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  • 1.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Susann
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Hellström, Elisabeth
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Persson, Ulrika
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Petersson, Ingemar F.
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Patients' perceptions of drug dispensing in a rheumatological in-patient unit2005In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 3, no 4, p. 213-223Article in journal (Refereed)
    Abstract [en]

    Introduction:

    The dispensing of drugs in medical care systems is, in most countries, strictly regulated, and nurses are responsible for distributing drugs to in-patients.

    Aim:

    To describe the perceptions of patients with rheumatic diseases regarding traditional drug dispensing during in-patient care and rehabilitation in a specialized rheumatological care unit.

    Method:

    Twenty in-patients who stayed in the Spenshult Hospital unit for 3-4 weeks and who were on continuous medication were chosen for the study. The phenomenographic approach was used for the collection and analysis of data.

    Findings:

    Three descriptive categories emerged - Relief, Active Participation and Dependence. These descriptive categories comprised: three perceptions for Relief (to experience security, to be served, to dare to bother), two for Active Participation (to rely on one's own ability, to search for knowledge) and two for Dependence (lack of independence, lack of information).

    Conclusion:

    The patients experienced relief due to the nurse assuming responsibility for the medication and its dispensation. Patients expressed a wish to be more active in the management of their medication, as they trusted their own ability. The patients articulated that they were dependent on the nurse to give them the correct medication and they also asked for more information about their medication.

  • 2.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Tingström, Pia
    Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Psychometric Properties of the Swedish Rheumatic Disease Empowerment Scale, SWE-RES-232012In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 10, no 2, p. 101-109Article in journal (Refereed)
    Abstract [en]

    Introduction. Empowerment is a central concept in both rheumatology and diabetes care. A Swedish empower- ment instrument for patients with rheumatic diseases has not been created before now. The aim of the present study was to determine the psychometric properties of the Swedish Rheumatic Disease Empowerment Scale, SWE-RES-23, such as construct validity, internal consistency reliability, inter-item correlations and discriminant validity.

    Methods. The already existing instrument, the Swedish Diabetes Empowerment Scale (SWE-DES-23), was adapted for use in patients with rheumatic diseases. The adapted instrument was called the SWE-RES-23. In 2009, 260 patients with rheumatic diseases from a rheumatology unit in Sweden completed the instrument. Construct validity was tested by using exploratory factor analysis. Internal consistency reliability was tested by the use of Cronbach’s a-coefficient. In order to determine unidimensionality of the empowerment subscales, inter-item correlations were calculated. To establish discrim- inant validity, an item about self-perceived health from the Short Form (SF) 36 was used in addition to the SWE-RES-23.

    Results. The exploratory factor analysis resulted in five factors (empowerment subscales) with eigenvalues >1, explaining 64.1% of the total variance: Goal achievement and overcoming barriers to goal achievement; Self- knowledge; Managing stress; Assessing dissatisfaction and readiness to change; and Support for caring. Cronbach’s a values ranged from 0.59 to 0.91, and the value for the total score was 0.92.

    Conclusion. The results support the possibility of adapting the SWE-DES-23 for use in patients with rheumatic diseases. The SWE-RES-23 shows acceptable psychometric properties, in terms of construct validity and internal consistency reliability. To validate the SWE-RES-23 fully, further studies are needed, with a focus on test-retest correlations. Copyright © 2012 John Wiley & Sons, Ltd.

  • 3.
    Arvidsson, Susann
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Nylander, Maria
    Spenshult Research and Development Centre, Halmstad, Sweden & Swedish Rheumatism Association, Stockholm, Sweden.
    Bergman, Stefan
    Spenshult Research and Development Centre, Halmstad, Sweden & The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Callers´perceptions of their contact with a rheumatology telephone helpline2019In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 17, no 1, p. 105-112Article in journal (Refereed)
    Abstract [en]

    Background: Telephone helplines are useful for improving patients' access to healthcare services and reducing the need for frequent face‐to‐face contact with healthcare professionals. Little is known about how people who phone a helpline perceive the encounter.

    Objectives: The aims of the present study were to describe the variation in how callers perceive their encounter with a rheumatology telephone helpline.

    Methods: The  study  had  a  descriptive,  qualitative  design  and  used  a phenomenographic approach, comprising 27 semi‐structured telephone interviews with callers to Rheuma Direct, a rheumatology telephone helpline with specially trained nurses. The callers comprised 22 women and five men, aged 22–89 years (mean 54 years).

    Results: The callers phoned Rheuma Direct when they had problems obtaining answers to questions on the internet or from healthcare professionals. Three descriptive categories emerged: constructive dialogue, specialized competence and applicability. The callers perceived that it was a constructive dialogue when they were able to discuss their concerns with someone, received emotional support, felt reassured and were satisfied with the information provided. They perceived specialized competence when the nurses were experienced and skilful, the advice provided complemented previously received information and when they had more knowledge after the call. The callers perceived that Rheuma Direct had applicability because it was easy to access and they could make different choices before, during and after the telephone call. 

    Conclusions: Callers to a rheumatology telephone helpline perceived it as a valuable complement to other sources of information, and felt that it could provide them with the tools to manage their disease better, as well as future contacts with healthcare professionals. © 2018 The Authors Musculoskeletal Care published by John Wiley & Sons Ltd.

  • 4.
    Bergsten, Ulrika
    et al.
    Spenshult Hospital for Rheumatic diseases, Oskarström, Sweden & Sahlgrenska University Hospital, Gothenburg, Sweden.
    Andrey, A-M
    Swedish Rheumatism Association, Stockholm, Sweden.
    Bottner, L.
    Swedish Rheumatism Association, Stockholm, Sweden.
    Nylander, Maria
    Swedish Rheumatism Association, Stockholm, Sweden.
    Persson, G.
    Swedish Rheumatism Association, Stockholm, Sweden.
    Petersson, E.
    Swedish Rheumatism Association, Stockholm, Sweden.
    Bergman, Stefan
    Spenshult Hospital for Rheumatic diseases, Oskarström, Sweden.
    Patient-Initiated Research in Rheumatic Diseases in Sweden – Dignity, Identity and Quality of Life in Focus When Patients Set the Research Agenda2014In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 12, no 3, p. 194-197Article in journal (Refereed)
  • 5.
    Bergsten, Ulrika
    et al.
    Research and Development Centre at Spenshult Hospital, Oskarström, Swede.
    Bergman, Stefan
    Research and Development Centre at Spenshult Hospital, Oskarström, Swede.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Berglund, Anita
    Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Petersson, Ingemar F.
    Lund University Hospital, Lund, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Patients’ conceptions of the cause of their Rheumatoid Arthritis: A qualitative study2009In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 7, no 4, p. 243-255Article in journal (Refereed)
  • 6.
    Bergsten, Ulrika
    et al.
    Spenshult Hospital, Halmstad, Sweden.
    Petersson, Ingemar F.
    Spenshult Hospital, Halmstad, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Perception of tactile massage as a complement to other forms of pain relief in rheumatic disease2005In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 3, no 3, p. 157-167Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate how patients with rheumatic disease perceive tactile massage as a complement to other pain alleviation methods.

    Methods: A phenomenographic approach with semi-structured interviews was employed on a strategic sample of 14 patients with various rheumatic diseases, both inflammatory and non-inflammatory, who had been admitted to Spenshult Rheumatic Hospital.

    Results: Three descriptive categories with a total of nine conceptions emerged. The descriptive categories were: experiencing alleviation, experiencing trust, and gaining insight. Experiencing alleviation described how patients experience relaxation, pleasure and respite. Experiencing trust described how patients experience a sense of security, confirmation and inner peace. Gaining insight described how patients get to know themselves, see possibilities, and experience wholeness.

    Conclusions: When caring for patients who have a chronic illness involving considerable changes to their lives, it is important for health professionals not only to be aware of their physical needs but also to take account of the whole person. This study demonstrates the importance of offering patients a complement to conventional treatment. Tactile massage is a method that promotes a holistic view of patients with chronic pain as well as allowing them to find a new focus in terms of the disease and how they cope with it in their daily lives.

  • 7.
    Bremander, Ann
    et al.
    Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden & Spenshult Research and Development Center, Halmstad, Sweden.
    Haglund, Emma
    Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). Spenshult Research and Development Center, Halmstad, Sweden.
    Bergman, Stefan
    Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden & Spenshult Research and Development Center, Halmstad, Sweden & Primary Health Care Unit, Department ofPublic Health and Community Medicine,Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Ndosi, Mwidimi E.
    Department of Nursing and Midwifery, University of the West of England, Bristol, United Kingdom.
    The educational needs of patients with undifferentiated spondyloarthritis: Validation of the ENAT questionnaire and needs assessment2018In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 16, no 2, p. 313-317Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of the present study was to validate the Swedish version of the educational needs assessment tool (SwENAT) in undifferentiated spondyloarthritis (USpA) and use it to study the educational needs of patients with USpA.

    METHODS: This was a cross-sectional study, recruiting a random sample of patients with USpA from a hospital register in Sweden. Educational needs data were collected, together with disease activity and function indices (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] and Bath Ankylosing Spondylitis Functional Index [BASFI]). Rasch analysis was utilized to evaluate the construct validity, internal consistency and unidimensionality of the SwENAT before studying differences in educational needs between patient subgroups (gender, age and disease severity).

    RESULTS: = 11.488; p = 0.119), including strict unidimensionality. Overall, the mean (SD) SwENAT score was 86 (32). Women reported higher needs than men in the domains of pain (mean [SD] 13.1 [6.8] versus 10.1 [6.0]; p = 0.05); movement (mean [SD] 13.0 [5.5] versus 9.9 [5.7]; p = 0.02) and self-help (mean [SD] 17.0 [5.8] versus 14.1 [5.0]; p = 0.03). Higher disease activity (BASDAI >4) was associated with higher educational needs (mean [SD] 92.6 [31.9] versus 73.7 [29.4]; p = 0.02).

    CONCLUSIONS: These data suggest that the SwENAT is valid in USpA. Women and patients with higher disease activity are more likely to have high levels of educational needs, so special attention and strategies to target patient education are warranted. © 2018 John Wiley & Sons, Ltd.

  • 8.
    Bremander, Ann
    et al.
    Halmstad University, School of Business, Engineering and Science, Biological and Environmental Systems (BLESS). Research and Development Center, Spenshult Hospital, Oskarström, Sweden.
    Wikström, Ingegerd
    Musculoskeletal Sciences, Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden.
    Larsson, Ingrid
    Research and Development Center, Spenshult Hospital, Oskarström, Sweden.
    Bengtsson, Maria
    Department of Rheumatology, Clinical Sciences Lund and Malmö, Lund University, Lund, Sweden.
    Hagel, Sofia
    Department of Rheumatology, Clinical Sciences Lund and Malmö, Lund University, Lund, Sweden.
    Strömbeck, Britta
    Musculoskeletal Sciences, Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden.
    Cultural adaptation, validity, reliability and responsiveness of the Swedish version of the effective musculoskeletal consumer scale (EC-17)2012In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 10, no 1, p. 43-50Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Endorsed by the Outcome MEasures in Rheumatoid Arthritis in Clinical Trials (OMERACT) group, The Effective Consumer Scale (EC-17) was developed in English for patients with musculoskeletal diseases to assess the skills and perceptions important for participating in and managing health care. The objective of this study was culturally to adapt the questionnaire into Swedish and to study its psychometric properties.

    METHODS: After translation of the questionnaire into Swedish, two different groups of outpatients from two specialist rheumatology departments participated in the study. Face validity was assessed, together with internal consistency, test-retest and responsiveness of the questionnaire. Construct validity was assessed using the Arthritis Self-Efficacy Scale (ASES), and responsiveness to a five day educational intervention was analysed using the standardized response mean (SRM).

    RESULTS: Analyses were based on 124 patients with inflammatory rheumatic diseases, of whom 50 attended the intervention. Data quality met the requirements, with missing values <5%, and floor and ceiling effects <15%. Item total correlations were all >0.4, ranging from 0.49 to 0.88. Cronbach's alpha was 0.93 and 0.95 for the two groups. The test-retest correlation (ICC₂.₁) was 0.94, and there was a significant improvement as a result of the intervention, with an SRM of 0.43. However, the questionnaire had a higher construct validity with the ASES subscale 'other symptoms' than hypothesized a priori (r(s) 0.75).

    CONCLUSION: The Swedish version of the EC-17 met the required recommendations for face validity, internal consistency, test-retest reliability and responsiveness. Its construct validity needs to be further established, and the questionnaire needs further testing in different groups of patients and in different interventions. © 2012 John Wiley & Sons, Ltd.

  • 9.
    Folkhammar Andersson, Siv
    et al.
    Kalmar County Council, Oskarshamn, Sweden.
    Bergman, Stefan
    Lund University, Lund, Sweden & The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Welin Henriksson, Elisabet
    Karolinska Institutet, Huddinge, Sweden & Linköping University, Linköping, Sweden.
    Bremander, Ann
    Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). Lund University, Lund, Sweden.
    Arthritis management in primary care – a study of physiotherapists’ current practice, educational needs, and adherence to national guidelines2017In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 15, no 3, p. 333-340Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: With an increasing number of patients with osteoarthritis (OA) and rheumatoid arthritis (RA) in primary care, our aim was to investigate arthritis-related practice in physiotherapy and to study adherence to evidence-based care.

    METHODS: Seventy physiotherapists (PTs) working in primary care were emailed a questionnaire to investigate current practice and the number of roles assumed by PTs, the degree of confidence, educational needs and adherence to national guidelines in managing patients with OA or RA. Interventions supported by national guidelines were compared with reports of treatment modalities in the questionnaire.

    RESULTS: Sixty-four (91%) PTs responded, and they reported a higher degree of confidence in assessment, treatment and education of patients with OA than for those with RA (p < 0.001). The total number of roles assumed by the PTs was higher in the management of OA than for RA (p < 0.001). PTs who assumed a greater number of roles also reported a stronger degree of confidence in assessing OA (p = 0.036). Those who assumed fewer roles also reported less confidence in RA treatment (p = 0.045). Recommendations in the guidelines were followed by the majority of PTs for eight of 11 treatment modalities in OA and for six of six in RA.

    CONCLUSIONS: PTs reported a lower degree of confidence and the assumption of fewer roles in managing patients with RA compared with OA. There was good adherence to the national guidelines for almost all the treatment modalities listed. Even so, the results indicate a need for education, especially in chronic inflammatory arthritis care.

    Copyright © 2016 John Wiley & Sons, Ltd.

  • 10.
    Haglund, Emma K.
    et al.
    Research & Development Center, Spenshult Hospital, Oskarström, Sweden.
    Bremander, Ann B.
    Research & Development Center, Spenshult Hospital, Oskarström, Sweden.
    Aerobic capacity in patients with rheumatoid arthritis: A comparison of two submaximal test methods2009In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 7, no 4, p. 288-299Article in journal (Refereed)
    Abstract [en]

    Background: In a clinical setting it is important to evaluate aerobic capacity in individuals with rheumatoid arthritis (RA) and to have a choice between tests, owing to disability of varying severity. Two submaximal tests, a bicycle ergometer test and a treadmill walking test, are commonly used. Despite expected differences in the results, these tests have been used interchangeably. The aim of the current study was to compare the results of the two tests, the size of the difference and factors expected to influence the results.

    Methods: Fifty-two outpatients with RA performed the two tests. Agreement and correlations between the results of the tests were calculated. Multivariate analysis was used to study the relationships between gender, weight, health assessment questionnaire, global health assessment and the difference between the tests.

    Results: Sixty per cent of the subjects exhibited a higher estimated value of maximum oxygen uptake (O2max) in the treadmill test. The limits of agreement for the estimated O2max values between the two methods ranged from −13.4 to +18.4 ml × min−1 × kg−1, and the intraclass correlation coefficient (ICCTwo-way mixed) was 0.34 (95% confidence interval [CI] 0.07, 0.56). Body weight was independently associated with the difference between the two tests (regression coefficient 0.3; 95% CI 0.14, 0.42). A higher body weight had a greater impact on the results of the bicycle test (R2 = 0.28; regression coefficient −0.3; 95% CI −0.47, −0.17) than on the treadmill walking test (R2 = 0.02; regression coefficient −0.06; 95% CI −0.14, 0.03).

    Conclusions: It is not advisable to use the two submaximal methods interchangeably. Weight influenced the difference between the two tests, and to a higher degree in the bicycle test than the treadmill walking test. Copyright © 2008 John Wiley & Sons, Ltd.

  • 11.
    Larsson, Ingrid
    et al.
    Spenshult hospital, Oskarström, Sweden.
    Arvidsson, Susann
    Spenshult hospital, Oskarström, Sweden.
    Bergman, Stefan
    Spenshult hospital, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Patients´conceptions of drug information given by a rheumatology nurse: a phenomenographic study2010In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 8, no 1, p. 36-45Article in journal (Refereed)
    Abstract [en]

    Background:

    Pain, stiffness and functional restriction of the joints are the main problems experienced by patients with inflammatory rheumatic conditions. The majority of patients with rheumatic diseases require several drugs every day. Adherence is highest among patients who have repeatedly been given drug information by a nurse from the start of the treatment. When developing patient information, it is essential to utilize patients' experiences.

    Objectives:

    The purpose of this study was to describe variations in how patients with rheumatic diseases perceive drug information given by a rheumatology nurse.

    Methods:

    The study had a descriptive qualitative design with a phenomenographic approach. Fifteen inpatients with rheumatic diseases who had received a new drug agreed to take part in the study and were interviewed.

    Results:

    Three descriptive categories emerged: autonomy, power and security. Autonomy was based on patients' experiences of taking responsibility and participating. Power meant gaining knowledge and being motivated to take the drug. Security involved trust, experiencing care and access to a rheumatology nurse.

    Conclusions:

    For patients with a rheumatic disease, drug information from a rheumatology nurse gave them autonomy, power and security. These factors could explain why information from a nurse increases adherence to drug treatment.

  • 12.
    Larsson, Ingrid
    et al.
    Research and Development Centre, Spenshult Hospital, Oskarström, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital, Oskarström, Sweden.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Patients' dependence on a nurse for the administration of their intravenous anti-TNF therapy: A phenomenographic study2009In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 7, no 2, p. 93-105Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Pain, stiffness and functional restriction of the joints are the main problems for many patients with inflammatory rheumatic conditions. When conventional drugs fail to delay the development of the disease, the patient may require biological treatment such as anti-TNF therapy. Some biological drugs are administered in the form of intravenous infusions and thus the patient is obliged to attend a clinic in order to receive his/her medication, which can affect everyday life as well as independence. It is therefore important to focus on the patient perspective.

    AIM: The aim of this study was to describe variations in how patients with rheumatic conditions conceive their dependence on a nurse for the administration of their intravenous anti-TNF therapy.

    METHOD: The study had a descriptive qualitative design with a phenomenographic approach. Interviews were conducted with 20 patients.

    RESULT: Three descriptive categories and seven sub-categories emerged: Dependence that affords security (encountering continuity, encountering competence and obtaining information); Dependence that creates involvement (being allowed influence and being given freedom); Dependence that invigorates (obtaining relaxation and encountering the environment).

    CONCLUSION: The patients had not reflected on the fact that they were dependent on a nurse for the administration of their intravenous anti-TNF therapy, which may be due to their possibility to influence the treatment. The patients' needs should constitute the basis for the nurse's role in the provision of care.

  • 13.
    Mogard, Elisabeth
    et al.
    Lund University, Lund, Sweden & Skåne University Hospital, Lund, Sweden.
    Lindqvist, Elisabet
    Lund University, Lund, Sweden & Skåne University Hospital, Lund, Sweden.
    Bergman, Stefan
    Lund University, Lund, Sweden; Spenshult Research and Development Center, Halmstad, Sweden & The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Bremander, Ann
    Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). Lund University, Lund, Sweden & Spenshult Research and Development Center, Halmstad, Sweden.
    Spinal Mobility in Axial Spondyloarthritis: A Cross-Sectional Clinical Study2017In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 15, no 1, p. 36-48Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Research concerning spinal mobility in axial spondyloarthritis (axSpA) has focused on ankylosing spondylitis (AS), and data on the clinical diagnosis of undifferentiated spondyloarthritis (USpA) are limited. The objective was to study differences in spinal mobility between axSpA subgroups AS and USpA, including gender differences.

    METHODS: A total of 183 patients with axSpA from a rheumatology clinic were included in the study. The earliest recorded spinal mobility measures (cervical rotation/flexion/extension/lateral flexion, tragus-to-wall distance, vital capacity, chest expansion, thoracic flexion, thoracolumbar flexion, lateral spinal flexion, lumbar flexion and intermalleolar distance) were obtained by specialized physiotherapists. Differences between subgroups were analysed using analysis of covariance, controlled for gender and disease duration.

    RESULTS: In the USpA group (n = 57), the mean [standard deviation (SD)] age was 41.6 (11.4) years, and disease duration was 13 (10.6) years, with 54% men. In the AS group (n = 126), the mean (SD) age was 48.4 (13.5) years, and disease duration 24.6 (13.3) years, with 77% men. Spinal mobility was less restricted in USpA versus AS patients (p ≤ 0.05), with a median (interquartile range) tragus-to-wall distance of 11 (10-12) cm versus 13 (11.3-18.5) cm; thoracolumbar flexion 9 (7-10) cm versus 6.5 (4-9) cm; lateral spinal flexion 29 (25-36) cm versus 21.3 (12-31) cm; lumbar flexion 4.5 (3.5-5.0) cm versus 3.5 (2.0-4.5) cm and intermalleolar distance 113 (102-121) cm versus 101 (86-114) cm. There were no differences between the subgroups in cervical mobility, vital capacity, chest expansion or thoracic flexion, and there were few gender differences, besides anthropometric measures.

    CONCLUSION: Patients with USpA and AS had similar cervical and chest mobility, while thoracic and lumbar mobility were more severely restricted in AS. There were few gender differences in either subgroup. Further studies, to understand the full impact of USpA on spinal mobility, are needed. Copyright © 2016 John Wiley & Sons, Ltd.

  • 14.
    Sjöquist, Emma S.
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden & Department of Physiotherapy, Karolinska University Hospital, Huddinge, Sweden.
    Brodin, Nina
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
    Lampa, Jon
    Department of Rheumatology, Karolinska University Hospital, Solna, Sweden.
    Jensen, Irene
    Department of Public Health Sciences, Division of Intervention and Implementation Research, Karolinska Institutet, Solna, Sweden.
    Opava, Christina H.
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden & Department of Rheumatology, Karolinska University Hospital, Solna, Sweden.
    Algebrandt, Marita
    Linköping University Hospital, Linköping, Sweden.
    Almin, Ingrid
    Örebro University Hospital, Örebro, Sweden.
    Andersson, Britt
    Karolinska University Hospital, Solna, Stockholm, Sweden.
    Bertholds, Gunhild
    Skövde Hospital, Skövde, Sweden.
    Forsberg, Catarina
    Falun Hospital, Falun, Sweden.
    Haglund, Emma
    Spenshult AB, Oskarström, Sweden.
    Holmén-Andersson, Ann‐Marie
    Sahlgrenska University Hospital, Mölndal, Sweden.
    Hultman, Anna
    Uppsala University Hospital, Uppsala, Sweden.
    Lennartsson, Claudia
    Karolinska University Hospital, Huddinge, Stockholm, Sweden.
    Norman, Elin
    Danderyd Hospital, Stockholm, Sweden.
    Physical Activity Coaching of Patients with Rheumatoid Arthritis in Everyday Practice: A Long-term Follow-up2011In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 9, no 2, p. 75-85Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate the long-term effects on perceived general health, disease activity, pain, activity limitation and cognitive behavioural factors of a one-year coaching programme performed in ordinary physical therapy practice to promote the adoption of health-enhancing physical activity in patients with early rheumatoid arthritis (RA).

    METHODS: A total of 228 patients with early RA, from 10 rheumatology clinics in Sweden, were randomly assigned to an intervention group (IG; n = 94) or a control group (CG; n = 134). The IG was coached by physical therapists during the first year to adopt health-enhancing levels of physical activity (30 minutes/day, moderately intensive, ≥ 4 days/week). No coaching was given during the subsequent year between post-intervention and follow-up. Follow-up assessment consisted of a postal questionnaire on physical activity and of visual analogue scales for ratings of general health perception and pain. The Health Assessment Questionnaire Disability Index (HAQ) and the Disease Activity Score in 28 joints (DAS 28) were collected at regular medical check-ups.

    RESULTS: Sixty-five (69%) participants in the IG and 92 (69%) in the CG completed the entire study period by filling in the follow-up questionnaire on physical activity two years after baseline. The intervention seemed to lack any significant influence on long-term outcome. However, different patterns of change in physical activity behaviour were observed in the two groups.

    CONCLUSIONS: No long-term improvement in perceived general health or other outcomes were found in the follow-up. This may partly be because the intervention lacked several important behavioural elements for physical activity maintenance. Copyright © 2011 John Wiley & Sons, Ltd.

  • 15.
    Wikström, Ingegerd
    et al.
    Department of Rheumatology, Malmö University Hospital, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Nilsson, Käth
    Department of Rheumatology, Malmö University Hospital, Sweden.
    Roos, Ewa
    Department of Orthopaedics, Clinical Sciences, Lund University, Sweden.
    Jacobsson, Lennart
    Department of Rheumatology, Malmö University Hospital, Sweden.
    Reliability, validity and responsiveness of a new leisure index: The Patient-Specific Leisure Scale (PSLS)2009In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 7, no 3, p. 178-193Article in journal (Refereed)
    Abstract [en]

    Objectives:

    To investigate the reliability, validity and responsiveness of a new Patient-Specific Leisure Scale (PSLS), constructed to identify goals and outcomes for individual patients with rheumatoid arthritis (RA).

    Methods:

    Forty-nine patients with RA were used to evaluate test-retest reliability, and 100 consecutive RA patients were used for construct validity. Twenty-five RA patients, commencing with treatment on tumour necrosis factor (TNF) inhibitors, were evaluated before the start and after three months of therapy, to test responsiveness. The most important leisure activity (as judged by the patients) was used when evaluating reliability and validity. The perceived difficulty with each activity was scored from 0 to 10 (0 = able to perform activity without difficulty, 10 = unable to perform activity).

    Results:

    Test-retest reliability indicated a good agreement (0.62-0.87) using weighted kappa. Construct validity was demonstrated by modest positive correlation between leisure activity and Health Assessment Questionnaire (HAQ) (rs = 0.27, p = 0.005) visual analogue scale (VAS) pain (rs = 0.28, p = 0.004) VAS global (rs = 0.22, p = 0.027), VAS fatigue (rs = 0.24, p = 0.013), joint index of 28 swollen joints (rs = 0.22, p = 0.027) and negative correlations with short-form-36 (SF-36) physical functioning (rs = -0.18, p = 0.008), bodily pain (rs = -0.31, p < 0.001), general health (rs = -0.23, p = 0.019), vitality (rs = -0.31, p < 0.001), social function (rs = -0.24, p = 0.016) and role-emotional (rs = -0.28, p = 0.005). Mean improvement for the most important leisure activity was 1.36, (p = 0.036, 95% confidence interval 0.10-2.62). Standardized response mean and effect size for the most important activity in PSLS was 1.05 and 0.72, respectively, and for HAQ 0.34 and 0.28, respectively.

    Conclusions:

    PSLS appears to be feasible, reliable, valid and responsive for measuring leisure activities in RA. It provides both an individual result which is useful in clinical work, and results at a group level.

  • 16.
    Wikström, Ingegerd
    et al.
    Department of Rheumatology, Malmö University Hospital, Sweden.
    Jacobsson, Lennart
    Department of Rheumatology, Malmö University Hospital, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    How people with rheumatoid arthritis perceive leisure activities: A qualitative study2005In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 3, no 2, p. 74-84Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore how people with rheumatoid arthritis (RA) perceive leisure activities. METHOD: A phenomenographic approach using semi-structured interviews to explore the impact of RA on leisure pursuits was used. RESULTS: Three descriptive categories containing 11 conceptions emerged: (1) Experiencing constraints included four conceptions: seeing limitations, needing time, finding balance, being dependent. (2) Experiencing coherence included four conceptions: accepting feelings participating in a social context, being active, having insight. (3) Finding solutions included three conceptions: choosing, planning, and adapting. CONCLUSIONS: This study emphasizes the limited choices and problems people with RA had participating in leisure activities, as well as its impact on self-esteem.

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