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  • 1.
    Aasa, Ulrika
    et al.
    Umeå universitet.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Personalens hälsa och arbetsmiljö2016Ingår i: Prehospital akutsjukvård / [ed] Björn-Ove Suserud, Lars Lundberg, Stockholm: Liber, 2016, 2, s. 72-79Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 2.
    Aasa, Ulrika
    et al.
    Umeå universitet.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Personalens hälsa och arbetsmiljö2009Ingår i: Prehospital akutsjukvård / [ed] Suserud, Björn-Ove. Svensson, Leif., Stockholm: Liber , 2009, s. 33-38Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 3.
    Björklund, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umeå Sweden.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Responsiveness and minimal important change for the ProFitMap-neck questionnaire and the Neck Disability Index in women with neck-shoulder pain2017Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 26, nr 1, s. 161-170Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    The aim was to determine the responsiveness and minimal important change (MIC) of the questionnaire ProFitMap-neck that measures symptoms and functional limitations in people with neck pain. The same measurement properties were determined for Neck Disability Index (NDI) for comparison purposes.

    Methods

    Longitudinal data were derived from two randomized controlled trials, including 103 and 120 women with non-specific neck pain, with questionnaire measurements performed before and after interventions. Sensitivity and specificity to discriminate between improved and non-improved participants, based on categorization of a global rating of change scale (GRCS), were determined for the ProFitMap-neck indices and NDI by using area under receiver operator curves (AUC). Correlations between the GRCS anchor and change scores of the questionnaires were also used to assess responsiveness. The change score that showed the highest combination of sensitivity and specificity was set for MIC.

    Results

    The ProFitMap-neck indices showed similar responsiveness as NDI with AUC exceeding 0.70 (Range: ProFitMap-neck, 0.74 – 0.83; NDI, 0.75 – 0.86). The MIC in the two samples ranged between 6.6 – 13.6% for ProFitMap-neck indices and 5.2 and 6.3% for NDI. Both questionnaires had significant correlations with GRCS (Spearman’s rho 0.47 – 0.72).

    Conclusions

    Validity of change scores was demonstrated for the ProFitMap-neck indices with adequate ability to discriminate between improved and non-improved participants. Values of minimal important change were presented.

  • 4.
    Heiden, Marina
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Richardsson, Linda
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Boman, Eva
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för socialt arbete och psykologi, Psykologi.
    Telecommuting in academia – Associations with staff’s health and well-being2018Ingår i: Proceedings of the 20th Congress of the International Ergonomics Association (IEA 2018): Volume IX: Aging, Gender and Work, Anthropometry, Ergonomics for Children and Educational Environments / [ed] Bagnara S., Tartaglia R., Albolino S., Alexander T., Fujita Y., Cham: Springer, 2018, s. 308-312Konferensbidrag (Refereegranskat)
    Abstract [en]

    The ability to telecommute has changed working life for staff at universities and colleges. Although the opportunity to work away from the office at any time gives workers more freedom to manage their work, it also imposes higher demands on workers to set limits to their work. The aim of this ongoing study is to determine if there is an optimal amount of telecommuting for male and female academics with respect to perceived health, work stress, recovery, work-life balance, and work motivation. A web-based survey is currently being conducted among lecturers and professors at Swedish universities and colleges. Results so far show that perceived fatigue and stress associated with indistinct organization and conflicts are higher among academics that telecommute to a larger extent. The results also show that female academics are more fatigued and stressed at work than male academics, but this does not seem to be related to the extent of telecommuting performed.

  • 5.
    Heiden, Marina
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Widar, Linda
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Boman, Eva
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för socialt arbete och psykologi, Psykologi.
    Telecommuting in academia – associations with health and well-being among staff2018Ingår i: Annals of Work Exposures and Health, ISSN 2398-7308Artikel i tidskrift (Refereegranskat)
  • 6.
    Nordlöf, Hasse
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Högberg, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Westerling, Ragnar
    Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    A cross-sectional study of factors influencing occupational health and safety management practices in companies2017Ingår i: Safety Science, ISSN 0925-7535, E-ISSN 1879-1042, Vol. 95, s. 92-103Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Companies need to ensure a functioning occupational health and safety management (OHSM) system to protect human health and safety during work, but generally there are differences in how successful they are in this endeavor. Earlier research has indicated that factors like company size, safety culture, and different measures of financial performance may be related to the quality of OHSM practices in companies. Therefore, the aim of this study was to investigate whether these factors are associated with OHSM practices in companies. A postal questionnaire was used to collect data from a sample of Swedish manufacturing companies, and complementary data regarding the companies were retrieved from a credit bureau database. The statistical analysis was performed with ordinal regression analysis using generalized estimating equations. Different predictor variables were modeled with OHSM practices as the outcome variable, in order to calculate p-values and to estimate odds ratios. Company size, safety culture, and creditworthiness were found to be associated with better, as well as worse, OHSM practices in companies (depending on directionality). Practical implications for industry and future research are discussed.

  • 7.
    Nordlöf, Hasse
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin..
    Wiitavaara, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Högberg, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Westerling, Ragnar
    Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    To measure OHS management practices in manufacturing companies2016Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction: Manufacturing companies are bound to manage many different processes in their day-to-day operations. A systematic management of occupational health and safety (OHS) factors is necessary in order to comply with OHS legislation. Work environmental risks should be assessed and controlled, and if not controlled immediately, an action plan should be established and followed up on later. A successful OHS management should reduce hazards in the workplace and protect worker health and safety. But how can we accurately measure how well companies actually comply with OHS legislation? Earlier measures exist, but they often assess the perceptions of the respondent rather than the circumstance of the company. The aim of this study was to develop and utilize a way to measure OHS management practices, by using a self-report-questionnaire distributed to companies.   

    Methods: A questionnaire was developed in several steps. OHS legislation and earlier studies were read in order to identify different relevant indicators for OHS management compliance. These indicators were then compiled, sorted, and narrowed down in order to produce a manageable and relevant list of 13 indicators. A criterion for relevant indicators was that they together should provide appropriate information on whether a company has come far, or not so far, in arranging a systematic OHS management. A yes–no question was formulated for each of the indicators. Three examples of indicators were: whether the company has written routines stating how the OHS management should be carried out or not, whether written risk assessments have been conducted during the last 12 months or not, and whether the company has routines in place for reporting incidents that occur (near-misses and accidents) or not. The indicators and questions were chosen and formulated in order to measure as much of an objective circumstance at the companies as possible. The rationale is that, either the companies have an arrangement for these indicators, or they do not. Questionnaires were sent to a sample of manufacturing companies (n=238) in central Sweden, for one manager and one safety delegate per company to answer.

    Results and discussion: Taken together, the 13 indicators formed an OHS management practices index. A yes-answer for each indicator was counted as 1 and no as 0, and the scores were summed together. Other measures were also collected for this study: companies’ safety culture, overall work environment priority, company profitability, and company size. The OHS management practices index will undergo psychometric testing for validity and reliability, such as test-retest and Cronbach’s alpha test statistic. The development process and usability of the OHS management practices measure will be presented in more detail at the conference. We believe that this novel measure of OHS management practices, as employed in this study, can be of interest for future research within the field of OHS. This approach provides a relatively straightforward way to measure companies’ OHS management practice using questionnaire items.

  • 8.
    Nordlöf, Hasse
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Winblad, Ulrika
    Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    Wijk, Katarina
    Samhällsmedicin, Landstinget Gävleborg. Institutionen för pedagogik, didaktik och utbildningsstudier, Uppsala universitet.
    Westerling, Ragnar
    Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    A description of reasons for risk-taking at a large steel manufacturing company2013Ingår i: Ergonomics for equality: Nordic Ergonomics Society (NES), Reykjavík, Iceland, 11-14 august 2013, 2013Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction: Risk-taking in an industrial work environment is a serious matter since it involves the risk for bodily injuries and in worst case death. The aim of this study was to investigate reasons for risk-taking at a large steel manufacturing company in Sweden which employs about 1000 people.

    Methods: Ten focus group interviews were conducted, each consisting of about 6–8 workers. The situation of safety at work was discussed in a semi-structured manner, letting the employees themselves explain the reasons behind risk-taking. The interviews were analyzed with qualitative content analysis.

    Results: Reasons for risk-taking were formed into the following six aspects: 1.Being new-at-work. 2.Being tired. 3.Being nonchalant to the safety risks. 4.Working on routine and being “blind-to-flaws”. 5.Too little staff to do the job. 6.To stress, hurry, and work faster in order to save time. Conclusion: One’s state-of-the-day and external work environment circumstances affects risk-taking.

  • 9.
    Nordlöf, Hasse
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Winblad, Ulrika
    Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    Wijk, Katarina
    Samhällsmedicin, Landstinget Gävleborg. Institutionen för pedagogik, didaktik och utbildningsstudier, Uppsala universitet.
    Westerling, Ragnar
    Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    En beskrivning av anledningar till risktagande vid ett stort stålindustriföretag2013Konferensbidrag (Övrigt vetenskapligt)
    Abstract [sv]

    Introduktion: Risktagande i en industriell arbetsmiljö är allvarligt eftersom det involverar risk för kroppsskada eller i värsta fall död. Syftet med föreliggande studie var att undersöka anledningar till risktagande, beskrivna av arbetare. Studien genomfördes i samarbete med ett stort svenskt stålindustriföretag med cirka 1000 anställda på den berörda orten.

    Metod: Studien hade en kvalitativ och beskrivande studiedesign. Datainsamlingen bestod av tio fokusgruppintervjuer med ca 6–8 arbetare per grupp och deltagarna var anställda i produktionen. Deltagarna rekryterades från samtliga av företagets fem huvudavdelningar för att få ett urval med maximal variation, och det slumpades fram vilka skiftlag som tillfrågades att delta. Intervjuerna hade en längd av 75 minuter och spelades in digitalt med en diktafon. Säkerhet på arbetet diskuterades på ett semi-strukturerat sätt, genom att låta arbetarna själva berätta och förklara anledningar till risktagande. Under intervjuerna lades betoningen på följdfrågor där deltagarna ombads att utveckla sina svar och använda egna exempel. Därutöver samlades bakgrundsdata in om deltagarna genom att de fyllde i ett kort frågeformulär. Intervjuerna transkriberades ordagrant och analyserades med kvalitativ innehållsanalys.

    Resultat: Anledningar till risktagande formades till följande sex aspekter: 1.Att vara ny på jobbet. 2.Att vara trött. 3.Att vara nonchalant inför riskerna. 4.Att arbeta på rutin och vara ”hemmablind”. 5.Att det finns för lite personal för att göra jobbet. 6.Att stressa, skynda sig och arbeta fortare för att spara tid. Ett incitament för anställda att riskera sin egen säkerhet kan till exempel vara att inte använda de avsedda verktygen för att snabbt få igång produktionen igen om ett stopp inträffar. Arbetarna upplevde att ledningen inte vill att produktionen ska gå långsamt, vilket dock användandet av rätt verktyg kan medföra. De upplevde också att ledningen inte vill att tillfälliga personalreduceringar skall påverka produktionstakten. Slutsats: Dels individens dagsform och dels yttre omständigheter i arbetsmiljön påverkar risktagandet.

  • 10.
    Nordlöf, Hasse
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Winblad, Ulrika
    Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    Wijk, Katarina
    Samhällsmedicin, Landstinget Gävleborg; Institutionen för pedagogik, didaktik och utbildningsstudier, Uppsala universitet.
    Westerling, Ragnar
    Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    Safety culture and reasons for risk-taking at a large steel-manufacturing company: Investigating the worker perspective2015Ingår i: Safety Science, ISSN 0925-7535, E-ISSN 1879-1042, Vol. 73, s. 126-135Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Workers in the steel-manufacturing industry face many safety risks due to the nature of the job. How well safety procedures and regulations are followed within an organization is considered to be influenced by the reigning culture of the organization. The aim of this study was to investigate and describe safety culture and risk-taking at a large steel-manufacturing company in Sweden by exploring workers’ experiences and perceptions of safety and risks. Ten focus group interviews were conducted with a total of 66 workers. In the interviews, the situation of safety at work was discussed in a semi-structured manner. The material was analyzed inductively using qualitative content analysis. The analysis resulted in a thorough description of safety culture and risk-taking at the company, based on the following five main categories: 1. Acceptance of risks, one simply has to accept the safety risks of the work environment, 2. Individual responsibility for safety, the responsibility for safe procedures rests to the largest extent on the individual, 3. Trade-off between productivity and safety, these are conflicting entities, wanting to produce as well as wanting to work safely, 4. Importance of communication, it is needed for safety actions to be effective, and 5. State-of-the-day and external conditions, an interplay between these factors affect risk-taking. In sociotechnical systems theory it is acknowledged that there are interactions between social and technical factors in organizations. The findings of this study are interpreted to be in line with a sociotechnical understanding of safety culture and risk-taking.

  • 11.
    Richardsson, Linda
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Boman, Eva
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för socialt arbete och psykologi, Psykologi.
    Att arbeta på distans – möjligheter och konsekvenser för universitetslärare2018Ingår i: 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, s. 118-Konferensbidrag (Refereegranskat)
    Abstract [sv]

    Bakgrund

    Universitets- och högskoleväsendet har under de senaste årtiondena genomgått stora förändringar. Den teknologiska utvecklingen och ökade konkurrensen nationellt och internationellt har lett till högre krav på effektivitet, produktivitet och tillgänglighet av personal oavsett vart de befinner sig. Arbetssituationen inom universitet- och högskole-väsendet har på detta sätt blivit mer krävande. Universitetslärare är en yrkesgrupp som i allt större utsträckning har möjlighet att arbeta på distans, och nyttjar den möjligheten regelbundet både inom och utanför ordinarie arbetstid. Trots detta är det få studier som undersökt hur undervisande och forskande personal inom högskolesektorn upplever och påverkas av distansarbete.

    Syfte

    Att undersöka hur distansarbete praktiseras av, och påverkar universitetslärare, samt att undersöka första linjens chefers upplevelser av att leda en personalgrupp som i varierande omfattning arbetar på distans.

    Metod

    Projektet innehåller fyra delstudier. Delstudie I består av en web-baserad enkätunder-sökning av hälsa, stress, återhämtning, balans mellan arbete och privatliv, arbetsmo-tivation, och förekomst av distansarbete bland universitetslärare vid svenska högskolor och universitet. Datainsamlingen pågår och förväntas vara avslutad i slutet av VT-18. I delstudie II kommer universitetslärare att följas under en arbetsvecka med mätningar av rörelsemönster, hjärtfrekvens och stresshormon. Mätningarna kommer att förläggas till en vecka då läraren arbetar minst en dag på ordinarie arbetsplats och minst en dag på annan plats, så att jämförelser av exponering kan göras inom person. Datainsamling för delpro-jekt III genomförs genom semistrukturerade intervjuer med universitetslärare för att undersöka deras upplevelser av att arbeta på, respektive utanför, ordinarie arbetsplats och vad som motiverar dem att arbeta på distans. I delprojekt IV undersöks upplevelser av att leda en personalgrupp som i varierande omfattning arbetar på distans, genom semistrukturerade intervjuer med universitetsanställda med en första linjens chefsposition.

    Resultat

    Projektet förväntas bidra med fördjupad kunskap om hur distansarbete inom universitets- och högskolesektorn relaterar till olika aspekter av hälsa och välbefinnande bland universitetslärare, och vilka effekter det får för individen att ta med sig arbetet från den ordinarie arbetsplatsen. Projektet förväntas även generera kunskap om hur universitets-anställda med en personalledande funktion upplever att leda anställda som arbetar på distans. Denna kunskap kommer att bidra till utvecklandet av rekommendationer för en hållbar arbetsmiljö, i lärarkåren och hos universitetsanställda med en personalledande funktion.

  • 12.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Balancing intrusive illness: the experiences of people with musculoskeletal problems2007Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The overall aim of the present thesis was to explore and describe the health experiences of men and women with musculoskeletal problems. The specific aims of the four papers were: (I) to explore the experience of illness and wellness among ambulance personnel with musculoskeletal symptoms; (II) to explore the experience of illness and wellness among female health care personnel with musculoskeletal symptoms; (III) to explore the experience of bodily illness among people with musculoskeletal problems in the neck-shoulder region, and; (IV) to investigate the symptoms described by people with non-specific neck-shoulder problems, to investigate the method of development of neck-shoulder questionnaires that assesses pain and other symptoms, to analyse the content and items of these questionnaires, and to compare the findings.

    The overall findings show that the occupationally active men and women with MSDs were “striving for balance” (I-II), that the disease course of chronic neck-shoulder disorders was characterised by “uncontrollable fluctuations” (III), and that most neck-shoulder questionnaires had a low correspondence to the variety of symptoms experienced during this course (IV). In the process of striving for balance (I-II), the informants’ health experiences were not a state of either wellness or illness, but of both, in varying degrees at different times. The balancing started when illness became too intrusive, and was a process of minimising the impact of illness by accepting and handling it, while attaining and maintaining wellness to feel well enough. When striving for balance, the interviewees kept on working to continue being nurtured at the same time as they made different efforts directed at minimising the impact of their illness. For both men and women, illness was characterised by disembodiment, vulnerability, and exhaustion. The illness experiences were counterbalanced by wellness, where some differences could be recognised between the men and the women. Study III further explored the experiences of bodily illness, focusing on people with chronic musculoskeletal disorders in the neck-shoulder region. The course of the disorder was described as characterised by uncontrollable fluctuations, and it usually developed from insidious symptoms to a state of constant discomfort. The participants experienced calmer periods during the course, but intermittent events of increasing illness were always lying in wait, with periodic moments of consuming intensity. In the interviews included in study IV a variety of symptoms were expressed, which indicated a bodily, mental, and emotional engagement, which included more general and more severe symptoms than are usually related to neck-shoulder disorders. Few of the questionnaires were developed using the experiences of the affected. Taken as a whole, did the questionnaires cover many of the symptoms of the interviewees, but each individual questionnaire only included a few. The fluctuations and nuances of symptoms were rarely considered. The correspondence between individual questionnaires and the experiences of those affected was most often low. This thesis reveals other aspects of health than just bodily experiences as important among occupationally active people with MSDs. It also provides a description of the disease course, and an indication of possibilities for improvement of neck-shoulder questionnaires

  • 13.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Health as balance: illness and wellness among persons with musculoskeletal disorders2006Ingår i: 5th Global Conference Making Sense Of: Health, Illness and Disease, 2006Konferensbidrag (Refereegranskat)
    Abstract [en]

    Musculoskeletal disorders is a condition mostly approached from an out-side perspective and with quantitative methodology. This paper presents health experiences of men with musculoskeletal problems, explored through narrative interviews and constant comparative analysis. As there is a need for further research concerning people with early musculoskeletal symptoms, we turned to persons still active in working life. Ten men working as ambulance personnel were interviewed about their health experiences.

    The analysis revealed a process of striving for balance between experiences of illness and wellness. The informants’ health experiences were not a state of either wellness or illness but both, in varying degrees at different times. The process of striving for balance started when the illness experience became too intrusive, and was a process of both minimising the impact of illness by accepting and handling it and attaining and maintaining enough wellness to strike a balance. The state of balance was the experience of feeling “well enough”.

    Illness was characterised by disembodiment, vulnerability, and exhaustion, as the illness experiences incorporated feelings of that the previously silent body made it self heard, of being vulnerable when suffering gets too close and of getting worn out. Those experiences were counterbalanced by wellness, which was nurtured by experiences of relatedness, usefulness, being some one, and by excitement, challenge, and freedom.

  • 14.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Well but ill: Lay perspectives on health among people with musculoskeletal disorders.2012Konferensbidrag (Refereegranskat)
    Abstract [en]

    This study departs from questions arisen in previous interview studies of health experiences with people with musculoskeletal disorders. During data collection about health experiences in this group a common comment to the question –“How do you experience your health”? was –“Well, but”…  This awoke our interest to further explore this topic. Thus the aim of present study was to investigate lay perspectives on health among people with musculoskeletal disorders. Semi-structured interviews were performed with 68 women and men with long term (>3 months) musculoskeletal disorders in neck, shoulder and/or low back. All informants were recruited as participants in previous studies on health experiences among people with MSDs (Wiitavaara et al., 2007a, b, 2008, 2009). The informants (39 women and 29 men), were 18-64 years old and most of them were occupationally active in a variety of different occupations. Analysis was performed using qualitative content analysis (Graneheim & Lundman, 2003). The lay perspective on health in this group of people with musculoskeletal problems was perceived as “Having resources and possibilities to lead the life one want”. This theme incorporated three main categories as the informants perceived health to include “A good enough physical and psychological functioning and balance”; “Freedom of action”; and “A positive state of emotion and an enriching social life”. The informants expressed a holistic view of health, encompassing physical, psychological, emotional, as well as social aspects, which can be interpreted from an action theoretical perspective (Nordenfelt, 2007).

  • 15.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Nursing, Umeå University, Umeå, Sweden.
    Barnekow-Bergkvist, Margareta
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Brulin, Christine
    Department of Nursing, Umeå University, Umeå, Sweden.
    Striving for balance: a grounded theory study of health experiences of nurses with musculoskeletal problems.2007Ingår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 44, nr 8, s. 1379-1390Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 16.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Bengs, Carita
    Sociologiska institutionen, Umeå universitet.
    Brulin, Christine
    Institutionen för omvårdnad, Umeå universitet.
    Lekmannaperspektiv på hälsa bland personer med muskuloskeletala besvär2015Ingår i: Best Practice : Smärta, Vol. 4, nr 10, s. 20-23Artikel i tidskrift (Övrigt vetenskapligt)
  • 17.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Bengs, Carita
    Sociologiska institutionen, Umeå universitet.
    Brulin, Christine
    Institutionen för omvårdnad, Umeå universitet.
    Well, I'm healthy, but...: lay perspectives on health among people with musculoskeletal disorders2016Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, nr 1, s. 71-80Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    urpose: The purpose was to investigate lay perspectives on health among people with musculoskeletal disorders. Method: Semi-structured interviews were performed with 39 women and 30 men, (aged 22–63 years) with long-term, non-specific musculoskeletal disorders in the neck, shoulder and/or low back. Data was analysed using qualitative content analysis. Results: These people experienced health as “having resources and opportunities to lead the life one wants”. Three categories, “a good enough physical and psychological functioning, freedom of action, and a positive state of emotion and an enriching life”, illustrate the different resources and opportunities that the informants described as important for them to perceive themselves as healthy. The informants also reflected on “being ill” and “being well” and what makes the difference. Five aspects influenced the dynamics of their health experiences: “body and soul, prognosis, character of symptoms, physical and social activity, and emotional state”. Consequently, the informants expressed a holistic view of health, where the focus lies on the opportunity and the ability to lead their lives the way they want. Conclusions: This study points at the value of taking lay perspectives on health into account, as it might increase the opportunity to design effective, personalized rehabilitation strategies.

  • 18.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Nursing, Ume̊ University, Umeå, Sweden.
    Björklund, Martin
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Alfta Research Foundation, Alfta, Sweden.
    Brulin, Christine
    Department of Nursing, Ume̊ University, Umeå, Sweden.
    Djupsjöbacka, Mats
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    How well do questionnaires on symptoms in neck-shoulder disorders capture the experiences of those who suffer from the disorders?: A content analysis of questionnaires and interviews2009Ingår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 10, nr 1, artikel-id 30Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Previous research has indicated neck-shoulder disorders to have a fluctuating course incorporating a variety of symptoms. These findings awoke our interest to make a comparison between symptoms experienced by people affected with the disorder and the content of questionnaires that assess pain and other symptoms in neck-shoulder disorders. Thus the aims of this study were: -to explore the symptoms experienced by people with non-specific neck-shoulder problems, as well as experiences of nuances and temporal variations (fluctuations) of symptoms; -to investigate which sources were used in the development of ten questionnaires for assessing pain and other symptoms in the neck-shoulder; -to analyse the item content of the questionnaires; -to analyse the correspondence between the item content of the questionnaires and the symptoms described by the informants. METHODS: Content analysis of interviews with 40 people with non-specific neck-shoulder pain, and 10 questionnaires used to assess pain and other symptoms in neck-shoulder disorders. RESULTS: The interviews revealed a variety of symptoms indicating a bodily, mental/cognitive, and emotional engagement, and more general and severe symptoms than are usually considered in neck-shoulder questionnaires. Taking all questionnaires together many of the symptoms were considered, but most questionnaires only included a few of them. The informants were able to distinguish fluctuation of symptoms, and a variety of different qualities which were not usually considered in the questionnaires. Only two questionnaires had made use of the opinions of affected people in the development. CONCLUSIONS: Few of the questionnaires had made use of the experiences of affected people in the development. The correspondence between the symptoms expressed by the affected and the content of the questionnaires was low. A variety of symptoms were expressed by the interviewees, and the participants were also able to distinguish nuances and fluctuations of symptoms. The present study points to the importance of other aspects than just pain and physical functioning as clinical trial outcome measures related to neck-shoulder disorders. To develop a condition-specific questionnaire, it is important to decide on the specific symptoms for the condition. Using the experiences of those affected, in combination with relevant research and professional knowledge, can enhance the validity of the questionnaires.

  • 19.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF.
    Björklund, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF.
    Djupsjöbacka, Mats
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF.
    Nilsson, Annika
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap.
    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)2010Ingår i: Proceedings of the Premus 2010 conference (Seventh International Conference on Prevention of Work-Related Musculoskeletal Disorders) August 29-September 2, Angers, France, 2010, s. 283-Konferensbidrag (Refereegranskat)
  • 20.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF.
    Björklund, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF.
    Nilsson, Annika
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap.
    An initial factor analysis of prominent aspects of health experiences for women with neck-shoulder pain2012Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, nr 11, s. 934-942Artikel i tidskrift (Refereegranskat)
    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.

  • 21.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Nursing, Umeå University, Umeå, Sweden.
    Brulin, Christine
    Department of Nursing, Umeå University, Umeå, Sweden.
    Barnekow Bergqvist, Margareta
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    When the body makes itself heard: the experience of bodily illness among people with neck-shoulder problems2008Ingår i: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 10, nr 2, s. 85-94Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 22.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Fahlström, Martin
    Institutionen för klinisk vetenskap, Umeå universitet.
    Djupsjöbacka, Mats
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Prevalence, diagnostics, and management of musculoskeletal disorders in primary health care in Sweden: an investigation of 2000 randomly selected patient records2017Ingår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 23, nr 2, s. 325-332Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. To improve the care of patients suffering from musculoskeletal disorders (MSD) further knowledge regarding the prevalence, diagnostics and management of different MSD in primary care is required. Thus the aims of this study were: -to investigate the prevalence of patients seeking care due to different MSD at primary health care centres (PHCs); -to chart different factors as symptoms, diagnosis, and actions prescribed for patients that visited the PHCs due to MSD; and -to make comparisons regarding differences due to gender, age, and rural or urban PHC.

    Methods. 2000 patient records for patients in working age were randomly selected equally distributed on one rural and one urban PHC. A 3-year period was reviewed retrospectively. For all patient records age, sex, occupation, occupational activity, date of visit, if it was a new or re-visit, cause to the visit, and diagnosis related to the visit were registered. For visits due to MSD the location of the patients symptoms, which symptoms were described in the patient record, the type of those symptoms, which actions were prescribed to resolve the patients problems, and also sickleave prior to and after the visit, were registered. Data was analysed using cross tabulation, multidimensional Chi-square (Pearson), and a probability level of p < .05.

    Results. The prevalence of MSD was high, almost 60 % of the patients had some sort of MSD symptoms, either at the day for visit or the reviewed 3 year period, and a bit higher among women than men. Upper and lower limb problems were most common. Symptoms were most prevalent in the young and middle age-groups. The patients got a variety of different diagnoses, and between 13-35 % of the patients did not receive a MSD-diagnose despite having MSD-symptoms. There was a great variation in how the cases were handled. Medication and sick leave certificates were most common while work-related rehabilitation was less common. Conclusion. The present study points out some weaknesses regarding diagnostics and management of MSD in primary care. Further studies to compare the results regarding diagnoses for musculoskeletal symptoms and measures taken to solve the patients’ problems would be of interest.

  • 23.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Content and psychometric evaluations of questionnaires for assessing physical function in people with low back disorders: a systematic review of the literature2018Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The purpose was to investigate how physical function is assessed in people with musculoskeletal disorders in the low back. Specifically:

    • Which questionnaires are used to assess physical function in people with musculoskeletal disorders in the low back?
    • What aspects of physical function do those questionnaires measure?
    • What are the measurement properties of the questionnaires?

    Materials and methods: A systematic review was performed to identify questionnaires and psychometric evaluations of them. The content of the questionnaires was categorised according to the International Classification of Function, Disability and Health, and the psychometric evaluations were categorised using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist.

    Results: The questionnaires measured disability or ability to cope in everyday life, rather than physical function as such. Different aspects of a person’s mobility and ability to attend to one’s personal care were most often included regarding activity and participation. For body functions, items about sleep and pain were most often included. The Oswestry Disability Index and the Quebec Back Pain Disability Scale showed adequate psychometric properties in most evaluations.

    Conclusions: The extent of psychometric evaluations differed substantially, as did the items included. Focus of measurement was predominantly on activities in daily life.

    • Implications for rehabilitation
    • Valid and reliable instruments that measure relevant aspects of low back disorders are needed to provide early diagnostics and effective treatment.
    • Most questionnaires need more psychometric evaluations to establish the quality.
    • The Oswestry Disability Index and the Quebec Back Pain Disability Scale showed adequate psychometric properties in most evaluations.
    • The results may be useful when making decisions about which measurement instruments to use when evaluating low back disorders.
  • 24.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Content and psychometric evaluations of questionnaires for assessing physical function in people with neck disorders –  A systematic review of the literature2018Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, nr 19, s. 2227-2235Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Purpose: The purpose was to investigate how physical function is assessed in people with musculoskeletal disorders (MSD) in the neck. Specifically, we aimed to determine: (1) Which questionnaires are used to assess physical function in people with MSD in the neck? (2) What do those questionnaires measure? (3) What are the measurement properties of the questionnaires?

    Materials and methods: A systematic review was performed to identify questionnaires and psychometric evaluations. The content of the questionnaires was categorized according to the International Classification of Function, Disability and Health, and the psychometric properties were quality-rated using the COnsensus-based Standards for the selection of health Measurement INstruments checklist.

    Results: Ten questionnaires and 32 articles evaluating measurement properties were analyzed. Most questionnaires covered only the components body functions and activity and participation, more often activity participation than body function. Internal consistency was adequate in most questionnaires, whereas responsiveness was generally low. Neck Disability Index was most evaluated, but the evaluations of all questionnaires tended to cover most properties in the checklist.

    Conclusions: The questionnaires differed substantially in items and extent to which their psychometric properties had been evaluated. Focus of measurement was on activities in daily life rather than physical function as such.

    • Implications for Rehabilitation
    • To provide early diagnostics and effective treatment for patients with neck disorders, valid and reliable instruments that measure relevant aspects of the disorders are needed.

    • This paper presents an overview of content and quality of questionnaires used to assess physical function in neck disorders, which may facilitate informed decisions about which measurement instruments to use when evaluating the course of neck disorders.

    • Most of the questionnaires need more testing to judge the quality, however the NDI was the most frequently tested questionnaire.

    • The COnsensus-based Standards for the selection of health Measurement INstruments checklist is a useful tool in relation to psychometric testing of questionnaires, but clear definitions of interpretation of the quality criteria in each study would enhance comparability of results.

  • 25.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Content and quality of questionnaires for assessment of physical functioning in neck disorders – A systematic review of the literature2017Ingår i: Joy at Work, NES, 2017, 2017Konferensbidrag (Refereegranskat)
    Abstract [en]

    Valid and reliable instruments are required in order to determine effective interventions in the treatment of musculoskeletal disorders (MSD). Today, there is a lack of consistency in use of self-report outcome measures in research and practice, which makes it difficult or impossible to compare treatment effects. The questionnaires differ widely, in content as well as quality. The focus of present study was on assessment of physical functioning among people with MSD in the neck. The aim was to investigate how physical function is assessed in people with MSD in the neck. Specifically we wanted to determine: - Which questionnaires are used to assess physical function in people with musculoskeletal disorders in the neck? - What do those questionnaires measure? - What are the measurement properties of the questionnaires?

    The study was performed as a systematic literature review in order to identify articles presenting the questionnaires and psychometric tests of them. Items included in the questionnaires were classified according to the "International Classification of Functioning, Disability and Health", ICF. Thereafter, all psychometric tests of the different questionnaires were analysed with respect to relevant quality indicators using the "Cosmin checklist".

    Included in the final analysis were 10 questionnaires and 32 articles presenting psychometric tests of them. The analysis revealed that questionnaires for measuring physical functioning in neck disorders differ substantially in items and extent to which their psychometric properties have been evaluated. Most questionnaires contained only the ICF-components body functions and activity and participation, more often activity and participation. The most psychometrically tested questionnaire was Neck Disability Index. Remaining questionnaires were tested in fewer studies and only some of the properties in the Cosmin checklist were tested for most of them.

    Questionnaires for assessment of physical function in people with neck disorders tend to focus more on the ability to engage in activities of daily life than on physical function as such. Furthermore, the measurement properties of the questionnaires have usually been evaluated in few studies. It is vital to measure aspects that are of importance for the individual wellbeing and ability to function in work and daily life when evaluating neck disorders. However, to increase the validity of the results in clinical and research studies, it is also important to include the most relevant aspects of physical function. We recommend more psychometric testing of the questionnaires, especially those that cover important aspects of the ICF categories. To ensure coverage of important aspects, validation of the questionnaires against patients and practitioners is needed.

    A review and analysis of this kind makes it easier for researchers and clinicians to select the most suitable questionnaire for their own purpose, based on the content and quality of the questionnaire.

  • 26.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    What do questionnaires for assessment of physical functioning in neck disorders really measure?: A systematic review of the literature2016Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background. In order to determine which interventions are effective in the treatment of musculoskeletal disorders, valid and reliable instruments are required. However, there is a lack of consistency in the use of outcome measures, both in research and in treatment, that makes comparisons difficult or impossible; the content and quality varies widely be-tween questionnaires. This study focuses on the measurements of the physical function-ing of people with MSDs. The aim of this systematic review is to investigate how physical function is measured in people with musculoskeletal disorders or chronic pain. Specifically we want to determine: (1) What instruments are used to measure physical function in people with musculoskeletal disorders or chronic pain? (2) What do those instruments measure? (3) What is the methodological quality of these instruments?

    Method. The study was performed as a systematic literature review in the data bases PubMed, Cinahl, Web of Science, and Scopus, using the same set of keywords and Bool-ean operators. The selection of relevant articles was performed by reviewing the title and abstract first, and the article text thereafter. Selected articles were classified according to the “ICF Classification of Functioning, Disability and Health.” Subsequently, articles will be examined with respect to relevant quality indicators using the “Cosmin checklist.”

    Results. 69 relevant questionnaires were found and were sorted into groups according to focus. As a first step, neck and arm-shoulder-hand questionnaires were analyzed. The ICF-classification revealed that the included items belonged to the components “body func-tions” and “activity/participation,” and the included domains varied significantly between the questionnaires. The quality of the instruments will be determined in the next step.

    Discussion. A review and analysis of this kind makes it possible for researchers and clini-cians to more easily select the most suitable questionnaire for their purpose based on the content and quality of the questionnaire.

  • 27.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Belastningsskadecentrum.
    Lundman, B
    Barnekow-Bergkvist, Margareta
    Högskolan i Gävle, Belastningsskadecentrum.
    Brulin, Christine
    Experiences of illness, wellness and work environment of male ambulance personnel2005Ingår i: Proceedings of the 37th Annual Conference of the Nordic Ergonomics Society, 2005, s. 266-270Konferensbidrag (Refereegranskat)
    Abstract [en]

    This study explored experiences of illness, wellness and work environment of male ambulance personnel with musculoskeletal symptoms. A Grounded theory approach was applied with interviews with ten ambulance men parallel to analysis. Illness was experienced as threefold, with experiences of getting too vulnerable/hardened and getting worn-out beside experiences of bodily illness. Wellness was closely connected to their identity as both individuals and ambulance workers. To create stability and make sense of their illness experiences, the men performed an inner reasoning about extenuating circumstances to make illness acceptable; they also consciously worked out a strategy for handling their problems.

  • 28.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Nursing, Umeå University, Umeå, Sweden.
    Lundman, B.
    Department of Nursing, Umeå University, Umeå, Sweden.
    Barnekow-Bergkvist, Margaretha
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Brulin, C.
    Department of Nursing, Umeå University, Umeå, Sweden.
    Striking a balance - health experiences of male ambulance personnel with musculoskeletal symptoms: a grounded theory2007Ingår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 44, nr 5, s. 770-779Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 29.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Rissén, Dag
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Region Gävleborg.
    Högberg, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Nilsson, Annika
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Psychometric testing of a short form questionnaire for measurement of health experiences among people with musculoskeletal disordersundergoing multimodal rehabilitation2019Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, artikel-id 9:e025103Artikel i tidskrift (Refereegranskat)
    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.

  • 30.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Rissén, Dag
    CFUG, Centrum för forskning och utveckling, Uppsala universitet / Landstinget Gävleborg.
    Nilsson, Annika
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap. Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    Utvärdering av muskuloskeletala besvär: Utveckling av ett kliniskt användbart frågeformulär för personer med besvär från rörelseapparaten2013Övrigt (Övrigt vetenskapligt)
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