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Hedlund, Å., Kristofferzon, M.-L., Boman, E. & Nilsson, A. (2023). A journey from darkness to a lighter, but changed, self: A qualitative study of women's drawings and comments describing their health and well-being after long-term sick leave for common mental disorders.
Open this publication in new window or tab >>A journey from darkness to a lighter, but changed, self: A qualitative study of women's drawings and comments describing their health and well-being after long-term sick leave for common mental disorders
2023 (English)In: Article in journal (Refereed) Submitted
National Category
Health Sciences
Research subject
Health-Promoting Work, Inkluderande arbetsliv
Identifiers
urn:nbn:se:hig:diva-43471 (URN)
Available from: 2023-12-18 Created: 2023-12-18 Last updated: 2023-12-18Bibliographically approved
Wiitavaara, B., Rissén, D. & Nilsson, A. (2023). Demographic and clinical factors associated with psychological wellbeing in people with chronic, non-specific musculoskeletal pain engaged in multimodal rehabilitation:– A cross-sectional study with a correlational design. Scandinavian Journal of Pain, 23(4), 705-711
Open this publication in new window or tab >>Demographic and clinical factors associated with psychological wellbeing in people with chronic, non-specific musculoskeletal pain engaged in multimodal rehabilitation:– A cross-sectional study with a correlational design
2023 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 23, no 4, p. 705-711Article in journal (Refereed) Published
Abstract [en]

Objectives

To investigate which demographic and clinical factors were associated with psychological wellbeing in working-aged people in multimodal rehabilitation for musculoskeletal disorders.

Methods

116 participants met the criteria for inclusion: persistent or intermittent pain for at least three months; pain that adversely impacts daily life; potential for active change despite pain; no co-morbidity or condition that will hinder participation in the rehabilitation program. Primary outcome was psychological wellbeing and independent measures were general, physical and mental health, pain intensity, limitations in daily life, depression and sleep.

Results

The results show decreased odds of psychological wellbeing for persons rating high on depression. The results remained significant after adjusting for sex and age. Being a woman increased the odds of high psychological wellbeing. Logistic regression showed that psychological wellbeing was not significantly associated with pain intensity; sleep; functional limitations; general, physical, or mental health. None of the other independent variables was significantly associated with high vs. low psychological wellbeing.

Conclusions

Depression turned out to be significantly related to psychological wellbeing, contrary to pain and limitations in daily life. If further studies with larger, random samples can confirm these results, this knowledge may be important both in clinical settings and in future research.

Place, publisher, year, edition, pages
De Gruyter, 2023
Keywords
depression; health; limitations in daily life; musculoskeletal disorders; pain; wellbeing
National Category
Occupational Health and Environmental Health
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-38425 (URN)10.1515/sjpain-2023-0028 (DOI)001029341000001 ()37440704 (PubMedID)2-s2.0-85165399431 (Scopus ID)
Available from: 2022-04-19 Created: 2022-04-19 Last updated: 2023-10-26Bibliographically approved
Hedlund, Å., Boman, E., Kristofferzon, M.-L. & Nilsson, A. (2023). Development and psychometric evaluation of a theory-based questionnaire measuring women’s return-to-work beliefs after long-term sick leave for common mental disorders. Work: A journal of Prevention, Assessment and rehabilitation, 76(1), 109-124
Open this publication in new window or tab >>Development and psychometric evaluation of a theory-based questionnaire measuring women’s return-to-work beliefs after long-term sick leave for common mental disorders
2023 (English)In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 76, no 1, p. 109-124Article in journal (Refereed) Published
Abstract [en]

Background: Common mental disorders (CMDs) are currently a major cause of long-term sick leave, with women being the most affected.Objective: Using the Theory of Planned Behaviour (TPB), we aimed to describe the development and psychometric evaluation of a new questionnaire to measure women's beliefs about return to work (RTW) after long-term sick leave for CMDs.Methods: Data were collected in central Sweden from women on long-term sick leave(2–24 months) for CMDs. The questionnaire was developed by conducting an elicitation study with 20 women and included direct and indirect measures. Subsequently, 282 women participated in a psychometric evaluation and 35 of them in a test-retest procedure. Psychometric properties were evaluated by determining reliability (internal consistency [Cronbach’s alpha] and test-retest stability [intraclasscorrelation coefficient]), construct validity (exploratory factor analysis) and content validity. Results: The development resulted in 60 questionnaire items. Content validity assessment showed that the women overall found it easy to complete the questionnaire. Reliability analyses showed satisfactory results for direct and indirect measures, with a few exceptions. Factor analyses of the indirect scales showed that items were generally in line with the TPB, but that items related to life as a whole/personal life and items related to work separated into two different factors. Conclusions: The questionnaire, called the RTW Beliefs Questionnaire, showed promising results and can among women with CMDs considered useful, especially scales for direct measures. This questionnaire gives the opportunity to identify new potential predictors for RTW.

Place, publisher, year, edition, pages
IOS Press, 2023
Keywords
Mental health recovery, Psychological Theory, Psychometrics, Rehabilitation
National Category
Nursing
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-40320 (URN)10.3233/WOR-220301 (DOI)001067722700009 ()36806536 (PubMedID)2-s2.0-85171600222 (Scopus ID)
Available from: 2022-10-29 Created: 2022-10-29 Last updated: 2024-01-03Bibliographically approved
Hedlund, Å., Kristofferzon, M.-L., Boman, E., Nieuwenhuijsen, K. & Nilsson, A. (2023). Women’s health and psychological well-being in the return-to-work process after long-term sick leave for common mental disorders: Women’s and first-line managers' perspectives. BMC Public Health
Open this publication in new window or tab >>Women’s health and psychological well-being in the return-to-work process after long-term sick leave for common mental disorders: Women’s and first-line managers' perspectives
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2023 (English)In: BMC Public Health, E-ISSN 1471-2458Article in journal (Refereed) Submitted
National Category
Health Sciences
Research subject
Health-Promoting Work, Inkluderande arbetsliv
Identifiers
urn:nbn:se:hig:diva-43470 (URN)
Available from: 2023-12-18 Created: 2023-12-18 Last updated: 2024-01-03Bibliographically approved
Hamberg Levedahl, K., Nilsson, A., Johansson, B. & Hedström, M. (2022). How persons with systemic mastocytosis describe the time between symptom onset and receiving diagnosis. Primary Health Care Research and Development, 23, Article ID e54.
Open this publication in new window or tab >>How persons with systemic mastocytosis describe the time between symptom onset and receiving diagnosis
2022 (English)In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 23, article id e54Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of the study was to explore how persons with systemic mastocytosis (SM) described the time between the onset of symptoms and signs and getting the diagnosis.

Background: SM is a rare disease caused by the accumulation of clonal mast cells with abnormal function. The symptoms and signs of the disease are varied, often diffuse and affect individuals differently. Due to this complexity, a multi-disciplinary diagnostic approach is required, in which general practitioners play an important part in identifying and referring patients relevant for such investigations.

Methods: Sixteen persons with SM were interviewed about their experiences of the time before the diagnosis was received. Systematic text condensation was used in the analysis process.

Findings: The time between symptom and signs onset and diagnosis was perceived as difficult. SM often had a complex and unpredictable effect on a person’s daily life, long before diagnosis. In the analysis, three themes were found. Having symptoms and signs with an unknown cause included the participants’ descriptions of numerous symptoms and signs, often years before diagnosis. These could be severe and result in worries for both participants and their next-of-kin. Dealing with the symptoms and signs encompassed the different ways in which the participants coped with the symptoms and signs, and sought relief. Being a patient without a diagnosis underlined the lack of information and knowledge within healthcare, often resulting in a delayed or incorrect diagnosis. The study highlighted the importance of a person-centred approach and the need to increase knowledge of the disease within primary care, to shorten this stressful and vulnerable time.

Place, publisher, year, edition, pages
Cambridge University Press, 2022
Keywords
Diagnosis delay, rare disease, systemic mastocytosis, qualitative, systematic text condensation
National Category
Nursing
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-34255 (URN)10.1017/S146342362200024X (DOI)000850449600001 ()36069067 (PubMedID)2-s2.0-85137313347 (Scopus ID)
Available from: 2020-11-15 Created: 2020-11-15 Last updated: 2022-09-19Bibliographically approved
Hamberg Levedahl, K., Nilsson, A., Ungerstedt, J. & Hedström, M. (2022). Living with systemic mastocytosis: balancing between vulnerability and resilience: A qualitative study. European Journal of Oncology Nursing, 60, Article ID 102172.
Open this publication in new window or tab >>Living with systemic mastocytosis: balancing between vulnerability and resilience: A qualitative study
2022 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 60, article id 102172Article in journal (Refereed) Published
Abstract [en]

Purpose Systemic mastocytosis (SM) is a rare group of hematological malignancies with heterogeneous symptoms from various organs, and overall survival ranges from normal for indolent SM (ISM) to 2–4 years for advanced SM subtypes (Adv SM). There is limited knowledge about the experience of living with SM. Thus, the purpose of this study was to describe the experiences of everyday life among persons diagnosed with ISM or Adv SM. 

Methods In this descriptive qualitative study, data were collected through purposive sampling and semi-structured interviews with 16 participants diagnosed with ISM (n = 9) or Adv SM (n = 7). Data were subsequently analysed with content analysis. 

Results Three main categories were identified. The persistent presence of the disease includes findings of how the symptoms affected the participants, how they handled its limitations, and the adaptions and medication management required. Struggling against ignorance illustrates contact with both healthcare professionals and strangers. The participants described being forced to be experts on SM due to a general lack of knowledge. An illness or wellness perspective encompasses the participants’ feelings of vulnerability and alienation, but also how various strategies were used to gain emotional control.

Conclusions 

The disease has a considerable impact on everyday life, with constant efforts required to manage symptoms and medication side effects. The complexity and rarity of the disease complicated relationships with healthcare professionals and contributed to feelings of marginalisation and alienation. The participants described feeling vulnerable but used a multitude of strategies in their striving for resilience. Trusting relationships with healthcare professionals, family members and friends promoted a wellness perspective. 

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Systemic mastocytosis, everyday life, experiences, qualitative study
National Category
Health Sciences
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-38982 (URN)10.1016/j.ejon.2022.102172 (DOI)000857247400006 ()35963124 (PubMedID)2-s2.0-85135941847 (Scopus ID)
Available from: 2022-06-14 Created: 2022-06-14 Last updated: 2022-10-06Bibliographically approved
Hedlund, Å., Nilsson, A., Boman, E. & Kristofferzon, M.-L. (2022). Predictors of return to work and psychological well-being among women during/after long-term sick leave due to common mental disorders - a prospective cohort study based on the theory of planned behaviour. Health & Social Care in the Community, 30(6), 5245-5258
Open this publication in new window or tab >>Predictors of return to work and psychological well-being among women during/after long-term sick leave due to common mental disorders - a prospective cohort study based on the theory of planned behaviour
2022 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 30, no 6, p. 5245-5258Article in journal (Refereed) Published
Abstract [en]

Common mental disorders are associated with long-term sick leave, especially among women. There is a lack of theory-based research regarding the impact of personal factors on return to work and psychological well-being. Therefore, the aim of this study was to examine whether return-to-work beliefs and perceived health were predictors of return to work and psychological well-being among women during or after long-term sick leave for common mental disorders, based on the Theory of Planned Behaviour. This was a prospective cohort study with a 1-year follow-up. At baseline, women (n = 282) had been on full- or part-time sick leave for common mental disorders for 2–24 months. Data were collected in October 2019–January 2020 and October 2020–January 2021 in Sweden. The Social Insurance Agency identified the women at baseline. The Return-To-Work Beliefs Questionnaire, EuroQol Visual Analogue Scale and General Health Questionnaire-12 were used. Multiple logistic and linear regression analyses were conducted. The women were divided into two groups: full-time sick leave or part-time sick leave at baseline. The results showed that stronger return-to-work intention significantly predicted return to work among women on full-time sick leave at baseline. No significant predictors of return to work were found among women on part-time sick leave at baseline. Psychological well-being was predicted by stronger social pressure to return to work (full-time group) and a more positive attitude toward returning to work and better perceived health (part-time group). We concluded that the Theory of Planned Behaviour can be useful for understanding return to work among women on full-time sick leave, and what underlies psychological well-being in both groups. However, return to work and psychological well-being were predicted by different factors, indicating that a multifactorial approach should be used in supporting women to return to work after long-term sick leave for common mental disorders.

Place, publisher, year, edition, pages
Wiley, 2022
Keywords
Common mental disorders, Psychological well-being, Return to work, Women
National Category
Nursing
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-39596 (URN)10.1111/hsc.13943 (DOI)000830456300001 ()35894151 (PubMedID)2-s2.0-85134969819 (Scopus ID)
Available from: 2022-07-13 Created: 2022-07-13 Last updated: 2024-01-03Bibliographically approved
Hedlund, Å., Kristofferzon, M.-L., Boman, E. & Nilsson, A. (2022). Vägen tillbaka: Vilka föreställningar har kvinnor till att återgå i arbete efter långtidssjukskrivning för psykisk ohälsa?. In: : . Paper presented at Forum för ArbetslivsForskning (FALF), Luleå Tekniska Universitet, 13-15 juni 2022.
Open this publication in new window or tab >>Vägen tillbaka: Vilka föreställningar har kvinnor till att återgå i arbete efter långtidssjukskrivning för psykisk ohälsa?
2022 (Swedish)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Health Sciences
Research subject
Health-Promoting Work, Inkluderande arbetsliv
Identifiers
urn:nbn:se:hig:diva-41755 (URN)
Conference
Forum för ArbetslivsForskning (FALF), Luleå Tekniska Universitet, 13-15 juni 2022
Available from: 2023-05-12 Created: 2023-05-12 Last updated: 2023-09-14Bibliographically approved
Hedlund, Å., Kristofferzon, M.-L., Boman, E. & Nilsson, A. (2021). Are return to work beliefs, psychological well-being and perceived health related to return-to-work intentions among women on long-term sick leave for common mental disorders? A cross-sectional study based on the Theory of Planned Behaviour. BMC Public Health, 21(1), Article ID 535.
Open this publication in new window or tab >>Are return to work beliefs, psychological well-being and perceived health related to return-to-work intentions among women on long-term sick leave for common mental disorders? A cross-sectional study based on the Theory of Planned Behaviour
2021 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 535Article in journal (Refereed) Published
Abstract [en]

Background: Long-term sick leave due to common mental disorders (CMDs) is a great burden in several countries. Women are more likely to be affected by CMDs. A strong intention to return to work (RTW) as well as symptom relief may facilitate RTW in this group. However, there is a lack of knowledge regarding what constitutes a strong intention. The Theory of Planned Behaviour is well-suited to identifying underlying beliefs about intentions to perform a behaviour. By including psychological well-being and perceived health, a more comprehensive picture of determinants of RTW intention might be achieved. Thus, the aim of the present study was to identify associations between RTW beliefs, psychological well-being, perceived health and RTW intentions among women on long-term sick leave due to CMDs, and to do so based on the Theory of Planned Behaviour.

Methods: The study was cross-sectional. Between October 2019 and January 2020, 282 women on long-term sick leave (>2 months) due to CMDs were included in the study. The questionnaires for data collection were: “RTW Beliefs Among Women-Questionnaire”, the “General Health Questionnaire -12” and the “EuroQol Visual Analogue Scale”. Standard multiple regression analysis was performed both with and without adjustment for potential confounders.

Results: The results showed that more positive attitude towards RTW, stronger social pressure to RTW, higher perceived control over RTW and higher psychological well-being were associated with stronger RTW intention. The adjusted analysis eliminated the importance of psychological well-being for RTW intention, but showed that women who reported that their employer had taken actions to facilitate their RTW had stronger RTW intention. 

Conclusion: The RTW beliefs, derived from the Theory of Planned Behaviour, were all important for a strong RTW intention, while psychological well-being and perceived health showed weaker associations. Furthermore, having an employer that take actions for facilitating RTW was associated with stronger RTW intentions. Though some caution is warranted regarding the representativeness of the sample, the results do improve our understanding of some important determinants of RTW intention among women on long-term sick leave for CMDs. 

Place, publisher, year, edition, pages
Springer, 2021
Keywords
Beliefs, Common mental disorders, Long-term sick leave, Return to work, Women
National Category
Health Sciences
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-34726 (URN)10.1186/s12889-021-10562-w (DOI)000631559800004 ()33740921 (PubMedID)2-s2.0-85102831363 (Scopus ID)
Available from: 2021-01-15 Created: 2021-01-15 Last updated: 2024-01-03Bibliographically approved
Hedlund, Å., Kristofferzon, M.-L., Boman, E. & Nilsson, A. (2021). Beliefs about return to work among women during/after long-term sick leave for common mental disorders: a qualitative study based on the theory of planned behaviour. Journal of occupational rehabilitation, 31, 604-612
Open this publication in new window or tab >>Beliefs about return to work among women during/after long-term sick leave for common mental disorders: a qualitative study based on the theory of planned behaviour
2021 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 31, p. 604-612Article in journal (Refereed) Published
Abstract [en]

Purpose: Long-term sick leave due to common mental disorders (CMDs) is an increasing problem, especially among women. To help these women return to work (RTW) sustainably, we need to know more about their own beliefs about RTW. One applicable theory is the theory of planned behaviour (TPB). Thus, the present study aimed to describe, based on the TPB, women's beliefs about RTW during or after long-term sick leave for a CMD.

Methods: A qualitative approach was used. Twenty women were included during a long-term sick leave period due to a CMD. A deductive content analysis was conducted using predetermined factors from the TPB: behavioural beliefs (advantages – disadvantages of RTW), normative beliefs (supporters and non-supporters of RTW), and control beliefs (facilitators of – barriers to RTW).

Results: The women believed that RTW would give them meaning and balance in life, but also that it would be challenging to maintain balance after RTW. They believed they had several supporters of RTW, but that the support was sometimes perceived as stressful rather than encouraging. Furthermore, individual adaptation and high demands were the most mentioned facilitator and barrier, respectively. Workplace conditions and personal strategies were thought to be important aspects.

Conclusions: By using the TPB, the present study was able to offer new findings on women’s beliefs about RTW after long-term sick leave for a CMD. Based on the findings, we suggest that various RTW stakeholders should focus on striving to provide the tasks and work pace women need so they can maintain their professional competence and sense of meaning.

Place, publisher, year, edition, pages
Springer, 2021
Keywords
Common mental disorders, Return to work, Sick leave, Women
National Category
Health Sciences
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-34319 (URN)10.1007/s10926-020-09946-3 (DOI)000611491100001 ()33492634 (PubMedID)2-s2.0-85099818163 (Scopus ID)
Available from: 2020-11-20 Created: 2020-11-20 Last updated: 2021-12-07Bibliographically approved
Projects
Arbetsmiljö och hälsa bland personal i äldreomsorgen: en modell för validering och lärande med stöd av IKT hos personal som saknar formell kompetens [100062]; University of GävleThe Intervention CAN-Work-S: Facilitating Work Participation among Cancer Survivors During their Entire Professional Career [2021-01546_Forte]; University of Gävle
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1969-0163

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