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  • 101.
    Schandl, Anna
    et al.
    Department of Anesthesiology, Surgical Services and Intensive Care Medicine, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden .
    Bottai, Matteo
    Unit of Biostatistics, Department of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden .
    Hellgren, Elisabeth
    Department of Anesthesiology, Surgical Services and Intensive Care Medicine, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden .
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sackey, Peter V.
    Department of Anesthesiology, Surgical Services and Intensive Care Medicine, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden .
    Developing an early screening instrument for predicting psychological morbidity after critical illness2013In: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 17, no 5, p. Art. no. R210-Article in journal (Refereed)
    Abstract [en]

    Introduction: Guidelines recommend follow-up for patients after an intensive care unit (ICU) stay. Methods for identifying patients with psychological problems after intensive care would be of value, to optimize treatment and to improve adequate resource allocation in ICU follow-up of ICU survivors. The aim of the study was to develop a predictive screening instrument, for use at ICU discharge, to identify patients at risk for post-traumatic stress, anxiety or depression. Methods: Twenty-one potential risk factors for psychological problems - patient characteristics and ICU-related variables - were prospectively collected at ICU discharge. Two months after ICU discharge 252 ICU survivors received the questionnaires Post-Traumatic Stress Symptom scale -10 (PTSS-10) and Hospital Anxiety and Depression Scale (HADS) to estimate the degree of post-traumatic stress, anxiety and depression. Results: Of the 150 responders, 46 patients (31%) had adverse psychological outcome, defined as PTSS-10 >35 and/or HADS subscales >= 8. After analysis, six predictors were included in the screening instrument: major pre-existing disease, being a parent to children younger than 18 years of age, previous psychological problems, in-ICU agitation, being unemployed or on sick-leave at ICU admission and appearing depressed in the ICU. The total risk score was related to the probability for adverse psychological outcome in the individual patient. The predictive accuracy of the screening instrument, as assessed with area under the receiver operating characteristic curve, was 0.77. When categorizing patients in three risk probability groups - low (0 to 29%), moderate (30 to 59%) high risk (60 to 100%), the actual prevalence of adverse psychological outcome in respective groups was 12%, 50% and 63%. Conclusion: The screening instrument developed in this study may aid ICU clinicians in identifying patients at risk for adverse psychological outcome two months after critical illness. Prior to wider clinical use, external validation is needed.

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  • 102.
    Schandl, Anna
    et al.
    Department of Anesthesiology, Surgical Services and Intensive Care Medicine, Karolinska University Hospital Solna, Sweden.
    Bottai, Matteo
    The Unit of Biostatistics, The Institution of Environmental Medicine, Karolinska Institute, Solna, Sweden.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Hellgren, Elisabeth
    Department of Anesthesiology, Surgical Services and Intensive Care Medicine, Karolinska University Hospital Solna, Sweden.
    Sackey, Peter
    Department of Anesthesiology, Surgical Services and Intensive Care Medicine, Karolinska University Hospital Solna, Sweden.
    Gender differences in psychological morbidity and treatment in intensive care survivors - a cohort study2012In: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, ISSN 1364-8535, Vol. 16, no 3, p. Art. no. R80-Article in journal (Refereed)
    Abstract [en]

    Introduction

    Many hospitals have initiated follow-up to facilitate rehabilitation after critical illness and intensive care, although the efficacy of such an intervention is uncertain. Studies in trauma research indicate significant differences in psychological reactions to traumatic events between men and women. Our aim was, in a quasi-experimental design, to compare psychological morbidity and treatment effects between men and women enrolled in a multidisciplinary intensive care unit (ICU) follow-up programme (follow-up group) and ICU patients not offered such follow-up (control group).

    Methods

    Men and women treated > 4 days in the ICU in 2006, before ICU follow-up started, were compared with men and women treated in 2007 and 2008, when all patients with ICU stay > 4 days were offered ICU follow-up at 3, 6 and 12 months post-ICU. Fourteen months after ICU discharge, psychological problems were measured with Impact of Event Scale (IES) for posttraumatic stress and Hospital Anxiety and Depression Scale (HADS) for anxiety and depression.

    Results

    Women with no follow-up reported significantly higher IES scores than men. Women in the follow-up group reported significantly lower IES scores compared to women in the control group, both in crude analysis and after adjusting for significant confounders/predictors (age, ICU length of stay and previous psychological problems). Furthermore, the 75th percentile for IES and HADS-Depression scores (high scores and degree of symptoms of psychological problems) in women in the follow-up group was lower than in those without follow-up (IES: -17.4 p, p<.01, HADS-depression: -4.9 p, p<.05). For men, no significant differences were found between the no follow-up and the follow-up group.

    Conclusion

    Psychological problems after critical illness and intensive care appear to be more common in women than in men. A multidisciplinary ICU follow-up may reduce the incidence of long-term symptoms of posttraumatic stress and depression for women.

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    Schandl_Gender_differences_in_psychological_morbidity
  • 103. Soares, J
    et al.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Linton, S.J
    Smärttillstånd2008In: Preventiv medicin: teori och praktik, Lund: Studentlitteratur , 2008Chapter in book (Other academic)
  • 104. Soares, Joaqim
    et al.
    Grossi, G
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Burnout among women: associations with demographic/socio-economic, work, life-style and health factors2007In: Archives of Women's Mental Health, ISSN 1434-1816, E-ISSN 1435-1102, Vol. 10, no 2, p. 61-71Article in journal (Refereed)
    Abstract [en]

    This study examined the occurrence of low/high burnout among women and the demographic/socio-economic, work, life-style, and health “correlates” of high burnout. The sample consisted of 6.000 randomly selected women from the general population, of which 3.591 participated. The design was cross-sectional. The univariate analyses showed that about 21% of the women had high burnout, and compared to those with low burnout, they were more often younger, divorced, blue-collar workers, lower educated, foreigners, on unemployment/retirement/sick-leave, financially strained, used more medication and cigarettes, reported higher work demands and lower control/social support at work, more somatic problems (e.g. pain) and depression. The regression analysis showed that only age, sick-leave, financial strain, medication, work demands, depression and somatic ailments were independently associated with high burnout. Thus, women with high burnout were apparently faring poorly financially, emotionally and physically. Considering our findings, interventions to alleviate their problems may be necessary. We may have provided new insights into women’s burnout experiences, but longitudinal studies are warranted to firmly identify “determinants” of burnout.

  • 105.
    Soares, Joaquim J. F.
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Fraga, S
    Department of Clinical Epidemiology, University of Porto Medical School, Porto, Portugal .
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Stankunas, M
    Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania .
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Melchiore, GB
    Italian National Institute of Health and Science on Aging, Ancona, Italy .
    Barros, H
    Medical School - Hygiene and Epidemiology, University of Porto, Porto, Portugal .
    The chronicity and severity of abuse among older persons by country: A European study2014In: Journal of Aggression, Conflict and Peace Research, ISSN 1759-6599, Vol. 6, no 1, p. 3-25Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this paper is to investigate chronicity (frequency) in different abuse types (e.g. psychological) and overall abuse (all abuse types) by severity (minor, severe, total) in seven European cities, and scrutinize factors associated with high chronicity levels (frequency on the median and higher) in psychological and overall abuse by severity. Design/methodology/approach: The study design was cross-sectional. The sample consisted of 4,467 randomly selected women/men (2,559 women) aged 60-84 years from seven European cities, and data were analysed with bivariate and multivariate methods. Findings: Chronicity varied across country and by abuse type. For instance, Germany had the highest chronicity means in physical and sexual abuse; Greece in physical, injury, sexual and overall abuse; Lithuania in physical, injury, financial and overall abuse; Portugal in physical abuse; Spain in physical, sexual and financial abuse; and Sweden in psychological, injury, financial and overall abuse. In general, Italy had the lowest chronicity means. The main perpetrators were people close to the respondents and women (in some cases). Research limitations/implications: The independent relationship (regressions) between chronicity/severity of abuse, country and other variables (e.g. depression) was examined only for psychological and overall abuse. More research into this issue with other types of abuse (e.g. sexual) is warranted. Originality/value: The paper reports data from the ABUEL survey, which gathered population-based data on elderly abuse.

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  • 106. Soares, Joaquim J. F.
    et al.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Grossi, Giorgio
    Age and muscousceletal pain2003In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 10, no 2, p. 181-190Article in journal (Refereed)
    Abstract [en]

    Using questionnaires, we analyzed associations between different pain variables (e.g., pain intensity) and age (20-65+ years) among 949 primary pain patients. Older patients (a) were more often divorced, were blue-collar workers, were less educated, and had greater difficulties with living expenses; (b) had pain of longer duration, more frequently and of more complexity, and felt more disabled; (c) consumed more painkillers, analgesics, sedatives, and other medications, and had received more pain treatments; and (d) had more health problems. Younger patients had more severe pain, were financially strained, and were more often unemployed. A multivariate regression analysis showed that high disability was more determined by older than young age. However, other factors (e.g., pain complexity) were also important. Thus, older and younger patients experienced their pain differently.

  • 107.
    Soares, Joaquim J. F.
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Melchiorre, Maria Gabriella
    Italian National Institute of Health and Science on Aging, INRCA, Ancona, Italy.
    Stankunas, Mindaugas
    Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Lindert, Jutta
    Department of Public Health Science, Protestant University of Applied Sciences, Ludwigsburg, Germany.
    Torres-Gonzales, Francisco
    Network of Biomedical Research on Mental Health Centers, University of Granada, Spain.
    Barros, Henrique
    Department of Hygiene and Epidemiology, University of Porto, Medical School, Porto, Portugal.
    Ioannidi-Kapolou, Elisabeth
    Department of Sociology, National School of Public Health, Athens, Greece.
    Quality of life among persons aged 60-84 years in Europe: The role of psychological abuse and socio-demographic, social and health factors2013In: Journal of Biosafety and Health Education, ISSN 2332-0893, Vol. 1, no 1, p. 1-12Article in journal (Refereed)
    Abstract [en]

    Background: Elder abuse and its effects are a serious public health issue. However, little is known about therelation between psychological abuse, other factors (e.g. social support) and quality of life (QoL) by domain. This studyaddressed differences in QoL by domain between psychologically abused and non-abused. While considering otherfactors such as social support.

    Methods: The respondents were 4,467 (2,559 women) randomly selected persons aged 60-84 years living in7 European cities. The mean response across countries was 45.2%. The cross-sectional data were analyzed withbivariate/multivariate methods.

    Results: Abused respondents contrasted to non-abused scored lower in QoL (autonomy, 67.42 ± 21.26 vs. 72.39± 19.58; intimacy, 55.31 ± 31.15 vs. 67.21 ± 28.55; past/present/future activities, 62.79 ± 19.62 vs. 68.05 ± 18.09;social participation, 65.03 ± 19.84 vs. 68.21 ± 19.77). Regressions showed that abuse was negatively associated withautonomy, intimacy and past/present/future activities, and positively with the social participation. All QoL dimensionswere negatively associated with country and depressive/anxiety symptoms, and positively with social support. Further,variables such as age, sex and somatic symptoms were negatively associated with some of the QoL dimensions andothers such as family structure, education, health care use and drinking positively. The regression model “explained”32.8% of the variation in autonomy, 45.6% in intimacy, 44.8% in past/present/future activities and 41.5% in socialparticipation.

    Conclusions: Abuse was linked to lower QoL in most domains, but other factors such as depressive symptomsalso carried a negative impact. Social support and to some extent family structure had a “protective” effect on QoL.Abuse, health indicators (e.g. depressive symptoms) and social support should be considered in addressing the QoL ofolder persons. However, QoL was influenced by many factors, which could not be firmly disentangled due to the crosssectionalapproach, calling for longitudinal research to address causality.

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    Soares_Quality_of_life
  • 108. Soares, Joaquim J.F
    et al.
    Luo, Jiayou
    Jablonska, Beata
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Men´s experiences of violence: extent, nature and ‘determinants’2007In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 16, no 3, p. 269-277Article in journal (Refereed)
    Abstract [en]

    We examined the extent, nature and 'determinants' of violence in a randomly selected sample of men from the general population (18-64 years, n = 520). The men were assessed on various factors (e.g. demographics). The design was cross-sectional and data were collected over eight consecutive weeks. About 68 per cent of the men reported experiencing violence at some point during their lifetime, and just over 14 per cent in the past 12 months. The violence occurred mainly in public and work settings, with threatening/aggressive language/physical assaults as the most common forms. The main perpetrators were strangers or clients. Sexual abuse was rare. Repeated/multiple abuses were common and injuries were sustained. The victims and non-victims were similar for many factors (e.g. alcohol use). Only younger age and being a blue-collar/low white-collar worker were risk factors for violence. Men's experiences of violence (e.g. physical assaults/multiple abuses) should be a source of concern as they can have profound negative effects. Extensive research on the impact of violence on men's health appears necessary in light of the present findings.

  • 109. Soares, Joaquim JF
    et al.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Grossi, Giorgio
    The stress of musculoskeletal pain:: a comparison between primary care patients in various ages.2004In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 56, no 3, p. 297-305Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To analyse differences in demographic/financial/pain/health variables, disability, General Health Questionnaire (GHQ; i.e., depression symptoms) and coping among 949 primary care pain patients in various ages (20-65+ years) and to identify predictors of disability and coping. METHOD: Patients completed scales about various areas (e.g., coping). The design was cross-sectional and data were collected during 15 consecutive days at 20 randomly selected primary care centres in Stockholm. RESULTS: Univariate analyses showed that older patients (a) were more often divorced, blue-collar workers, less educated and had greater difficulties with living expenses, (b) had pain of longer duration, more frequently and of more complexity, and felt more disabled, (c) consumed more painkillers, analgesics, sedatives and other medications, had received more pain treatments and had more health problems and (d) more often used passive coping for pain. Younger patients (a) had more severe pain, were financially strained and were more often unemployed and (b) more often used active coping for pain. There were no significant differences concerning GHQ scores. Multivariate regression analyses showed that active coping was associated with younger age. High disability and passive coping were associated with older age. CONCLUSION: We corroborated previous findings and may provide new insights into the experiences of older and younger pain patients. Further research concerning, for example, the elderly at risk of developing pain problems is needed.

  • 110. Soares, Joaquim JF
    et al.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Jablonska, Beata
    Psychosocial experiences of foreign and native patients with/without pain2004In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 11, no 1, p. 36-48Article in journal (Refereed)
    Abstract [en]

    The psychosocial experiences of foreign/native primary care patients with/without pain were examined. The study comprised 328 foreign patients and 794 native patients who completed various scales (e.g. burnout). The design was cross-sectional and data were collected over 15 consecutive days at 20 randomly selected primary care centres. Pain patients were faring worse than pain-free patients concerning demographics/finances, depression, burnout and job demands/control/strain. Foreign pain patients had the worst situation of all patients. Foreign background was a risk factor for depression and burnout. Foreign pain patients also had a more severe clinical situation (e.g. disability) than native pain patients and being a foreign pain patient was associated with a higher risk of disability/the diagnosis of multiple pain. However, foreign background was not a pain risk factor. Female gender was a risk factor for pain and for complex/constant pain/disability. Variables such as sick leave were also important. The authors confirmed previous research and may have provided new insights into the experiences of foreign/native primary care patients with/without pain. However, further research appears necessary, not the least concerning the role of burnout as an antecedent to pain and the role of ethnicity.

  • 111.
    Soares, Joaquim J.F.
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Stankunas, Mindaugas
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Melchiorre, Maria Gabriella
    Italian National Institute of Health and Science on Aging , I.N.R.C.A., Ancona, Italy.
    Barros, Henrique
    University of Porto, Medical School, Porto, Portugal.
    Lindert, Jutta
    Protestant University of Applied Sciences, Ludwigsburg, Germany.
    Torres-Gonzalez, Francisco
    University of Granada, Granada, Spain.
    Ioannidi-Kapolou, Elisabeth
    National School of Public Health, Athens, Greece.
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The relationship between the chronicity and severity of abuse, socio-economics, psychosocial factors and mental health2015In: International journal of healthcare, insurance and equity, ISSN 2345-3168, Vol. 2, no 1Article in journal (Refereed)
    Abstract [en]

    The abuse and mental health of older persons are sources of great concern. However, there are limited data on the relation between the chronicity (frequency of abuse) by severity (minor, severe) of abuse (e.g. psychological, physical) and mental health (e.g. depression). Women/men aged 60–84 years from seven European cities (n=4,467) participated in this study, and data were analysed with bivariate/multivariate methods. High chronicity (frequency, median/above) of psychological and physical abuse independently of severity was related to depression and anxiety; financial and overall abuse to anxiety; and minor financial abuse and overall abuse to depression. Regressions showed that some factors (e.g. being from Greece) were associated with a lower depression/anxiety “risk” and others (e.g. low social support) with high risk. Low chronicity (frequency, below median) of psychological abuse was associated with a lower anxiety risk. The management of depression/anxiety, particularly anxiety, among elders should also consider the roles of abuse and social support.

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  • 112.
    Stankunas, Mindaugas
    et al.
    School of Public Health, Griffith University, Gold Coast, Queensland, Australia.
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija Riitta
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Melchiorre, Maria Gabriella
    Scientific Technological Area, Socio Economic Research Centre, Italian National Institute of Health and Science on Aging (INRCA), Ancona, Italy.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Torres-Gonzales, Francisco
    Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), University of Granada, Granada, Spain.
    Stankuniene, Aurima
    Department of Pharmaceutical Technology and Social Pharmacy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Avery, Mark
    School of Public Health, Griffith University, Gold Coast, Queensland, Australia.
    Ioannidi-Kapolou, Elisabeth
    Department of Sociology, National School of Public Health, Athens, Greece.
    Barros, Henrique
    Department of Hygiene and Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal.
    Lindert, Jutta
    Department of Public Health, Protestant University of Applied Sciences, Ludwigsburg.
    Factors associated with refraining from buying prescribed medications among older people in Europe2014In: Australasian Journal on Ageing, ISSN 1440-6381, E-ISSN 1741-6612, Vol. 33, no 4, p. 25-36Article in journal (Refereed)
    Abstract [en]

    Aim

    To evaluate the associations between refraining from buying prescribed medications and selected factors among older persons.

    Methods

    A total of 4467 people aged 60–84 years from seven European countries answered a questionnaire (response rate 45.2%). Refraining from buying prescribed medications was measured with the question: ‘Have you ever refrained from buying prescribed medication and care?’

    Results

    About 11.9% of older people refrained from buying prescribed medications. The multiple regression analysis showed that ages 60–64 (odds ratio (OR) = 2.08; 95% confidence interval (95%CI): 1.38–3.13) and 65–69 (OR = 1.73; 95%CI: 1.16–2.57) years, experience of financial strain (OR = 1.59; 95%CI: 1.27–2.01), as well as exposure to abuse (OR = 1.64; 95%CI: 1.31–2.06) when taking into account country of participant were independently associated with refraining from buying medications, while an opposite association was observed for being male (OR = 0.72; 95%CI: 0.58–0.91).

    Conclusions

    The study has revealed that refraining from buying prescription medications is a problem among older people and it has identified a number of factors associated with this.

  • 113.
    Stén, Kersti Danell
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Soares, Joaquim J. F.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Stankunas, Mindaugas
    Lithuanian Univ Hlth Sci, Med Acad, Dept Hlth Management, Kaunas, Lithuania.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Melchiorre, Maria Gabriella
    INRCA Ancona, Italian Natl Inst Hlth & Sci Aging, Sci Technol Area, Socio Econ Res Ctr, Ancona, Italy.
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Barros, Henrique
    Univ Porto, Sch Med, Dept Hyg & Epidemiol, P-4100 Oporto, Portugal.
    Lindert, Jutta
    Protestant Univ Appl Sci, Dept Publ Hlth Sci, Ludwigsburg, Germany.
    Torres-Gonzalez, Francisco
    Univ Granada, Ctr Invest Biomed Red Salud Mental CIBERSAM, Granada, Spain.
    Ioannidi-Kapolou, Elisabeth
    Natl Sch Publ Hlth, Dept Sociol, Athens, Greece.
    The relationship between abuse, psychosocial factors and pain complaints among older persons in Europe2014In: Medicina (Kaunas), ISSN 1010-660X, E-ISSN 1648-9144, Vol. 50, no 1, p. 61-74Article in journal (Refereed)
    Abstract [en]

    Background and objective: Abuse and pain complaints are common among older persons. However, little is known about relationships between abuse (e.g. psychological) and pain complaints (e.g. backache) among older persons while considering other factors (e.g. depression).Therefore, the aim of this study was to determine these relationships.Materials and methods: The design was cross-sectional. A total of 4467 women and men aged 60-84 years from Germany, Greece, Italy, Lithuania, Portugal, Spain, and Sweden answered questionnaires regarding various areas such as abuse, mental health (e.g. anxiety) and pain complaints (e.g. backache). The data were examined with bivariate (analyses ofvariance) and multivariate methods (linear regressions).Results: The bivariate analyses showed that psychological abuse was connected with all pain complaints; physical with headache and head pressure; sexual with neck or shoulder pain and headache; injury with all complaints (except pain in joints or limbs); financial with pain in joints or limbs and head pressure; and overall abuse (one or more types) with all complaints (except headache). The regressions showed that psychological abuse increased the likelihood of being affected by head pressure and heaviness or tiredness in the legs; physical abuse of being affected by headache and head pressure; financial abuse of being affected by head pressure; and overall abuse of being affected by headache and head pressure. In general, respondents from Sweden and younger (60-64 years) were less affected by the complaints than those from other counties (e.g. Germany) and older (e.g. 70-74 years), respectively. Respondents on medication (e.g. pain killers) were less affected by all pain complaints and those with high social support by pain in joints or limbs. High scores on anxiety and depression and having many diseases increased the likelihood of being affect by all pain complaints.Conclusions: Abuse was related with certain pain complaints (e.g.headache), but other factors and in particular mental health and physical diseases impacted on all pain complaints. Medication and partly social support had a positive effect on the pain experience, i.e. the complaints interfered less with for instance the daily-life of the respondents.

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  • 114. Sundin, Örjan
    Cardiovascular response patterning and type A behavior in middle aged men1992In: Journal of Psychophysiology, ISSN 0269-8803, E-ISSN 2151-2124, Vol. 6, p. 40-51Article in journal (Refereed)
  • 115.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Strategier vid behandling av dubbla störningar1998In: Dubbla störningar - nya rön och erfarenheter i diagnos och behandling av samtidigt beroende och psykisk störning, Örebro: Rustung , 1998, p. 90-102Chapter in book (Other academic)
  • 116. Sundin, Örjan
    et al.
    Burell, Gunilla
    Uppsala universitet.
    Öhman, Arne
    Karolinska institutet.
    Ström, Gunnar
    Uppsala universitet.
    Heart and lifestyle: a type A treatment program for myocardial infarction patients.1986In: Scandinavian Journal of Behaviour Therapy, ISSN 0284-5717, Vol. 15, p. 87-93Article in journal (Refereed)
  • 117. Sundin, Örjan
    et al.
    Fagerström, Karl Olov
    Uppsala Universitet.
    Raynauds disease1978In: Scandinavian Journal of Behaviour Therapy, ISSN 0284-5717, p. 247-251Article in journal (Refereed)
  • 118. Sundin, Örjan
    et al.
    Fredrikson, Mats
    Uppsala universitet.
    Danilsons, Tomas
    Uppsala universitet.
    Engels, Bernhard
    University of Baltimore .
    Frisk-Holmberg, Marianne
    Uppsala universitet.
    Ström, Gunnar
    Uppsala School of Medicine.
    Autonomic nervous function and essential hypertension: individual response specificity with and without beta-adrenergic blockade1985In: Psychophysiology, ISSN 0048-5772, E-ISSN 1469-8986, Vol. 22, p. 167-174Article in journal (Refereed)
  • 119. Sundin, Örjan
    et al.
    Fredrikson, Mats
    Uppsala universitet.
    Frankenhauser, Marianne
    Stockholms universitet.
    Cortisol excretion during the defence reaction in humans1985In: Psychosomatic Medicine, ISSN 0033-3174, E-ISSN 1534-7796, Vol. 47, p. 313-319Article in journal (Refereed)
  • 120.
    Sundin, Örjan
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Jinder, D
    Det är mycket nu - Insikt och utveckling2002In: Insikt och utveckling - tidningen för personal inom Stockholms produktionsområde, p. 19-20Article in journal (Other academic)
  • 121.
    Sundin, Örjan
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Lisspers, Jan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Hofman-Bang, Claes
    Nygren, Åke
    Rydén, Lars
    Öhman, Arne
    Comparing Multifactorial Lifestyle Interventions and Stress Management in Coronary Risk Reduction.2003In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 10, no 3, p. 191-204Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare the effects of residential multifactorial cardiac rehabilitation, outpatient multifactorial rehabilitation, stress management, and standard coronary rehabilitation, on cardiac risk reduction. Out of 144 eligible male patients recently treated with percantaneous transluminal coronary angiography (PTCA), coronary artery bypass graft (CABG), or acute myocardial infarction (AMI), 132 were randomized into this study. All interventions covered a 12-month active intervention, intense during the first months and subsequently leveled out. Main assessments were performed before randomization and after the intervention. Patients offered behavioral rehabilitation showed improved selfreported healthy diet habits and exercise frequency, and higher internal locus of control. Although blood lipids, exercise capacity, body mass, anxiety, depression, and Type A scores were changed in the expected direction, no significant difference emerged between active intervention and the standard care condition. Standard care of today appears to have great potential in particular if supplemented with some kind of stress management.

  • 122.
    Sundin, Örjan
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Grossi, Georgio
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden..
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Burnout among foreign born and Swedish native women. A longitudinal study in Sweden2011In: Women & health, ISSN 0363-0242, E-ISSN 1541-0331, Vol. 51, no 7, p. 643-660Article in journal (Refereed)
    Abstract [en]

    The authors of this study addressed burnout experiences (generally defined as chronic depletion of an individual's energetic resources') over time in relation to other factors (e. g., distress, sleep difficulties, job demands, etc.) among foreign-born women and Swedish native women living in Stockholm. The study design was a longitudinal panel survey with two waves one year apart. In the first wave, 3,616 of 6,000 randomly selected women took part, and 2,300 of the initial 3,616 women also participated in the second wave; 427 were foreign-born women, and 1,873 were Swedish native women. Baseline/emerging distress, emerging sleep difficulties, worsening general social support, job demands at baseline/escalating during the assessment period, emerging unemployment, constraints in social support at work, and sustained/emerging financial strain were associated with future burnout, regardless of background. More foreign-born women than Swedish native women reported burnout, with these differences maintained at one-year follow-up. The factors related to burnout were largely the same in both groups, but smoking and cardiovascular disease were related to burnout only among foreign-born women. Younger age, job demands, and working hours were associated with burnout among Swedish native women. The authors found that the women had concurrent problems such as burnout, distress, and sleep problems, but foreign background was not independently related to burnout.

  • 123. Sundin, Örjan
    et al.
    Öhman, Arne
    Karolinska Institutet.
    Burell, Gunilla
    Uppsala universitet.
    Palm, Thomas
    Uppsala universitet.
    Psychophysiological effects of cardiac rehabilitation in post-myocardial infarction patients1994In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 1, p. 55-75Article in journal (Refereed)
  • 124. Sundin, Örjan
    et al.
    Öhman, Arne
    Karolinska institutet.
    Palm, Thomas
    Uppsala universitet.
    Ström, Gunnar
    Uppsala universitet.
    Cardiovascular reactivity, type A behavior, and coronary heart disease.1995In: Psychophysiology, ISSN 0048-5772, E-ISSN 1469-8986, Vol. 32, p. 28-36Article in journal (Refereed)
  • 125.
    Söderman, Eva
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Lisspers, Jan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Depression as a predictor of return to work in patients with coronary artery disease.2002In: Social Science & Medicine, ISSN 0277-9536, Vol. 56, no 1, p. 193-202Article in journal (Refereed)
    Abstract [en]

    The importance of depression in coronary artery disease (CAD) outcomes is being increasingly recognized. The aim of this study was to investigate the power of depression as a predictor of return to work, both at full time and at reduced working hours, within 12 months of participation in a behaviorally oriented rehabilitation program in Sweden. The sample comprised 198 employed patients who had recently experienced an acute myocardial infarction (AMI, n=85), or had been treated with coronary by-pass surgery (CABG, n=73) or coronary angioplasty (PTCA, n=40). The results showed that clinical depression before intervention (16 as measured by the Beck Depression Inventory) exerted a great influence on work resumption both at full-time (odds ratio 9.43, CI=3.15–28.21) and at reduced working-hours (odds ratio 5.44, CI=1.60–18.53), while mild depression (BDI 10–15) influenced only work resumption at full-time (odds ratio 2.89, CI=1.08–7.70). Education and, at full-time hours, age also predicted work resumption. This highlights the importance of depressive symptoms in relation to return to work after a CAD event. More research is needed in order to elaborate the degree to which treatment of depression enhances work resumption rates.

  • 126.
    Söderman, Eva
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Lisspers, Jan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences. Karolinska Institute, Stockholm.
    Impact of Depressive Mood on Lifestyle Changes in Patients with Coronary Artery Disease2007In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, no 5, p. 412-417Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aims of this study were to investigate the time-course of depressive mood in patients with coronary artery disease during a secondary prevention rehabilitation program, and to analyse how different pre-treatment levels of depressive mood during a treatment phase were related to the degree of lifestyle change at 36 months follow-up. SUBJECTS: The study group comprised 109 of the original 183 consecutive coronary artery disease patients (91 male and 18 female) of whom 48 recently had experienced an acute myocardial infarction, 36 had been treated with coronary bypass surgery, 13 with percutaneous transluminal coronary angioplasty, and 12 had angina pectoris that had not been invasively treated. The subjects were divided into 3 subgroups based on their pre-treatment level of depressive mood. METHODS: Depressive mood was assessed at baseline, after 4 weeks and 12 months, using the depression subscale of the Hospital Anxiety and Depression scale. Lifestyle changes analysed included diet, smoking, relaxation (stress management) and exercise. RESULTS: Overall depressive mood ratings were significantly lower, both at the 4-week and 12-month assessments, compared with baseline, with the greatest improvements in patients with higher Hospital Anxiety and Depression measured depression. Original levels of depressive mood were not found to influence change of lifestyle habits during a 36-month follow-up period. CONCLUSION: Depressive mood might not be an obstacle to lifestyle changes when participating in a behaviourally oriented rehabilitation program including exercise-training, which might be a component important for improved depressive mood.

  • 127.
    Söderman, Eva
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Lisspers, Jan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Depression och livsstilsförändring vid rehabilitering av kranskärlspatienter2002In: Svensk Rehabilitering, ISSN 1403-4468, no 3, p. 48-51Article in journal (Other scientific)
    Abstract [sv]

    Mellan 17 och 45% av kranskärlspatienter kan sägas vara deprimerade. Cirka hälften av de deprimerade kranskärlspatienterna har tidigare haft depressiva episoder och var tredje anses utveckla depression någon gång under året närmast efter en hjärtinfarkt. Förutom vid hjärtinfarkt är depression också mycket vanligt hos patienter med angina pectoris.

  • 128.
    Tabrizi, Fara
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Larsson, Andreas
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Grönvall, Hampus
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Söderstrand, Lux
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Hallén, Ellen
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Champoux-Larsson, Marie-France
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Lundgren, Tobias
    Centre for Karolinska Institutet; Region Stockholm, Sweden.
    Sundström, Felicia
    Uppsala Universitet, Sweden.
    Lavefjord, Amani
    Uppsala Universitet, Sweden.
    Buhrman, Monica
    Uppsala Universitet, Sweden.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    McCracken, Lance
    Uppsala Universitet, Sweden.
    Åhs, Fredrik
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Jansson, Billy
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Psychometric Evaluation of the Swedish Multidimensional Psychological Flexibility Inventory (MPFI)2023In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 52, no 4, p. 295-316Article in journal (Refereed)
    Abstract [en]

    Psychiatric disorders are common, and reliable measures are crucial for research and clinical practice. A cross-diagnostic construct that can be used to index treatment outcomes as well as prevalence of psychological ill health is psychological flexibility. The aim of this study was to validate a Swedish version of the Multidimensional Psychological Flexibility Inventory (MPFI). The MPFI has 12 subscales, six of which measure flexibility, and six that measure inflexibility. Using confirmatory factor analysis in a community sample of 670 participants, we found that a model with 12 factors had the best fit to the data(CFI = .955). All 12 subscales showed adequate reliability (CRs = .803-.933) and the factor structure was similar across age groups and gender. Findings suggest that the Swedish version ofthe MPFI is a reliable instrument that can be used to index psychological flexibility. Potential areas for improvement of the instrument are discussed.

  • 129.
    Tabrizi, Fara
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    William-Olsson, Victor Rahimzadeh
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Rosén, Jörgen
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Grönvall, Hampus
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Arner, Erik
    Magnusson, Patrik K. E.
    Palm, Camilla
    Larsson, Henrik
    Viktorin, Alexander
    Bernhardsson, Jens
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Jansson, Billy
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Zhou, Xuan
    Speed, Doug
    Åhs, Fredrik
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    P117. Predicting Genetic Risk for Depression and Anxiety Disorders2022In: Biological Psychiatry, ISSN 0006-3223, E-ISSN 1873-2402, Vol. 91Article in journal (Refereed)
    Abstract [en]

    Background

    Polygenic scores (PGSs) harness the potential to provide an overall measure of individuals’ genetic liability to develop a disease (Torkamani et al., 2018), though much research is still needed. The aim of the present study was to predict prescription of pharmacological treatment of anxiety or depression from PGSs.

    Methods

    The target sample comprised two cohorts of genotyped Swedish twins (n = 11037). Cases were defined as individuals prescribed pharmacological treatment of depression (n = 1129) or anxiety (n = 1446). We constructed 6 PGSs based on GWAS on MDD diagnosis, Anxiety, Schizophrenia, Neuroticism scores, the GAD-7 scale, and the PHQ-9. Data were analyzed by logistic regression models with change in pseudo-R2 (above the baseline model with sex, age, cohort, and 20 ancestral PCs) following the inclusion of PGSs to predict the risk of anxiety or depression medication. All results corrected for multiple comparisons.

    Results

    Predictive performance was estimated to ΔR2depression = 0.028; ΔR2anxiety = 0.025 when all PGSs were included in the same model, with PGS for MDD being the single best predictor for both anxiety and depression. Individuals in the top 10% of the PGS distribution had greater odds of drug prescription (ORdepression = 1.82; CI95% = 1.53—2.17; ORanxiety = 1.65; CI95% = 1.40—1.95), while the bottom 10% had decreased risk (ORanxiety = 0.56; CI95% = 0.45—0.70; ORdepression = 0.58; CI95% = 0.45—0.74) compared to the remaining 90% of the distribution.

    Conclusions

    PGSs can predict drug prescription for anxiety and depression in an independent sample.

  • 130.
    Ternström, Elin
    et al.
    Uppsala University, Uppsala.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Uppsala University, Uppsala.
    Haines, Helen
    University of Melbourne, Victoria, Australia.
    Karlström, Annika
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Ekdahl, Johanna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Segeblad, Birgitta
    Uppsala University Hospital, Uppsala.
    Larsson, Birgitta
    Uppsala University, Uppsala; Sundsvall Hospital, Sundsvall.
    Rondung, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Rubertsson, Christine
    Uppsala University, Uppsala.
    A randomized controlled study comparing internet-based cognitive behavioral therapy and counselling by standard care for fear of birth – A study protocol2017In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 13, p. 75-82Article in journal (Refereed)
    Abstract [en]

    Fear of birth is a concern that requires evidence based treatment. The aim of this study is to present the protocol of a randomized controlled multi-center trial to compare internet-based cognitive therapy with counseling as standard care for pregnant women reporting fear of birth. Participants will be recruited in mid-pregnancy. Women who score 60 or above on the Fear of Birth Scale will be offered to participate in this study. Data will be collected by questionnaires including validated instruments at baseline and follow-ups at gestational weeks 30 and 36, two months and one year after birth. The primary outcome will be level of fear of birth measured with the Fear of Birth Scale at 36 weeks of gestation. Secondary outcome measures are level of fear of birth at two months and one year after giving birth, preferences for mode of birth, requests for elective cesarean section, compliance and satisfaction with treatment and birth outcomes. A power calculation based on a 20% reduction of fear implies that approximately 200 will be included in the trial. The study outlined in this protocol will be the first randomized controlled trial comparing internet-based cognitive therapy with counseling for women reporting fear of birth. An effective treatment may result in better overall health for women with fear of birth and a reduction in cesarean sections for non-medical reasons. Evidence regarding treatment options of fear of birth will also provide a greater choice for women.

  • 131.
    Thomtén, Johanna
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Rondung, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Kognitiv beteendeteapi vid förlossningsrädsla: en internetbaserad självhjälpsbehandling2013Other (Other academic)
  • 132.
    Thomtén, Johanna
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Pain among women: Associations with socioeconomic factors over time and the mediating role of depressive symptoms2012In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 3, no 2, p. 62-67Article in journal (Refereed)
    Abstract [en]

    Background and aims: Lower socioeconomic status (SES), based on economic situation, education and occupation, has been associated with greater morbidity and mortality in a wide range of diseases, and socioeconomic inequalities have been found in several chronic pain populations. Sincewomen are overrepresented in several clinical pain conditions, there is a need to understand the influence of SES among women with pain. In a previous cross-sectional study, socioeconomic- and work conditions were associated with pain among women from the general population of Sweden. In the present study, based on baseline and follow-up measures from 2300 of the same sample, we examined associations between painvariables, socioeconomic status and work conditions over time by means of multiple logistic/linear regression analyses. Additionally, a possible mediating role of depressive symptoms on the relationship between SES and pain was examined. Methods: The study was a prospective panel survey with two measurements 12 months apart among 2300 women with and without pain from the general population in Stockholm (aged 18-64). Logistic and linear regression analyses were used to identify associations between SES and pain outcomes. Results: Results revealed that pain is a rather stable condition with large impact on daily functioning among many women. Certain SES variables (educational level, financial strain, occupational level) were related to pain and pain related disability prospectively. Financial strain and to be a blue-collar worker were related to the incidence of pain among all women, while educational level was related to worse pain outcomes among women with pain in terms of pain intensity,pain frequency, number of pain locations and pain-related disability. Symptoms of depression were associated with pain incidence and with painvariables (intensity, number of pain locations and pain-related disability) and with lower SES. Conclusions: Financial strain and occupational level were here identified as risk factors for the incidence of pain, and could be interpreted as increasing both physical and psychological stress and thereby work both as predisposing the individual to pain and to perpetuate the development of a pain condition. Educational level was associated with the course of pain in terms of pain duration and pain-related disability which may indicate that once affected by pain, lower educational level may be related to less functional coping strategies in the adaptation to the pain condition. Depressive symptoms could be understood as a mediator of the relationship between SES and pain among women in terms of limiting the individual's strategies to handle pain in a functional manner by increasing passive behavior patterns such as avoidance. Implications: The interplay between SES and symptoms of depression should be regarded in preventive interventions and in treatment of pain among women. An overall risk-profile in terms of psychosocial and biological factors needs to be assessed early on within pain treatment for women. Increased knowledge of socioeconomic risk factors for long term pain, e.g. low educational level, is needed on all levels among all professionals within the healthcare system in order to facilitate effective communication in the treatment of womenwith pain. © 2012 Scandinavian Association for the Study of Pain.

  • 133.
    Thomtén, Johanna
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    The influence of psychosocial factors on Quality of Life among women with pain: A prospective study in Sweden2011In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 20, no 8, p. 1215-1225Article in journal (Refereed)
    Abstract [en]

    Objectives: To identify/quantify predictors of QOL among women with pain over time. Methods: The study comprised 2,300 women aged 18-64 years with and without pain. A longitudinal panel survey with two waves of measurement, 1 year apart, by means of questionnaires was used. Multiple linear regression analyses were used to identify and quantify predictors of QOL. Results: After controlling for socio-demographics, physical health, and baseline pain parameters, QOL, psychological factors, and pain-related disability at base line, as well as their changer scores, predicted differential aspects of social, psychological, and physical QOL, respectively, over time. Aspects of social support were central for the social dimension of QOL and to a lower degree for the psychological dimension. Change scores of burnout and distress were related to all dimensions of QOL. Conclusions: QOL seems to be a rather stable characteristic influenced not only by pain but also related to psychosocial factors over time. Addressing such factors seems central in treatment interventions aiming at improving QOL among individuals with pain

  • 134.
    Thomtén, Johanna
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    The role of psychosocial factors in the course of pain - A 1-year follow-up study among women living in Sweden2011In: Archives of Women's Mental Health, ISSN 1434-1816, E-ISSN 1435-1102, Vol. 14, no 6, p. 493-503Article in journal (Refereed)
    Abstract [en]

    The understanding of the associations between psychosocial factors and persistent pain and their impact on the course of pain among women is crucial to identify risk populations and prevent long-term pain from developing. The aim of the study was to investigate the course of pain among women and the psychosocial factors associated with it. The study was a 1-year follow-up (FU) among 2,300 women in the general population of Sweden. Sociodemographic and psychosocial factors were analyzed in relation to the course of pain, assessed as the presence of pain during the last 3 months at baseline (BL) and at FU. Thirty-three percent of the women with no pain at BL and 77% of those with pain at BL reported pain at FU. Compared to the pain-free women, those who developed pain at FU reported lower social support and physical quality of life (QoL) and worse mental health. Women with sustained pain were older and reported worse mental health, lack of social support, and lower levels of QoL compared to those who recovered from pain. In the multiple logistic regression analyses, only post-traumatic stress symptoms were associated with the development of pain at FU. Number of pain locations and pain duration at BL and physical QoL were associated with sustained pain. Moreover, social support was identified as a protective factor against sustained pain. Pain is persistent or recurrent in a general female population. The results indicate that psychosocial factors do not work as primary predictors in the course of pain and might be better understood through indirect processes by limiting the individual's resources for handling pain in a functional manner.

  • 135.
    Tredal, Ingrid
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Soares, Joaquim J. F.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Viitasara, Eija Riitta
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Melchiorre, MG
    Scientific Technological Area, Socio Economic Research Centre, Italian National Institute of Health and Science on Aging, Ancona, Italy .
    Torres-Gonzales, F
    Network of Biomedical Research on Mental Health Centers, University of Granada, Granada, Spain .
    Stankunas, M
    Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania .
    Lindert, J
    Department of Public Health Sciences, Protestant University of Applied Sciences, Ludwigsburg, Germany .
    Ioannidi-Kapolou, E
    Department of Sociology, National School of Public Health, Athens, Greece.
    Barros, H
    Department of Hygiene and Epidemiology, University of Porto, Medical School, Porto, Portugal.
    Alcohol use among abused and non-abused older persons aged 60-84 years: A European study2013In: Drugs: education prevention and policy, ISSN 0968-7637, E-ISSN 1465-3370, Vol. 20, no 2, p. 96-109Article in journal (Refereed)
    Abstract [en]

    Aims: Describing alcohol use by abuse type (e.g. psychological) and considering other factors (e.g. depression).

    Methods: The respondents were 4467 (2559 women, 57.3%) randomly selected elders (60–84 years) from seven European cities. The cross-sectional data were collected with scales covering various areas and examined with bivariate/multivariate methods.

    Findings: Psychologically abused elders were more often alcohol users than non-users (21.7% vs. 16.3%) and the opposite regarding financially abused elders (4.8% vs. 3.5%). Psychologically abused elders also had more often three or more drinks containing alcohol in a drinking day (21.1% vs. 16.1%) and six or more drinks on one occasion (24.5% vs. 18.3%). Psychological abuse, demographics/socio-economics (e.g. education), smoking and leisure activities were positively associated alcohol use, and being from certain countries (e.g. Italy), age (e.g. 80–84 years), depression and financial abuse negatively.

    Conclusions: Across countries, 64.2% of the elders were drinkers. Some variables (e.g. psychological abuse) were positively related to alcohol use and others (e.g. depression) negatively. Many of the elders were exposed to abuse. Our findings may be useful to prevent/manage drinking and abuse among elders. However, alcohol use was influenced by various factors that need to be further elucidated, particularly the relation between abuse and drinking.

  • 136.
    Öhman, Arne
    et al.
    Karolinska institutet.
    Sundin, Örjan
    Emotional factors in cardiovascular disorder1995In: Current Opinion in Psychiatry, ISSN 0951-7367, E-ISSN 1473-6578, Vol. 8, p. 410-413Article in journal (Refereed)
  • 137.
    Öhman, Arne
    et al.
    Karolinska institutet.
    Sundin, Örjan
    Stress, hjerteinfarkt og type A-atferd. (Stress, myocardial infarction and type A behavior.)1991In: Diskriminanten, ISSN 0801-0536, Vol. 18, p. 23-36Article in journal (Refereed)
123 101 - 137 of 137
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