Purpose: To assess overall reliability and validity of a neck-specific questionnaire, the Profile Fitness Mapping neck questionnaire (ProFitMap-neck), on three chronic neck pain groups. Method: Participating groups were as follows: whiplash associated disorders, inpatient care (IP-WAD, n = 127); nonspecific neck pain, inpatient care (IP-NS, n = 83) and nonspecific neck pain subjects (non-IP-NS, n  = 104). All groups answered the ProFitMap-neck and the SF-36, whereas non-IP-NS also answered the Neck Disability Index (NDI) and the Functional Self-Efficacy Scale (SES). Internal consistency, test–retest reliability and components of convergent construct, face and content validity were determined for the ProFitMap-neck. Results: The ProFitMap-neck showed good internal consistency in all three groups, and ICC test–retest reliability (0.80–0.91). Good correlation (0.66–0.78) and highest agreement was reached with NDI. According to the International Classification of Functioning, Disability and Health, the symptom scale of the ProFitMap-neck was mainly classified to the domain of impairments–body functions, and the functional limitation scale to the activity limitation domain. Conclusion: The results indicate that the ProFitMap-neck is valid for measuring symptoms and functional limitations in people with chronic neck pain. The combination of a composite total score of symptoms and function as well as separate scores of each domain makes ProFitMap-neck suitable for research as well as in clinical practice.

Implications for Rehabilitation

• The ProFitMap-neck can be used as a valid self-assessment tool for measuring symptoms and functional limitations in people belonging to the most prevalent categories of neck pain.

• The combination of the symptom and functional limitation questionnaire scores in a total score can be used for an overall clinical judgment.

Background: Disability questionnaires for LBP-patients mostlyemanate from health professionals and have a content of differentdomains of disability presented as a single sum score, makingit difficult to derive changes within a specific domain. Thisstudy introduces a new back-specific questionnaire, the ProfileFitness Mapping questionnaire (PFM), which was based on patient’sself-reported characteristics of the LBP. The PFM incorporatesboth a functional limitation and a symptom scale, with furthersubdivision of the symptom scale in separate indices for severityand temporal aspects. The aim of the study was to assess theoverall validity of the PFM.

Methods and Results: Chronic LBP-patients (n=193) answered thePFM and four validated back-specific criterion questionnaires.The correlation coefficients between the PFM and the criterionquestionnaires showed good concurrent criterion validity (0.61– 0.83). The best discriminative ability between patientswith different pain severity was demonstrated by the functionallimitation scale of the PFM. Classification according to theICF revealed a high degree of homogeneous item content of thesymptom scale to the domain of impairments, and of the functionallimitation scale to the domain of activity limitations. Wellcentered score distribution indicates that the PFM has the potentialto detect improvement or worsening of symptoms and functionallimitations in chronic LBP-patients.

Conclusion: The results of the study signify that the PFM isa valid indicator of symptoms and functional limitations ofLBP-patients. It provides the combination of a composite totalscore and the possibility of evaluations within specific domainsof disability.

he present study assesses and evaluates the psychometric properties of a Swedish version of the Job Stress Survey (JSS; Spielberger, 1991; Spielberger & Vagg, 1999). This instrument is constructed to measure generic sources of occupational stress encountered by employees in a wide variety of work settings, settings that often result in psychological strain. The JSS was administered to metal assembly industry workers and medical service personnel in northern Sweden (n= 1186). The exploratory factor analysis showed that there is a high similarity between the present Swedish version and the original American version. Internal reliabilities of the scales, as well as test-retest reliabilities were shown to be high, and concurrent validity, as examined by comparisons with the Perceived Stress Questionnaire Index (Levenstein et al., 1993) was found to be satisfactory. The consistency of these findings is discussed with particular focus on groups of employees, gender, and cross-cultural evaluations.

The aim of the study was to evaluate the effects of individually prescribed physical exercise programmes on development of fatigue during the carrying of a loaded stretcher up and down the stairs. Nineteen ambulance personnel performed the training for 1 year. Testing occurred before and after 1 year of the training. Both the training group (n = 19) and the control group (n = 15) were assessed for physical capacity and lactate concentration in blood and ratings of perceived exertion during carrying a stretcher on the stairs. When comparisons were made between those who had been training three times/week for 1 year and the control group, lactate concentration was significantly decreased. In conclusion, markers of fatigue during stretcher carrying can be reduced by the use of individually prescribed physical exercise programmes.

The aim of this study was to explore the experience of bodily illness among people with musculoskeletal disorders (MSDs) in the neck/shoulder region. The study had a grounded theory approach, with constant comparisons and simultaneous data collection and analysis. Initially, parts of interviews about health experiences related to MSDs previously performed among men and women with musculoskeletal symptoms in the neck/shoulder and/or back were analysed. Next, complementary semi-structured interviews among men and women with neck/shoulder problems were performed, focusing on the experience of bodily illness, until saturation was reached. The results describe the experiences of bodily illness among people with MSDs in the neck/shoulder region as being characterized by uncontrollable fluctuations. The experiences are presented as a model of the disease course as experienced by the affected. The process usually developed from a beginning with insidious symptoms to a state of constant discomfort. Along the line of this development, periods of intermittent events of increasing illness occurred with peaks of consuming intensity. A variety of different symptoms was present during the process, which are presented in this paper. An increased knowledge of the disease course can be useful in prevention and treatment as communication about the disorder can be more specific.

OBJECTIVE: To evaluate the effects of a cognitive behavioural training programme and a physical activity programme for patients with stress-related illnesses. DESIGN: In a randomized controlled study, patients were allocated randomly to 1 of 3 groups, where group 1 participated in a cognitive behavioural training programme, group 2 participated in a physical activity programme, and group 3, the control group, was offered usual care for the course of the study. SUBJECTS: A total of 75 patients participated in the study. They had been on sick leave for at least 50% of the time for between 1 month and 2 years due to stress-related illnesses. METHODS: Measurements of autonomic activity, pressure-pain thresholds and subjective ratings of health and behaviour were made before and after a 10-week intervention period, and at 6 and 12 months after the intervention. RESULTS: Minor differences in autonomic activity and pressure-pain thresholds were found between the groups immediately after the intervention. At the 6- and 12-month follow-up assessments, the differences were no longer present. Patients in the cognitive behavioural training group improved their ratings of general health compared with the physical activity group throughout the study. CONCLUSION: The study showed little difference in the effect of cognitive behavioural training and physical activity, compared with usual care, for patients with stress-related illnesses.

Background: Musculoskeletal disorders (MSD) are a dominant cause to long-term sick leave and early retirement. Some occupational groups are more affected than others and ambulance personnel are among them. Despite a vast amount of research, only a small part focuses the experiences of the affected.

Objectives: The aim of the study was to explore the experience of illness and wellness in ambulance personnel with musculoskeletal symptoms.

Design: An emerging design was used in accordance with Grounded Theory.

Participants: Informants in the study were ten men with musculoskeletal symptoms, working as ambulance personnel at an ambulance station located in a mid-sized city in Sweden.

Methods: Narrative interviews were performed, parallel to a constant comparative analysis.

Results: The study resulted in a model, which describes the experience of illness and wellness as characterised by an effort to strike a balance. Wellness through nurturing appeared parallel to encountering illness as an experience and a threat. Accepting and handling illness was of importance to maintaining wellness, and wellness through nurturing was the motivation for accepting and handling illness.

Conclusions: Enhancing the understanding of wellness and illness makes it possible to avoid undermining the meaningfulness that support accepting and handling illness, and by understanding different aspects of illness prevention can become facilitated. This is of importance as other aspects than solely physical have shown to be similarly important in the development of MSD.

BACKGROUND: Musculoskeletal disorders (MSD) are one of the major causes of the high levels of long-term sickleave and early retirement, and healthcare personnel are among the occupational groups most affected. Only limited research in the area has focused on the experiences of those affected, and to increase the understanding of MSD, all dimensions of the health experiences need to be taken into consideration. OBJECTIVES: The aim of this paper was to explore the experiences of illness and wellness among female healthcare personnel with musculoskeletal symptoms. DESIGN: A qualitative grounded theory approach guided the study in data collection and analysis. SETTINGS: Medical and surgical ward units at three hospitals; one university hospital and two minor hospitals. PARTICIPANTS: Eight women, registered nurses and nursing aides, with neck, shoulder and/or back problems in early stages. METHODS: A grounded theory approach was used with narrative thematic interviews and parallel data analysis with constant comparisons. RESULTS: The analysis revealed a process of striving to reach a balance between illness and wellness, through accepting and handling illness. Illness appeared as a threat and an experience, while experiences of wellness were simultaneously nurtured. The informants were striving for balance through an inner reasoning leading to acceptance and by handling illness in various ways depending on the character of the illness. CONCLUSION: This paper indicates the diversity of the illness experience, the parallel importance of wellness, and the process of balancing these two in order to feel well enough. As previous research has shown that MSD has a multifactorial cause, a holistic view of health promotion, prevention and rehabilitation may provide a more effective tool than the bodily physical focus most frequently used today.

Many of the existing low back pain (LBP) questionnaires of function and symptoms have a content of different domains of disability presented as a single sum score, making it difficult to derive changes within a specific domain. The present study describes the development of a clinically derived back-specific questionnaire incorporating both a functional limitation and a symptom scale, with a further subdivision of the symptom scale in separate indices for severity and temporal aspects. The aims of the study were to assess the overall reliability and validity of the new questionnaire, named the Profile Fitness Mapping questionnaire (PFM). A total of 193 chronic LBP patients answered the PFM together with five validated criterion questionnaires. For the internal consistency of the questionnaires, the three indices of the PFM had the highest Cronbach's alpha (0.90-0.95) and all items had item-total correlations above 0.2. The correlation coefficients between the PFM and the back-specific criterion questionnaires ranged between 0.61 and 0.83, indicating good concurrent criterion validity. The best discriminative ability between patients with different pain severities was demonstrated by the functional limitation scale of the PFM. Well centered score distribution with no patient's score at the floor or the ceiling level indicates that the PFM has the potential to detect the improvement or worsening of symptoms and functional limitations in chronic LBP patients. Classification according to the International Classification of Functioning, Disability and health (ICF) of WHO revealed a high degree of homogeneous item content of the symptom scale to the domain of impairments, and of the functional limitation scale to the domain of activity limitations. The present study suggests that the PFM has a high internal consistency and is a valid indicator of symptoms and functional limitations of LBP patients. It offers the combination of a composite total score and the possibility of evaluations within specific domains of disability. Complementary evaluation of test-retest reliability and responsiveness to change is warranted.