealth and well-being. Although participatory approaches have user involvement in common, they differ in terms of the explicit guidance on how to actually involve and engage children and young people in health research. The aim of this scoping review was to systematically map recent research involving children and young people in the development of interventions targeting issues of health and well-being. Methods: An interpretative scoping literature review based on: a scientific literature search in (health and social science) databases, reference lists, a manual search in key journals and contact with existing networks was conducted. A total of 4458 references were identified through the literature search, of which 41 studies published between 2000 and 2017 were included in the review. The target population was children and young people under 25 years old. Level of participation was categorized according to Shier's Pathways to Participation Model. Results: The review showed that participatory approaches were most often used in the development of interventions in school settings and in community and healthcare settings and on issues concerning support in lifestyle or in managing illness or disease. The level of participation varied from children and young people taking part just as active informants, through stages of greater participation both in quantitative and qualitative terms, to children and youngpeople becoming an active agent involved as a co-researcher where the research process was shaped by views of a higher level of mutuality. Most of the studies were categorised at a medium level and only three studies were judged to involve the children and young people at the highest level. Conclusions: This scoping review showed that work remains in enabling children and young people to influence the development of interventions targeting health and well-being. In relation to level of sustainability in the interventions, it is relevant that goals, strategies and processes are formulated by those who can gain from the interventions. Participatory approaches aiming for a higher level of participation where children and young people work together with the researchers in partnerships are thus warranted. © 2018 The Author(s).

Place, publisher, year, edition, pages
London: BioMed Central, 2018
Keywords
Children, Intervention, Participatory approach, Scoping review, User involvement, Young people
National Category
Other Health Sciences
Identifiers
urn:nbn:se:hh:diva-38203 (URN)10.1186/s12913-018-3219-2 (DOI)000436841600004 ()29954392 (PubMedID)2-s2.0-85049212510 (Scopus ID)
Note

Funding Agency: Centre of Welfare, Health and Sports at Halmstad University

Available from: 2018-10-23 Created: 2018-10-23 Last updated: 2018-10-24Bibliographically approved
Malm, K., Bergman, S., Bremander, A., Larsson, I. & Andersson, M. L. (2018). Discussions of lifestyle habits as an integral part of care management in patients with established rheumatoid arthritis. Paper presented at Annual European Congress of Rheumatology EULAR, Amsterdam, Netherlands, 13-16 June, 2018. Annals of the Rheumatic Diseases, 77, 1817-1817, Article ID FRI10741-HPR.
Open this publication in new window or tab >>Discussions of lifestyle habits as an integral part of care management in patients with established rheumatoid arthritis
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2018 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, p. 1817-1817, article id FRI10741-HPRArticle in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Rheumatoid arthritis (RA) is associated with an increased risk of developing comorbidities which are known to be associated with lifestyle-related habits; such as having a sedentary lifestyle, having an unhealthy diet, smoking, and over-consumption of alcohol. In 2010, the European League Against Rheumatism (EULAR) published general guidelines on risk management in patients with RA, with an update 2017 (1,2) in which health professionals are encouraged to prioritize discussions with patients regarding their lifestyle and it is of interest to study the extent to which these discussions actually occur.

Objectives: To study if lifestyle habits; physical activity, diet, smoking and alcohol had been discussed with patients having RA during health care visits.

Methods: A cross-sectional postal survey in 2017 included 1542 eligible patients from the BARFOT (Better Anti-Rheumatic Pharmacotherapy) study. All patients received a questionnaire including lifestyle habits (physical activity, diet, smoking, and alcohol), and whether these habits had been discussed during health care visits. There was also a question regarding if they would have wanted such a discussion.

Results: 1,061 patients (68%) responded to the survey (mean age 67 years (SD 13); 73% women). Physical activity was discussed with 49% of the patients (figure 1A). Those who reported that they were active on a health-enhancing level were more likely to have discussed physical activity with health professionals. Diet had been discussed with 23% of the patients (figure 1B). Patients who reported a non-traditional mixed diet were more likely to have discussed diet. Smoking was discussed with 25% of the patients (figure 1C). Current smokers had more often discussed smoking habits with healthcare professionals compared with never smokers (32% vs. 17%; p=0.000). Alcohol had been discussed with 17% of the patients (figure 1D). Of the patients with hazardous drinking habits, 77% had not had a discussion regarding alcohol.

Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2018
Keywords
lifestyle habits, rheumatoid arthritis
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-37137 (URN)
Conference
Annual European Congress of Rheumatology EULAR, Amsterdam, Netherlands, 13-16 June, 2018
Note

On behalf of The BARFOT study group

Available from: 2018-06-18 Created: 2018-06-18 Last updated: 2018-07-27Bibliographically approved
Landgren, E., Bremander, A., Lindqvist, E., van der Elst, K. & Larsson, I. (2018). Patients’ experiences of health in early rheumatoid arthritis – a qualitative study. Paper presented at Annual European Congress of Rheumatology EULAR, Amsterdam, Netherlands, 13-16 June, 2018. Annals of the Rheumatic Diseases, 77, 1802-1803, Article ID FRI10707-HPR.
Open this publication in new window or tab >>Patients’ experiences of health in early rheumatoid arthritis – a qualitative study
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2018 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, p. 1802-1803, article id FRI10707-HPRArticle in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: The World Health Organization defines health as ”a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Health changes dramatically when a person becomes ill in a chronic disease as rheumatoid arthritis (RA). RA is a disease with great impact on all aspects of life. Living with RA affects patients’ health including physical, emotional, psychological and social aspects. The purpose of a person-centered care is to see patients as experts; sharing decisions with them and helping them manage their health. Therefore it is important to understand how patients in early disease stage of RA experience the concept of health.

Objectives: The purpose of this study was to describe patients’ experiences of health in early RA.

Methods: The study had a descriptive design with a qualitative content analysis approach. Individual interviews were conducted with 24 patients with early RA. In this study the patients had disease duration less than 12 months. A manifest qualitative content analysis was used to analyze the question: “What does health mean to you?”

Results: In the early stage of RA, patients experienced health as the most important goal in their life. They described health as well-being, independence, life satisfaction and vitality. Health as well-being meant to feel good, be painless and have a good sleep to feel rested. Health as independence meant to have both physical and financial prerequisites to perform everyday activities, to exercise and being able to travel. Health as life satisfaction meant to feel joy in life, enjoy the family and to believe in the future. Health as vitality meant to have the energy, power and strength to cope with everyday life. The patients expressed that their health had been adversely affected by the RA disease and they had a strong desire for full health including well-being, independence, life satisfaction and vitality.

Conclusions: Patients in an early stage of RA describe a strong desire to regain health in terms of well-being, independence, life satisfaction and vitality. The concept of health at early RA is similar to health at established RA in terms of well-being, independence and life satisfaction. Unique findings for patients with early RA are the description of health as vitality, and the emphasis of having energy, power and strength to cope with everyday life. Health professionals should have these different ways of experiencing health in mind when providing person-centred care to patients with early RA. Depending on the patients’ perception of health, different support strategies are needed.

Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2018
Keywords
Early rheumatoid arthritis, Health, Patients’ experiences, Qualitative study
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-37133 (URN)
Conference
Annual European Congress of Rheumatology EULAR, Amsterdam, Netherlands, 13-16 June, 2018
Available from: 2018-06-18 Created: 2018-06-18 Last updated: 2018-07-27Bibliographically approved
Larsson, I., Andersson, M. L., Ajeganova, S., Bala, V., Svensson, B., Bergman, S., . . . ֖stenson, A. (2018). Reasons to stop drinking alcohol among patients with rheumatoid arthritis in Sweden: A mixed-methods study. BMJ Open, 8(12), Article ID e024367.
Open this publication in new window or tab >>Reasons to stop drinking alcohol among patients with rheumatoid arthritis in Sweden: A mixed-methods study
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2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 12, article id e024367Article in journal (Refereed) Published
Abstract [en]

Objectives: The aims were to identify patients with rheumatoid arthritis (RA) who had stopped drinking alcohol and compare them with patients drinking alcohol, and to explore reasons for stopping drinking alcohol. Design: A sequential explanatory mixed methods design was used. Setting: Six rheumatology clinics in Southern Sweden Better Anti-Rheumatic FarmacOTherapy cohort. Participants: A total of 1509 patients completed the questions about alcohol and were included in the study. 86 of these had stopped drinking alcohol and 72 responded to the open question and their answers were analysed with qualitative content analysis. Outcome measures: The quantitative data were from a cross-sectional survey assessing disease severity, physical function (Health Assessment Questionnaire, HAQ) and health-related quality of life (EuroQol five dimensions, EQ5D), pain, fatigue, patient global assessment (PatGA) and lifestyle factors, for example, alcohol. The questions assessing alcohol included an open question ’Why have you stopped drinking alcohol?’ Results: The patients who stopped drinking alcohol were older (median (min-max) 69 (36-90) vs 66 (23-95), p=0.011), had worse HAQ (1.00 (0-2.75) vs 0.50 (0-3.00), p<0.001), worse EQ5D (0.69 (-0.02-1.00) vs 0.76 (-0.58-1.00), p<0.001) worse PatGA (5 (0-10) vs 3 (0-10), p<0.001), more pain (5 (0-10) vs 3 (0-10), p<0.001) and more fatigue (6 (0-10) vs 4 (0-10), p<0.001 compared with patients drinking alcohol. The qualitative content analysis revealed five categories describing reasons for patients with RA to stop drinking alcohol: illness and treatment; health and well-being; work and family; faith and belief; and dependences and abuse. Conclusions: The patients who had stopped drinking had worse physical functioning and higher levels in pain-related variables. Most stopped drinking due to their illness or a desire to improve health. © 2018 Author(s).

Place, publisher, year, edition, pages
BMJ Publishing Group, 2018
Keywords
qualitative research, rheumatology
National Category
Substance Abuse Nursing
Identifiers
urn:nbn:se:hh:diva-38698 (URN)10.1136/bmjopen-2018-024367 (DOI)2-s2.0-85058786151 (Scopus ID)
Note

For the BARFOT study group

Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-01-07Bibliographically approved
Aili, K., Andersson, M., Bremander, A., Haglund, E., Larsson, I. & Bergman, S. (2018). Sleep problems and fatigue as a predictor for the onset of chronic widespread painover a 5- and 18-year perspective: a 20-year prospective study. Paper presented at Annual European Congress of Rheumatology EULAR, Amsterdam, Netherlands, 13-16 June, 2018. Annals of the Rheumatic Diseases, 77, 87-87, Article ID OP0072.
Open this publication in new window or tab >>Sleep problems and fatigue as a predictor for the onset of chronic widespread painover a 5- and 18-year perspective: a 20-year prospective study
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2018 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, p. 87-87, article id OP0072Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: If localised pain represent one end of a pain spectra, with overall better general health, chronic widespread pain (CWP) and fibromyalgia represent the other end of the spectra with worse general health and more comorbidities with other somatic diseases and mental illness. Sleep problems and fatigue are common among individuals reporting CWP and previous research indicate that sleep problems may be an important predictor for pain prognosis.

Objectives: The aim of this population-based study was to investigate if sleep problems and fatigue predict the onset of CWP 5 and 18 years later.

Methods: In order to get more stable baseline classifications of CWP, a wash-out period was used, including only individuals who had not reported CWP (according to ACR 1990 criteria for fibromyalgia) at baseline (−98) and three years prior baseline (−95). In all, data from 1249 individuals entered the analyses for the 5 year follow-up (−03) and 791 entered for the 18 year follow-up (−16). Four parameters related to sleep (difficulties initiating sleep, maintaining sleep, early morning awakening and non-restorative sleep), and one parameter related to fatigue (SF-36 vitality scale) were investigated as predictors for CWP. Binary logistic regression analysis were used for analyses.

Results: All investigated parameters predicted the onset of CWP five years later (problems with initiating sleep (OR 1.91; 1.16–3.14), maintaining sleep (OR 1.85; 1.14–3.01), early awakening (OR 2.0; 1.37–3.75), non-restorative sleep (OR 2.27; 1.37–3.75) and fatigue (OR 3.70; 1.76–7.84)) in a model adjusted for age, gender, socio-economy and mental health. All parameters except problems with early awakening predicted the onset of CWP also 18 years later. In all, 785 individuals did not report any of the sleeping problems at baseline (fatigue not included), 268 reported one of the problems, 167 two, 128 three and 117 subjects reported to have all four sleep problems. Reporting all four sleep problems was significantly associated with CWP at follow-up at both time points when adjusting for age, gender, socio economy and mental health (OR 4.00; 2.03–7.91 and OR 3.95; 1.90–8.20); adjusting for age, gender, socio economy and number of pain regions (OR 2.94; 1.48–5.82 and OR 2.65; 1.24–5.64) and in a model adjusting for age, gender, socio economy and pain severity (OR 2.97;1.53–5.76; and OR 3.02;1.47–6.21) for the 5 year and 18 year follow-up respectively, compared to not reporting any of the sleep problems at baseline.

Conclusions: Both sleeping problems and fatigue predicts the onset of CWP 5- and 18 years later. The results highlight the importance of the assessment of sleep quality in the clinic.

Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2018
Keywords
Chronic widespread pain, Sleep problems
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-37138 (URN)
Conference
Annual European Congress of Rheumatology EULAR, Amsterdam, Netherlands, 13-16 June, 2018
Available from: 2018-06-18 Created: 2018-06-18 Last updated: 2018-07-26Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4341-660X

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