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  • 1.
    Dahl, Joanne
    et al.
    University of Gävle, Department of Education and Psychology, Ämnesavdelningen för psykologi.
    Nilsson, Annika
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Evaluation of a randomized preventive behavioural medicine work site intervention for public health workers at risk for developing chronic pain.2001In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 5, no 4, p. 421-432Article in journal (Refereed)
  • 2.
    Dahl, Joanne
    et al.
    University of Gävle, Department of Education and Psychology, Ämnesavdelningen för psykologi.
    Wilson, Kelly G
    University of Missisippi.
    Nilsson, Annika
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Acceptance and Commitment Therapy and the Treatment of Persons at Risk for Long-Term disability resulting from stress and pain symptoms: A Preliminary Randomizad trial2004In: Behavior Therapy, ISSN 0005-7894, E-ISSN 1878-1888, Vol. 35, no 4, p. 785-801Article in journal (Refereed)
    Abstract [en]

    Approximately 14% of the working-age Swedish population are either on long-term sick leave or early retirement due to disability. Substantial increase of sick listing,reports of work disabilities and early retirement due to stress and musculoskeletal

    chronic pain suggest a need for methods of preventing loss of function resulting from these conditions. The present preliminary investigation examined the effects of a brief Acceptance and Commitment Therapy (ACT) intervention for the treatment of public health sector workers who showed chronic stress/pain and were at risk for high sick leave utilization. ACT was compared in an additive treatment design with medical treatment as usual (MTAU). A group of 19 participants were randomly distributed

    into 2 groups. Both conditions received MTAU. The ACT condition receivedfour 1-hour weekly sessions of ACT in addition to MTAU. At post and 6-month followup, ACT participants showed fewer sick days and used fewer medical treatment resources

    than those in the MTAU condition. No significant differences were found inlevels of pain, stress, or quality of life. Improvements in sick leave and medical utilization could not be accounted for by remission of stress and pain in the ACT group

    as no between-group differences were found for stress or pain symptoms.

  • 3.
    Dahlkvist, Eva
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Residents’ use and perceptions of residential care facility gardens: a behavior mapping and conversation study2019In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743Article in journal (Refereed)
    Abstract [en]

    Aim

    To describe the gardens and their use by individuals living at residential care facilities (RCFs) with high ratings on restorative values.

    Background

    Being outdoors has been described as important to older people's well‐being. Use of outdoor gardens may increase residents’ well‐being through experiences of restorative qualities such as being away and fascination. Thus far, there has been little research on restorative experiences of gardens in the care of older people.

    Design

    A descriptive design using behaviour mapping observations integrated with qualitative field notes and recorded conversations.

    Methods

    A criterion sampling of two gardens (out of a total of 87) was made based on residents’ ratings of restorative values; the two with the highest values were chosen. Eleven residents at the two RCFs took part. Data were collected through behaviour mapping observations, field notes and conversations on five occasions in the respective facilities during residents’ visits to the garden.

    Results

    The observations revealed that the main uses of the gardens were to socialise and relax. The conversations also showed that the garden stimulated residents’ senses and evoked memories from the past. These restorative values were interpreted as a sense of being away and fascination. Not having opportunities for outdoor visits was reported to result in disappointment and reduced well‐being.

    Conclusions

    The findings showed that two basic gardens with different characteristics and views could stimulate residents’ senses and evoke memories from the past; this supports the call for residents to be able to spend time in gardens to promote their well‐being.

    Implications for practice

    First‐line managers, nurses and healthcare staff in the care of older people should consider that regular opportunities to spend time outdoors may promote older people's well‐being through feelings of being away and fascination.

  • 4.
    Dahlkvist, Eva
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Health and Medicine, Örebro University, Örebro, Sweden.
    Hartig, Terry
    Department of Psychology, Uppsala university, Uppsala, Sweden; Institute for Housing and Urban Research,Uppsala university, Uppsala, Sweden.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Skovdahl, Kirsti
    Faculty of Health Sciences, Buskerud and Vestfold university, Norway.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Garden greenery and the health of older people in residential care facilities: A multi-level cross-sectional study2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 9, p. 2065-2076Article in journal (Refereed)
    Abstract [en]

    AIMS:

    To test the relationship between greenery in gardens at residential facilities for older people and the self-perceived health of residents, mediated by experiences of being away and fascination when in the garden and the frequency of visitation there. To examine how these indirect effects vary with the number of physical barriers to visiting the garden.

    BACKGROUND:

    Many older people in residential facilities suffer from complex health problems. Access to a green outdoor environment may enable psychological distance, engage effortless attention, encourage more frequent visitation and promote resident health.

    DESIGN:

    A multi-level, cross-sectional, correlational design.

    METHODS:

    Questionnaires were administered June-August, 2011 to convenience samples of residents at 72 facilities for older people with complex healthcare needs. One to 10 eligible residents were sampled during self-motivated garden visits at each facility (n = 290). They reported on their garden experiences and health. Facility staff reported on objective garden characteristics and barriers to access. A serial mediation model was tested with multiple linear regression analysis.

    RESULTS:

    The total indirect effect of greenery on self-perceived health was positive and significant. Garden greenery appears to affect health by enhancing a sense of being away, affording possibilities to experience the outdoor environment as interesting and encouraging visitation. Among residents in homes with multiple barriers, only fascination mediated the relationship between greenery and self-perceived health.

    CONCLUSION:

    Ample greenery in outdoor space at residential facilities for older people appears to promote experiences of being away and fascination, more frequent visitation and better health.

  • 5.
    Dahlkvist, Eva
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Health and Medicine, Örebro University.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University.
    Skovdahl, Kirsti
    Örebro Universitet, Institutionen för Hälsovetenskap och medicin.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University.
    Is there a caring perspective in garden/patio design in elderly care?: a description and a comparison of residents' and staff members' perceptions of these outdoor spaces2014In: Journal of Housing for the Elderly, ISSN 0276-3893, E-ISSN 1540-353X, Vol. 28, no 1, p. 85-106Article in journal (Refereed)
    Abstract [en]

    This article aimed to describe characteristics of and design elements in gardens/patios at 87 residential living homes for older people and to describe and compare residents’ and staff members’ perceptions of these spaces. The result showed that many gardens/patios had several recommended design elements and at the same time obvious deficiencies. The residents (n=415) valued various aspects of the garden/patio more highly than the staff did (n=667). One conclusion is that managers responsible for residential living homes for older people should pay attention to and takes measures to ameliorate shortcomings and deficient elements in design and accessibility so that the garden/patio can be used as an important health promotion resource in the care of older people. Residents and staff can be seen as very important actors in such development work.

     

  • 6.
    Engström, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    Working life and stress symptoms among caregivers in elderly care with formal and no formal competence2011In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 19, no 6, p. 732-741Article in journal (Refereed)
    Abstract [en]

    Working life and stress symptoms among caregivers in elderly care with formal and no formal competence Aim  The aim of the present study was to describe and compare caregivers with formal and no formal competence on job satisfaction, psychosomatic health, structural and psychological empowerment and perceptions of care quality. A further aim was to study relationships among study variables. Methods  A convenience sample of 572 caregivers in elderly care participated. Results  Caregivers with no formal competence perceived higher workload, more communication obstacles, less competence, poorer sleep and more stress symptoms than did their colleagues. Linear regression analyses revealed that the factor self-determination was an explanatory variable of stress levels among caregivers with no formal competence, and self-determination and impact among caregivers with formal competence. Linear regression analysis revealed that different dimensions in structural and psychological empowerment explained the variance in staff job satisfaction, perceived stress symptoms and quality of care. Conclusions  No formal competence seems to be a risk factor for psychosomatic health problems. Implications for nursing management  Managers need to have a strategic plan for how to create a working environment for caregivers with no formal competence. Caregivers' self-determination seems to be important for stress symptoms. Meaning, self-determination, impact and opportunities appear to be important for job satisfaction and competence, opportunities, resources and formal power for quality of care.

  • 7.
    Eriksson, Elisabet
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Wejåker, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Danhard, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Living with a spouse with chronic illness – the challenge of balancing demands and resources2019In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, no 1, article id 422Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. To describe the partners’ experiences of living with a person with chronic illness and how they manage everyday life.

    Background. The number of partners providing informal care for their chronically ill spouse is rising, and they describe their daily life as demanding.

    Design. A descriptive design with a qualitative approach was used.   

    Methods. A purposive sample of 16 partners with a chronically ill spouse were interviewed. The interviews were recorded, transcribed, and analyzed using qualitative content analysis.

    Results Four main themes were identified: ‘Living with challenges caused by the spouse's disease,’ ‘Seeking support for living with the spouse’s illness,’ ‘Appreciating the good parts of life’ and ‘Adapting to constant changes and an uncertain future.’ The participants rated their health as rather good and had great confidence in their own ability to cope with daily life. Their experiences of support from formal care providers varied; they expressed the need for more assistance from the health care sector.

    Conclusions. The partners experienced many challenges in everyday life when providing informal care for their chronically ill spouse. This affected both their physical and psychological health, as they had limited time for themselves. The partners seemed to receive more support from their informal network than from formal care providers. In handling daily life, the partners balanced demands and resources to identify possibilities to move forward and find meaning in life.

    Relevance to clinical practice. Formal care providers must acknowledge partners' needs, develop evidence-based assessment guidelines, and provide efficient support to partners with a chronically ill spouse. 

  • 8.
    Forsberg, Markus
    et al.
    Department of Anaesthesia, Gävle Sjukhus, Gävle, Sweden.
    Björn, Catrine
    Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala, Sweden; Centre for Research & Development, Gävleborg, Gävle, Sweden.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Nurse anesthetists' reflections on caring for patients with previous substance dependence: Balancing between professionalism and preconceptions2018In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 1, p. 69-77Article in journal (Refereed)
    Abstract [en]

    Purpose

    The study aim was to describe nurse anaesthetists’ reflections on provision of perioperative care to patients with previous substance dependence.

    Design

    A qualitative approach with a descriptive design.

    Methods

    Semi-structured interviews based on clinical vignettes were conducted with ten nurse anaesthetists.

    Findings

    The perioperative care provided to patients with previous substance dependence was perceived as balancing between professionalism and preconceptions for this specific patient group. The nurse anaesthetists felt that anesthetizing this group of patients constituted an anaesthesiological challenge with regard to knowledge, experience and time. However, the nurses also had feelings of distrust and uncertainty due to lack of knowledge.

    Conclusion

    The nurse anaesthetists strove to uphold the principle that patients who are/have been substance dependent have the same right to adequate treatment and care as all patients. If guidelines were developed for this patient group, care could be made safer and nurses’ sense of uncertainty minimized.

     

  • 9.
    Hedlund, Åsa
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Nordström, Tina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    New insights and access to resources change the perspective on life among persons with long-term illness - An interview study2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 4, p. 580-1588Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to describe individuals’ experiences of living with long-term illness.

    Methods: A qualitative approach with a descriptive design was used. Semi-structured interviews were conducted with 16 persons (50–80 years). They were also asked to self-rate their perceptions of their current health status and confidence in their ability to cope with everyday life.

    Results: One main theme was identified: new insights and access to resources change the perspective on life. Personal characteristics and support from others were advantageous in finding ways to deal with limitations related to the illness. Most of the persons experienced a changed approach to life, in that they now valued life more than they had before. However, some persons also experienced lost values and found it difficult to accept medications. The persons rated their current health status as slightly above average, but their confidence in their ability to cope with everyday life as high.

  • 10.
    Hedman, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Pöder, Ulrika
    Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Mamhidir, Anna-Greta
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Häggström, Elisabet
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Life memories and the ability to act: the meaning of autonomy and participation for older people when living with chronic illness2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 824-833Article in journal (Refereed)
    Abstract [en]

    There is a lack of knowledge about how older people living with chronic illness describe the meaning of autonomy and participation, indicating a risk for reduced autonomy and participation in their everyday life. The purpose of this study was to describe the meaning of autonomy and participation among older people living with chronic illness in accordance with their lived experience. The design was descriptive with a phenomenological approach guided by Giorgi's descriptive phenomenological psychological method. Purposive sampling was used, and 16 older people living with chronic illness who lived in an ordinary home participated in individual interviews. The findings showed that the meaning of autonomy and participation among the older people emerged when it was challenged and evoked emotional considerations of the lived experience of having a chronic illness. It involved living a life apart, yet still being someone who is able, trustworthy and given responsibility – still being seen and acknowledged. The meaning of autonomy and participation was derived through life memories and used by the older people in everyday life for adjustment or adaption to the present life and the future. Our conclusion is that autonomy and participation were considered in relation to older people's life memories in the past, in their present situation and also their future wishes. Ability or disability is of less importance than the meaning of everyday life among older people. We suggest using fewer labels for limitations in everyday life when caring for older people and more use of the phrase ‘ability to act’ in different ways, based on older people's descriptions of the meaning of autonomy and participation.

  • 11.
    Kristofferzon, Marja-Leena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Nursing Department, Medicine and Health College, Lishui University, Lishui, China.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Coping mediates the relationship between sense of coherence and mental quality of life in patients with chronic illness: a cross-sectional study2018In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 27, no 7, p. 1855-1863Article in journal (Refereed)
    Abstract [en]

    Purpose

    The aim of the present study was to investigate relationships between sense of coherence, emotion-focused coping, problem-focused coping, coping efficiency, and mental quality of life (QoL) in patients with chronic illness. A model based on Lazarus’ and Folkman’s stress and coping theory tested the specific hypothesis: Sense of coherence has a direct and indirect effect on mental QoL mediated by emotion-focused coping, problem-focused coping, and coping efficiency in serial adjusted for age, gender, educational level, comorbidity, and economic status.

    Methods

    The study used a cross-sectional and correlational design. Patients (n = 292) with chronic diseases (chronic heart failure, end-stage renal disease, multiple sclerosis, stroke, and Parkinson) completed three questionnaires and provided background data. Data were collected in 2012, and a serial multiple mediator model was tested using PROCESS macro for SPSS.

    Results

    The test of the conceptual model confirmed the hypothesis. There was a significant direct and indirect effect of sense of coherence on mental QoL through the three mediators. The model explained 39% of the variance in mental QoL.

    Conclusions

    Self-perceived effective coping strategies are the most important mediating factors between sense of coherence and QoL in patients with chronic illness, which supports Lazarus’ and Folkman’s stress and coping theory.

  • 12.
    Kristofferzon, Marja-Leena
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Lindqvist, Ragny
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Nilsson, Annika
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Living with chronic illness2009In: The 2nd International Research Seminar on Salutogenesis: Helsinki, May 14-16, 2009, 2009Conference paper (Refereed)
    Abstract [en]

    Aim: To study differences between two groups, end-stage renal disease (ESRD) and chronic heart failure (CHF), regarding sense of coherence (SOC), General Self-efficacy (GSE), and quality of life (QoL) as well as relationships between these variables. 

    Design: Descriptive, comparative and correlative design.  

    Sample: A Swedish sample of 100 patients (59 CHF and 41 ESRD) was included. The mean age was 68 years (46 – 80 years).  

    Measures: Data were collected with the SOC, the GSE and the Life Satisfaction Questionnaire (LSQ). Age, sex, educational level and living area were also examined.    

    Data analysis: Differences were tested with chi-square and Mann-Whitney U-test and correlations with Pearson’s correlation coefficient. 

    Results: Both SOC (r=0.58, P<0.01) and GSE (r=0.46, P=<0.01) were positively correlated with LSQ. No significant differences between the two groups were found for the study variables. Older persons (>65 years) rated their personal relationships within QoL higher (P=0.045) and older ESRD patients their SOC stronger (P=0.049). Men with CHF rated their self-efficacy higher (P=0.034).

    Conclusions: Our preliminary results indicate that it seems more important how the individual tackle their present situation than what chronic illness they have.  

     

  • 13.
    Kristofferzon, Marja-Leena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Lindqvist, Ragny
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Relationships between coping, coping resources and quality of life in patients with chronic illness: a pilot study2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 476-483Article in journal (Refereed)
    Abstract [en]

    In Sweden there are approximately about 3500 end-stage renal disease and 250 000 chronic heart failure patients. 

    Objectives: The original purpose of the study was to determine differences between two groups of patients with chronic illness (end-stage renal disease and chronic heart failure) regarding the following study variables: coping, sense of coherence, self-efficacy and quality of life. Following this, the aim was to explore the relationships between demographic variables (sex, age, educational level and living area) and quality of life as well as between coping, sense of coherence, self-efficacy and quality of life for the combined sample of patients with end-stage renal disease and chronic heart failure.

    Methods: A comparative and correlative design was used with a sample of 100 patients (n=41 end-stage renal disease, n=59 chronic heart failure). The data were collected during 2004, using four standardized questionnaires and regression analyses were conducted.

    Results: No significant differences were found between the two groups. Positive correlations were identified between sense of coherence, general self-efficacy and quality of life, whereas negative correlations emerge between emotion-focused coping, sense of coherence, general self-efficacy and quality of life. Sense of coherence, general self-efficacy and emotion-focused coping explained 40% of the variance in quality of life. Those with low sense of coherence and general self-efficacy showed negative correlations between emotion-focused coping and quality of life, whereas no such correlations were shown for those with high values on sense of coherence and general self-efficacy.    

    Conclusions: The present results on coping and quality of life correspond with previous research regarding how other groups with chronic illness handled their daily life. Preliminary results indicate that how individuals tackle their present situation is more important than which chronic illness they have. Women used more emotion-focused coping than men, which constitute an important finding for further research.

  • 14.
    Nilsson, Annika
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Musculoskeletal pain among health care staff: riskfactors for, pain, disability and sick leave2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The present thesis is based on four empirical studies concerning risk factors related to musculoskeletal pain (MSP), disability, and sick leave among three non-clinical samples of health care staff. Initially, in Study I, cognitive, behavioural and environmental factors related to MSP of nurses' aides were explored. An experimental design including baseline, intervention and follow-ups among 29 nurses' aides working in a home for the elderly was used in to evaluate effects of a workplace intervention based on cognitive behaviour (CB)- and conventional, symptom reduction principles. In Study II, a cross-sectional and correlational design was applied. A self-administrated questionnaire was used to describe and investigate the relationship between risk factors and development of persistent pain, sick leave and long sick leave among 914 municipal health care staff. In Study III and IV, a longitudinal design was used among 200 registered nurses (RN) working in a county hospital to describe and predict pain, disability and sick leave. Data collection involved two self-administered questionnaires covering: 1) work and personal factors, pain, disability and sick leave at baseline and 2) valued life dimensions at baseline. The results showed that MSP was common among the staff. Study I showed positive effects among nurses' aides receiving the CB principles related to MSP compared with nurses' aides receiving the conventional principles. In Study II, pain severity and expectations to be working in 6 months were associated with persistent MSP and sick leave, respectively. In Study III, pain, disability and sick leave at baseline were the strongest predictors of pain, disability and sick leave at the three-year follow-up. In Study IV, the findings support the notion that individual values in different life domains are possible predictors of pain and disability.

  • 15.
    Nilsson, Annika
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University.
    Andrén, Marianne
    University of Gävle, Faculty of Health and Occupational Studies.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University.
    E-assessment of prior learning: a pilot study of interactive assessment of staff with no formal education who are working in Swedish elderly care2014In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 14, p. 52-Article in journal (Refereed)
    Abstract [en]

    Background: The current paper presents a pilot study of interactive assessment using information and communication technology (ICT) to evaluate the knowledge, skills and abilities of staff with no formal education who are working in Swedish elderly care.

    Methods: Theoretical and practical assessment methods were developed and used with simulated patients and computer-based tests to identify strengths and areas for personal development among staff with no formal education.

    Results: Of the 157 staff with no formal education, 87 began the practical and/or theoretical assessments, and 63 completed both assessments. Several of the staff passed the practical assessments, except the morning hygiene assessment, where several failed. Other areas for staff development, i.e. where several failed (>50%), was the theoretical assessment of the learning objectives: Health, Oral care, Ergonomics, hygiene, esthetic, environmental, Rehabilitation, Assistive technology, Basic healthcare and Laws and organization. None of the staff passed all assessments. Number of years working in elderly care and staff age were not statistically significantly related to the total score of grades on the various learning objectives.

    Conclusion: The interactive assessments were useful in assessing staff members’ practical and theoretical knowledge, skills, and abilities and in identifying areas in need of development. It is important that personnel who lack formal qualifications be clearly identified and given a chance to develop their competence through training, both theoretical and practical.

  • 16.
    Nilsson, Annika
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Carlsson, Marianne
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Lindqvist, Ragny
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    A comparative correlational study of coping strategies and quality of life in patients with chronic heart failure and the general Swedish population2017In: Nursing Open, E-ISSN 2054-1058, Vol. 4, no 3, p. 157-167Article in journal (Refereed)
    Abstract [en]

    The aim was to compare coping strategies and quality of life (QoL) in patients with chronic heart failure (CHF) with such strategies and QOL in persons from two general Swedish populations as well as to investigate relationships between personal characteristics and coping strategies. Methods:A cross-sectional, comparative and correlational design was used to examine data from three sources. The patient group (n=124), defined using ICD-10, was selected consecutively from two hospitals in central Sweden. The population group (n=515) consisted of persons drawn randomly from the Swedish population. Data were collected with questionnaires in 2011; regarding QoL, Swedish population reference data from 1994 were used. Results: Overall, women used more coping strategies than men did. Compared to the general population data from SF-36, patients with CHF rated lower QoL. In the regression models, perceived low ‘efficiency in managing psychological aspects of daily life’ increased use of coping. Other personal characteristics related to increased use of coping strategies were higher education, lower age and unsatisfactory economic situation. Conclusion: Differences between the patients and the general Swedish population showed an unclear pattern for coping and a clear pattern for QoL. To deal with the psychological consequences of daily life, men with CHF and persons in the general Swedish population seemed to use both problem- and emotion-focused coping. 

  • 17.
    Nilsson, Annika
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Denison, Eva
    Department of Caring and Public Health Sciences, Mälardalen University, Västerås, Sweden.
    Lindberg, Per
    Department of Psychology Uppsala University, Uppsala, Sweden.
    Life values as predictors of pain, disability and sick leave among Swedish registered nurses: a longitudinal study2011In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 10, no 17Article in journal (Refereed)
  • 18.
    Nilsson, Annika
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    E-assessment and an e-training program among elderly care staff lacking formal competence: results of a mixed-methods intervention study2015In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 15, no 1, article id 189Article in journal (Refereed)
    Abstract [en]

    Background

    Among staff working in elderly care, a considerable proportion lack formal competence for their work. Lack of formal competence, in turn, has been linked to higher staff ratings of stress symptoms, sleep disturbances and workload. Objectives: 1) To describe the strengths and weaknesses of an e-assessment and subsequent e-training program used among elderly care staff who lack formal competence and 2) to study the effects of an e-training program on staff members’ working life (quality of care and psychological and structural empowerment) and well-being (job satisfaction and psychosomatic health). The hypothesis was that staff who had completed the e-assessment and the e-training program would rate greater improvements in working life and well-being than would staff who had only participated in the e-assessments.

    Methods

    An intervention study with a mixed-methods approach using quantitative (2010–2011) and qualitative data (2011) was conducted in Swedish elderly care. Participants included a total of 41 staff members. To describe the strengths and weaknesses of the e-assessment and the e-training program, qualitative data were gathered using semi-structured interviews together with a study-specific questionnaire. To study the effects of the intervention, quantitative data were collected using questionnaires on: job satisfaction, psychosomatic health, psychological empowerment, structural empowerment and quality of care in an intervention and a comparison group.

    Results

    Staff who completed the e-assessments and the e-training program primarily experienced strengths associated with this approach. The results were also in line with our hypotheses: Staff who completed the e-assessment and the e-training program rated improvements in their working life and well-being.

    Conclusion

    Use of the e-assessments and e-training program employed in the present study could be one way to support elderly care staff who lack formal education by increasing their competence; increased competence, in turn, could improve their self-confidence, working life, and well-being.

  • 19.
    Nilsson, Annika
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Häggström, Elisabeth
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
     The meaning of living with rheumatoid arthritis:  – a single case study based on one woman’s eight-year diary2009In: Tidsskrift for Sygeplejeforskning, ISSN 0900-3002, Vol. 25, no 3, p. 9-15Article in journal (Refereed)
    Abstract [en]

    Previous studies about experiences with rheumatoid arthritis (RA) often have a biomedical perspective. Few studies have discussed the meaning of living with the phenomenon RA from a single-case investigation. This was an important issue when deciding to analyse and interpret one woman’s diary, which covered eight years of living with RA. The aim of this study was to investigate the meaning of living with the phenomenon RA, using one woman’s personal diary spanning eight years. The present study is an in-depth case investigation with a phenomenological-hermeneutic design. One woman diagnosed with RA eight years ago and the meaning of living with RA, according to her. A personal periodically written diary was used for this study. The text was analysed using a phenomenological-hermeneutic method inspired by the philosopher Ricoeur. Results. The results are presented in two themes and five subthemes. The theme ‘To feel doubt, grief and lost identity’ mirror the big challenge it is to live with rheumatoid arthritis for body, soul, identity and social contacts in daily life. This theme emerged from the following subthemes: ‘Being sad about constant physical pain and the loss of bodily function’, ‘Being sad about feelings of constant tiredness’, ‘Losing identity creates a lack of confidence,’ and ‘Being sad and disappointed when meeting carers and colleagues face to face.’ The theme ‘To be good enough’ mirrors a long process in which an expression of more confidence becomes visible. This theme emerged from the subtheme ‘Enjoying the small things in life’. The meaning of living with RA for a number of years seems to have created feelings of not being good enough and also of losing one’s identity. The process of implementing a changed picture of oneself and also of implementing a good self-image seems to be a very long and difficult process for a person living with RA. This is an important issue for care staff working with RA patients to be aware of, since it has influence on the RA patient’s self-respect.

  • 20.
    Nilsson, Annika
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Lindberg, Per
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Denison, Eva
    Department of Caring and Public Health Sciences, Mälardalen University, Västerås, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Predicting of pain, disability, and sick leave regarding a non-clinical sample among Swedish nurses2010In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 1, no 3, p. 160-166Article in journal (Refereed)
    Abstract [en]

    Objectives: Health care providers, especially registered nurses (RNs), are a professional group with a high risk of musculoskeletal pain (MSP). This longitudinal study contributes to the literature by describing the prevalence and change in MSP, work-related factors, personal factors, self reported pain, disability and sick leave (> 7 days) among RNs working in a Swedish hospital over a three-year period. Further, results concerning prediction of pain, disability and sick leave from baseline to a three-year follow-up are reported. Method:  In 2003, a convenience sample of 278 RNs (97.5% women, mean age 43 years) completed a questionnaire. In 2006, 244 RNs (88% of the original sample) were located, and 200 (82%) of these completed a second questionnaire. Results: Logistic regression analyses revealed that pain, disability and sick leave at baseline best predicted pain, disability, and sick leave at follow-up. The personal factors self rated health and sleep quality during the last week predicted pain at follow-up, while age, self rated health, and considering yourself as optimist or pessimist predicted disability at follow-up, however weakly. None one of the work- related factors contributed significantly to the regression solution. Conclusions: The results support earlier studies showing that a history of pain and disability is predictive of future pain and disability. Attention to individual factors such as personal values may be needed in further research. 

  • 21.
    Nilsson, Annika
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Sjödén, Per-Olow
    Inst.folkhälsovetenskap och vårdvetenskap Uppsala.
    Dahl, Joanne
    Inst.för psykologi Uppsala.
    Denison, Eva
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Factors related to long-duration pain and sick leave among Swedish staff working in the public health service2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 4, p. 419-26Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to provide information about factors related to long-duration pain (LDP) (>3 months), sick leave (SL) and long sick leave (LSL) (>3 months) among staff in the community health services. The specific research question was: To what extent do data on activity, physical function, pain severity, psychological/cognitive factors, expectations of LDP, expectations to be working within 6 months and work satisfaction predict LDP, SL and LSL respectively? Logistic regression analyses were used to test predicted membership in the groups LDP, SL and LSL. In this context prediction refers to statistical prediction only, due to the cross-sectional design. Staff (n = 914) in the public health services in a medium-sized Swedish city completed a questionnaire during the spring of 2000. The results show that musculoskeletal pain and SL for this occupational group are common. Pain severity, expectations of LDP and fear-avoidance increased the odds of being in the LDP group, while kinesiophobia decreased the odds. Pain severity and kinesiophobia increased the odds of being in the SL group, while expectations to be working in 6 months decreased the odds. Only expectations to be working in 6 months predicted membership in the LSL group, decreasing the odds. Although some caution is warranted concerning the representativity of the sample, the results indicate that expectations about pain duration and ability to work are important psychosocial factors in LDP and LSL.

  • 22.
    Rashid, Mamunur
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Do work ability and well-being matter for return to work?: Cut-off points for Work Ability Index and Life Satisfaction questionnaire among women with long-term musculoskeletal painManuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: To determine whether work ability and well-being predict return to work (RTW) among women with long-term neck/shoulder and/or back pain at a 1-year follow-up, and to assess the ability of the Work Ability Index (WAI) and Life Satisfaction questionnaire (LiSat-11) to discriminate between those who did RTW and those who did not RTW. 

    Methods: A survey was sent to 600 women receiving time-loss benefits from the Swedish Social Insurance Agency. In total, 208 women responded at baseline, and 141 at a 1-year follow-up. To identify whether work ability and well-being predicted RTW, multiple logistic regression analyses were performed with and without adjustment for type of work and pain intensity. To assess the discriminative ability of the WAI and LiSat-11 for women who did RTW and those who did not RTW, Receiver Operating Characteristic curves were fitted.  

    Results: Work ability predicted RTW, and the results remained significant after adjusting for type of work and pain intensity (OR 1.12, 95% CI: 1.04-1.22). Well-being was not significant. The WAI at baseline adequately discriminated between RTW and no RTW after one year (AUC 0.78, 95% CI 0.70-0.86), but the LiSat-11 did not.

    Conclusions: Our results indicate that work ability is an important factor for RTW among women on SL for long-term neck/shoulder and/or back pain. The WAI has adequate discriminatory ability in this population, but the LiSat-11 has not.  

     

    Keywords: Life satisfaction, Musculoskeletal pain, Sickness absence, Work status

  • 23.
    Rashid, Mamunur
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden.
    Factors related to work ability and well-being among women on sick leave due to long-term pain in the neck/shoulders and/or back: a cross-sectional study2018In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, no 1, article id 672Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Musculoskeletal pain is one of the leading causes of sick leave, especially among women, in Western countries. The aim of the present study was to identify factors associated with work ability and well-being, respectively, among women on sick leave due to long-term pain in the neck/shoulders and/or back.

    METHODS:

    A cross-sectional study with a correlational design was conducted on women who were sick-listed due to long-term pain in the neck/shoulders and/or back. A total of 208 participants responded to a survey comprising eight instruments: Multidimensional Pain Inventory scale, General Self-Efficacy scale, Sense of Coherence scale, Coping Strategies Questionnaire, Demand-Control-Support Questionnaire, Hospital Anxiety and Depression Scale, Work Ability Index and Life Satisfaction questionnaire. Multiple linear regression analyses were performed to identify factors associated with work ability and well-being, respectively.

    RESULTS:

    Women who more strongly believed they would return to the same work had greater work ability (β = 0.39, p < 0.001), whereas women with higher pain intensity (β = - 0.30, p < 0.001) and higher job strain (β = - 0.12, p < 0.05) had lower work ability. Women with higher self-efficacy rated greater well-being (β = 0.14, p < 0.05). As the women's scores for depression increased, their well-being decreased by 48%, which was statistically significant (p < 0.001). The regression models for work ability and well-being were significant (p < 0.001), and their adjusted R- square values were 48% and 59%, respectively.

    CONCLUSIONS:

    The study suggests that the factors beliefs to be back at the same work, pain intensity and job strain are predictive of work ability. Moreover, the factors self-efficacy and depression seem to be predictive of well-being. The findings highlight factors that should be considered by health care professionals and policy-makers to guide attempts to reduce sick leave.

  • 24.
    Rashid, Mamunur
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Predictors of return to work among women with long-term neck/shoulder and/or back pain: a 1-year prospective studyManuscript (preprint) (Other academic)
    Abstract [en]

    Objective: The aim of this study was to identify predictors of return to work (RTW) among women on sick leave due to long-term neck/shoulder and/or back pain.

    Methods: The study was a prospective survey with a 1-year follow-up. Data on predictors and outcome were collected using a self-administrated questionnaire containing eight instruments – Coping Strategies Questionnaire, General Self-Efficacy scale, Sense of Coherence, Multidimensional Pain Inventory, Hospital Anxiety and Depression Scale, Demand-Control-Support Questionnaire, Work Ability Index, and Life Satisfaction questionnaire, as well as a set of background questions. A total of 208 women, aged 23-63 years, were included at baseline, and 141 responded at the 1-year follow-up. Multiple logistic regression analyses were performed to identify predictors of RTW.

    Results: Of the 141 women, 94 had RTW and 47 had not at the 1-year follow-up. Women who engaged in more coping by increasing behavioral activities, such as leisure activities, reading and socialization, (OR 1.12, 95% CI 1.02-1.22) and those who more strongly believed they would return to the same work within 6 months (OR 1.24, 95% CI 1.12-1.38) had an increased probability of RTW. Getting more social support outside work (OR 0.49, 95% CI 0.26-0.90) decreased the odds of RTW at the 1-year follow-up.

    Conclusions: The findings suggested that behavioral activities, belief in returning to the same work and social support were predictors of RTW at the 1-year follow-up. Healthcare professionals should consider these predictors in efforts to prevent prolonged sick leave and to promote RTW among women with long-term neck/shoulder and/or back pain.

     

     

    Key terms: Follow-up study, musculoskeletal pain, prognostic factors, sickness absence, return to work.

     

  • 25.
    Rashid, Mamunur
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Predictors of work ability among women on long-term sick leave due to musculoskeletal pain2017In: NES2017 conference proceedings / [ed] Anna-Lisa Osvalder, Mikael Blomé and Hajnalka Bodnar, 2017, p. 140-Conference paper (Refereed)
    Abstract [en]

    Background: Musculoskeletal pain is one of the leading causes of sick leave (SL), especially among women in Sweden and in other western countries. It is, therefore, important to know which health- and work-related factors are associated with work ability (WA) among women with long-term musculoskeletal pain.

         Purpose: The aim of this study was to determine whether there is any association between self-efficacy, anxiety, depression, sense of coherence, job strain, support at work, pain intensity, physical activity, beliefs to be back at the same work, coping strategies, and WA.

         Methods: A cross-sectional study was conducted on women with long-term pain who were on SL. Inclusion criteria: (i) age 18-65 years, (ii) SL: ≥ 1 months, (iii) SL: ≥ 50%, (iv) pain in neck, shoulder or back (≥ 3 months), and (v) understanding Swedish. Exclusion criteria: (i) rheumatoid arthritis, (ii) multiple sclerosis, (iii) stroke, (iv) cancer, (v) Parkinson, (vi) bipolar disease, (vii) schizophrenia, (viii) pregnancy. In spring 2016, self-administered questionnaires were sent out to 600 women who were receiving time-loss benefits according to the Swedish Social Insurance registers. Out of these, a total of 208 participants responded and were included in the analysis. For assessing the predictors and the outcome, seven instruments were used: General Self-Efficacy, Hospital Anxiety and Depression Scale, Demand-Control-Support Questionnaire, Sense of Coherence, Multidimensional Pain Inventory, Coping Strategy Questionnaire and Work Ability Index. Two of the predictors, physical activity and beliefs to be back at the same work, were measured by single questions. Multiple linear regression analyses were performed to detect which of the factors were associated with WA.

         Results: Women who more strongly believed that they would return to the same work within 6 months had higher WA (β= 0.39, p < .001), whereas women with higher pain intensity (β= -0.28, p < .001) and higher job strain (β= -0.12, p < .05) had lower WA. The results did not change when age, cohabitant, economic situation and social support were controlled for in the analysis. The regression model was significant (p < .0001), and its adjusted R- square was 48%.

         Discussion and practical implications: Women’s positive beliefs are associated with higher WA in accordance with previous studies. Our study also found that pain intensity and high job strain are associated with reduced WA. The results suggest that health care providers and employers should take women’s beliefs to be back at the same work into account for supporting them to return to work. Furthermore, the focus of rehabilitation program should be on women suffering from high pain intensity to increase WA.

         Conclusion: This study showed that beliefs to be back at the same work, pain intensity and job strain might be predictors of WA. Further studies are needed to identify if these predictors are also important for WA among women with long-term pain who are at work.

     

    Key words: Factors, ability to work, sickness absence, women and pain

  • 26.
    Rashid, Mamunur
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden .
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden .
    Work ability, well-being and return-to-work among women in Gävleborg on sick leave due to long-term pain in the neck/shoulders and/or back2018In: FALF KONFERENS 2018 Arbetet – problem eller potential för en hållbar livsmiljö?   10-12 juni 2018 Gävle: Program och abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, p. 68-Conference paper (Refereed)
    Abstract [en]

    Background

    Sickness absence due to long-term musculoskeletal pain (MSP) is a common phenom-enon in Sweden as well as in other European countries. Sick leave due to MSP (i.e. pain in the neck/shoulders and/or back) is higher among women than among men; therefore, women can be considered as a vulnerable group.

    Aim

    The overall aim is to identify factors of importance for work ability, well-being and return to work among women of working age who are on sick leave due to long-term pain in the neck/shoulders and/or back. The project includes three empirical studies.

    Methods

    The project was a result of a joint collaboration between the University of Gävle and the Swedish Social Insurance Agency in Gävleborg. Initially, a postal survey was sent to 600 women in Gävleborg who were receiving time-loss benefits during spring 2016. The inclusion criteria were: women aged 18-65 years, ≥ 50% sick leave from service, sick leave ≥ 1 month due to pain in the neck/shoulders and/or back (≥ 3 months) and understanding the Swedish language. The exclusion criteria were: rheumatoid arthritis, multiple sclerosis, stroke, cancer, Parkinson, bipolar disease, schizophrenia and preg-nancy. After 12 months, a follow-up survey was sent to the 208 women who answered the survey at baseline, and 141 responded.

    Results

    Study-I aimed to identify factors associated with work ability and well-being among women on sick leave. The results showed that beliefs to be back at the same work, pain intensity and job strain correlated with work ability. Self-efficacy and depression correlated with well-being. Study-II aimed to compare work ability and well-being over time, among women who returned to work (RTW) versus women who remained on sick leave in one year. The findings indicated that out of 141 women, 94 did RTW and 47 remained on sick leave. The group that RTW improved in work ability as well as well-being over time, whereas the group that remained on sick leave tended to decline over time in well-being. Study-III aims to identify predictors of RTW among women on sick leave. The analysis is under way. This project highlights factors that should be considered by health care professionals and policy-makers to guide attempts to reduce sick leave in this vulnerable group.

  • 27.
    Rashid, Mamunur
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala University, Uppsala, Sweden.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala University, Uppsala, Sweden.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Factors associated with return-to-work among people on work absence due to long-term neck or back pain: a narrative systematic review2017In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 6, article id e014939Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVE:

    The purpose of this narrative systematic review was to summarise prognostic factors for return to work (RTW) among people with long-term neck/shoulder or back pain.

    METHODS:

    A systematic literature search was performed through three databases (Medline, CINAHL and PsycINFO) for studies published until February 2016. Only observational studies of people on work absence (≥2 weeks) due to neck/shoulder or back pain were included. The methodological quality of the included studies was assessed using guidelines for assessing quality in prognostic studies on the basis of Framework of Potential Biases. Factors found in the included studies were grouped into categories based on similarities and then labelled according to the aspects covered by the factors in the category.

    RESULTS:

    Nine longitudinal prospective cohort studies and one retrospective study fulfilled the inclusion criteria. From these, five categories of factors were extracted. Our findings indicate that recovery beliefs, health-related factors and work capacity are important for RTW among people with long-term neck or back pain. We did not find support for workplace factors and behaviour being predictive of RTW.

    CONCLUSIONS:

    Our findings suggest that recovery beliefs, perceived health and work capacity may be important targets of intervention for people with long-term neck or back pain. However, more high-quality prospective studies are needed to confirm the results and improve our understanding of what is needed to facilitate RTW in this population.

  • 28.
    Sundin, Rakel
    et al.
    Caring Sciences, Municipality in Söderhamn, Sweden.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Waage-Andrée, Rebecca
    Department of Endocrinology, Gävle Hospital, Gävle, Sweden.
    Björn, Catrine
    Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden; Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden; Department of Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden.
    Nurses’ Perceptions of Patient Safety in Community Mental Health Settings: A Qualitative Study2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 4, p. 387-396Article in journal (Refereed)
    Abstract [en]

    Mental health care has moved from hospital settings to community mental health settings, and there is a need to explore the perceptions of patient safety among registered nurses working in this field. Patient safety is to include everyone and to be the goal in all aspects of health care. The aim of the study was to explore registered nurses’ perceptions of patient safety in community mental health settings for people with serious mental illness. The study was qualitative and descriptive in nature and interviews were carried out during spring 2012, with seven registered nurses working in community mental health settings for people with serious mental illness in five municipalities in the middle of Sweden. The sampling was purposive and data were analysed using qualitative content analysis. The findings showed that the registered nurses understood patient safety as providing support to people with serious mental illness in regaining and maintaining health through good treatment and respecting self-determination and avoiding coercion. The terms of daily living in small community mental health settings within the a large community health care organization, communication, sufficient knowledge of psychiatric disabilities among people in the residents’ network, and national laws and regulations, all had implications for patient safety. The registered nurses perceived patient safety as involving a wide range of issues that in other areas of care are more often discussed in terms of quality of care. Determining the boundaries of patient safety in community mental health settings for people with serious mental illness can be a first step in establishing workable routines that ensure safe patient care.

  • 29.
    Wiitavaara, Birgitta
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Can internationally recommended outcome domains capture aspects that are prominent for the health experiences of women with neck- and shoulder pain?: A factor analysis. (Poster)2010In: Proceedings of the Premus 2010 conference (Seventh International Conference on Prevention of Work-Related Musculoskeletal Disorders) August 29-September 2, Angers, France, 2010, p. 283-Conference paper (Refereed)
  • 30.
    Wiitavaara, Birgitta
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    An initial factor analysis of prominent aspects of health experiences for women with neck-shoulder pain2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 11, p. 934-942Article in journal (Refereed)
    Abstract [en]

    Purpose: The prospect of adequate comparisons is essential to decide on the effectiveness of different treatments. As there is a lack of unity in choice of questionnaires and included measures concerning musculoskeletal disorders, further investigations based on international recommendations are of interest. The intention of present study was to initiate the development of a clinically useful short-form questionnaire.  The aim was to select items that capture prominent health aspects for women with neck-shoulder pain and thereby reduce the number of items to a clinically more convenient amount, and to determine the underlying structure of included items. Method: Data were collected in a randomised controlled trial including women with non-specific neck-shoulder pain >3 months (n = 117). Data collection included three core domains: pain intensity, physical and emotional functioning, and analysis was performed using Principal component analysis, and Varimax rotation. Results: The resulting 9-factor solution included interference, solicitous/distracting responses, mood and feelings about self and relations, pain intensity, punishing responses, personal growth, life-control, sleep, and appetite (29 items). Conclusions: The results will contribute to the development of a reduced battery of questions representing core dimensions. Such questionnaire would lighten the assessment load in the clinic as well as in research.

  • 31.
    Wiitavaara, Birgitta
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Rissén, Dag
    Region Gävleborg.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Psychometric testing of a short form questionnaire for measurement of health experiences among people with musculoskeletal disorders undergoing multimodal rehabilitation2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 5, article id e025103Article in journal (Refereed)
    Abstract [en]

    Aim

    The aim of present study was to assess if a previously suggested short-form questionnaire tested among women with non-specific neck-shoulder pain is suitable also for use among men and women with non-specific musculoskeletal disorders in any part of the body, by testing its construct validity by a confirmatory factor analysis. If not, the secondary aim was to investigate the evolving factor structure when performing an explorative factor analysis of data in the expanded sample.

    Methods

    Questionnaire data was collected in three different contexts, in primary care via eight different multimodal rehabilitation teams, in specialised care via two different specialist care centres. The sample consisted of 116 participants, male (n=29) and female (n=87) with non-specific musculoskeletal disorders.

    Data was analysed using confirmatory and exploratory factor analysis and a visual comparison between the result of the Principal Component Analysis in present study, and the results attained in a previous study with a similar aim and design.

    Results

    The confirmatory factor analyses did not end up in a model with acceptable measures for validity. Three models were tested, none of them met the criterion for an acceptable model and the goodness-of-fit statistics were not fully acceptable. The exploratory factor analysis had an only partly comparable result, compared to previous study.

    Conclusion

    The results of present study did not prove the suggested short form questionnaire to be suitable for evaluation of symptoms among men and women with non-specific musculoskeletal disorders in any part of the body. Further studies including larger samples are recommended.

  • 32.
    Wiitavaara, Birgitta
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Rissén, Dag
    CFUG, Centrum för forskning och utveckling, Uppsala universitet / Landstinget Gävleborg.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    Utvärdering av muskuloskeletala besvär: Utveckling av ett kliniskt användbart frågeformulär för personer med besvär från rörelseapparaten2013Other (Other academic)
1 - 32 of 32
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