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  • 1. Björk, Mathilda
    et al.
    Gerdle, Björn
    Thyberg, Ingrid
    Peolsson, Michael
    KTH, School of Technology and Health (STH), Centres, Centre for Technology in Medicine and Health, CTMH.
    Multivariate relationships between pain intensity and other aspects of health in rheumatoid arthritis - cross sectional and five year longitudinal analyses (the Swedish TIRA project)2008In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 30, no 19, p. 1429-1438Article in journal (Refereed)
    Abstract [en]

    Objectives. This study analyses the relationships between pain intensity and other aspects of health commonly used to assess disease activity and disability in early rheumatoid arthritis and examines whether such relationships were different between women and men. Subjects and methods. This study included the 189 patients (69% women) with early RA (symptoms < 12 months at diagnosis) still remaining in the Swedish TIRA cohort 5 years after inclusion. Disease activity and disability was assessed 3, 6, 12, 18, 24, 36, 48, and 60 months (M0-M60) after inclusion by erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), number of swollen and tender joints, physicians global assessment of disease activity (PGA), grip force average over 10 seconds (Grippit), Grip Ability Test (GAT), Signals of Functional Impairment (SOFI) in hand, lower limb and upper limb, Health Assessment Questionnaire (HAQ), and pain intensity measured with a visual analogue scale (VAS). The variables were divided into meaningful blocks according to the correlation structure in a principal component analysis (PCA) at M60. Using hierarchical partial least squares (PLS) analyses, this study investigated the blocks cross-sectionally to test for correlations with pain intensity at M0 and M60. The blocks at M0 were also used as predictors of pain intensity at M60 in a hierarchical PLS. Results. The strongest relationship was found between pain intensity and the second block, consisting of HAQ and SOFI-lower limb at the cross-sectional analyses in both women and men. The block representing disease activity (i.e., ESR, CRP, PGA, and swollen and tender joints) had the weakest relation to pain intensity. According to the longitudinal analyses, the disease activity variables (block 1) at M0 had the strongest relationship to pain intensity at M60 in men. In contrast, HAQ and SOFI-lower limb (block 2) at M0 had a strong relation to pain intensity in women.

  • 2. Borsbo, Bjorn
    et al.
    Gerdle, Bjorn
    Peolsson, Michael
    KTH, School of Technology and Health (STH).
    Impact of the interaction between self-efficacy, symptoms and catastrophising on disability, quality of life and health in with chronic pain patients2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 17, p. 1387-1396Article in journal (Refereed)
    Abstract [en]

    Purpose. To investigate the interactions between self-efficacy - including subcomponents - and symptoms (pain, depression and anxiety), catastrophising, disability, quality of life and health in a population of patients with chronic pain. Method. The study used 433 patients with chronic pain including 47 patients with spinal cord injury-related pain, 150 patients with chronic whiplash-associated disorders and 236 patients with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration and psychological- and health-related variables. Results. In the multivariate context, depression, anxiety, catastrophising and disability were intercorrelated. Self-efficacy correlated positively with variables of quality of life and general health. These two groups of variables were negatively correlated. The pain variables - duration of pain, pain intensity and spreading of pain - formed a third group of variables. Self-efficacy function was negatively correlated to these three pain variables. When regressing disability, quality of life and health, we found that self-efficacy had a positive impact whereas symptoms, catastrophising and pain had a negative influence on these aspects. Different patterns of influencing variables were discerned for the three different analyses, and specific patterns of the subscales of self-efficacy corresponded to specific patterns of negative factors for the outcome of disability, quality of life and health. Conclusion. There is a complex interaction of psychological factors and symptoms and their positive and negative influence on disability, quality of life and health. The results indicate that it might be important to assess and influence both enhancing and detoriating factors to ensure an effective pain management programme.

  • 3. Börsbo, Björn
    et al.
    Peolsson, Michael
    KTH, School of Technology and Health (STH), Centres, Centre for Technology in Medicine and Health, CTMH.
    Gerdle, Björn
    The complex interplay between pain intensity, depression, anxiety and catastrophising with respect to quality of life and disability2009In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, no 19, p. 1605-1613Article in journal (Refereed)
    Abstract [en]

    Purpose. To identify subgroups of patients with chronic pain based on the occurrence of depression, anxiety and catastrophising and the duration of pain and pain intensity. In addition to this, the relationship between the subgroups with respect to background variables, diagnosis, pain-related disability and perceived quality of life are investigated. Methods. This study used 433 patients with chronic pain including 47 patients with spinal cord injury-related pain, 150 with chronic whiplash associated disorders and 236 with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration and psychological and health-related items. Results. On the basis of depression, anxiety, catastrophising, pain intensity and duration, we identified subgroups of patients with chronic pain that differed with respect to perceived quality of life, disability and diagnosis. The psychological factors, especially depression, significantly influenced perceived quality of life and disability. Pain intensity and duration play a minor role with respect to quality of life, although pain intensity is associated to perceived disability. Conclusions. The results of this study highlight the importance of not looking at patients with chronic pain as a homogenous entity. A detailed assessment, including psychological factors with emphasis on depressive symptoms, might be essential for planning and carrying through treatment and rehabilitation.

  • 4.
    Frennert, Susanne
    et al.
    Lund University.
    Östlund, Britt
    KTH, School of Technology and Health (STH), Health Systems Engineering.
    What happens when seniors participate in new eHealth schemes?2016In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 11, no 7, p. 572-580Article in journal (Refereed)
    Abstract [en]

    This article adds empirical depth to our understanding of seniors’ involvement in the making of eHealth systems. Multi-sited interviews and observations were conducted at seniors’ homes before an eHealth system was installed, during the home trials and post-removal of the system. Our findings indicate that although the senior participants chose to participate in the home trials, the choice itself was configured by the stigmatization of seniors as technophobes, fear of “falling behind” and the association of technology with youth, the future and being up-to-date. Being a participant in home trials of an eHealth system became an identity of its own, representing a forward thinking and contemporary person who embraced changes and new technology.

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