Rita Sjöström - Academia.edu (original) (raw)
Papers by Rita Sjöström
Nursing Research and Practice
Background. Gestational diabetes mellitus (GDM) is increasing and is associated with adverse outc... more Background. Gestational diabetes mellitus (GDM) is increasing and is associated with adverse outcomes for both mother and child. The metabolic demands of pregnancy can reveal a predisposition for type 2 diabetes mellitus (T2DM), and women with a history of GDM are more likely to develop T2DM than women with normoglycemic pregnancies. Aim. The aim of this study was to explore midwives’ and diabetes nurses’ experience of their role in screening, care, and follow-up of women with gestational diabetes mellitus and, further, to explore their opinions and thoughts about existing routines and guidelines. Method. Individual interviews were performed with ten diabetes nurses and eight midwives working in primary and special care. Qualitative content analysis was done according to Graneheim and Lundman. Results. The analysis of the interviews resulted in the overall theme “An act of balance between normalcy and illness, working for motivation with dilemmas throughout the chain of health care....
European Journal of Applied Physiology
Purpose Exposure to cold air may harm the airways. It is unclear to what extent heavy exercise ad... more Purpose Exposure to cold air may harm the airways. It is unclear to what extent heavy exercise adds to the cold-induced effects on peripheral airways, airway epithelium, and systemic immunity among healthy individuals. We investigated acute effects of heavy exercise in sub-zero temperatures on the healthy airways. Methods Twenty-nine healthy individuals underwent whole body exposures to cold air in an environmental chamber at − 15 °C for 50 min on two occasions; a 35-min exercise protocol consisting of a 5-min warm-up followed by 2 × 15 min of running at 85% of VO2max vs. 50 min at rest. Lung function was measured by impulse oscillometry (IOS) and spirometry before and immediately after exposures. CC16 in plasma and urine, and cytokines in plasma were measured before and 60 min after exposures. Symptoms were surveyed pre-, during and post-trials. Results FEV1 decreased after rest (− 0.10 ± 0.03 L, p < 0.001) and after exercise (− 0.06 ± 0.02 L, p = 0.012), with no difference betw...
European Respiratory Society Congress, Paris, France, 15-19 September, 2018
Journal of International Migration and Integration, 2021
This study aims to evaluate an intervention, consisting of nine weeks of health-management course... more This study aims to evaluate an intervention, consisting of nine weeks of health-management course, combined with social and working life orientation and language instruction for recently settled immigrants in Sweden. One hundred one participants in the intervention groups and 48 participants in the control group participated. The intervention consisted of a health management course combined with social and working life orientation and the control group participated in the regular local authority program for social and working life orientation. Measurement instruments were health-related quality of life (HRQoL) and registration of work rate. Several participants in the groups were in work, primarily in subsidized employment, after six months. Recently settled men were employed to a greater extent than the women, where poorer physical and mental health could be observed among women in this study. Participants in the intervention and the control groups had maintained HRQoL from pre-int...
International Journal of Circumpolar Health, 2021
Exposure to a cold climate is associated with an increased morbidity and mortality, but the speci... more Exposure to a cold climate is associated with an increased morbidity and mortality, but the specific mechanisms are largely unknown. People with cardiopulmonary disease and winter endurance athletes are particularly vulnerable. This study aimed to map multiple domains of airway responses to exercise in subzero temperature in healthy individuals. Thirty-one healthy subjects underwent whole-body exposures for 50 minutes on two occasions in an environmental chamber with intermittent moderate-intensity exercise in +10 °C and-10 °C. Lung function, plasma/urine CC16 , and symptoms were investigated before and after exposures. Compared to baseline, exercise in-10 °C decreased FEV 1 (p=0.002), FEV 1 /FVC (p<0.001), and increased R20Hz (p=0.016), with no differences between exposures. Reactance increased after +10 °C (p=0.005), which differed (p=0.042) from a blunted response after exercise in-10 °C. Plasma CC16 increased significantly within exposures, without differences between exposures. Exercise in-10 °C elicited more intense symptoms from the upper airways, compared to +10 °C. Symptoms from the lower airways were few and mild. Short-duration moderate-intensity exercise in-10 °C induces mild symptoms from the lower airways, no lung function decrements or enhanced leakage of biomarkers of airway epithelial injury, and no peripheral bronchodilatation, compared to exercise in +10 °C.
Bakgrund: Exponering for kyla leder till okad sjuklighet och dodlighet i befolkningen. Tidigare s... more Bakgrund: Exponering for kyla leder till okad sjuklighet och dodlighet i befolkningen. Tidigare studier av symptom i samband med koldexponering har mestadels varit befolkningsbaserade enkatstudier ...
Background: Until recently, clinical ultrasound technology was limited to the hospital-based disc... more Background: Until recently, clinical ultrasound technology was limited to the hospital-based disciplines, and few studies assessed training in focused cardiac ultrasound (FCU) in primary care. We designed an interview study among general practitioner (GP) registrars taking part in an FCU training program and discussed their experiences compared to their documented skills.Methods: This qualitative content analysis used an inductive approach. Five GP registrars and their tutor participated in semi-structured individual interviews during April–July 2017. Participants were interviewed after they each had conducted 20 supervised and 7–10 independent examinations and were encouraged to complete self-directed study using video tutorials on web-based platforms. FCU examinations of study patients recruited from primary care clinics were conducted with a hand-held device (Vscan 1.2) at the Centre of Clinical Research, Östersund Hospital, Sweden. Results: We identified two categories of inform...
Journal of Multidisciplinary Healthcare, 2020
Introduction: Stress and stress-related ill health have a multifactorial impact; both on physical... more Introduction: Stress and stress-related ill health have a multifactorial impact; both on physical and mental health. To better meet this category of patients a primary care unit started a stress-management programme using cognitive behavioural therapy and basic body awareness therapy. Purpose: To describe participant´s experiences of a primary care stress-management programme using cognitive behavioural therapy and basic body awareness therapy. Methods: In a qualitative study, a semi-structured interview guide was used in individual interviews with 9 people, all women aged 41-57, working or on sick leave, who had enrolled in the stress-management programme. The material was analysed through qualitative content analysis. Results: The analysis resulted in the theme "Process of change for a sustainable everyday living". The participants described having gained awareness of the symptoms of their stress, knowledge and tools to manage their stress, ways to relax, awareness of their body, and the means to develop better habits and to change their behaviour. Fundamental in the material was the importance of participants' identification with the others in the group. Conclusion: The participants started a process of change with new knowledge and growth, but they encountered difficulties and obstacles. Behavioural change is a time-consuming process.
Occupational and Environmental Health, 2018
Humans react to cold with various symptoms. Previous studies enquiring about symptoms during cold... more Humans react to cold with various symptoms. Previous studies enquiring about symptoms during cold exposure have for the most part been population based studies using questionnaries and have focused ...
International Journal of Circumpolar Health, 2019
Stenfors (2019) Qualitative identification and characterisation of self-reported symptoms arising... more Stenfors (2019) Qualitative identification and characterisation of self-reported symptoms arising in humans during experimental exposure to cold air,
Journal of Immigrant and Minority Health, 2019
Of all individuals diagnosed with tuberculosis (TB) in Sweden 2015 were 90% born in other countri... more Of all individuals diagnosed with tuberculosis (TB) in Sweden 2015 were 90% born in other countries. Early diagnosis and treatment is essential to avoid TB transmission. Lack of knowledge about TB and anticipated negative social consequences have proved to be significant contributing factors to delay in seeking health care. This study aimed to understand the perception of TB among people originating from a high-endemic region, currently living in a low-endemic region. A qualitative study design, with male and female participants from a high-endemic region divided into focus groups. A semi-structured interview guide was used to elicit their perceptions of TB. A qualitative content analysis was performed on the recorded material from the interviews. The informants noted that their attitude towards individuals with TB had changed, previously they had felt prejudiced towards them whereas now they felt supportive. It seems possible to diminish TB stigma by ensuring suitable health care is available in combination with correct information about transmission, infectiousness and treatment.
Journal of Exercise Rehabilitation, 2017
In sports, there is a constant discussion about the hyper-pronation and supination of the foot du... more In sports, there is a constant discussion about the hyper-pronation and supination of the foot during loading and its relation to injuries or discomfort. The purpose of the present study was to investigate the possible differences in the subtalar joint in the midstance phase of running, between individuals with Pes Planus and Pes Cavus, after 5 min and 45 min of running. Thirty-four subjects, meeting the requirements for Pes Planus (30 feet) and Pes Cavus (35 feet), according to the criteria for Medial Longitudinal Arch-angle, were included in the study. The calcaneal vertical angle, representing the eversion/inversion of the subtalar joint, was measured using with two-dimensional digital analysis and Dartfish Software with the subjects running barefoot on a treadmill, before and after 45 min of outside running wearing shoes. Both individuals with Pes Cavus and Pes Planus showed a significant increase in the calcaneal eversion (P < 0.05) after 45 min of running. Between the groups, there was a significantly greater eversion of the Pes Planus, on the right foot, after 45 min of running (P< 0.05) compared to the Pes Cavus. The effect of fatigue evident in the present study suggests that further biomechanical research should be considered when exposing the foot to the repetitive nature of running, conditions most likely responsible for the overrepresented overuse injuries among runners.
Journal of Exercise Rehabilitation, 2015
The purpose of this qualitative study was to understand and examine how patients with rheumatoid ... more The purpose of this qualitative study was to understand and examine how patients with rheumatoid arthritis (RA) experience climate care and its effects. A qualitative approach was chosen for the study. Two men and six women were interviewed according to a semistructured interview guide. The text was analyzed using a manifest content analysis. The analysis resulted in four categories and 10 subcategories. The interviewees experienced climate care positively. The training was perceived increasing gradually. The patients felt that they performed to a maximum capacity during training and were impressed by the staff's enthusiasm and encouragement. The patients felt that they were involved in the goal setting and the choice of treatment, and the staff noticed individual needs. There was a feeling among the patients of being acknowledged by the staff. Information about the disease was perceived as individualized. The climate and beautiful surroundings were viewed as encouraging physical activity and a feeling of well-being. Patients made new friends, had fun together and also shared experiences about their disease. Furthermore, the patients described a sense of belonging to a group as well as a feeling of not being the only one that was sick among the healthy. Not having to do everyday tasks and having time to themselves were perceived positively. Several factors contributed to the positive experiences of climate care; climate, environment, physical activity, social context, staff involvement, and information about the disease were described as interacting together and resulting in a sense of well-being. A proposal for future research would be to examine if/how the various factors might interact and affect the RA patients' illness and quality of life.
The primary aim of this investigation was to evaluate a seven-week multidisciplinary rehabilitati... more The primary aim of this investigation was to evaluate a seven-week multidisciplinary rehabilitation programme, with emphasis on musculoskeletal disorders, for working-age people, by assessments at the start and end of the rehabilitation programme, and at follow-up examinations 6, 12 and 24 months after completion of the programme. A further aim was to explore the experiences of people not returning to work during a period of six years after participation in an extensive multidisciplinary rehabilitation programme. Sixty participants, 40 women and 20 men (mean age 46.8 ± SD 7.9), with musculoskeletal disorders, mainly neck and back pain, participated in a 7week rehabilitation programme which was based on a combination of theoretical and practical education, physical activities, relaxation and individual guidance. Before and after the programme and at the follow-up occasions all participants were evaluated with the Global Self-Efficacy Index (GSI), Hospital Anxiety and Depression Scale (HAD), and Stress test (Study I). A group of participants who were still full-time sick-listed (Group I) at the end of the study period were compared with participants who were part-time or not sick-listed (Group II) at the end of the study period (II, III, IV). They were evaluated with the Disability Rating Index (DRI), with the Pain Intensity Rating Index on a visual analogue scale (VAS) (II, III)), mobility tests (III), GSI (III), HAD, and a stress test (IV). Seven women (median age 48 years) and three men (53 years) (Group I) were interviewed and the interviews were analysed by manifest content analysis (V). At the 2-year follow-up full-time sick leave, anxiety, depression and selfexperienced stress had decreased in both sexes. They also showed increased quality of life (QoL) (I). In participants with full-time sick leave (Group I), self-experienced physical disability and pain ratings were high and showed no decrease up until the 2-year follow-up. In participants with part-time or no sick leave (Group II), physical disability and pain ratings decreased gradually throughout the 2-year follow-up period (II). Cervical and thoracolumbar spine range of motion (ROM) was lower in Group I than in Group II from the start of rehabilitation to a 2-year follow-up. Only Group II showed a temporal improvement in ROM. No changes in DRI, VAS or GSI were found in parallel with corresponding temporal changes in any of the ROM (III). Group I experienced no change in anxiety or depression during the study period, in contrast to Group II, in which this decreased. Decreased stress was found in both groups (IV). Group I described perceived barriers to and possibilities of returning to work, and also gave information on what strategies they used, to cope with everyday life (V). The majority of the participants improved and they continued to be physically active, their QoL improved, and most participants returned to work. Ten of the participants, however, were on full-time sick leave 1 throughout the whole study period, with high self-experienced physical disability, high pain rating and no improvement in anxiety and depression. They experienced barriers to re-entering the labour market as consequences of physical symptoms and fatigue. But they also believed in possibilities of returning to work if they could get a modified job adapted to their own capacity. Thus, persons with severe disability and pain did not improve by rehabilitation in this project. New methods of treatment have to be developed for improvement of symptoms resulting in reduction of functional impairment and a consequent need for sick leave.
Journal of Exercise Rehabilitation, 2015
The purpose of this study was to examine beach volleyball players' experience regarding shoulder ... more The purpose of this study was to examine beach volleyball players' experience regarding shoulder injury and how it affects their return to play. To achieve the research aims a qualitative design with semi-structured interviews had been conducted, five elite beach volleyball players, four men and one woman aged 27-42 participated in the study. All participants had suffered a severe shoulder injury, with absence from training and competing for at least 28 days. The findings of this study indicate that it is the individual´s inner motivation, together with a clear goal and support from the community, family, teammate and coach that are the most important factors when going through rehabilitation and getting back to playing beach volleyball after a shoulder injury. All participants had been affected by their injury in some way; some of the participants had been affected in a positive way since they had become mentally stronger and had developed better volleyball technique after rehabilitation. The conclusions of this study indicate that there are three distinct factors that increase the chances of getting back to playing beach volleyball after shoulder injury; it is the players´ self motivation, together with a clear goal and support from the community.
Work (Reading, Mass.), 2013
The aim of this study was to perform a 5-year follow-up of a 7-week multidisciplinary rehabilitat... more The aim of this study was to perform a 5-year follow-up of a 7-week multidisciplinary rehabilitation program focusing on pain, physical disability, anxiety and depression as well as stress and sick leave and to compare the results from the baseline, a 2-year follow-up and this 5-year follow-up. Out of 60 participants of the original rehabilitation program 54 were followed-up after 5 years. The rehabilitation program was individually adapted and consisted of physical activity in several forms as well as theoretical and practical education. At baseline (start of study) and 2 and 5 years after completion of the rehabilitation program all participants were evaluated in terms of sick leave, pain rating (Visual Analogue Scale), the Disability Rating Index, Hospital Anxiety and Depression Scale, and Stress Test. Between the start of the program and the 5-year follow-up pain rating (P< 0.017) and the rate of full-time sick leave (P< 0.0005) decreased. Physical disability, anxiety, dep...
Work (Reading, Mass.), 2011
The aim of this qualitative study was to explore experiences of sick-listed persons of not return... more The aim of this qualitative study was to explore experiences of sick-listed persons of not returning to work during a six-year period after participation in an extensive multidisciplinary rehabilitation programme. The study comprised ten participants with musculoskeletal disorders, mainly neck and back pain. Semi-structured interviews were conducted and analysed by manifest content analysis. This led to identification of three primary categories and six sub-categories, which described the participants' experiences of barriers to and possibilities of returning to work, and indicated what strategies they used to cope with everyday life. The participants described that the main barriers to returning to work were pain and somatic symptoms, fatigue, and not fulfilling the work requirements. Participants considered physical activity a key factor in coping with pain. Most participants thought that they had residual work ability, and could utilise this if they could get a modified job a...
Work (Reading, Mass.), 2010
To investigate whether improvement of range of motion (ROM) in persons with musculoskeletal disor... more To investigate whether improvement of range of motion (ROM) in persons with musculoskeletal disorders, mainly neck and back pain, was associated with a favourable development regarding physical disability, pain, and health-related quality of life (QoL), and whether such development differed between sick-listed and non-sick-listed persons during and up to 2 years after a multidisciplinary rehabilitation programme. Ten persons with full-time sick leave (Group I) and 49 with part-time or no sick leave (Group II) at the end of a previous study participated. It was shown in that study that Group I had higher pain rating and higher subjective physical disability than Group II, with little or no improvement during and after rehabilitation. In the present study, all participants were evaluated with neck and back mobility tests: Disability Rating Index (DRI); Pain Intensity Rating on a visual analogue scale (VAS); and Global Self-Efficacy Index (GSI). Cervical and thoracolumbar spine ROM wer...
Musculoskeletal Disorder, 2012
Health is a concept with many definitions. The concept also has various meanings in different par... more Health is a concept with many definitions. The concept also has various meanings in different parts of the world and in different cultures. The definition of health has gone through many changes. Up to the middle of the 20th century, health was defined in terms of the absence of physical illness (Hassmén & Hassmén, 2005). In the mid-1940s the World Health Organization (WHO, 1946) defined the health as follows: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity". This idea has been considered by some to be too utopian to be acceptable as a definition of health. The definition would mean that nobody could be regarded as healthy, since nobody experiences complete physical, psychological and social well-being. Over the years WHO has developed its view of the concept of health (Faresjö & Åkerlind, 2008), and in 1986 WHO wrote, "Health is seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities". Thus, health was related to physical, personal and social resources. This means that individuals and groups must be able to identify and realize their desires, satisfy their needs and manage in their environment (Faresjö & Åkerlind, 2008). In primary care there is a concept of health that includes not only medical factors but also psychological and social aspects, and the concept of health refers to the overall conditions for a good quality of life. The concept of life quality covers a person's overall situation, the functioning capacity of the individual, and the ability to manage daily life including a social role, in addition to the absence of stress in working life, meaningful leisure time and general physical and psychological well-being (Faresjö & Åkerlind, 2008). Historically speaking we have probably never been healthier than we are today, despite reports about increased stress and people being burned out, more allergies and rising obesity in the population. If we have any faith in the trends we have seen for many decades, health will probably slowly but surely improve in terms of rising average life expectancy (SOU, 2009 [National Board of Health and Welfare]; Faresjö & Åkerlind, 2008). Some differences in health between women and men have their origins in the power structure, as well as cultural and ideological attitudes in society, but there are also biological differences in factors that affect health. The rate of ill health is considerably higher among women, and www.intechopen.com Musculoskeletal Disorder 2 self-perceived health is significantly worse. In general, men have greater opportunities in terms of influence and participation, both at workplaces and in society as a whole. Men have a better financial situation overall compared with women. There is an over-representation of women in occupations with high health risks, and women have longer real working hours. In some cases women have fewer opportunities to cultivate healthy living habits; for example two jobs and the fear of being exposed to violence, reduce their opportunities for taking physical exercise
Nursing Research and Practice
Background. Gestational diabetes mellitus (GDM) is increasing and is associated with adverse outc... more Background. Gestational diabetes mellitus (GDM) is increasing and is associated with adverse outcomes for both mother and child. The metabolic demands of pregnancy can reveal a predisposition for type 2 diabetes mellitus (T2DM), and women with a history of GDM are more likely to develop T2DM than women with normoglycemic pregnancies. Aim. The aim of this study was to explore midwives’ and diabetes nurses’ experience of their role in screening, care, and follow-up of women with gestational diabetes mellitus and, further, to explore their opinions and thoughts about existing routines and guidelines. Method. Individual interviews were performed with ten diabetes nurses and eight midwives working in primary and special care. Qualitative content analysis was done according to Graneheim and Lundman. Results. The analysis of the interviews resulted in the overall theme “An act of balance between normalcy and illness, working for motivation with dilemmas throughout the chain of health care....
European Journal of Applied Physiology
Purpose Exposure to cold air may harm the airways. It is unclear to what extent heavy exercise ad... more Purpose Exposure to cold air may harm the airways. It is unclear to what extent heavy exercise adds to the cold-induced effects on peripheral airways, airway epithelium, and systemic immunity among healthy individuals. We investigated acute effects of heavy exercise in sub-zero temperatures on the healthy airways. Methods Twenty-nine healthy individuals underwent whole body exposures to cold air in an environmental chamber at − 15 °C for 50 min on two occasions; a 35-min exercise protocol consisting of a 5-min warm-up followed by 2 × 15 min of running at 85% of VO2max vs. 50 min at rest. Lung function was measured by impulse oscillometry (IOS) and spirometry before and immediately after exposures. CC16 in plasma and urine, and cytokines in plasma were measured before and 60 min after exposures. Symptoms were surveyed pre-, during and post-trials. Results FEV1 decreased after rest (− 0.10 ± 0.03 L, p < 0.001) and after exercise (− 0.06 ± 0.02 L, p = 0.012), with no difference betw...
European Respiratory Society Congress, Paris, France, 15-19 September, 2018
Journal of International Migration and Integration, 2021
This study aims to evaluate an intervention, consisting of nine weeks of health-management course... more This study aims to evaluate an intervention, consisting of nine weeks of health-management course, combined with social and working life orientation and language instruction for recently settled immigrants in Sweden. One hundred one participants in the intervention groups and 48 participants in the control group participated. The intervention consisted of a health management course combined with social and working life orientation and the control group participated in the regular local authority program for social and working life orientation. Measurement instruments were health-related quality of life (HRQoL) and registration of work rate. Several participants in the groups were in work, primarily in subsidized employment, after six months. Recently settled men were employed to a greater extent than the women, where poorer physical and mental health could be observed among women in this study. Participants in the intervention and the control groups had maintained HRQoL from pre-int...
International Journal of Circumpolar Health, 2021
Exposure to a cold climate is associated with an increased morbidity and mortality, but the speci... more Exposure to a cold climate is associated with an increased morbidity and mortality, but the specific mechanisms are largely unknown. People with cardiopulmonary disease and winter endurance athletes are particularly vulnerable. This study aimed to map multiple domains of airway responses to exercise in subzero temperature in healthy individuals. Thirty-one healthy subjects underwent whole-body exposures for 50 minutes on two occasions in an environmental chamber with intermittent moderate-intensity exercise in +10 °C and-10 °C. Lung function, plasma/urine CC16 , and symptoms were investigated before and after exposures. Compared to baseline, exercise in-10 °C decreased FEV 1 (p=0.002), FEV 1 /FVC (p<0.001), and increased R20Hz (p=0.016), with no differences between exposures. Reactance increased after +10 °C (p=0.005), which differed (p=0.042) from a blunted response after exercise in-10 °C. Plasma CC16 increased significantly within exposures, without differences between exposures. Exercise in-10 °C elicited more intense symptoms from the upper airways, compared to +10 °C. Symptoms from the lower airways were few and mild. Short-duration moderate-intensity exercise in-10 °C induces mild symptoms from the lower airways, no lung function decrements or enhanced leakage of biomarkers of airway epithelial injury, and no peripheral bronchodilatation, compared to exercise in +10 °C.
Bakgrund: Exponering for kyla leder till okad sjuklighet och dodlighet i befolkningen. Tidigare s... more Bakgrund: Exponering for kyla leder till okad sjuklighet och dodlighet i befolkningen. Tidigare studier av symptom i samband med koldexponering har mestadels varit befolkningsbaserade enkatstudier ...
Background: Until recently, clinical ultrasound technology was limited to the hospital-based disc... more Background: Until recently, clinical ultrasound technology was limited to the hospital-based disciplines, and few studies assessed training in focused cardiac ultrasound (FCU) in primary care. We designed an interview study among general practitioner (GP) registrars taking part in an FCU training program and discussed their experiences compared to their documented skills.Methods: This qualitative content analysis used an inductive approach. Five GP registrars and their tutor participated in semi-structured individual interviews during April–July 2017. Participants were interviewed after they each had conducted 20 supervised and 7–10 independent examinations and were encouraged to complete self-directed study using video tutorials on web-based platforms. FCU examinations of study patients recruited from primary care clinics were conducted with a hand-held device (Vscan 1.2) at the Centre of Clinical Research, Östersund Hospital, Sweden. Results: We identified two categories of inform...
Journal of Multidisciplinary Healthcare, 2020
Introduction: Stress and stress-related ill health have a multifactorial impact; both on physical... more Introduction: Stress and stress-related ill health have a multifactorial impact; both on physical and mental health. To better meet this category of patients a primary care unit started a stress-management programme using cognitive behavioural therapy and basic body awareness therapy. Purpose: To describe participant´s experiences of a primary care stress-management programme using cognitive behavioural therapy and basic body awareness therapy. Methods: In a qualitative study, a semi-structured interview guide was used in individual interviews with 9 people, all women aged 41-57, working or on sick leave, who had enrolled in the stress-management programme. The material was analysed through qualitative content analysis. Results: The analysis resulted in the theme "Process of change for a sustainable everyday living". The participants described having gained awareness of the symptoms of their stress, knowledge and tools to manage their stress, ways to relax, awareness of their body, and the means to develop better habits and to change their behaviour. Fundamental in the material was the importance of participants' identification with the others in the group. Conclusion: The participants started a process of change with new knowledge and growth, but they encountered difficulties and obstacles. Behavioural change is a time-consuming process.
Occupational and Environmental Health, 2018
Humans react to cold with various symptoms. Previous studies enquiring about symptoms during cold... more Humans react to cold with various symptoms. Previous studies enquiring about symptoms during cold exposure have for the most part been population based studies using questionnaries and have focused ...
International Journal of Circumpolar Health, 2019
Stenfors (2019) Qualitative identification and characterisation of self-reported symptoms arising... more Stenfors (2019) Qualitative identification and characterisation of self-reported symptoms arising in humans during experimental exposure to cold air,
Journal of Immigrant and Minority Health, 2019
Of all individuals diagnosed with tuberculosis (TB) in Sweden 2015 were 90% born in other countri... more Of all individuals diagnosed with tuberculosis (TB) in Sweden 2015 were 90% born in other countries. Early diagnosis and treatment is essential to avoid TB transmission. Lack of knowledge about TB and anticipated negative social consequences have proved to be significant contributing factors to delay in seeking health care. This study aimed to understand the perception of TB among people originating from a high-endemic region, currently living in a low-endemic region. A qualitative study design, with male and female participants from a high-endemic region divided into focus groups. A semi-structured interview guide was used to elicit their perceptions of TB. A qualitative content analysis was performed on the recorded material from the interviews. The informants noted that their attitude towards individuals with TB had changed, previously they had felt prejudiced towards them whereas now they felt supportive. It seems possible to diminish TB stigma by ensuring suitable health care is available in combination with correct information about transmission, infectiousness and treatment.
Journal of Exercise Rehabilitation, 2017
In sports, there is a constant discussion about the hyper-pronation and supination of the foot du... more In sports, there is a constant discussion about the hyper-pronation and supination of the foot during loading and its relation to injuries or discomfort. The purpose of the present study was to investigate the possible differences in the subtalar joint in the midstance phase of running, between individuals with Pes Planus and Pes Cavus, after 5 min and 45 min of running. Thirty-four subjects, meeting the requirements for Pes Planus (30 feet) and Pes Cavus (35 feet), according to the criteria for Medial Longitudinal Arch-angle, were included in the study. The calcaneal vertical angle, representing the eversion/inversion of the subtalar joint, was measured using with two-dimensional digital analysis and Dartfish Software with the subjects running barefoot on a treadmill, before and after 45 min of outside running wearing shoes. Both individuals with Pes Cavus and Pes Planus showed a significant increase in the calcaneal eversion (P < 0.05) after 45 min of running. Between the groups, there was a significantly greater eversion of the Pes Planus, on the right foot, after 45 min of running (P< 0.05) compared to the Pes Cavus. The effect of fatigue evident in the present study suggests that further biomechanical research should be considered when exposing the foot to the repetitive nature of running, conditions most likely responsible for the overrepresented overuse injuries among runners.
Journal of Exercise Rehabilitation, 2015
The purpose of this qualitative study was to understand and examine how patients with rheumatoid ... more The purpose of this qualitative study was to understand and examine how patients with rheumatoid arthritis (RA) experience climate care and its effects. A qualitative approach was chosen for the study. Two men and six women were interviewed according to a semistructured interview guide. The text was analyzed using a manifest content analysis. The analysis resulted in four categories and 10 subcategories. The interviewees experienced climate care positively. The training was perceived increasing gradually. The patients felt that they performed to a maximum capacity during training and were impressed by the staff's enthusiasm and encouragement. The patients felt that they were involved in the goal setting and the choice of treatment, and the staff noticed individual needs. There was a feeling among the patients of being acknowledged by the staff. Information about the disease was perceived as individualized. The climate and beautiful surroundings were viewed as encouraging physical activity and a feeling of well-being. Patients made new friends, had fun together and also shared experiences about their disease. Furthermore, the patients described a sense of belonging to a group as well as a feeling of not being the only one that was sick among the healthy. Not having to do everyday tasks and having time to themselves were perceived positively. Several factors contributed to the positive experiences of climate care; climate, environment, physical activity, social context, staff involvement, and information about the disease were described as interacting together and resulting in a sense of well-being. A proposal for future research would be to examine if/how the various factors might interact and affect the RA patients' illness and quality of life.
The primary aim of this investigation was to evaluate a seven-week multidisciplinary rehabilitati... more The primary aim of this investigation was to evaluate a seven-week multidisciplinary rehabilitation programme, with emphasis on musculoskeletal disorders, for working-age people, by assessments at the start and end of the rehabilitation programme, and at follow-up examinations 6, 12 and 24 months after completion of the programme. A further aim was to explore the experiences of people not returning to work during a period of six years after participation in an extensive multidisciplinary rehabilitation programme. Sixty participants, 40 women and 20 men (mean age 46.8 ± SD 7.9), with musculoskeletal disorders, mainly neck and back pain, participated in a 7week rehabilitation programme which was based on a combination of theoretical and practical education, physical activities, relaxation and individual guidance. Before and after the programme and at the follow-up occasions all participants were evaluated with the Global Self-Efficacy Index (GSI), Hospital Anxiety and Depression Scale (HAD), and Stress test (Study I). A group of participants who were still full-time sick-listed (Group I) at the end of the study period were compared with participants who were part-time or not sick-listed (Group II) at the end of the study period (II, III, IV). They were evaluated with the Disability Rating Index (DRI), with the Pain Intensity Rating Index on a visual analogue scale (VAS) (II, III)), mobility tests (III), GSI (III), HAD, and a stress test (IV). Seven women (median age 48 years) and three men (53 years) (Group I) were interviewed and the interviews were analysed by manifest content analysis (V). At the 2-year follow-up full-time sick leave, anxiety, depression and selfexperienced stress had decreased in both sexes. They also showed increased quality of life (QoL) (I). In participants with full-time sick leave (Group I), self-experienced physical disability and pain ratings were high and showed no decrease up until the 2-year follow-up. In participants with part-time or no sick leave (Group II), physical disability and pain ratings decreased gradually throughout the 2-year follow-up period (II). Cervical and thoracolumbar spine range of motion (ROM) was lower in Group I than in Group II from the start of rehabilitation to a 2-year follow-up. Only Group II showed a temporal improvement in ROM. No changes in DRI, VAS or GSI were found in parallel with corresponding temporal changes in any of the ROM (III). Group I experienced no change in anxiety or depression during the study period, in contrast to Group II, in which this decreased. Decreased stress was found in both groups (IV). Group I described perceived barriers to and possibilities of returning to work, and also gave information on what strategies they used, to cope with everyday life (V). The majority of the participants improved and they continued to be physically active, their QoL improved, and most participants returned to work. Ten of the participants, however, were on full-time sick leave 1 throughout the whole study period, with high self-experienced physical disability, high pain rating and no improvement in anxiety and depression. They experienced barriers to re-entering the labour market as consequences of physical symptoms and fatigue. But they also believed in possibilities of returning to work if they could get a modified job adapted to their own capacity. Thus, persons with severe disability and pain did not improve by rehabilitation in this project. New methods of treatment have to be developed for improvement of symptoms resulting in reduction of functional impairment and a consequent need for sick leave.
Journal of Exercise Rehabilitation, 2015
The purpose of this study was to examine beach volleyball players' experience regarding shoulder ... more The purpose of this study was to examine beach volleyball players' experience regarding shoulder injury and how it affects their return to play. To achieve the research aims a qualitative design with semi-structured interviews had been conducted, five elite beach volleyball players, four men and one woman aged 27-42 participated in the study. All participants had suffered a severe shoulder injury, with absence from training and competing for at least 28 days. The findings of this study indicate that it is the individual´s inner motivation, together with a clear goal and support from the community, family, teammate and coach that are the most important factors when going through rehabilitation and getting back to playing beach volleyball after a shoulder injury. All participants had been affected by their injury in some way; some of the participants had been affected in a positive way since they had become mentally stronger and had developed better volleyball technique after rehabilitation. The conclusions of this study indicate that there are three distinct factors that increase the chances of getting back to playing beach volleyball after shoulder injury; it is the players´ self motivation, together with a clear goal and support from the community.
Work (Reading, Mass.), 2013
The aim of this study was to perform a 5-year follow-up of a 7-week multidisciplinary rehabilitat... more The aim of this study was to perform a 5-year follow-up of a 7-week multidisciplinary rehabilitation program focusing on pain, physical disability, anxiety and depression as well as stress and sick leave and to compare the results from the baseline, a 2-year follow-up and this 5-year follow-up. Out of 60 participants of the original rehabilitation program 54 were followed-up after 5 years. The rehabilitation program was individually adapted and consisted of physical activity in several forms as well as theoretical and practical education. At baseline (start of study) and 2 and 5 years after completion of the rehabilitation program all participants were evaluated in terms of sick leave, pain rating (Visual Analogue Scale), the Disability Rating Index, Hospital Anxiety and Depression Scale, and Stress Test. Between the start of the program and the 5-year follow-up pain rating (P< 0.017) and the rate of full-time sick leave (P< 0.0005) decreased. Physical disability, anxiety, dep...
Work (Reading, Mass.), 2011
The aim of this qualitative study was to explore experiences of sick-listed persons of not return... more The aim of this qualitative study was to explore experiences of sick-listed persons of not returning to work during a six-year period after participation in an extensive multidisciplinary rehabilitation programme. The study comprised ten participants with musculoskeletal disorders, mainly neck and back pain. Semi-structured interviews were conducted and analysed by manifest content analysis. This led to identification of three primary categories and six sub-categories, which described the participants' experiences of barriers to and possibilities of returning to work, and indicated what strategies they used to cope with everyday life. The participants described that the main barriers to returning to work were pain and somatic symptoms, fatigue, and not fulfilling the work requirements. Participants considered physical activity a key factor in coping with pain. Most participants thought that they had residual work ability, and could utilise this if they could get a modified job a...
Work (Reading, Mass.), 2010
To investigate whether improvement of range of motion (ROM) in persons with musculoskeletal disor... more To investigate whether improvement of range of motion (ROM) in persons with musculoskeletal disorders, mainly neck and back pain, was associated with a favourable development regarding physical disability, pain, and health-related quality of life (QoL), and whether such development differed between sick-listed and non-sick-listed persons during and up to 2 years after a multidisciplinary rehabilitation programme. Ten persons with full-time sick leave (Group I) and 49 with part-time or no sick leave (Group II) at the end of a previous study participated. It was shown in that study that Group I had higher pain rating and higher subjective physical disability than Group II, with little or no improvement during and after rehabilitation. In the present study, all participants were evaluated with neck and back mobility tests: Disability Rating Index (DRI); Pain Intensity Rating on a visual analogue scale (VAS); and Global Self-Efficacy Index (GSI). Cervical and thoracolumbar spine ROM wer...
Musculoskeletal Disorder, 2012
Health is a concept with many definitions. The concept also has various meanings in different par... more Health is a concept with many definitions. The concept also has various meanings in different parts of the world and in different cultures. The definition of health has gone through many changes. Up to the middle of the 20th century, health was defined in terms of the absence of physical illness (Hassmén & Hassmén, 2005). In the mid-1940s the World Health Organization (WHO, 1946) defined the health as follows: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity". This idea has been considered by some to be too utopian to be acceptable as a definition of health. The definition would mean that nobody could be regarded as healthy, since nobody experiences complete physical, psychological and social well-being. Over the years WHO has developed its view of the concept of health (Faresjö & Åkerlind, 2008), and in 1986 WHO wrote, "Health is seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities". Thus, health was related to physical, personal and social resources. This means that individuals and groups must be able to identify and realize their desires, satisfy their needs and manage in their environment (Faresjö & Åkerlind, 2008). In primary care there is a concept of health that includes not only medical factors but also psychological and social aspects, and the concept of health refers to the overall conditions for a good quality of life. The concept of life quality covers a person's overall situation, the functioning capacity of the individual, and the ability to manage daily life including a social role, in addition to the absence of stress in working life, meaningful leisure time and general physical and psychological well-being (Faresjö & Åkerlind, 2008). Historically speaking we have probably never been healthier than we are today, despite reports about increased stress and people being burned out, more allergies and rising obesity in the population. If we have any faith in the trends we have seen for many decades, health will probably slowly but surely improve in terms of rising average life expectancy (SOU, 2009 [National Board of Health and Welfare]; Faresjö & Åkerlind, 2008). Some differences in health between women and men have their origins in the power structure, as well as cultural and ideological attitudes in society, but there are also biological differences in factors that affect health. The rate of ill health is considerably higher among women, and www.intechopen.com Musculoskeletal Disorder 2 self-perceived health is significantly worse. In general, men have greater opportunities in terms of influence and participation, both at workplaces and in society as a whole. Men have a better financial situation overall compared with women. There is an over-representation of women in occupations with high health risks, and women have longer real working hours. In some cases women have fewer opportunities to cultivate healthy living habits; for example two jobs and the fear of being exposed to violence, reduce their opportunities for taking physical exercise