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Ekholm, Kristina Schüldt
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Björnhagen, V., Ekholm, K. S., Larsen, F. & Ekholm, J. (2018). Burn survivors' pulmonary and muscular impairment, exercise tolerance and return-to-work following medical-vocational rehabilitation: A long-term follow-up. Journal of Rehabilitation Medicine, 50(5), 465-471
Öppna denna publikation i ny flik eller fönster >>Burn survivors' pulmonary and muscular impairment, exercise tolerance and return-to-work following medical-vocational rehabilitation: A long-term follow-up
2018 (Engelska)Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, nr 5, s. 465-471Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: To follow up the long-term outcome in return-to-work (RTW) rate in burn-injury patients, and to determine the degree of impairment in pulmonary and muscular function and exercise tolerance. Design: A prospective, longitudinal follow-up study without a control group. Patients: Twenty-five burn-injury patients referred for medical-vocational rehabilitation. Methods: Return-to-work rate was followed after completed medical-vocational rehabilitation. Pulmonary function was evaluated with spirometry, diffusing capacity and radio spirometry. Exercise capacity was determined using a bicycle ergometer. Muscle functions evaluated in the arms and legs were: isokinetic torque, isometric strength, endurance and muscular strength utilization. Results: Return-to-work rate was 87%. During bicycle exercise tests the patients, on average, reached their expected workloads. The dominating lung function abnormality observed on lung scintigraphy was delayed wash-out time of inhaled radioactive xenon gas, suggesting airway obstruction. All tests of shoulder-flexor and knee-extensor muscle function showed large minimum-maximum differences. Mean isometric endurance of shoulder flexors was lower than mean of references, and isokinetic knee extensor torques were slightly lower. Conclusion: High return-to-work rates can be achieved after burn injury requiring hospital-ward care. Despite measurable impairments in muscle strength/endurance and pulmonary function in a substantial proportion of these patients, overall normal bicycle exercise capacity was observed except for a few cases.

Nyckelord
Burn injury, Cardio-pulmonary exercise capacity, Lung scintigraphy, Medical rehabilitation, Muscle function, Pulmonary function, Return to work, Vocational rehabilitation
Nationell ämneskategori
Klinisk medicin
Identifikatorer
urn:nbn:se:miun:diva-33696 (URN)10.2340/16501977-2337 (DOI)000437193300012 ()29670997 (PubMedID)2-s2.0-85046482634 (Scopus ID)
Tillgänglig från: 2018-06-01 Skapad: 2018-06-01 Senast uppdaterad: 2019-08-06Bibliografiskt granskad
Linder, J., Jansen, G. B., Schüldt-Ekholm, K. & Ekholm, J. (2014). RELATIONSHIP BETWEEN SLEEP DISTURBANCE, PAIN, DEPRESSION AND FUNCTIONING IN LONG-TERM SICK-LISTED PATIENTS EXPERIENCING DIFFICULTY IN RESUMING WORK. JOURNAL OF REHABILITATION MEDICINE, 46(8), 798-805
Öppna denna publikation i ny flik eller fönster >>RELATIONSHIP BETWEEN SLEEP DISTURBANCE, PAIN, DEPRESSION AND FUNCTIONING IN LONG-TERM SICK-LISTED PATIENTS EXPERIENCING DIFFICULTY IN RESUMING WORK
2014 (Engelska)Ingår i: JOURNAL OF REHABILITATION MEDICINE, ISSN 1651-2081, Vol. 46, nr 8, s. 798-805Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: To describe the frequency of reported sleeping, depression and pain problems, the severity of these problems and the degree of self-estimated difficulties in mental functions and activities in relation to the sleep disturbance and pain category group in patients on long-term sick-leave. Design: Cross-sectional study. Patients: A total of 1206 patients experiencing difficulty in resuming work. Methods: Patient examinations by specialists in psychiatry, orthopaedic surgery and rehabilitation medicine. Validated questionnaires, including status regarding depression, sleep, pain and functioning were used. Results: The prevalence of sleep disturbance was 83%; 74% of the patients with moderate/severe sleep disturbance also had moderate/severe pain problems and 26% had no/mild pain problems. Fifty-seven percent of the patients with no/mild sleep disturbance and 83% of the patients with moderate/severe sleep disturbance also had depression. The degree of difficulty in performing the 6 selected International Classification of Functioning, Disability and Health activities and mental functions was higher for the category with moderate/severe sleep problems, compared with those with no/mild sleep problems. Conclusion: To optimize rehabilitation for patients on long-term sick-leave experiencing difficulties in returning to work, the results indicate a need also to focus attention on sleep problems and not only on pain and depression. This may entail the planning of measures to improve decision-making and concentration and alleviate lassitude, fatigability, sadness and pessimistic thoughts.

Nyckelord
sleep disorders, pain, depression, functioning, sick leave, rehabilitation, mental functions, activity limitations, disability, work resumption
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:miun:diva-23226 (URN)10.2340/16501977-1833 (DOI)000342037500011 ()2-s2.0-84921976500 (Scopus ID)
Tillgänglig från: 2014-10-16 Skapad: 2014-10-16 Senast uppdaterad: 2015-03-13Bibliografiskt granskad
Jansen, G. B., Linder, J., Ekholm, K. S. & Ekholm, J. (2011). Differences in symptoms, functioning, and quality of life between women on long-term sick-leave with musculoskeletal pain with and without concomitant depression.. Journal of Multidisciplinary Healthcare, 4, 281-292
Öppna denna publikation i ny flik eller fönster >>Differences in symptoms, functioning, and quality of life between women on long-term sick-leave with musculoskeletal pain with and without concomitant depression.
2011 (Engelska)Ingår i: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 4, s. 281-292Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: The aim was to describe the differences in symptoms, functioning and quality of life between women on long-term sick-leave due to protracted musculoskeletal pain with and without concomitant depression.

DESIGN: Descriptive and comparisons with/without comorbid depression.

METHODS: 332 female patients were examined by three specialist physicians in psychiatry, orthopedic surgery, and rehabilitation medicine and assigned to four groups according to the ICD-10 diagnoses: low back/joint disorders (LBJ, n = 150), myalgia (M, n = 43), fibromyalgia (FM, n = 87), or depression without somatic pain diagnosis (DE, n = 52).

RESULTS: Patients with somatic pain conditions LBJ, M, or FM showed more activity-related difficulties if concomitant depression was present during the activities 'focusing attention', 'making decisions', and 'undertaking a single task'; and in the domains 'energy level', 'memory functions', 'emotional functions', and 'optimism/pessimism'. Patients with FM and concomitant depression perceived higher pain intensity than patients in group DE. No statistically significant differences in physically related activities were noted between each of the somatic pain conditions with and without coexisting depression. FM patients with coexisting depression reported fewer painful sites on their pain drawings compared with FM-patients without depression. Patients with LBJ or FM and concomitant depression reported lower quality of life in the dimensions vitality, social functioning, emotional role, and mental health. Comorbid depression affected disability and restricted working capacity by reducing mental activity and functioning but not by affecting physical activity problems.

CONCLUSION: Women on long-term sick-leave, who have concomitant depression with LBJ or FM, also have more difficulties in focusing attention, making decisions, and carrying out tasks, and with memory functions and optimism/pessimism, as well as reduced quality of life in the dimensions of vitality, social functioning, emotional role, and mental health, than female patients without comorbid depression. As a consequence we suggest further efforts to integrate somatic and psychiatric interventions in the same rehabilitation program.

Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:miun:diva-24595 (URN)10.2147/JMDH.S21827 (DOI)21847350 (PubMedID)2-s2.0-84876007881 (Scopus ID)
Tillgänglig från: 2015-03-17 Skapad: 2015-03-17 Senast uppdaterad: 2017-05-18Bibliografiskt granskad
Jakobsson, B., Ekholm, J., Bergroth, A. & Ekholm Schüldt, K. (2010). Improved employment rates after multiprofessional cross-sector cooperation in vocational rehabilitation: A 6-year follow-up with comparison groups. International Journal of Rehabilitation Research, 33(1), 72-80
Öppna denna publikation i ny flik eller fönster >>Improved employment rates after multiprofessional cross-sector cooperation in vocational rehabilitation: A 6-year follow-up with comparison groups
2010 (Engelska)Ingår i: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 33, nr 1, s. 72-80Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The objective of this study was to better understand the long-term effects of an improved model for cooperation on employment between rehabilitation professionals in vocational rehabilitation (VR). To compare these effects with those associated with the traditional model of cooperation. The study featured a group of patients who participated in a developmental project. All of the patients had some degree of restricted work capacity, which was evidenced somatically as well as mentally/socially. They had all experienced long periods of unemployment during the 2-year period before the intervention. A 'natural experiment study design' that relied on database records was used. Using matching criteria, we identified 'social twins' from a government register to create comparison groups at the local, county and national levels (n=4×51 patients). Repeated-measures analysis of variance and logistic regression were used to analyse the data. The majority (59%) of the study group was employed 3 years after the intervention compared with 39 and 41% in the two matched control groups, respectively. The corresponding figures after 6 years were 51 versus 39 and 37%. An individual with a somatically restricted work capacity was about twice as likely to secure gainful employment following VR as compared with an individual with a mentally/socially restricted work capacity. In conclusion, the study focused on an improved method of cooperation between rehabilitation actors in the context of VR programmes. A model that included systematic multiprofessional cross-sector group meetings was explored, and we concluded that a substantial percentage of the enrolled patients successfully secured employment over a 6-year period. This percentage exceeded that of matched pairs in a county and national group; we presume that these groups represented 'the usual form of cooperation'.

Nyckelord
Cooperation; Employment rate; Long-term follow-up; Matched pairs design; Multiprofessional; Rehabilitation group; Restricted work capacity; Vocational rehabilitation
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:miun:diva-9963 (URN)10.1097/MRR.0b013e32832fea0a (DOI)000275062600011 ()19741547 (PubMedID)2-s2.0-76749129391 (Scopus ID)
Tillgänglig från: 2009-10-05 Skapad: 2009-10-05 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
Linder, J., Schüldt Ekholm, K., Brodda Jansen, G., Lundh, G. & Ekholm, J. (2009). Long-term sick-leavers with difficulty in resuming work: comparisons between psychiatric-somatic co-morbidity and monodiagnosis. International Journal of Rehabilitation Research, 32(1), 20-35
Öppna denna publikation i ny flik eller fönster >>Long-term sick-leavers with difficulty in resuming work: comparisons between psychiatric-somatic co-morbidity and monodiagnosis
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2009 (Engelska)Ingår i: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 32, nr 1, s. 20-35Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The number of patients with difficulty in resuming work after long-term sick leave has increased in several European countries including Sweden. The general aim of this study was a comprehensive description - based on multidisciplinary diagnostics and assessments - of patients with the common feature of marked difficulty in resuming working life after a long absence. A particular aim was to elucidate the possible effect of comorbidity on pain descriptors, disability, quality of life, assessed working ability and rehabilitation needs. Six hundred and thirty-five long-term sick leavers were referred from National Insurance Offices and consecutively accepted for investigation. Several self-report questionnaires were used. All patients were examined by three board-certified specialist physicians in psychiatry, orthopaedic surgery and rehabilitation medicine, respectively. Fifty-five percent of the patients had psychiatric-somatic comorbidity. The three most frequent combinations of diagnoses in the comorbidity group were fibromyalgia/myalgia and depressive episode, fibromyalgia/myalgia and recurrent depression, spinal pain and depressive episode, whereas the three most frequent in those with psychiatric diagnosis only were depressive episode, recurrent depression, phobias/anxiety. Differences in pain descriptors and in difficulties with activities were found among the three groups. All had lower health-related quality of life than references. Only one-sixth had no assessed working capacity and only 3% were assessed as able to resume work without rehabilitation; 80% were multidisciplinarily assessed as needing rehabilitation. Patients with psychiatric diagnoses, with or without concomitant somatic diagnoses, need medical rehabilitation or medical/vocational rehabilitation in combination to a greater extent than patients with somatic diagnoses only. This implies that medical rehabilitation programmes ought to adapt increasingly to the needs of patients with psychiatric-somatic comorbidity.

Nyckelord
rehabiliteringsvetenskap
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:miun:diva-6595 (URN)10.1097/MRR.0b013e328306351d (DOI)000264360000003 ()2-s2.0-67650928599 (Scopus ID)5681 (Lokalt ID)5681 (Arkivnummer)5681 (OAI)
Tillgänglig från: 2009-02-24 Skapad: 2009-02-24 Senast uppdaterad: 2017-12-12Bibliografiskt granskad
Linder, J., Ekholm, K. S., Lundh, G. & Ekholm, J. (2009). Long-term sick-leavers with fibromyalgia: Comparing their multidisciplinarily assessed characteristics with those  of others with chronic pain conditions and depression. Journal of Multidisciplinary Healthcare, 2, 23-37
Öppna denna publikation i ny flik eller fönster >>Long-term sick-leavers with fibromyalgia: Comparing their multidisciplinarily assessed characteristics with those  of others with chronic pain conditions and depression
2009 (Engelska)Ingår i: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 2, s. 23-37Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: The aim was to gain knowledge of fibromyalgia (FM) patients on long-term sick leave and with particular difficulties in resuming work, and to compare them with patients with myalgia, back or joint diagnoses, and depression.

Methods: Patients were identified by and referred from social insurance offices and were multidisciplinarily examined by three board-certified specialists in psychiatry, orthopedic surgery and rehabilitation medicine. Ninety-two women were diagnosed with FM only. Three female comparison groups were chosen: depression, back/joint diagnoses, and myalgia.

Results and conclusions: Ceaseless pain was reported by 73% of FM patients, 54% of back/joint diagnoses patients, 43% of myalgia patients, and 35% of depression patients. The distribution of pain (>50%) in FM patients was to almost all regions of the body, and in depression patients to the lower dorsal neck, upper shoulders and lumbosacral back but not in the anterior body. Reduced sleep was more evident in FM patients. FM patients did not meet more criteria for personality disorder than patients with the other somatic pain conditions. The most common dimension of “personality traits” of somatic pain conditions was the “obsessive compulsive” but at a level clearly below that indicating a personality disorder. More FM patients experienced disabilities, the most common being in the mobility and domestic-life areas.

Nyckelord
fibromyalgia, long-term sick-leave, multidisciplinary assessment, depression, chronic pain conditions, disability, pain distribution
Nationell ämneskategori
Hälsovetenskaper
Identifikatorer
urn:nbn:se:miun:diva-32008 (URN)10.2147/JMDH.S4659 (DOI)2-s2.0-77955475022 (Scopus ID)
Tillgänglig från: 2017-11-03 Skapad: 2017-11-03 Senast uppdaterad: 2017-11-03
Chamberlain, M. A., Moser, V. F., Schuldt Ekholm, K., O´Connor, R. J., Herceg, M. & Ekholm, J. (2009). Vocational rehabilitation: An educational review. Journal of rehabilitation, 41(11), 856-869
Öppna denna publikation i ny flik eller fönster >>Vocational rehabilitation: An educational review
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2009 (Engelska)Ingår i: Journal of rehabilitation, ISSN 0022-4154, Vol. 41, nr 11, s. 856-869Artikel, forskningsöversikt (Refereegranskat) Published
Abstract [en]

The aim of this review is to describe aspects of vocational rehabilitation relevant for a physician aiming to become a specialist in physical and rehabilitation medicine (PRM). The review discusses the epidemiology of incapacity for work, the major patient groups in vocational rehabilitation (musculoskeletal and psychiatric diagnoses comprise approximately 50-70% of the patients), the influence of different kinds of environmental and individual risk factors on work resumption (such as the legal framework, application of the law, resources for rehabilitation and its effectiveness, the degree of co-operation between vocational rehabilitation agencies, economic factors/labour market situation, medical and personal factors). The review describes different models of vocational rehabilitation, the effectiveness of various vocational rehabilitation programmes on work resumption or sick leave (where strong evidence is reported for multimodal rehabilitation programmes for patients with long-lasting musculoskeletal pain). Finally, there are sections about the PRM physician's history-taking in vocational rehabilitation (using the International Classification of Functioning, Disability and Health (ICF)), and report writing with a Structure where ICF body functions and activity limitations are reported separately.

Nyckelord
LOW-BACK-PAIN; SICK-LISTED PEOPLE; FOLLOW-UP; RHEUMATOID-ARTHRITIS; MULTIDISCIPLINARY REHABILITATION; WORK-ABILITY; RISK-FACTORS; INTERNATIONAL CLASSIFICATION; FUNCTIONAL RESTORATION; OUTPATIENT TREATMENT
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:miun:diva-10293 (URN)10.2340/16501977-0457 (DOI)000271102800002 ()2-s2.0-61849163744 (Scopus ID)
Tillgänglig från: 2009-11-09 Skapad: 2009-11-09 Senast uppdaterad: 2017-12-12Bibliografiskt granskad
Ekholm, J. & Ekholm Schudt, K. (2009). Vocational rehabilitation: Editorial. Journal of Rehabilitation Medicine, 41(3), 113-114
Öppna denna publikation i ny flik eller fönster >>Vocational rehabilitation: Editorial
2009 (Engelska)Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, nr 3, s. 113-114Artikel i tidskrift (Övrigt vetenskapligt) Published
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:miun:diva-11638 (URN)10.2340/16501977-0327 (DOI)000264017100001 ()2-s2.0-60749134376 (Scopus ID)
Tillgänglig från: 2010-06-10 Skapad: 2010-06-10 Senast uppdaterad: 2017-12-12Bibliografiskt granskad
Ekholm, J. & Schüldt Ekholm, K. (2008). Arbets(o)förmåga ur rehabiliteringsmedicinskt perspektiv. In: Arbets(o)förmåga :: ur ett mångdisciplinärt perspektiv (pp. 402). Stockholm: Santérus Academic Press Sweden
Öppna denna publikation i ny flik eller fönster >>Arbets(o)förmåga ur rehabiliteringsmedicinskt perspektiv
2008 (Svenska)Ingår i: Arbets(o)förmåga :: ur ett mångdisciplinärt perspektiv, Stockholm: Santérus Academic Press Sweden, 2008, s. 402-Kapitel i bok, del av antologi (Övrigt vetenskapligt)
Ort, förlag, år, upplaga, sidor
Stockholm: Santérus Academic Press Sweden, 2008
Nyckelord
rehabiliteringsvetenskap
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:miun:diva-4573 (URN)5680 (Lokalt ID)978-91-7359-010-5 (ISBN)5680 (Arkivnummer)5680 (OAI)
Tillgänglig från: 2008-09-30 Skapad: 2008-09-30 Senast uppdaterad: 2011-12-21Bibliografiskt granskad
Jakobsson, B., Bergroth, A., Ekholm, J., Schüldt Ekholm, K. & Svedlund, M. (2008). Multi-professional vocational rehabilitation group meetings with female clients - a qualitative study.. Work: A journal of Prevention, Assesment and rehabilitation, 30(4), 413-421
Öppna denna publikation i ny flik eller fönster >>Multi-professional vocational rehabilitation group meetings with female clients - a qualitative study.
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2008 (Engelska)Ingår i: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 30, nr 4, s. 413-421Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Many women require vocational rehabilitation before they can return to work. The objective with the present study was to describe female clients' situation during the rehabilitation process, as it became apparent during the rehabilitation meetings with the various actors involved. The clients' diagnoses varied, but the majority was affected with musculoskeletal disorders. The meetings were audio-taped and transcribed verbatim, after which they were analysed by qualitative content analysis. The following themes emerged: Adaptation to the rehabilitation group; client's health status; the workplace's significance for rehabilitation; and the client's decision-point. Conflict between health and work was immensely important for rehabilitation. Differences in attitude were apparent during the rehabilitation meetings, as some clients were passive and exercised less influence on the planning, than the other more active clients did.

Nyckelord
rehabilitation, Rehabiliteringsvetenskap
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:miun:diva-4113 (URN)000258695100009 ()18725704 (PubMedID)2-s2.0-50049086415 (Scopus ID)4730 (Lokalt ID)4730 (Arkivnummer)4730 (OAI)
Tillgänglig från: 2008-11-29 Skapad: 2008-11-19 Senast uppdaterad: 2017-12-12Bibliografiskt granskad
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